Dermotraction as a Simple and Effective Technique for Fasciotomy Wound Closure.

Background| Fasciotomy is the best treatment option of acute compartment syndrome, but it results into large wounds which are difficult to manage. Different techniques have been utilized to manage the fasciotomy wounds which have their respective merits and demerits. This study was conducted to evaluate yet another novel technique which requires skin stapler and Prolene #1 sutures. Methods| This descriptive cases series was done using non-probability convenient sampling technique from January 2015 and June 2017 at Department of Orthopedics Surgery, King Edward Medical University / Mayo Hospital, Lahore. We included 24 fasciotomy wounds. They were managed with Dermotraction technique. We excluded patients with vascular injury. All wounds were successfully closed within an average time of seven days. The procedure was found to be cost effective, easy to execute and with minimal complications. Results| Amongst the total 13 patients, all were males of age ranging from 14 to 45year with mean age of 28.46±9.97. Majority, 10 patients (77 %) had acute compartment syndrome of leg and each patient managed with two fasciotomy wounds (N= 20). All fasciotomy wounds were closed with serial traction technique and the average time of closure was 07 days ranging from 3 days to 17 days 8.61±2.63. Conclusion| We concluded from the study that dermotraction technique has good outcome in fasciotomy wound closer and healing and it is a cost effective.

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Early morbidity associated with fasciotomies for acute compartment syndrome in children

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180049 ◽

2018 ◽

Vol 12 (5) ◽

pp. 480-487 ◽

Cited By ~ 1

Author(s):

K. B. L. Lim ◽

T. Laine ◽

J. Y. Chooi ◽

W. K. Lye ◽

B. J. Y. Lee ◽

...

Keyword(s):

Hospital Stay ◽

Compartment Syndrome ◽

Wound Closure ◽

Case Series ◽

Skin Grafting ◽

Acute Compartment Syndrome ◽

Inpatient Stay ◽

Wound Infections ◽

Short Term ◽

Level Of Evidence

Purpose Acute compartment syndrome (ACS) requires urgent fasciotomy to decompress the relevant muscle compartment/s prior to onset of irreversible myonecrosis and nerve injury. A fasciotomy is not a benign procedure. This study aims to describe and quantify early morbidity directly associated with fasciotomies for ACS in children. Methods Clinical charts of 104 children who underwent 112 fasciotomies over a 13-year period at a tertiary children’s hospital were reviewed. The following were analyzed: ACS aetiology, fasciotomy site, number of subsequent procedures, method of wound closure, short-term complications and length of hospital stay. Results Short-term complications included wound infections (6.7%) and the need for blood transfusion (7.7%). Median number of additional operations for wound closure was two (0 to 10) and median inpatient stay was 12 days (3 to 63; SD 11.7). After three unsuccessful attempts at primary closure, likelihood of needing skin grafting for coverage exceeded 80%. Analyses showed that fasciotomy-wound infections were associated with higher risk for four or more closure procedures. Number of procedures required for wound closure correlated with longer inpatient stay as did ACS associated with non-orthopaedic causes. Conclusion Fasciotomy is associated with significant early morbidity, the need for multiple closure operations, and prolonged hospital stay. The decision for fasciotomy needs careful consideration to avoid unnecessary fasciotomies, without increasing the risk of permanent injury from missed or delayed diagnosis. Skin grafting should be considered after three unsuccessful closure attempts. Less invasive tests or continuous monitoring (for high-risk patients) for compartment syndrome may help reduce unnecessary fasciotomies. Level of Evidence Level IV, Case series

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Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.180117 ◽

2019 ◽

Vol 18 ◽

Author(s):

José Maciel Caldas dos Reis ◽

Lauro José Mendes Queiroz ◽

Pablo Ferreira Mello ◽

Renan Kleber Costa Teixeira ◽

Fábio de Azevedo Gonçalves

Keyword(s):

Compartment Syndrome ◽

Wound Closure ◽

Early Recognition ◽

Acute Compartment Syndrome ◽

Lower Limbs ◽

Lithotomy Position ◽

Activity Levels ◽

Urological Surgery ◽

Baseline Activity

Abstract Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

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Secondary Wound Closure Following Fasciotomy for Acute Compartment Syndrome Increases Intramuscular Pressure

Journal of Orthopaedic Trauma ◽

10.1097/00005131-199802000-00009 ◽

1998 ◽

Vol 12 (2) ◽

pp. 117-121 ◽

Cited By ~ 24

Author(s):

Per Wiger ◽

Peter Tkaczuk ◽

Jorma Styf

Keyword(s):

Compartment Syndrome ◽

Wound Closure ◽

Acute Compartment Syndrome ◽

Intramuscular Pressure ◽

Secondary Wound Closure

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Efficacy of Oral Itraconazole in the Treatment of Seborrheic Dermatitis

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v29i4.11326 ◽

2012 ◽

Vol 29 (4) ◽

pp. 201-206 ◽

Cited By ~ 2

Author(s):

L Khondker ◽

AM Choudhury ◽

MA Wahab ◽

MSI Khan

Keyword(s):

Treatment Option ◽

Oral Treatment ◽

Seborrheic Dermatitis ◽

Sampling Technique ◽

Papular Eruption ◽

Base Study ◽

Significant Efficacy ◽

Oral Itraconazole ◽

Medical University ◽

Severe Type

Background: Seborrheic dermatitis is a common papulosquamous dermatosis and occurring in 2% to 5% of the population. The prevalence of seborrheic dermatitis among HIV-positive and AIDS patients between 34% and 83%. The anti-inflammatory activity of oral itraconazole and efficacy on Malessezia suggests that itraconazole capsule will be the first oral treatment option in future in seborrheic dermatitis. Unfortunately there is no data base study with the efficacy of oral itraconazole for the treatment of seborrheic dermatitis over Bangladeshi people.Objectives: To evaluate the efficacy of itraconazole in the treatment of Seborrheic dermatitis.Methods: This was an interventional type of study and total thirty seven patients of seborrheic dermatitis from department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) was enrolled. The study was carried out for a period of two years from January 2008 to December 2009 and purposive type non-probability sampling technique was followed in this study.Results: The scoring of seborrhea was 6.33±1.15 before treatment and 4.33 ±3.21 after treatment, scoring of itching was 6.66 ±1.49 before treatment and 3.61 ±2.70 after treatment and scoring of greasy crust was 7.12 ±2.70 before treatment and 4.00 ±3.16 after treatment. It was observed that before treatment, erythema was severe in 43.2% cases, moderate in 51.4% cases and mild type erythema was present in 5.4% cases. And after treatment, 29.7% had severe type erythema, no patient had moderate type erythema, only 43.2% had mild type and 27% cases had no erythema at all. Before treatment, papular eruption was severe in 27% cases, moderate in 54.1% cases and only 18.9% had mild type papular eruption. But after treatment, 10.8% had severe type, 18.9% had moderate, 51.4% had mild and 18.9% had no papular eruption at all. It was observed that before treatment, squamation was severe in 37.8% cases and moderate in 62.2% cases. But after treatment, 18.9% had severe type squamation, 10.8% had moderate, 45.9% had mild and 24.3% had no squamation. Improvement was shown in 26(70.27%) cases and 11(29.73%) cases shown no improvement at all.Conclusion: The study suggests that oral itraconazole has significant efficacy profile for treatment option of seborrheic dermatitis. DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11326 J Bangladesh Coll Phys Surg 2011; 29: 201-206

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Novel technique for treating multiple wounds with NPWT

Negative Pressure Wound Therapy Journal ◽

10.18487/npwtj.v2i2.15 ◽

2015 ◽

Vol 2 (2) ◽

Author(s):

Dominik Andrzej Walczak ◽

Rajmund Jaguśik ◽

Karolina Ptasińska ◽

Michał Wojtyniak ◽

Piotr Wojciech Trzeciak

Keyword(s):

Cost Effective ◽

Effective Technique ◽

Novel Technique ◽

Cost Effective Technique

Treatment of separate wounds on the same patient with one NPWT device may be challenging. We present novel, cost-effective technique for multiple wounds management.

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WOUND CLOSURE BY DERMATOTRACTION AFTER FASCIOTOMY FOR ACUTE COMPARTMENT SYNDROME

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery ◽

10.1080/028443100750059084 ◽

2000 ◽

Vol 34 (4) ◽

pp. 315-320 ◽

Cited By ~ 12

Author(s):

Per Wiger, Gunnar Blomqvist, Jorma Styf

Keyword(s):

Compartment Syndrome ◽

Wound Closure ◽

Acute Compartment Syndrome

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Wound closure expectations after fasciotomy for paediatric compartment syndrome

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.170102 ◽

2018 ◽

Vol 12 (1) ◽

pp. 9-14 ◽

Cited By ~ 4

Author(s):

E. D. Shirley ◽

V. Mai ◽

K. M. Neal ◽

G. M. Kiebzak

Keyword(s):

Lower Extremity ◽

Compartment Syndrome ◽

Upper Extremity ◽

Skin Graft ◽

Wound Closure ◽

Acute Compartment Syndrome ◽

Split Thickness Skin Graft ◽

Paediatric Patients ◽

Thickness Skin ◽

Additional Surgery

Purpose Acute compartment syndrome often requires additional surgery to achieve wound closure. Little information exists regarding the expected number of surgeries, techniques and complications after closure in paediatric patients. Methods A retrospective chart review identified patients treated for acute compartment syndrome at four hospitals over a ten-year period. The cause of injury, type of dressing, number of surgeries, type of closure and complications were recorded. Results In all, 32 patients (mean 10.9 years, 1 to 17) who underwent 18 lower and 14 upper extremity fasciotomies met inclusion criteria. Definitive wound closure technique was delayed primary in 72%, split thickness skin graft in 25%, and primary in 3% of patients. Closure required a mean 2.4 surgeries (0 to 4) over a mean 7.7 days (0 to 34). Days to closure and number of surgeries required were not significantly affected by mechanism of injury, fasciotomy location or type of dressing used. A total of 23.1% of patients with upper extremity and 0% with lower extremity fasciotomies had concerns about the scar appearance. Other complications included neurapraxia (6.7%), stiffness (6.7%), swelling (3.3%), scar pain (3.3%) and weakness (3.3%). Conclusions The most common complication after paediatric compartment syndrome is an unpleasant scar. Wound closure after upper or lower extremity fasciotomies in paediatric patients requires a split thickness skin graft in approximately one in four patients. However, avoiding a skin graft does not guarantee the absence of cosmetic concerns, which are more likely following upper extremity fasciotomies. Level of Evidence IV

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A Cost-Effective Technique for Spinal Instrumentation in the Treatment of Adolescent Idiopathic Scoliosis

Journal of Long-Term Effects of Medical Implants ◽

10.1615/jlongtermeffmedimplants.2016010150 ◽

2016 ◽

Vol 26 (2) ◽

pp. 143-149

Author(s):

Michael A. Clark ◽

Steven J. Cowart ◽

Jonathan Pellet ◽

David M. Cearley ◽

Styles L. Bertrand

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Spinal Instrumentation ◽

Cost Effective ◽

Effective Technique ◽

Cost Effective Technique

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E-Voting Kepala Desa dan Modal Sosial

Jurnal Sains Komunikasi dan Pengembangan Masyarakat [JSKPM] ◽

10.29244/jskpm.2.6.759-772 ◽

2019 ◽

Vol 2 (6) ◽

pp. 759

Author(s):

Khaulah Afifah ◽

Lala M Kolopaking ◽

Zessy Ardinal Barlan

Keyword(s):

Social Capital ◽

Random Sampling ◽

Qualitative Data ◽

Sampling Technique ◽

Cost Effective ◽

Simple Random Sampling ◽

Community Based ◽

Time Saving ◽

The Social ◽

Voting System

Head of a village election with e-voting system is a new thing for community The success level of e-voting system can be reached by fulfil several principles in order to the implementation going effective and the result of the election can be accepted by all. The objectives of this research is to analyze the relation between the success level of e-voting system with social capital of the community. This research is carried out with the quantitative approach and supported by qualitative data. This research takes 60 respondents using simple random sampling technique. The results showed that the success level of e-voting has a correlation with the level of social capital of the community. Based on the field study, the social capital of the community is classified as high. The high social capital makes the implementation of e-voting successful and the success level is also high, because in the election ten years ago occurred a conflict. The community considers e-voting easier and more practical, cost effective and time-saving, and the results of e-voting are also reliable. A practical and fast of e-voting system can be a solution especially for “rural-urban” community who are busy or work outside the village.Keywords: E-voting, the success level of the system, social capital Pemilihan kepala desa dengan sistem e-voting merupakan hal yang baru bagi masyarakat. Keberhasilan penerapan sistem e-voting dilihat dari terpenuhinya beberapa prinsip agar penerapannya berlangsung efektif dan hasilnya dapat diterima oleh seluruh masyarakat. Penelitian ini bertujuan untuk menganalisis hubungan tingkat keberhasilan sistem e-voting dalam pemilihan kepala desa dengan tingkat modal sosial masyarakat. Bentuk penelitian ini adalah penelitian kuantitatif yang didukung oleh analisis data kualitatif. Penelitian ini mengambil enam puluh responden dengan teknik simple random sampling. Hasil penelitian menunjukkan bahwa tingkat keberhasilan e-voting memiliki hubungan dengan tingkat modal sosial masyarakat. Berdasarkan kajian di lapang, modal sosial masyarakat tergolong tinggi. Tingginya modal sosial tersebut membuat pelaksanaan e-voting berhasil dan tingkat keberhasilannya juga tergolong tinggi karena pada pemilihan sepuluh tahun silam sempat terjadi konflik. Masyarakat menganggap sistem evoting lebih mudah dan praktis, hemat dalam segi biaya dan waktu, serta hasil dari pemilihan juga dapat dipertanggungjawabkan. Sistem e-voting yang praktis dan cepat dapat menjadi solusi khususnya bagi masyarakat daerah “desa-kota” yang memiliki kesibukan atau pekerjaan di luar desa.Kata Kunci: E-voting, keberhasilan sistem, modal sosial.

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