Management of Gustilo Type IIIC Injuries in the Lower Extremity

McMahon, Heather A.; Stranix, John T.; Lee, Z‐Hye; Levine, Jamie P.

doi:10.1016/j.cps.2020.12.006

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…Only by considering early management of both can it contribute to the patient’s treatment. Therefore, the key points for the management of open fractures also includes when to cover the wound, how to cover the wound, etc [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

Fang,

Wang,

et al. 2024

World J Clin Cases

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BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat. Patients often experience difficulty in wound healing. Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis. AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures. METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects. They were divided into a study group (n = 40, healed with negative pressure closed drainage) and a control group (n = 40, healed with conventional dressing changes) according to the variation in the healing they received. The efficacy of the clinical interventions, the variations in the regression indicators (time to wound healing, time to fracture healing, time to hospitalization), and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention. RESULTS The total effective rate of patients among the study group was 95.00% (38/40), which was notably higher than 75.00% (30/40) among the control group (P < 0.05). The wound healing time, fracture healing time, and hospital stay of the patients in the study group was shorter than the control group (P < 0.05). After the intervention, the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group (P < 0.05). CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury. It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

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Section: Discussionmentioning

confidence: 99%

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

Fang,

Wang,

et al. 2024

World J Clin Cases

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“…Free flaps, such as the latissimus dorsi flap and the anterolateral thigh flap (ALT) have widely been used in lower limb reconstructions. 3 A latissimus dorsi flap only provides a skin island of 7–9 cm in width if subsequent skin graft at the donor site has to be avoided. 4 Otherwise, the flap will require skin graft to cover the muscle with risk of later development of verrucous hyperplasia of the skin graft and thus a stump prone to swelling and breakdown.…”

Section: Discussionmentioning

confidence: 99%

Knee-saving Amputation by Use of a Bipedicled Four-zone Deep Inferior Epigastric Artery Perforator Flap

Saritas

Kiil

Sværdborg

2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Degloving traumatic lower extremity injuries can lead to an above-knee amputation with decreased functional capacity compared with below-knee amputation. The unique properties of the deep inferior epigastric artery perforator flap providing a substantial amount of skin and subcutaneous tissue combined with reliability and low donor-site morbidity makes the flap ideal for coverage of below-knee amputation stumps when soft tissue is required. A bipedicled four-zone deep inferior epigastric artery perforator flap with a skin area of 13 × 33 cm was used as coverage of a degloved lower leg amputation stump, in a 27-year-old woman with a left-sided Gustillo type 3B comminute diaphyseal tibial fractur and major degloving injury. Hereby, above-knee amputation was avoided. Ten months postoperatively the patient had achieved full prosthetic function.

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“…Los criterios de selección de colgajos para la reconstrucción de las extremidades se basan en el área de la superficie de la herida, tipo de deficiencia tisular, la longitud del pedículo, el volumen del tejido deficiente y morbilidad del sitio donante [12]. La finalidad del manejo quirúrgico es asegurar la perfusión local de los tejidos afectados, limpiezas quirúrgicas, desbridamiento secuencial y precoz, impedir la infección, seguido de una cobertura adecuado con tejido vitalizado con la finalidad de cubrir estructuras anatómicas críticamente comprometidas conservando el tejido expuesto y su funcionalidad [13][14][15][16]. La selección de la técnica de cobertura dependerá de la localización del defecto y extensión del mismo [17].…”

Section: Introductionunclassified

Ortoplastia con colgajos en fracturas con pérdida de la cobertura

Villarroel Rovere,

Jaramillo Becerra,

Betancourt Castillo

2023

AM/EC

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Introducción: La reparación de lesiones musculocutáneas en extremidades es un reto para la cirugía ortopédica. La cobertura de estas lesiones debe ser flexible, vascularizada y cubrir las estructuras anatómicas comprometidas. Este estudio demuestra la eficacia de combinar técnicas de cirugía plástica con técnicas ortopédicas (Ortoplastia) para la resolución quirúrgica de defectos cutâneos en extremidades. Métodos: El presente estudio es descriptivo, retrospectivo en pacientes tratados por perdida cutánea en extremidades, en el servicio de Traumatología del Hospital Alcívar, periodo 2020 – 2022. Resultados: Fueron 33 pacientes, 28 hombres y 5 mujeres, con edad promedio de 32 años. Se realizaron 33 colgajos:10 cutáneos, 11 fasciocutaneos, 8 musculares y 4 vasculares. Se obtuvo un alto grado de satisfacción postquirúrgica según la escala de Likert. Conclusiones: La resolución de los defectos cutáneos mejora la fijación esquelética de fracturas, con el retorno de la forma y función de las extremidades.

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Management of Gustilo Type IIIC Injuries in the Lower Extremity

Cited by 9 publications

References 21 publications

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

Knee-saving Amputation by Use of a Bipedicled Four-zone Deep Inferior Epigastric Artery Perforator Flap

Ortoplastia con colgajos en fracturas con pérdida de la cobertura

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