MANAGEMENT OF SOFT TISSUE INJURIES – CASE SERIES

AbstractSoft tissue injuries, whether isolated or in combination with other injuries, are amongst the most common traumatic craniofacial injuries encountered in our day to day practice.Soft tissue injuries may involve the skin, subcutaneous tissue, underlying muscle or a combination of any of these elements. Although rarely life-threatening, the treatment of these injuries can be complex and may have significant impact on the patients' facial aesthetics and function. Hence one should know the “do's and don'ts”.Disfigurement following trauma, has a detrimental effect on the victim's personality and future. Therefore such cases should be most appropriately managed with thorough knowledge of applied anatomy, an aesthetic sense and meticulous tissue handling, along with surgical skills to repair composite structures.

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The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016

Otolaryngology ◽

10.1177/0194599817725713 ◽

2017 ◽

Vol 157 (4) ◽

pp. 602-607 ◽

Cited By ~ 7

Author(s):

Alexander Lanigan ◽

Brentley Lindsey ◽

Stephen Maturo ◽

Joseph Brennan ◽

Adrienne Laury

Keyword(s):

Soft Tissue ◽

Tertiary Care ◽

Case Series ◽

Soft Tissue Injuries ◽

Published Data ◽

Care Hospital ◽

Neck Injuries ◽

Facial Fractures ◽

Tympanic Membrane Perforations ◽

Tissue Injuries

Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.

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RECONSTRUCTION OF UPPER LIMB SOFT TISSUE INJURIES, EXCEPT FOR FINGERTIPS LESIONS

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212902239180 ◽

2021 ◽

Vol 29 (2) ◽

pp. 81-86

Author(s):

CARLOS ALBERTO EGUEZ JELSKI ◽

GUSTAVO BALADORE SZENDLER ◽

CRISTINA SCHMITT CAVALHEIRO ◽

LUIZ ANGELO VIEIRA ◽

EDIE BENEDITO CAETANO

Keyword(s):

Soft Tissue ◽

Upper Limb ◽

Case Series ◽

Soft Tissue Injuries ◽

Free Flaps ◽

Fasciocutaneous Flaps ◽

Muscle Flaps ◽

Reconstructive Procedures ◽

Advantages And Disadvantages ◽

Tissue Injuries

ABSTRACT Objective: The main purpose of this work was to evaluate the advantages and disadvantages of reconstructive procedures applied in upper limb soft tissue injuries according to their location. Methods: The study involved 94 male and 22 female patients (116 total) operated between April 2001 and November 2017 due to traumatic injuries in a upper limb. Individuals were evaluated considering their age, sex, etiology, reconstruction area , applied methodology and complications. The finger injuries were excluded. Results: The performed reconstruction procedures include 29 skin grafts; six advancement flaps; seven rotation flaps; 33 pedicled fasciocutaneous flaps, 9 free fasciocutaneous flaps; 5 pedicled muscle flaps; 12 free muscle flaps, three pedicled musculocutaneous flaps; one free musculocutaneous flap; 11 neurovascular free flaps. Conclusion: Reconstructive procedures in the upper limbs are diverse, varying from skin grafting to free flaps. The indication of the best option depends on the type of injurie and the surgeon. The final goal is to reach the best functional result combined with the lowest possible morbidity. Level of Evidence IV, Case series.

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SOFT TISSUE INJURIES OF THE FACE: EARLY AESTHETIC RECONSTRUCTION IN POLY TRAUMA PATIENTS

10.36106/ijsr/1824682 ◽

2021 ◽

pp. 58-61

Author(s):

RK Jain ◽

Nitesh Lamoria

Keyword(s):

Soft Tissue ◽

Composite Structures ◽

Wound Care ◽

Primary Repair ◽

Soft Tissue Injuries ◽

Trauma Patients ◽

Facial Soft Tissue ◽

Study Results ◽

The Face ◽

Tissue Injuries

INTRODUCTION One of the most challenging and common problem faced by the plastic surgeons in polytrauma ward are Facial Soft tissue injuries, which can be completely isolated or be in combination with other injuries .The face consists of several organs and aesthetic units. The nal outcome depends on initial wound care and primary repair. So one should know the “do's and don'ts”. Disgurement following trauma, becomes a social stigma and has the gross detrimental effect on the personality and future of the victim. Therefore, such cases are most appropriately managed by Plastic Surgeons who have a thorough knowledge of applied anatomy, an aesthetic sense and meticulous atraumatic tissue handling expertise, coupled with surgical skill to repair all the composite structures simultaneously. METHOD This study is conducted in the department of Plastic and Reconstructive surgery, SMS Medical College & Hospital Jaipur India from January 2019 to December 2020. 50 patients with history of facial soft tissue injuries who were admitted in the polytrauma ward are included in the study. RESULTS Seventy-ve percent of the facial injuries were repaired primarily and the remainder were reconstructed with skin grafts or local aps from adjacent tissues. We had no post-operative infection, hematoma, ischemia, or necrosis in our patients and the patients were satised after the operation. CONCLUSION The study concludes that Primary reconstruction should be the mainstay of management and the most important responsibility of the surgeon is to convert the contaminated wound to a clean one and then to perform reconstruction.

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