Intensive, Extensive, Expensive: Management of Distal Limb Shearing Injuries in Cats

2009 ◽  
Vol 11 (9) ◽  
pp. 747-757 ◽  
Author(s):  
Sandra Corr
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Soft Tissues ◽  
Road Traffic ◽  
Skin Grafting ◽  
Soft Tissue Injuries ◽  
Wound Management ◽  
Prolonged Treatment ◽  
Distal Limb ◽  
Superficial Skin

Practical relevance Cats often present with distal limb shearing injuries as a result of road traffic accidents (RTAs). Many apparently unsalvageable limbs can be saved through intensive and appropriate early treatment if the basic principles of good wound management are followed. Clinical challenges When a limb is crushed under the wheel of a car, the skin, soft tissues and bone can be injured in a variety of ways, and the wounds are invariably heavily contaminated. Management of such cases is intensive, extensive and expensive. As well as the client's financial constraints, the ethics of prolonged treatment versus the alternative of amputation should be carefully considered. This article reviews the priorities for managing these cases, and presents a logical approach for achieving optimal outcomes. Patient group Any cat allowed access to the outdoors is potentially at risk of sustaining RTA injuries, young cats particularly so. Evidence base Many textbooks and original articles have been published on aspects of managing soft tissue injuries and skin grafting. To the author's knowledge, only two peer-reviewed papers have dealt specifically with shearing injuries, both presenting a retrospective analysis of cases in dogs. The prognosis is rarely determined by the extent of superficial skin loss, but rather by the underlying soft tissue and bone damage.

scholarly journals A study on faciomaxillary injuries in a tertiary care hospital

2017 ◽  
Vol 4 (8) ◽  
pp. 2450
Author(s):  
Ravikumar G. ◽  
. Manoharan ◽  
Sugapradha G. R.
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Soft Tissue Injuries ◽  
Treatment Modalities ◽  
Road Traffic Accidents ◽  
The People ◽  
Human Bites ◽  
The Face ◽  
Tissue Injuries

Background: Faciomaxillary injuries are increasing in frequency and severity due to road traffic accidents and violence among the people of the delta districts of Tamilnadu. Alcohol plays a major role both in road traffic accidents and assaults resulting in faciomaxillary injuries. Human bites play a significant role in the soft tissue injuries of the face resulting in loss of lobule of ear, nasal tip loss and partial loss of lower lip. The purpose of this study was to evaluate the aetiology, incidence, patterns and treatment modalities of faciomaxillary injuries which include both soft tissue and bony injuries.Methods: The study was conducted in the Department of Plastic and Reconstructive Surgery of Thanjavur Medical College, Tamil Nadu, India between 2012-2015. About 850 patients in and around the delta districts of Tamilnadu admitted with various soft tissue and bony injuries of the faciomaxillary region were studied. Age, sex, time, mechanism and aetiology of injury, history of bleeding, unconsciousness and prior first aid, type of vehicle and use of preventive measures, type of fracture, associated injuries and treatment modalities were evaluated.Results: Faciomaxillary injuries were mostly due to road traffic accidents. Highest number of fractures was predominantly occurring in the age group of 21-30 years. Males incurred more fractures with a male to female ratio of 7.4:1.1. Fracture mandible was the most common followed by zygoma, nasal and naso ethmoid fractures. Pan facial fractures were more common among alcoholics. 28 patients had associated head injury and 14 patients had cervical spine injuries. Open reduction and internal fixation was the preferred modality for mandible whereas the mid face fractures were treated more often by closed methods. Soft tissue injuries involving ear, nose, lip and eyelids were more common.Conclusions: Drunken driving should be curbed in the society. Educating the people about road safety rules will bring down the faciomaxillary injuries. Motivating the public against violence will reduce human bites and soft tissue injuries of the face. 

scholarly journals CASE SUMMARY ON ACUTE WOUND MANAGEMENT OF EXTENSIVE FACIAL SOFT TISSUE INJURY

2020 ◽  
pp. 1-3
Author(s):  
Sunita Das ◽  
Hironya Borah ◽  
Arup Kakati
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Wound Management ◽  
Aesthetic Outcome ◽  
Facial Soft Tissue ◽  
Physical Strain ◽  
The Face

Injuries to the face are commonly encountered in the Emergency department and is usually seen following road traffic accidents. It may include injuries to the soft tissue or bones of the face. Soft tissue injuries of the face almost always include injuries to the nose, as it is the most prominent feature of the face. These injuries are often not life-threatening, but its mismanagement can hamper the functional and aesthetic outcome leading to permanent mental and physical strain. Thus, to achieve a suitable final outcome, proper understanding of the facial anatomy, assessment of the wound and its proper management is necessary. This report discusses the case of a middle aged man who suffered from contaminated facial soft tissue injury following road traffic accident. Good functional and aesthetic outcome was achieved with special emphasis on the proper assessment, irrigation and meticulous repair of the wound. Follow-up of the patient was done after being discharged from the hospital.

scholarly journals Ocular manifestations in road traffic accidents

2021 ◽  
Vol 7 (2) ◽  
pp. 157-162
Author(s):  
Syed Saifullah Bokhari ◽  
Rani Sujatha M.A
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Soft Tissue Injuries ◽  
Ophthalmological Examination ◽  
Adult Males ◽  
Road Traffic Accidents ◽  
Ocular Manifestations ◽  
Ophthalmic Manifestations ◽  
Tissue Injuries

Road traffic accidents (RTAs) are the most common cause of polytrauma. This study aims to evaluate the various ocular manifestations in cases of RTAs. A retrospective review of patients who were treated for RTAs in a tertiary hospital in 6 months from December 2018 to May 2019. A total of 126 patients were reviewed. Age ranged from 2 to 85 years. The mean age was 32 years. Ophthalmological examination was undertaken in all patients involved in RTA. Out of 126 patients, 112 were males and 14 were females. Young adult males (21-30 years) were most vulnerable to RTAs. Soft tissue injuries were the most common manifestations (57.93%) followed by neuro-ophthalmic manifestations (26.98%) and orbital fractures (15.07%). The presence of CT abnormalities especially intra cranial haemorrhage was associated with neuro-ophthalmic deficits. Soft tissue injuries were the most common ocular manifestations. It was found that head trauma causes many neuro-ophthalmic manifestations. Relative afferent pupillary defect (RAPD) was the most common neuro-ophthalmic manifestation. The most common cranial nerve involved was found to be oculomotor nerve. Retrobulbar neuritis was a rare finding.

scholarly journals REVERSE RADIAL FOREARM FLAP

2018 ◽  
Vol 25 (12) ◽  
Author(s):  
Hyder Ali ◽  
Bushra Zulfiqar
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Donor Site ◽  
Skin Grafting ◽  
Mechanical Trauma ◽  
Soft Tissue Defects ◽  
Radial Forearm ◽  
Web Space ◽  
Tissue Defects

Objectives: To highlight the usefulness of reverse radial forearm fasciocutaneous flap in covering various soft tissue defects of hand and wrist. Study Design: Descriptive, experimental study. Setting: Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences & Dr Ruth KM Pfau Civil Hospital Karachi. Period: December 2016 to January 2018. Material & Methods: A total of 16 reverse radial forearm flaps were utilizedto cover various soft tissue defects of hand and wrist from various etiologies including road traffic accidents, mechanical trauma, and industrial trauma and fireworks injuries were included. Patients with segmental bone loss and those patients having partial of complete amputation of thumb were excluded. The age ranged from 18 – 45 (mean 29.25) years. Soft tissue defects of dorsum were covered with this flap in 8 cases, 4 cases on palmer aspect and 2 cases for transmetacarpal level and 1st web space defects each. Donor site was covered with split skin graft in all cases. Patients were followed for at least three months postoperatively. Results: We had partial loss of flap in two cases which was managed with debridement and skin grafting. Superficial epidermolysis was found in one case and managed conservatively. Donor site was skin grafted in all cases which was healed uneventfully and quite acceptable to the patients in due course of time. Conclusion: Reverse radial artery flap has a quite long arc of rotation, which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum and first web space.

Mechanisms of Soft Tissue Injury

2021 ◽  
Author(s):  
Oneida A. Arosarena ◽  
Issam N. Eid
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Visual Fields ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Wound Management ◽  
Facial Soft Tissue ◽  
Tissue Injuries ◽  
Free Closure ◽  
High Level

AbstractSoft tissue trauma to the face is challenging to manage due to functional and aesthetic concerns. Management requires careful regional considerations to maintain function such as visual fields and oral competence in periorbital and perioral injuries, respectively. Basic wound management principles apply to facial soft tissue injuries including copious irrigation and tension-free closure. There is no consensus and high-level evidence for antibiotic prophylaxis especially in various bite injuries. Ballistic injuries and other mechanisms are briefly reviewed. Scar revision for soft tissue injuries can require multiple procedures and interventions. Surgery as well as office procedures such as resurfacing with lasers can be employed and will be reviewed.

scholarly journals The multi-modality approach in a case of fracture of the humerus with an ipsilateral floating knee: A case report

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1088-1092
Author(s):  
Hitendra Wamborikar ◽  
Priyank Bhatt ◽  
Swapnil Date ◽  
Naresh Dhaniwala ◽  
Khizar Khan
Keyword(s):  
High Velocity ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Excellent Result ◽  
Full Range ◽  
Skin Grafting ◽  
Complex Nature ◽  
Road Traffic Accidents ◽  
Multiple Fractures ◽  
Modality Approach

Ipsilateral fractures of humerus, femur and tibia is a rare entity. The number of fractures resulting due to road traffic accidents is on the rise. These Type of injuries usually occur due to high-velocity road traffic accidents. High-velocity road traffic accidents are associated with multiple bony injuries as well as injuries to various internal organs. These injuries are often difficult to manage due to their complex nature. Mostly multiple fractures are produced in ipsilateral limbs. This condition makes the management even more difficult. Hence a multi-modality approach is often required. A 55-year-old male sustained floating knee with ipsilateral shaft humerus fracture. After a three-staged surgical approach with three modalities for treating the compound injury, the patient had an excellent result with the full range of motion in the knee and complete coverage of wound. Compound floating injuries should be treated with simultaneous fixation of femur and tibia fractures to achieve early full range of knee motion with Vacuum-assisted closure followed by skin grafting for complete wound coverage.

scholarly journals Non-whiplash soft tissue injuries following low-velocity impact collisions: A retrospective analysis

2019 ◽  
Vol 88 (1) ◽  
pp. 31-36
Author(s):  
Holly Morris ◽  
David Ensor ◽  
Chika Uzoigwe ◽  
Farzad Shabani ◽  
Harish Kurup
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Psychological Symptoms ◽  
Spinal Injury ◽  
Soft Tissue Injuries ◽  
Low Velocity Impact ◽  
Low Velocity ◽  
Velocity Impact ◽  
Significant Difference ◽  
Tissue Injuries

Whiplash is the most common injury reported in low-velocity impact road traffic accidents, but claimants report a range of other soft tissue injuries and we looked at the prevalence of these and any patterns. We retrospectively reviewed reports from the medico-legal practice of an orthopaedic surgeon. We collected data on 609 claimants. Sixty-two per cent were women (p < 0.0001). Majority (90.3%) reported an injury to at least one other area than neck, and 48% of claimants reported shoulder pain. Hand/wrist injuries were almost exclusive to drivers (p = 0.0013). Those with knee injuries were older than those without (p = 0.001). There was a significant difference in the age of patients with different spinal injury patterns (p < 0.0001). Occupational status did not appear to influence the pattern of injuries (p = 0.06). Psychological symptoms were associated with a greater number of body parts injured (p < 0.01). Our data confirm a strong association between these soft tissue injuries and psychological symptoms.

scholarly journals The Effectiveness of Dental Protection and the Material Arrangement in Custom-Made Mouthguards

2021 ◽  
Vol 11 (20) ◽  
pp. 9363
Author(s):  
Ana Messias ◽  
Inês J. Gomes ◽  
Paulo N. B. Reis ◽  
Ana M. Amaro ◽  
Maria A. Neto
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Mechanical Response ◽  
Scientific Information ◽  
Soft Tissue Injuries ◽  
Ethylene Vinyl Acetate ◽  
Outer Shell ◽  
The Core ◽  
Anterior Teeth ◽  
Custom Made

Experimental research studies have shown that wearing a mouthguard (MG) is an effective way to prevent tooth or maxillofacial trauma. However, there is a lack of scientific information regarding how the material arrangement within the mouthguard can modify its mechanical response during an impact. Hence, this study aimed to evaluate the influence of material arrangement within custom-made mouthguards on stress transmitted to anterior teeth, bone, and soft tissue after impact. Four 3D finite element models of a human maxilla were reconstructed based on the CBCT of a young patient and analyzed according to the presence or absence of a mouthguard and the type of material arrangement within those with a mouthguard: model NMG with no mouthguard; model CMG representing the conventional arrangement with a single 4 mm-thick ethylene-vinyl acetate (EVA) foil; model FMG presenting layer arrangement with two 1 mm-thick foils of EVA in the outer shell and one 2 mm-thick foil of EVA foam in the core; model HMG presenting a 1 mm-thick compact inner and outer shell of EVA and a 2 mm wide air-filled zone in the core. Linear quasi-static analysis and frontal load were used to simulate an impact with an energy of 4.4 J. Isotropic linear elastic properties were assumed for the bone and teeth but not for the mouthguard protection and oral soft tissues. The results were evaluated and compared in terms of displacement, stretches, and stresses. All the mouthguards analyzed reduced the risk of injury to teeth and bone, reducing the displacement and stress of these structures. However, the implementation of a honeycomb structured layer allowed more significant displacement and deformation of the mouthguard's external layer, thus promoting higher protection of the anatomic structures, namely the root dentin and the bone tissue. Nevertheless, the results also indicate that improving the mouthguard flexibility might increase the soft tissue injuries.

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