scholarly journals Thumb Reconstruction after Severe Trauma Using the Masquelet Technique and the Foucher Neurovascular Flap

2020 ◽  
Vol 8 (9) ◽  
pp. e3097
Author(s):  
Martin Luttenberger ◽  
Feras Taqatqeh ◽  
Adrian Dragu ◽  
Olimpiu Bota
Keyword(s):  
Severe Trauma ◽  
Thumb Reconstruction ◽  
Masquelet Technique ◽  
Neurovascular Flap

scholarly journals Application of Artificial Dermal Graft Combined with Fascia Sleeve Flap in the Treatment of Chronic Bone and Steel Plate Exposed Wounds of Lower Extremities

2021 ◽  
Author(s):  
Yong Li ◽  
Zhi-bo Zhang ◽  
Ji-song Liu ◽  
Zhu-min Wu ◽  
Xin-cheng Sun ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Steel Plate ◽  
Wound Dehiscence ◽  
Severe Trauma ◽  
Lower Limbs ◽  
Bone Plate ◽  
Good Effect ◽  
Necrotic Tissue ◽  
Sinus Formation ◽  
Neurovascular Flap

Abstract Background:Bone tendon or graft exposure such as steel plate is common after severe trauma of lower extremity.The traditional repair method is to use a variety of skin flaps to cover the exposure, but the wound can not heal after operation, or the wound dehiscence, ulcer, sinus, etc. occur again after short healing, and the bone plate is exposed again.The reason for this result is that the space around the bone plate is not well closed when the flap is covered，dead space is formed, blood and exudate accumulate, hematoma forms or infection occurs, and finally the wound breaks.Also due to swelling and contracture after flap operation,the tension of the suture between the flap and the receiving area is too large and becomes thin and cracked, forming an exposed state.In order to solve the above problems, we have carried out the research on "Application of artificial gradient combined with fascia sleep flap in the treatment of chronic bone and steel plate exposed woods of lower extremes".Methods:In this paper, 11 cases of chronic wounds with bone exposure and skin necrosis after steel plate implantation were selected. First stage is the wound bed preparation including primary wound expansion,removal of necrotic tissue and incision of sinus wall, removal of deep necrotic bone and fibrotic scarred skin on the outer wall of steel plate to normal tissue on the outer edge of the wound, removal of precipitated peptone and purulent fur in the hole, periphery and bone space of the steel plate, and removal of tendon tissue with basal necrosis and disintegration of the wound. After vacuum sealing drainage (VSD) 1~2 weeks, the peritraumatic basal granulation tissue grew well and there was no necrotic tissue in the wound. In the second stage, the exposed bone was covered with artificial dermis, the steel plate hole or the periphery and the basal space were filled, and the exposed steel plate was completely embedded, and then the fascia sleeve flap was transplanted to cover the wound. The sural neurovascular flap was performed in 6 cases and the lateral superior malleolar artery perforator flap in 1 case. Results:The flap survived well in all 11 cases. During the follow-up of 6 months to the removal of the plate, there was no case of rupture, exposure and sinus formation.Conclusions:Artificial dermal covering combined with fascial sleeve flap transplantation can effectively avoid wound dehiscence or sinus formation caused by foreign body retention, infection and flap contracture,It has good effect in repairing chronic wounds with bone plate exposure after severe trauma of lower limbs,.

scholarly journals Analysis of the Therapeutic Effect of Artificial Leather Embedding Combined with Fascial Sleeve Flap Transplantation on Chronic Wounds of Lower Limbs with Bone and Plate Exposure

2022 ◽  
Author(s):  
Yong Li ◽  
Zhi-bo Zhang ◽  
Ji-song Liu ◽  
Zhu-min Wu ◽  
Xin-cheng Sun ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Steel Plate ◽  
Severe Trauma ◽  
Lower Limbs ◽  
Bone Plate ◽  
Good Effect ◽  
Necrotic Tissue ◽  
Sinus Formation ◽  
Neurovascular Flap ◽  
Suture Tension

Abstract Background: After severe trauma of lower limbs, bone、tendon or plate graft exposure is common.The traditional repair method is to use a variety of skin flap transplantation to cover the exposed part, but the wound often can not heal after operation, or the wound is cracked, ulcer, sinus, bone and steel plate are exposed again after wound healing.The reason for this result is that when the flap is covered, the space around the bone plate is not well closed, forming a dead cavity, blood and exudate accumulation, hematoma formation or infection, and finally the wound ruptures again. In addition, due to the swelling and contracture of the flap after operation, the suture tension between the flap and the receiving area becomes larger, the skin becomes thinner and broken, and then the wound is formed. In order to solve the above problems, we carried out the study of artificial true skin embedding combined with fascial sleeve flap transplantation in the treatment of chronic bone plate exposed wounds of lower limbs.Methods: In this paper, 11 cases of chronic wounds with bone exposure and skin necrosis after steel plate implantation were selected. First stage is the wound bed preparation including primary wound expansion,removal of necrotic tissue and incision of sinus wall, removal of deep necrotic bone and fibrotic scarred skin on the outer wall of steel plate to normal tissue on the outer edge of the wound, removal of precipitated peptone and purulent fur in the hole, periphery and bone space of the steel plate, and removal of tendon tissue with basal necrosis and disintegration of the wound. After vacuum sealing drainage (VSD) 1~2 weeks, the peritraumatic basal granulation tissue grew well and there was no necrotic tissue in the wound. In the second stage, the exposed bone was covered with artificial dermis, the steel plate hole or the periphery and the basal space were filled, and the exposed steel plate was completely embedded, and then the fascia sleeve flap was transplanted to cover the wound. The sural neurovascular flap was performed in 9 cases and the lateral superior malleolar artery perforator flap in 2 case. Results: The flap survived well in all 11 cases. During the follow-up of 6 months to the removal of the plate, there was no case of rupture, exposure and sinus formation.Conclusions: Artificial dermal covering combined with fascial sleeve flap transplantation can effectively avoid wound dehiscence or sinus formation caused by foreign body retention, infection and flap contracture,It has good effect in repairing chronic wounds with bone plate exposure after severe trauma of lower limbs.

Unfavorable Results of Thumb Reconstruction

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Samir Kumta ◽  
Sudhir Warrier ◽  
Shrirang Purohit
Keyword(s):  
Thumb Reconstruction

Acute changes in steroid biosynthesis in patients following severe trauma: the golden hour study

2019 ◽  
Author(s):  
Angela Taylor ◽  
Conor Bentley ◽  
Mark Foster ◽  
Janet Lord ◽  
Jon Hazeldine ◽  
...  
Keyword(s):  
Severe Trauma ◽  
Steroid Biosynthesis ◽  
Golden Hour ◽  
Acute Changes

Integration of CAD/CAE/RP Environment for Developing a New Product in Medical Field

2020 ◽  
Vol 38 (9A) ◽  
pp. 1276-1282
Author(s):  
Nabeel I. Allawy ◽  
Amjad B. Abdulghafour
Keyword(s):  
Maxillofacial Surgery ◽  
Essential Element ◽  
Severe Trauma ◽  
Simulation Software ◽  
Oral And Maxillofacial Surgery ◽  
Virtual Surgery ◽  
Multiple Fractures ◽  
Engineering Programs ◽  
Mesh Model ◽  
The Face

Reconstruction of the mandible after severe trauma is one of the most difficult challenges facing oral and maxillofacial surgery. The mandible is an essential element in the appearance of the human face that gives the distinctive shape of the face, holds. This paper aims to propose a methodology that allows the surgeon to perform virtual surgery by investing engineering programs to place the implant by default and with high accuracy within the mandible based on the patient's medical data. The current study involved a 35-year-old man suffering from a traffic accident in the mandible with multiple fractures of the facial bones. Basically, an identification of the steps required to perform virtual surgery and modeling images from the CBCT technology has been done by using the software proposed in the research. The implant model is designed as a mesh model, allowing the patient to return to a normal position. Moreover, an application of FEA procedures using the Solidworks simulation software to test and verify the mechanical properties of the final transplant.

scholarly journals Interleukin 8 Elicits Rapid Physiological Changes in Neutrophils That Are Altered by Inflammatory Conditions

2021 ◽  
pp. 1-17
Author(s):  
Stefan Bernhard ◽  
Stefan Hug ◽  
Alexander Elias Paul Stratmann ◽  
Maike Erber ◽  
Laura Vidoni ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Severe Trauma ◽  
Induced Response ◽  
Neutrophil Granulocytes ◽  
Inflammatory Conditions ◽  
Flow Cytometric ◽  
Time Flow ◽  
Flow Cytometric Measurement ◽  
Detailed Kinetics

A sufficient response of neutrophil granulocytes stimulated by interleukin (IL)-8 is vital during systemic inflammation, for example, in sepsis or severe trauma. Moreover, IL-8 is clinically used as biomarker of inflammatory processes. However, the effects of IL-8 on cellular key regulators of neutrophil properties such as the intracellular pH (pH<sub>i</sub>) in dependence of ion transport proteins and during inflammation remain to be elucidated. Therefore, we investigated in detail the fundamental changes in pH<sub>i</sub>, cellular shape, and chemotactic activity elicited by IL-8. Using flow cytometric methods, we determined that the IL-8-induced cellular activity was largely dependent on specific ion channels and transporters, such as the sodium-proton exchanger 1 (NHE1) and non-NHE1-dependent sodium flux. Exposing neutrophils in vitro to a proinflammatory micromilieu with N-formyl-Met-Leu-Phe, LPS, or IL-8 resulted in a diminished response regarding the increase in cellular size and pH. The detailed kinetics of the reduced reactivity of the neutrophil granulocytes could be illustrated in a near-real-time flow cytometric measurement. Last, the LPS-mediated impairment of the IL-8-induced response in neutrophils was confirmed in a translational, animal-free human whole blood model. Overall, we provide novel mechanistic insights for the interaction of IL-8 with neutrophil granulocytes and report in detail about its alteration during systemic inflammation.

scholarly journals Structured and Systematic Team and Procedure Training in Severe Trauma: Going from ‘Zero to Hero’ for a Time-Critical, Low-Volume Emergency Procedure Over Three Time Periods

2021 ◽  
Vol 45 (5) ◽  
pp. 1340-1348
Author(s):  
Maryam Meshkinfamfard ◽  
Jon Kristian Narvestad ◽  
Johannes Wiik Larsen ◽  
Arezo Kanani ◽  
Jørgen Vennesland ◽  
...  
Keyword(s):  
Injury Severity ◽  
Trauma System ◽  
Severe Trauma ◽  
Emergency Procedure ◽  
Emergency Thoracotomy ◽  
Severity Scores ◽  
Time Periods ◽  
Low Volume ◽  
Time Critical ◽  
Over Time

Abstract Background Resuscitative emergency thoracotomy is a potential life-saving procedure but is rarely performed outside of busy trauma centers. Yet the intervention cannot be deferred nor centralized for critically injured patients presenting in extremis. Low-volume experience may be mitigated by structured training. The aim of this study was to describe concurrent development of training and simulation in a trauma system and associated effect on one time-critical emergency procedure on patient outcome. Methods An observational cohort study split into 3 arbitrary time-phases of trauma system development referred to as ‘early’, ‘developing’ and ‘mature’ time-periods. Core characteristics of the system is described for each phase and concurrent outcomes for all consecutive emergency thoracotomies described with focus on patient characteristics and outcome analyzed for trends in time. Results Over the study period, a total of 36 emergency thoracotomies were performed, of which 5 survived (13.9%). The “early” phase had no survivors (0/10), with 2 of 13 (15%) and 3 of 13 (23%) surviving in the development and mature phase, respectively. A decline in ‘elderly’ (>55 years) patients who had emergency thoracotomy occurred with each time period (from 50%, 31% to 7.7%, respectively). The gender distribution and the injury severity scores on admission remained unchanged, while the rate of patients with signs on life (SOL) increased over time. Conclusion The improvement over time in survival for one time-critical emergency procedure may be attributed to structured implementation of team and procedure training. The findings may be transferred to other low-volume regions for improved trauma care.

scholarly journals Repair cell first, then regenerate the tissues and organs

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiao-Bing Fu
Keyword(s):  
Tissue Repair ◽  
Cell Damage ◽  
Ischemia Reperfusion ◽  
Severe Trauma ◽  
Basic Unit ◽  
Basic Process ◽  
Tissue Repair And Regeneration ◽  
Healing Tissue ◽  
Organ Repair ◽  
And Function

AbstractWound healing, tissue repair and regenerative medicine are in great demand, and great achievements in these fields have been made. The traditional strategy of tissue repair and regeneration has focused on the level of tissues and organs directly; however, the basic process of repair at the cell level is often neglected. Because the cell is the basic unit of organism structure and function; cell damage is caused first by ischemia or ischemia-reperfusion after severe trauma and injury. Then, damage to tissues and organs occurs with massive cell damage, apoptosis and even cell death. Thus, how to achieve the aim of perfect repair and regeneration? The basic process of tissue or organ repair and regeneration should involve repair of cells first, then tissues and organs. In this manuscript, it is my consideration about how to repair the cell first, then regenerate the tissues and organs.

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