An earthquake reality: fasciotomy wounds and treatments

Hakan Erdoğan, A. Oto, Gamze Yerci, Gülcan Koçer, Burcu Menekşe, Berna Aktürk, Ümit Yıldırım, Şefika Elmas Bozdemir
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Abstract

Earthquake-induced Crush Syndrome and subsequent acute kidney injury are important issues that affect morbidity and mortality. Fasciotomies prolong the length of stay in intensive care unit in patients with Compartment Syndrome due to the complications it causes. Infections and delayed wound healing are two common complications among these. Therefore, early closure of fasciotomy wounds is recommended. Although different treatments can be applied for treatment of wounds, data on this subject in pediatric patients are insufficient. We report the case of a 15-year-old girl who developed acute renal failure due to crush syndrome after being trapped in the wreckage for 9 hours and undergoing fasciotomy procedures for four locations, in the left extremity, two in the thigh and two in the cruris. Hemodialysis, antihypertensive, and antibiotic treatment were administered during the intensive care follow-up due to acute kidney injury, hypertension, and sepsis. With negative pressure therapy, silver alginate wound dressing, and hyperbaric oxygen therapy, all wounds epithelialized within two months. However, rehabilitation for drop foot syndrome caused by nerve cuts in the left extremity continues.
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地震现实:筋膜切开术的伤口和治疗方法
地震引发的挤压综合征和随后的急性肾损伤是影响发病率和死亡率的重要问题。由于开筋膜手术引起的并发症,会延长室间隔综合症患者在重症监护室的住院时间。感染和伤口延迟愈合是其中两种常见的并发症。因此,建议尽早缝合筋膜切开伤口。虽然可以采用不同的治疗方法来处理伤口,但有关儿科患者的数据并不充分。我们报告了一例 15 岁女孩的病例,她被困在飞机残骸中 9 个小时,接受了四个部位的筋膜切开术,其中两个在左肢,两个在大腿,两个在臀部。由于急性肾损伤、高血压和败血症,在重症监护随访期间进行了血液透析、降压和抗生素治疗。通过负压治疗、银藻酸盐伤口敷料和高压氧治疗,所有伤口都在两个月内上皮化。不过,左肢神经损伤导致的足下垂综合症的康复治疗仍在继续。
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