A step-by-step guide to classifying and managing pretibial injuries

Dunkin, Christopher; Elfleet, D; Cui, Ling; Brown, Tim

doi:10.12968/jowc.2003.12.3.26473

Cited by 27 publications

(16 citation statements)

References 16 publications

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“…Management of pretibial lacerations is dependent on the extent of injury, which can be classified according to the Dunkin classification (Table 1). 9…”

Section: Introductionmentioning

confidence: 99%

The management of pretibial lacerations

Singh

Khatib

Elfaki

et al. 2017

annals

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Introduction Pretibial lacerations are common injuries, often presenting in the elderly and infirm. Unclear management pathways often result in inappropriate care. We identify patient demographics, morbidity risk factors, injury severity and management options. Materials and methods This retrospective study involved analysing databases and hardcopy notes for patients admitted with pretibial lacerations to Addenbrooke's Hospital, January to December 2012. Microsoft Excel and Fishers exact test were used to analyse the data with a P-value of less than 0.05 representative of statistical significance. Information on patient demographics, site of lesion, preoperative symptoms, management, operative details and clinical outcomes were collected. Results A total of 36 patients were identified; the mean age was 79 years (± 16 years, 1 standard deviation) with a three to two female to male preponderance; 57% of injuries were caused by mechanical fall, 33% traumatic blunt impact and 7% road traffic accidents. American Society of Anesthesiologists physical status classification was 43% level III, 40% II, 9% I and 9% IV. Dunkin classification of severity was 33% grade III, 30% grade I, 24% grade IV and 12% grade II. Median inpatient duration was 11 days for surgically managed compared with 15 days for conservatively managed patients. Discussion Pretibial lacerations tend to affect the elderly. Management is compounded by polypharmacy and comorbidities. If inadequately managed, such injuries can adopt characteristics of chronic wounds, with lengthy inpatient stays. Surgical intervention may be appropriate where injuries are severe and the patient stable enough for theatre. Conclusions We believe that surgical management with autologous tissue repair, with minimal delay between presentation and theatre, is warranted for extensive injuries wherever possible, with conservative management used for predominantly less extensive pretibial lacerations.

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“…Management of pretibial lacerations is dependent on the extent of injury, which can be classified according to the Dunkin classification (Table 1). 9…”

Section: Introductionmentioning

confidence: 99%

The management of pretibial lacerations

Singh

Khatib

Elfaki

et al. 2017

annals

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“…To the Editor: Healing times for pretibial skin tears have not been reported in the community setting. Preexisting conditions such as diabetes mellitus, peripheral vascular disease, peripheral edema, 1 and corticosteroid use may impair healing, 2 although the association between diabetes mellitus and pretibial healing is unclear 3…”

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confidence: 99%

Pretibial Skin Tears in Older Adults: A 2‐year Epidemiological Study

Kennedy

Kerse

2011

J American Geriatrics Society

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“…They do not compromise tissue viability in the way that sutures and staples can because they only adhere to the skin surface. Short, wide strips are used as they produce fewer shearing forces ( Figure 6) (Dunkin et al 2003).…”

Section: Figurementioning

confidence: 99%