Plastic surgery

2019 ◽  
pp. 733-746
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Plastic Surgery ◽  
Lower Limb ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Paediatric Surgery ◽  
Wide Range ◽  
Limb Trauma ◽  
Lower Limb Trauma

This chapter on ‘plastic surgery’ encompasses the management and reconstruction of a wide range of elective and acute pathologies. Its spectrum includes skin and soft tissue oncology, hand and upper limb, oncoplastic breast, aesthetics, head and neck, burns, lower limb trauma, and paediatric surgery. This broad specialty is structured well for conditions seen commonly in clinic, in the emergency department, and in theatre. It highlights cases to see such as skin cancer, cleft lip and palate, and trauma. It covers burns in appropriate details including causes and immediate management, as well as reconstruction and grafts. This chapter reiterates ABCDE management and is written for both those looking to apply for medicine, and those in medical school.

Association of clinical characteristics with decision making in patients with severe lower extremity trauma

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Lower Extremity ◽  
Limb Salvage ◽  
Lower Limb ◽  
Patient Management ◽  
Treatment Time ◽  
Emergency Department Admission ◽  
Stump Closure ◽  
Limb Trauma ◽  
Lower Limb Trauma

Severe lower limb trauma represents a challenge for both the emergency department physicians and the surgeons. These injuries are associated with significant incidence of limb loss and it is not uncommon for the treating physician to make the hard decision between limb salvage, amputation or stump closure for a patient in critical condition. Our aim was to evaluate the epidemiology of traumatic lower extremity amputations and to analyze the factors which may have effect on patient resuscitation, limb salvage and efficient patient management. Patients who were admitted to our institution’s emergency department for traumatic lower extremity amputation over an 8 years’ period (2012 to 2020) were retrospectively analyzed. Patient files with the possibility of severe lower limb trauma and mangled extremity were retrieved and analyzed using ICD codes recorded/registered during the emergency department admission. Mean time from emergency admission to transfer to operating theater was 184,5 minutes. Replantation of the amputate was performed in 4 patients (19%). 25% of the amputations at the ankle level (1 out of 4) and 37.5% of the transtibial amputates (3 out of 8) were replanted. A multidisciplinary approach is necessary in every aspect of patient management; however, this does not justify a delay in treatment. Time spent during conclusion of necessary consultations does not have negative effects on patient outcome as long as patient is closely monitored and resuscitated in the emergency department.

Consideration of pulmonary thromboembolism in paediatric patients presenting to the emergency department with abdominal pain

2021 ◽  
Vol 14 (5) ◽  
pp. e239175
Author(s):  
Wasyla Ibrahim ◽  
Farhat Mushtaq
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Lower Limb ◽  
Pulmonary Thromboembolism ◽  
Signs And Symptoms ◽  
Paediatric Population ◽  
Limb Trauma ◽  
High Index Of Suspicion ◽  
Lower Limb Trauma

Venous thromboembolism (VTE) is a recognised complication of lower limb trauma in adult patients and classically presents with cardiopulmonary symptoms. However, the risk of VTE and its presenting signs and symptoms are less well documented in the paediatric population. We report the case of a child who presented to our emergency department with abdominal pain 2 weeks after lower limb fracture, who was subsequently found to have a pulmonary thromboembolism (PTE). This case report highlights the importance of having a high index of suspicion for VTE in the paediatric population if there are predisposing risk factors and to consider PTE as a differential cause of abdominal pain. To the authors’ knowledge, no case has been described in which a child presenting with abdominal pain was consequently found to have a pulmonary embolism.

Principles of acute management of lower limb trauma

2021 ◽  
pp. 583-584
Author(s):  
Michael Kelly
Keyword(s):  
United Kingdom ◽  
Soft Tissue ◽  
Lower Limb ◽  
Initial Assessment ◽  
Acute Management ◽  
The United Kingdom ◽  
Limb Trauma ◽  
Principles Of Treatment ◽  
Lower Limb Trauma ◽  
Complex Injuries

The morbidity of lower limb trauma can be significant and a combination of orthopaedic and plastic surgery expertise is required from the initial assessment through to completion of treatment for these complex injuries. Guidelines have been established in the United Kingdom that address assessment, timing of treatment, and the management of soft tissue and skeletal components of injury. This chapter outlines these principles of treatment.

scholarly journals Free Tissue Transfer in Pediatric Lower Limb Trauma

2019 ◽  
Vol 52 (01) ◽  
pp. 037-044 ◽  
Author(s):  
R. Srikanth
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Large Series ◽  
Soft Tissue Coverage ◽  
Wound Coverage ◽  
Tissue Transfer ◽  
Limb Trauma ◽  
Lower Limb Trauma

AbstractFree tissue transfer has become the standard in wound coverage and further refinements have given us newer flap donor sites or modifications of existing flaps to decrease morbidity; smaller vessels are being anastomosed, a direct spin-off following successful distal replantations. Younger children are presenting with traumatic defects similar to adults. Although there were apprehensions of free tissue transfer in children occasioned by smaller vessels, duration of procedure and concerns of growth following flap harvest, reports of small and large series have appeared in the literature with similar success. Pediatric-free tissue transfer is now an established entity. This article seeks to arrive at a consensus based on a review of the existing literature on free flaps for skin and soft-tissue coverage of lower limb trauma in children.

Early soft tissue coverage and negative pressure wound therapy optimises patient outcomes in lower limb trauma

Injury ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 772-778 ◽  
Author(s):  
David Shi Hao Liu ◽  
Foti Sofiadellis ◽  
Mark Ashton ◽  
Kirstie MacGill ◽  
Angela Webb
Keyword(s):  
Soft Tissue ◽  
Patient Outcomes ◽  
Negative Pressure ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Soft Tissue Coverage ◽  
Wound Therapy ◽  
Limb Trauma ◽  
Lower Limb Trauma
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