Management of Acute Soft Tissue Injuries of the Cheek and Principles of Scar Revision

2021 ◽  
Author(s):  
Caroline Hudson ◽  
Krista Olson
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Management Plan ◽  
Complex Problem ◽  
Facial Soft Tissue ◽  
Scar Revision ◽  
The Face ◽  
Tissue Injuries

AbstractFacial soft tissue injury is a challenging and complex problem for the facial plastic and reconstructive surgeon for cosmetic and functional reasons. This article will focus on the management of soft tissue injuries of the cheek, one of the most important presenting areas of the face. The cheek, like any other part of the face, is susceptible to several types of injury and any of these injuries have the potential to disfigure and debilitate. Knowledge of anatomical structures and wound healing principles is critical to devising an appropriate management plan and achieving superior patient outcomes in scar revision cases. Multiple techniques to improve long-term scarring from facial soft tissue injuries are available.

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 Facial Soft Tissue Injuries in Pediatric Patients

2021 ◽  
Author(s):  
Sam Schild ◽  
Tatiana Reis Puntarelli ◽  
Margarita delaPena ◽  
Adam Johnson ◽  
Sydney C. Butts
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Pediatric Population ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Facial Soft Tissue ◽  
Case Examples ◽  
Reconstructive Ladder ◽  
Pediatric Populations ◽  
Tissue Injuries

AbstractSoft tissue injuries of the head and neck are a common reason for medical evaluation and treatment in pediatric populations with some unique and important considerations when compared with adults. The incidence and type of injuries continue to evolve with the adoption of new safety measures, technology advancements, and education of the general population. The goal of this article is to provide the reader with a thorough understanding of the evaluation and management of pediatric soft tissue trauma including the initial workup, physical examination, appropriateness of antimicrobial therapy, and setting for surgical repair. Additionally, the pediatric anesthetic considerations for evaluation and repair in regard to local anesthesia, sedation, and general anesthesia are described in detail. There is a focus on dog bites, perinatal injuries, and child abuse as these entities are distinctive to a pediatric population and have particular management recommendations. Lastly, application of the reconstructive ladder as it applies to children is supported with specific case examples and figures. Although there are many parallels to the management of soft tissue injury in adults, we will highlight the special situations that occur in pediatric populations, which are imperative for the facial plastic and reconstructive surgeon to understand.

The Hazards of Skateboard-Riding

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 793-793
Author(s):  
◽  
Fernando Atienza ◽  
Calvin Sia
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Bone Fractures ◽  
Tissue Injury ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Major Surgery ◽  
Cerebral Concussion ◽  
Tissue Injuries

Skateboard-riding has become increasingly popular among Hawaii's children. The thrill of the ride and the challenge of keeping one's balance and working intricate maneuvers while speeding down a hill captures the fancy of many of our young. This sport, however, has produced an alarmingly high toll of injury and illness. Pediatricians and emergency departments of our major hospitals have seen and taken care of large numbers of patients (aged between 3 years and 35 years, but with a distribution overwhelmingly pediatric) with significant injuries which include cerebral concussion, fractures, soft tissue injuries of varying degrees of severity and complications, and injury to internal organs. During a three-month period at the Kauikeolani Children's Hospital, July to August 1975, there were 16 patients admitted with the following: seven cerebral concussions, one skull fracture, five assorted bone fractures, one soft tissue injury and infection, one retroperitoneal hemorrhage, and one instance of major surgery for removal of the spleen. During the months of August and September 1975 the Emergency Department of Straub Clinic reported the following skateboard injuries: 14 fractures, 14 soft tissue injuries, 5 lacerations, and 2 cerebral concussions. Of the 35 patients seen, three were admitted—one with an open fracture, one with cerebral concussion, and one with a skull fracture. During a four-week period (two weeks in June and July and two weeks in August and September) at the Emergency Department of Kaiser Medical Center, 66 cases of skateboard injuries were seen with six patients requiring admission for fractures and brain concussion.

Primary Repair of Soft Tissue Facial Trauma

2020 ◽  
Author(s):  
Michelle Seu ◽  
Amir H. Dorafshar ◽  
Fan Liang
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Primary Repair ◽  
Soft Tissue Injury ◽  
Facial Trauma ◽  
Facial Soft Tissue ◽  
The Face ◽  
Craniofacial Trauma ◽  
Facial Anatomy ◽  
Tissue Defects

Craniofacial trauma can result in a wide variety of injuries that cause soft tissue injury of face. However, despite the enormous diversity in presentation of these injuries, they tend to follow certain patterns. Most facial injuries are either contusions, abrasions, lacerations, or avulsions. The extent of injury and approach to repair can be further assessed by the size, depth, and number of facial subunits involved. A plastic surgeon in the setting of acute craniofacial trauma, armed with certain principles of facial anatomy and primary repair methods, can drastically restore function and cosmesis to the face, while also mitigating the chance of future deformity and functional deficit. This review contains 3 figures and 26 references Keywords: facial trauma, craniofacial surgery, primary repair, facial soft tissue defects, soft tissue, facial injury, plastic surgery, facial lacerations, facial avulsions

Skeletal and soft tissue injuries after manual and mechanical chest compressions

2019 ◽  
Vol 5 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Niklas Friberg ◽  
Simon Schmidbauer ◽  
Charles Walther ◽  
Elisabet Englund
Keyword(s):  
Cardiac Arrest ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Chest Compressions ◽  
Sternal Fracture ◽  
Tissue Injuries ◽  
Severe Soft Tissue ◽  
Severe Soft Tissue Injury

Abstract Aims To determine the rate of injuries related to cardiopulmonary resuscitation (CPR) in cardiac arrest non-survivors, comparing manual CPR with CPR performed using the Lund University Cardiac Assist System (LUCAS). Methods and results We prospectively evaluated 414 deceased adult patients using focused, standardized post-mortem investigation in years 2005 through 2013. Skeletal and soft tissue injuries were noted, and soft tissue injuries were evaluated with respect to degree of severity. We found sternal fracture in 38%, rib fracture in 77%, and severe soft tissue injury in 1.9% of cases treated with CPR with manual chest compressions (n = 52). Treatment with LUCAS CPR (n = 362) was associated with significantly higher rates of sternal fracture (80% of cases), rib fracture (96%), and severe soft tissue injury (10%), including several cases of potentially life-threatening injuries. Conclusion LUCAS CPR causes significantly more CPR-related injuries than manual CPR, while providing no proven survival benefit on a population basis. We suggest judicious use of the LUCAS device for cardiac arrest.

Soft-tissue injuries associated with cast application for distal limb orthopaedic conditions

2011 ◽  
Vol 24 (02) ◽  
pp. 126-131 ◽  
Author(s):  
C. Davidson ◽  
G. I. Arthurs ◽  
R. L. Meeson
Keyword(s):  
Soft Tissue ◽  
Medical Records ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Severe Injuries ◽  
Calcaneal Tendon ◽  
Tissue Injuries ◽  
The Cost ◽  
Susceptible Group

Summary Objectives: Casts applied for orthopaedic conditions can result in soft-tissue injuries. The purpose of our study was to describe the nature and prevalence of such complications. Methods: We performed a retrospective review of medical records of dogs and cats that had a cast placed for an orthopaedic condition between October 2003 and May 2009. The data were analysed and categorised. Results: Of the 60 animals that had a cast placed, 63% developed a soft-tissue injury (60% mild, 20% moderate and 20% severe). Injuries could occur any time during coaptation, and an association with duration of casting and severity (p = 0.42) was not shown. Severe injuries took the longest to resolve (p = 0.003). Sighthounds were significantly more likely to develop a soft-tissue injury (p = 0.04), and cross-breeds were less likely (p = 0.01). All common calcaneal tendon reconstructions suffered soft-tissue injuries, but significance was not shown (p = 0.08). Veterinarians identified the majority of injuries (80%) rather than the owners. The financial cost of treating soft-tissue injuries ranged from four to 121% the cost of the original orthopaedic procedure. Clinical significance: Soft-tissue injuries secondary to casting occur frequently, and can occur at any time during the casting period. Within our study, sighthounds were more likely to develop soft tissue injuries, and should therefore perhaps be considered as a susceptible group. The only reliable way to identify an injury is to remove the cast and inspect the limb.

scholarly journals Morel-Lavallée Lesion Following a Low-speed Injury: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 642-643
Author(s):  
Daniel Porter ◽  
Jeff Conley ◽  
John Ashurst
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Lower Extremity ◽  
Tissue Injury ◽  
Fluid Collection ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Low Speed ◽  
Degloving Injury ◽  
Tissue Injuries

Introduction: Soft tissue injuries are a common presenting complaint seen in the emergency department following trauma. However, internal degloving injuries are not commonly seen by the emergency provider. Case Report: A 57-year-old male presented with right lower extremity pain, bruising, and swelling after a low-speed bicycle accident five days prior. Physical examination revealed an edematous and ecchymotic right lower extremity extending from the mid-thigh distally. Computed tomography of the thigh demonstrated a hyperdense foci within the fluid collection suggesting internal hemorrhage and internal de-gloving suggestive of a Morel-Lavallée lesion. Discussion: The Morel-Lavallée lesion is a post-traumatic soft tissue injury that occurs as a result of shearing forces that create a potential space for the collection of blood, lymph, and fat. First described in 1853 by French physician Maurice Morel-Lavallée, this internal degloving injury can serve as a nidus of infection if not treated appropriately. Magnetic resonance imaging has become the diagnostic modality of choice due to its high resolution of soft tissue injuries. Treatment has been focused on either conservative management or surgical debridement after consultation with a surgeon. Conclusion: The emergency physician should consider Morel-Lavallée lesions in patients with a traumatic hematoma formation to avoid complications that come from delayed diagnosis.

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

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.

scholarly journals A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Enxian Shi ◽  
Gang Chen ◽  
Bengang Qin ◽  
Yi Yang ◽  
Jintao Fang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tibial Fracture ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Trauma Research ◽  
Group 4 ◽  
Group 3 ◽  
Tissue Injuries ◽  
Group 1

Abstract Background The outcomes for open tibial fractures with severe soft tissue injury are still a great challenge for all the trauma surgeons in the treatment. However, most of the existing open tibial fracture models can only provide minimal soft tissue injury which cannot meet the requirement of severe trauma research. Our goal is to investigate a novel tibial fracture model providing different fractures combined with soft tissue injury for better application in trauma research. Methods A total of 144 Sprague-Dawley rats were randomly divided into 4 groups. With group 1 as control, the other groups sustained different right tibial fractures by the apparatus with buffer disc settings either 3 mm, 10 mm, or 15 mm. X-ray and computed tomography angiography (CTA) were performed at 6 h to evaluate the fracture patterns and vascular injuries. Peripheral blood and tibialis anterior muscle were harvested at 6 h, 1 day, 3 days, 7 days, 14 days, and 28 days for ELISA and histological analysis. Results X-ray and μCT results indicated that different fractures combined with soft tissue injuries could be successfully provided in this model. According to OTA and Gustilo classification, the fractures and soft tissue injuries were evaluated and defined: 36 type I in group 2, 34 type II in group 3, and 36 type III in group 4. The CTA confirmed no arterial injuries in groups 1 and 2, 2 arterial injuries in group 3, and 35 in group 4. ELISA indicated that the levels of pro-inflammatory cytokines TNF-α and IL-1β were significantly higher in group 4 than in other groups, and the levels of anti-inflammatory cytokines TGF-β and IL-10 were significantly higher in surgery groups than in group 1 in later stage or throughout the entire process. HE, Masson, and caspase-3 stains confirmed the most severe inflammatory cell infiltration and apoptosis in group 4 which lasted longer than that in groups 2 and 3. Conclusions The novel apparatus was valuable in performing different fractures combined with soft tissue injuries in a rat tibial fracture model with high reproducibility and providing a new selection for trauma research in the future.

scholarly journals Management of Traumatic Soft Tissue Injuries of the Face

2021 ◽  
Author(s):  
Daniel Y. Cho ◽  
Brooke E. Willborg ◽  
G. Nina Lu
Keyword(s):  
Soft Tissue ◽  
Systematic Approach ◽  
Soft Tissue Injuries ◽  
Facial Soft Tissue ◽  
Initial Management ◽  
Lacrimal Apparatus ◽  
Parotid Duct ◽  
The Face ◽  
Tissue Injuries ◽  
Definitive Management

AbstractFacial soft tissue injuries encompass a broad spectrum of presentations and often present significant challenges to the craniofacial surgeon. A thorough and systematic approach to these patients is critical to ensure that the patient is stabilized, other injuries identified, and the full extent of the injuries are assessed. Initial management focuses on wound cleaning with irrigation, hemostasis, and debridement of nonviable tissue. Definitive management is dependent on the region of the face involved with special considerations for critical structures such as the globe, lacrimal apparatus, facial nerve, and parotid duct. Following sound surgical principles, these injuries can be managed to maximize both functional and aesthetic outcomes while minimizing complications.

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