Biodegradeable temporising matrix use in a traumatic chest wound

The Welsh Centre for Burns and Plastic Surgery is responsible for a population of 10 million people in Wales and England. We describe the use of biodegradable temporising matrix (BTM) in a large traumatic chest wound in a 23-year-old woman. BTM is a synthetic dermal substitute and has been utilised to achieve soft tissue coverage in complex wounds. This wound was sustained after the patient fell from a tractor into a large silage rake, resulting in injuries to her chest and limbs. Following meticulous debridement, her resulting full thickness skin defect measured 30 × 30 cm extending from the sternal notch to the upper abdomen, with bone, muscle and breast tissue exposure. The central chest area is complex to reconstruct due to the contours of the breasts and tendency to contracture following skin graft reconstruction. We demonstrate the first reported use of BTM for breast reconstruction, as far as we are aware.

Left-sided diaphragmatic hernia after a chest wound with a grenade. D-r S. Samuelson (D. medic. Woch. 1932, no. 9)

Dr. S. Samuelson (D. medic. Woch. 1932, no. 9) cites a case of left-sided diaphragmatic hernia after a chest wound with a grenade. For 16 years, diaphragmatic hernia was not recognized in b-th

Retrospective Assessment of Donkeys’ Health and Welfare problems in Dale Sadi District Haro Sabbu Veterinary Clinic, Oromia, Ethiopia

Background: Although donkey contributed vital role in human livelihoods through direct and indirect contributions to financial, human and social capital, emphasis has not been given to study the welfare issue which include health problems and management requirement. A retrospective study and questionnaire survey was conducted to assess the health and the welfare problem of donkeys coming to the Haro Sabbu Veterinary clinic for treatment at the Dale Sadi district, Haro SabbuVeterinary clinic, Oromia, Ethiopia. Data on 448 donkeys from 2018 to 2020 were analyzed from the data record sheet kept by the clinic. Results: The most common case for wound occurrence were back sore 135(30.1%), chest wound 37(8.3%), bite 27(6.0%) and combined wound of both back and bite 14(3.1%). The finding indicated that the occurrence of wound in donkeys having poor 170 (64.4%), medium 41(33.6%) and good 7(11.6%) body condition and this was found to be statistically significantly associated (p=0.000). Among the common health problems and abnormalities encountered in donkeys back sore wound 135(30.1%), lameness 92(20.5%), parasitic infestation 60(13.6%), chest wound 37(8.3) and signs of colic 34 (7.6%) were the major problems encountered in donkeys coming to clinic for treatment with there was no a statistically significant difference among different years. In addition to body condition, the occurrence of wounds was found to be statistically significantly associated with age category and work type. In addition, pack donkeys experienced higher lameness occurrences as compared to cart donkeys and it was statistically significant (P>0.05). In addition to health related problems, the questionnaire survey conducted also revealed welfare problems such as management condition, overloading, working hour, housing problems, and wounds due to harnessing were the major welfare problems of donkeys in the study area.Conclusion: This retrospective study and questionnaire survey revealed the significant health and welfare problems of donkeys that need to be addressed in order to improve welfare status, their health and working efficiency. Therefore, there should be immediate awareness creation for community, government, community, local service providers and policy makers on welfare issue of donkey and health management in the study area in particular and in the country in general.

TẠO HÌNH XƯƠNG ỨC VÀ THÀNH NGỰC BẰNG NẸP VÍT TRONG VẾT THƯƠNG NGỰC XUYÊN

chest wall was destroyed in the penetrating chest wound is dificult problems for a variety of conditions and has been a complex problem in the past due to intraoperative technical difficulties, surgical complications, and respiratory failure. The surgical technique of chest wall stabilization for fail chest and reconstruction with a screws plate as a part of destroyed chest wall and reconstruction is described here in this article.Cas reporte A 54-year-old male was shot in the left thorax , fired from a AK bullet at close range (plus than 3 m). He arrived to our hopital approximately 8 hours after the injury. He had absent breath sounds on the left side, rapid respiratory rate 35 L/P,upper anterior fail chets(paradoxical motion of segments of the chest wall) and his vital signs were stable (pulse was 130, blood pressure was 140/90 mmHg. Physical examination revealed a single skin laceration (plus than 2. cm) with less surrounding contusion at the left anterier-axillary line; 3th intercostal space. The admission chest radiograph revealed a all left hemothorax(pleural effusion). chest X-ray demonstrated a foreign body at the right clavicle bone with the form of an bulett (Figure 1). A leftsided thoracostomy tube drained blood, the patient underwent a traumatic thoracotomie.the bullet and ribs,1/2 anterior upper sternum, muscles on the destroyed anterior upper chest wall were removed.wide anterior chest wall defects on only shaped by steel wires and screws plate and grand pectoralis muscles to the chest wall fix (stabilisation), avoid reversal respiratory and mediastinal infection.. The patient had an uneventful hospital stay and was discharged home 25 days later.

Results of manangement for post-chest trauma and chest wound retrained hemothorax and empyema by VATs at Viet Duc University Hospital

Introduction: To describe several clinical and para-clinical signs of patients with post-chest trauma and chest wound retained hemothorax and empyema treated at Viet Duc Hospital from 1/2015 to 4/2018, and to report the early results of treatment. Material and Methods: Retrospective descriptive study of patients diagnosed post-chest trauma and chest wound retained hemothorax and empyema treated by Video Assisted Thoracoscopic (VAT) surgery at Viet Duc Hospital from 1/2015 to 4/2018. Results: 59 patients, of them the mean age was 39,63 ± 15,78. The mean duration from injury onset to surgery was 16,64 ± 9,81 days. Chest trauma were 45 cases (76,27%), and chest wounds were 14 cases (23,73%). 46 patients (90,2%) had been treated by chest tube drainage at lower level hospitals. The rate of patients with fever and high white blood cells were 18,6 % and 64,4% respectively. There were 50,85% treated by thoracoscopic surgery, and other in 49,15% treated by VAT surgery. The mean duration of the removal of chest drainage after the thoracoscopic surgery was 4,93 days shorter than the group underwent VAT surgery was 7,01 days (p = 0.004). The post-operative days in group with total thoracoscopic surgery lower than 7 days was 83,33%, higher than the group of patients underwent VAT surgery (41,38%) with p = 0.003. The rate of patients indicated for pain-killer and complications occurred after the total thoracoscopic surgery were 23,33% and 6,67%, lower than those in group with VAT surgery, were 58,62% and 10,34%. Conclusion: Post-chest trauma and chest wound retained hemothorax and empyema were most common surgical emergencies. Thoracoscopic surgery is a safe and effective treatment method to the patients. Keywords: Retained hemothorax, post-trauma and chest wound empyema, video-assisted thoracoscopic surgery.