scholarly journals Complex Wound Closure Following Mysterious and Vicious Animal Attack

Cureus ◽  
2020 ◽  
Author(s):  
Karleigh R Curfman ◽  
Russell Dumire ◽  
Kamran Shayesteh
Keyword(s):  
Wound Closure ◽  
Complex Wound ◽  
Animal Attack

Vacuum-assisted complex wound closure with elastic vessel loop augmentation: a novel technique

2003 ◽  
Vol 12 (6) ◽  
pp. 212-213 ◽  
Author(s):  
S.G. Moran ◽  
S.T. Windham ◽  
J.M. Cross ◽  
S.M. Melton ◽  
L.W. Rue III
Keyword(s):  
Wound Closure ◽  
Novel Technique ◽  
Elastic Vessel ◽  
Complex Wound

Unique closure of Gustilo IIIA fracture with a hard-to-heal lower extremity wound

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S24-S27
Author(s):  
Caroline E Clarke ◽  
William H Tettelbach
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Wound Closure ◽  
Interdisciplinary Approach ◽  
Wound Management ◽  
Reconstructive Ladder ◽  
Creative Solutions ◽  
Lower Extremity Wound ◽  
Complex Wound ◽  
Wound Bed Preparation

Consistently achieving wound closure requires a broad understanding of wound physiology, anatomy and wound healing phases. The multifaceted principles of wound closure are comprised of: perfusion evaluation; diabetes control; nutritional optimisation; infection control; mechanical stress avoidance; oedema management; wound bed preparation; and community care. Optimisation of each element is crucial to timely and durable resolution of acute and hard-to-heal wounds. This objective is realisable only through an interdisciplinary approach to wound healing. The reconstructive ladder represents the graduation of complex wound management as applied by the specialty of plastic surgery. The approach to reconstruction typically begins with the least invasive option, which is considered reliable. However, there are instances when the most reliable option on the reconstructive ladder is not a viable option and creative solutions for wound closure are required. The following case report demonstrates a unique approach to lower extremity salvage in a subacute compound fracture surgical site infection using a limited reconstructive ladder.

scholarly journals The Impact of Interdisciplinary Education on Skills and Attitudes of Surgery and Emergency Medicine Residents

2019 ◽  
Vol 05 (01) ◽  
pp. e18-e24
Author(s):  
Anastasia Kunac ◽  
Neil King ◽  
Ilya Ostrovsky ◽  
David Rytzarev ◽  
Aziz Merchant ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Wound Closure ◽  
Improve Patient Safety ◽  
Tube Thoracostomy ◽  
Interdisciplinary Education ◽  
Entire Study ◽  
Confidence Levels ◽  
Complex Wound ◽  
Survey Responses ◽  
The Impact

Background Interdisciplinary education (IDE) has been proposed as a means to improve patient safety by enhancing the performance of diverse health care teams. The improved camaraderie between members of different specialties may enhance communication and can foster a more supportive and positive work environment. Objective This study was aimed to assess the effect of IDE on the procedural skills of general surgery (GS) and emergency medicine (EM), as well as the perceptions that GS and EM residents have of one another. Methods EM and GS residents participated in two separate IDE sessions (4 months apart) designed to teach extended focused assessment with sonography in trauma (e-FAST), tube thoracostomy, and complex wound closure. Surveys were administered to determine the effects that IDE had on confidence in performing bedside procedures, perceptions of IDE, and perceptions of one another's specialty. Survey responses were recorded using a 5-point Likert's scale. Results Nine GS residents and 10 EM residents participated in the entire study. Significant improvements in the confidence levels of performing bedside procedures were noted among both groups of residents. We also report a significant improvement in the perceived respect and communication between EM and GS residents. Conclusions Although further studies with a larger sample size are required, we have shown that IDE can improve the confidence levels of EM and GS residents in performing tube thoracostomy, e-FAST, and complex wound closure. These IDE sessions also improve the perceptions that the residents have of one another. IDE is a useful tool and may translate into improved consultation, collaboration, and patient care.

722 An Experience with a Biodegradable Temporizing Matrix in a Metropolitan Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Rachelle J Lodescar ◽  
Cameron J Gibson ◽  
James Gallagher
Keyword(s):  
Wound Closure ◽  
Retrospective Chart Review ◽  
Skin Grafting ◽  
Burn Center ◽  
Life Saving ◽  
Complex Wound ◽  
Critical Patients ◽  
Grafting From ◽  
Wound Bed Preparation ◽  
Complex Wounds

Abstract Introduction In a large adult and pediatric metropolitan burn center, we are faced with a variety of challenging burn and complex wound cases that require surgical intervention. With the introduction of a new biodegradable temporizing matrix (BTM) in the US in 2017, we have introduced into our surgical routine a new option for wound coverage in these complex cases. This new biodegradable temporizing matrix has allowed us to provide dermal support and temporary wound closure in critical patients undergoing life-saving clinical support while awaiting skin graft closure. We share our experience using BTM in managing complex wounds in a series of patients over the past year. Methods A retrospective chart review of six patients who were admitted to our burn center, underwent BTM placement and subsequent skin grafting from February 2018 – August 2019 was performed. We analyzed mechanism and type of injury, indication for BTM placement, post burn day (PBD) placement of BTM and PBD to skin grafting and objective patient outcome. Results Conclusions: The availability of a biodegradable temporizing, polyurethane-based material in our burn center has positively added to our repertoire as surgeons an additional method for temporary wound closure as a dermal template. What we have learned is that we can improve wound bed preparation for ultimate skin grafting, particularly in critically ill patients with complex wounds and comorbidities. Applicability of Research to Practice Directly applicable to research.

544 Temporizing Matrix in the Complex Wound: A Retrospective Three-year Review

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S120-S121
Author(s):  
Sigrid A Blome-Eberwein ◽  
Lydia Bothwell
Keyword(s):  
Wound Closure ◽  
Subcutaneous Tissue ◽  
Complication Rates ◽  
Duration Of Treatment ◽  
Post Discharge ◽  
Study Objective ◽  
The Matrix ◽  
Complex Wound ◽  
Graft Success ◽  
Complex Wounds

Abstract Introduction A complex wound is a wound that will not heal spontaneously or with simple or standard closure techniques. Often functional structures (bone, tendon, fascia, joint capsule etc.) are exposed and a matrix can be used for bridging of these structures. The Temporizing Matrix is an entirely synthetic matrix made from polyurethane open-cell foam. This matrix was used in the burn center for three years for the indication “complex wound” with good success. The study objective was to evaluate success rate (leading to wound closure after STSG, duration of treatment) and complications (infection, failure, scarring) on this patient cohort. IRB approval was obtained. Methods All charts of patients receiving the Matrix between June 2017 through May 2020 were reviewed. Data collected were demographics, surgery dates, wound descriptions, healing, infection, failure, reapplication, time from application to STSG, time to healing, post discharge complications and scar quality. Results 33 patients with 37 complex wounds were identified to meet inclusion criteria, 61% male, 39% female, age ranging from 3 months to 72 years. The wounds were caused by Burns, necrotizing infections, trauma or amputation post burn. The Matrix was placed for widely exposed structures (70%), failed STSG(3%), thin subcutaneous tissue coverage over amputation stumps (15%) and other reasons (12%). Primary graft success was 97%. Infection rate was 15% with 8% reapplication. Most infections were treated locally. The average Vancouver scar scale rating after discharge was 9/15. Conclusions This temporizing Matrix in preparation to STSG led to successful wound closure in 97% of these complex wounds with low complication rates and an acceptable long-term scar.

scholarly journals Current Management of Facial Wounds in UK Accident and Emergency Departments

2006 ◽  
Vol 88 (2) ◽  
pp. 144-150 ◽  
Author(s):  
CL Allonby-Neve ◽  
CD Okereke
Keyword(s):  
Emergency Departments ◽  
Wound Closure ◽  
Soft Tissue Injuries ◽  
Facial Soft Tissue ◽  
Initial Management ◽  
Regional Nerve Block ◽  
Accident And Emergency ◽  
Complex Wound ◽  
Facial Wounds ◽  
The Uk

INTRODUCTION The objective of this study was to determine the current practice in the management of adult facial soft tissue injuries in patients presenting to UK accident and emergency departments. MATERIALS AND METHODS Questionnaire study to the lead clinicians of 217 UK emergency departments seeing over 30,000 new patients annually. RESULTS There was a 76% response rate. Suturing was the preferred method of closure, with the majority of clinicians preferring 6/0 or 5/0 non-resorbable sutures. Use of a regional nerve block would be considered by a quarter of clinicians, and adrenaline vasoconstrictor by a third. Referral rates ranged from 5–77% for a more complex wound. Maxillofacial services were preferred by 51% of respondents; on-site referral availability was indicated by only 28%, with an average journey of 16 miles for treatment. Up to 30% of clinicians considered prescribing antibiotics after wound closure, with flucloxacillin and co-amoxiclav most commonly suggested. Accident and emergency review rates ranged from 16% to 45%, with most wounds either being referred to the GP or no formal review being suggested. CONCLUSIONS The results of this survey suggest that there is considerable variation in the initial management, referral and review of facial wounds in the UK. Further work is required to formulate guidelines for optimal patient care, ideally in conjuncture with the receiving surgical specialties.

“Jelly VAC” for Negative-Pressure Therapy for Complex Wound Closure

2018 ◽  
Vol 8 (1) ◽  
pp. e18-e18 ◽  
Author(s):  
Patrick F. Bergin ◽  
Jason R. Wild ◽  
Timothy G. Weber
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Complex Wound
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