Crush Injuries of the Foot with Compartment Syndrome: Immediate One-Stage Management

Foot & Ankle ◽  
1989 ◽  
Vol 9 (4) ◽  
pp. 185-189 ◽  
Author(s):  
I. Ziv ◽  
R. Mosheiff ◽  
A. Zeligowski ◽  
M. Liebergal ◽  
J. Lowe ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Skin Flap ◽  
Tarsal Tunnel ◽  
One Stage ◽  
Flap Viability ◽  
Thickness Skin ◽  
Skin Loss ◽  
Crush Injuries ◽  
High Index Of Suspicion ◽  
Compartment Pressures

Severe crush injuries with compartment syndrome were treated in five patients by an immediate one-stage procedure. This procedure included the assessment of skin flap viability with accurate debridement of devascularized tissues. It was performed according to the split-thickness skin excision technique. Compartment pressures were measured and the fasciotomies were performed through open wounds or separate medial and lateral incisions. The medial incision was extended to release the tarsal tunnel. Fractures were reduced and internally fixed and exposed bones were covered with locally transposed muscles. Skin grafts, taken earlier for the skin viability assessment, were meshed and applied to replace skin loss. All wounds and fractures healed uneventfully with no major functional loss. In multiple trauma, the physician should maintain a high index of suspicion for early diagnosis and treatment of severe foot injuries. Early treatment leads to more desirable results, shorter hospitalization, and faster rehabilitation.

Split-Thickness Skin Excision: Its Use for Immediate Wound Care in Crush Injuries of the Foot

Foot & Ankle ◽  
1989 ◽  
Vol 10 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Mark Myerson
Keyword(s):  
Wound Care ◽  
Skin Flap ◽  
Free Flaps ◽  
Complete Coverage ◽  
Compartment Syndromes ◽  
Wound Debridement ◽  
Thickness Skin ◽  
Skin Excision ◽  
Crush Injuries ◽  
Skin Coverage

Split-thickness skin excision (STSE) was used as an adjunctive modality in the treatment of eight crush injuries of the foot. Compartment syndromes were present in four feet and were treated with fasciotomy. Wound debridement, internal fixation of fractures, and STSE followed. This technique accurately determined the viability of the skin flap, simultaneously providing skin for local wound coverage. All flaps treated in this manner survived and all (100%) of the degloved STSE grafts healed. Additional procedures were performed in four patients (two free flaps and two split-thickness skin grafts) adjacent to the debrided flap for complete coverage. STSE proved to be an effective modality for skin coverage in crush injuries of the foot associated with degloving of skin.

scholarly journals Reconstruction of Long Anterior Urethral Strictures by Dorsally Quilted Penile Skin Flap

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Abdel Moneim M. Abuzeid ◽  
M. S. Abdel Kader
Keyword(s):  
Skin Flap ◽  
Urine Flow ◽  
Skin Flaps ◽  
Penile Skin ◽  
Internal Urethrotomy ◽  
One Stage ◽  
Urethral Strictures ◽  
Skin Loss ◽  
Dorsal Onlay ◽  
One Year

Objective. To present the results of reconstruction of long (>5 cm), penile, bulbar, and bulbopenile urethral strictures by penile skin flap as dorsal onlay in one-stage procedure. Patients and Methods. Between January, 1998 and December, 2004, 18 patients (aged from 28-65 years) presented with long urethral strictures, 5.6–13.2 cm (penile in 6, bulbar in 2 and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal onlay flap in one stage (Orandi flap 6 cm in 6 cases, circular flaps 7–10 cm in 8, and spiral flaps 10–15 cm in 4). Followup of all patients after reconstruction included urine flow rate at weekly intervals, RUG at 6–12 weeks, and urethrocystoscopy at 12 and 18 months. Results. The urethral patency was achieved in 77% of patients. The complications were fistula in one patient (5.5%), restricture occurred in 3 patients (16.6%) that required visual internal urethrotomy and two patients (11%) showed curvature on erection that dose not interfere with sexual intercourse. Diverticulum (penile urethra) was seen in one patient (5.5%) containing stones and was excised surgically. There was penile skin loss in 3 patients (16.6%). All patients completed at least one-year followup period. Conclusion. Free penile skin flaps offer good results (functional and cosmetic) in long penile and/or bulbar urethral strictures. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.

scholarly journals The effect of ovariectomy on the skin flap viability and myeloperoxidase levels

2014 ◽  
Vol 115 (12) ◽  
pp. 766-770
Author(s):  
A. Coskun ◽  
D. C. Arikan ◽  
Y. K. Coban ◽  
H. Sayar ◽  
M. Kilinc ◽  
...  
Keyword(s):  
Skin Flap ◽  
Flap Viability

scholarly journals Forearm compartment pressures and grip strength in elite motorbike racers with chronic exertional compartment syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Dominic P. O’Dowd ◽  
Heike Romer ◽  
Richard Hughes ◽  
Noel Harding ◽  
Samantha Ball ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Grip Strength ◽  
Exercise Programme ◽  
Post Exercise ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
The Mean ◽  
Compartment Pressures ◽  
Forearm Flexor

Abstract Background Remarkably little research has been published on chronic exertional compartment syndrome (CECS) of the forearm. This study investigated forearm flexor compartment pressure pre- and post-exercise in elite motorbike racers clinically diagnosed with CECS and assessed their grip strength before and after arm pump exercise. Methods Elite motorbike riders with a clinical diagnosis of CECS of the right forearm when racing were recruited during the opening rounds of a British Superbike season. Their grip strength and forearm flexor compartment pressures were measured before and after a set exercise programme. Results Of the 11 riders recruited to the study, 10 completed the full testing regime. The mean pre-exercise forearm compartment pressures [11.7 mmHg (range 7–17 mmHg)] significantly increased post-exercise [30.5 mmHg (range 15–45 mmHg)], with a mean increase of 18.80 mmHg (P < 0.0001). The mean pre-exercise grip strength [50.61 mmHg (range 37–66.7 mmHg)] decreased post-exercise to [35.62 mmHg (range 17.1–52.5 mmHg)], a mean decrease of 14.99 mmHg (P < 0.0001). Conclusion There is a statistically significant increase in the forearm flexor compartment pressures in elite motorbike racers with CECS, but with marked variability of these values. Grip strength decreases statistically significantly following onset of symptoms of CECS of the forearm.

scholarly journals The effectiveness of local surgical technique in treatment of axillary bromhidrosis

2019 ◽  
Vol 7 (2) ◽  
pp. 187-191
Author(s):  
Thuong Nguyen Van ◽  
Tan Nguyen Manh ◽  
Phuong Pham Thi Minh ◽  
Trang Trinh Minh ◽  
Nghi Dinh Huu ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Skin Necrosis ◽  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Life Quality ◽  
Arm Movement ◽  
Surgical Excision ◽  
Heart Valve Disease ◽  
Apocrine Glands ◽  
Thickness Skin

BACKGROUND: Up to now, surgical excision of apocrine glands still has been a method that yields high treatment results and low rate of odour recurrent for patients, but many people worry about some serious complications that have been observed postoperatively, such as hematoma and skin necrosis. These prolong wound healing, leading to unsightly scars in the axillary fossae. AIM: We conducted this research to investigate the effects and complications of our surgical technique for axillary bromhidrosis. METHODS: Forty-three patients with axillary bromhidrosis were treated. An elliptical incision was made at a central portion of the area marked, with both tips of the ellipse along the axillary crease. The elliptical skin with the subcutaneous tissue was removed en lock. The adjacent skin was undermined to the periphery of the hair-bearing area with straight scissors. The undermined subcutaneous tissue was removed with curved scissors, and the skin was defatted to become a full-thickness skin flap. Any suspected hemorrhagic spots were immediately coagulated electrosurgically. Appropriate drains were placed, and the treated area was covered with thick gauze to each axilla. Arm movement was strictly controlled in the first 3 days post-operatively. RESULTS: Thirty-one patients have been followed up and evaluated for 6 months. 56 out of 62 axillae (90.3%) showed good to excellent results for malodor elimination. All patients reported a reduction in axillary sweating. There were two axillae of skin necrosis and three axillae of hematoma, with one patient receiving an anticoagulant from a cardiologist after the first day of surgery, to treat heart valve disease. The Dermatology Life Quality Index (DLQI) score decreased significantly, and the quality of life improved after the operation. CONCLUSION: Our technique is a simple surgical procedure and easy to perform helping to achieve results for high malodor elimination, with almost no serious complications. Patient’s life quality improved significantly after the operation.

scholarly journals Forearm Compartment Syndrome following Thrombolytic Therapy for Massive Pulmonary Embolism: A Case Report and Review of Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Ravi Badge ◽  
Mukesh Hemmady
Keyword(s):  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Compartment Syndrome ◽  
Signs And Symptoms ◽  
Massive Pulmonary Embolism ◽  
Heparin Therapy ◽  
Arterial Line ◽  
The Right ◽  
High Index Of Suspicion ◽  
Passive Stretch

Use of thrombolytic therapy in pulmonary embolism is restricted in cases of massive embolism. It achieves faster lysis of the thrombus than the conventional heparin therapy thus reducing the morbidity and mortality associated with PE. The compartment syndrome is a well-documented, potentially lethal complication of thrombolytic therapy and known to occur in the limbs involved for vascular lines or venepunctures. The compartment syndrome in a conscious and well-oriented patient is mainly diagnosed on clinical ground with its classical signs and symptoms like disproportionate pain, tense swollen limb and pain on passive stretch. However these findings may not be appropriately assessed in an unconscious patient and therefore the clinicians should have high index of suspicion in a patient with an acutely swollen tense limb. In such scenarios a prompt orthopaedic opinion should be considered. In this report, we present a case of acute compartment syndrome of the right forearm in a 78 years old male patient following repeated attempts to secure an arterial line for initiating the thrombolytic therapy for the management of massive pulmonary embolism. The patient underwent urgent surgical decompression of the forearm compartments and thus managed to save his limb.

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