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Comparison of pediatric injury patterns before and during the COVID-19 pandemic in Korea: a retrospective study. 韩国 COVID-19 大流行之前和期间儿科伤害模式的比较:一项回顾性研究。
Pub Date : 2023-12-01 Epub Date: 2023-12-22 DOI: 10.20408/jti.2023.0053
Geom Pil Nam, Woo Sung Choi, Jin-Seong Cho, Yong Su Lim, Jae-Hyug Woo, Jae Ho Jang, Jea Yeon Choi

Purpose: The COVID-19 pandemic led to significant changes in the lifestyle patterns of children and affected the patterns of pediatric injuries. This study analyzed the changing patterns of pediatric injury overall and by age groups, based on the datasets before and during the COVID-19 pandemic.

Methods: This study is based on the data of patients who presented with injuries at 23 hospital emergency departments participating in the Emergency Department-based Injury In-depth Surveillance (EDIIS) conducted by the Korea Disease Control and Prevention Agency. The surveillance data was categorized by injury mechanism, location, activity, and severity. We analyzed the injury patterns of pediatric patients aged 0 to 15 years. Subgroup analysis was conducted by age group in children aged 7 to 15 years, 1 to 6 years, and <1 year.

Results: When comparing the COVID-19 pandemic period to the pre-COVID-19 period, the total number of pediatric patients with injuries decreased by 38.7%, while the proportions of in-home injuries (57.9% vs. 67.9%), and minor injuries (38.9% vs. 39.7%) increased. In the 7 to 15 years group, bicycle riding injuries (50.9% vs. 65.6%) and personal mobility device injuries (2.4% vs. 4.6%) increased. The 1 to 6 years group also showed an increase in bicycle accident injuries (15.8% vs. 22.4%). In the <1 year group, injuries from falls increased (44.5% vs. 49.9%). Self-harm injuries in the 7 to 15 years group also increased (1.6% vs. 2.8%).

Conclusions: During the COVID-19 pandemic period, the overall number of pediatric injuries decreased, while injuries occurring at home and during indoor activities increased. Traffic accidents involving bicycles and personal mobility devices and self-harm injuries increased in the 7 to 15 years group. In the <1 year group, the incidence of falls increased. Medical and societal preparedness is needed so that we might anticipate these changes in the patterns of pediatric injuries during future infectious disease pandemics.

目的:COVID-19 大流行导致儿童的生活方式发生了重大变化,并影响了儿科伤害的模式。本研究根据 COVID-19 大流行之前和期间的数据集,分析了儿科伤害的总体变化模式和各年龄组的变化模式:本研究基于 23 家医院急诊科的受伤患者数据,这些急诊科参与了韩国疾病控制和预防局开展的基于急诊科的伤害深度监测(EDIIS)。监测数据按受伤机制、地点、活动和严重程度进行了分类。我们分析了 0 至 15 岁儿童患者的受伤模式。按年龄组对 7 至 15 岁、1 至 6 岁和结果进行了分组分析:与 COVID-19 流行前相比,COVID-19 流行期间受伤的儿科病人总数减少了 38.7%,而在家中受伤(57.9% 对 67.9%)和轻微伤(38.9% 对 39.7%)的比例却增加了。在 7-15 岁年龄组中,骑自行车受伤(50.9% 对 65.6%)和使用个人移动设备受伤(2.4% 对 4.6%)的比例有所上升。1 至 6 岁年龄组的自行车事故受伤人数也有所增加(15.8% 对 22.4%)。结论在 COVID-19 大流行期间,儿科受伤的总人数有所下降,而发生在家中和室内活动中的受伤人数有所增加。涉及自行车和个人移动设备的交通事故以及自残伤害在 7-15 岁年龄组中有所增加。在
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引用次数: 0
Penetrating chest trauma from a "less lethal" bean bag in the United States: a case report. 美国“不那么致命”的豆袋造成的穿透性胸部创伤:一例报告
Pub Date : 2023-12-01 Epub Date: 2023-09-05 DOI: 10.20408/jti.2023.0021
Gloria Sanin, Gabriel Cambronero, Megan E Lundy, William T Terzian, Martin D Avery, Samuel P Carmichael, Maggie Bosley

This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.

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引用次数: 0
Traumatic degloving injuries: a prospective study to assess injury patterns, management, and outcomes at a single center in northern India. 创伤性脱臼损伤:一项前瞻性研究,旨在评估印度北部一家中心的损伤模式、处理方法和结果。
Pub Date : 2023-12-01 Epub Date: 2023-11-17 DOI: 10.20408/jti.2023.0032
Divij Jayant, Atul Parashar, Ramesh Sharma

Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India.

Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up.

Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability.

Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.

目的:本研究调查了在印度北部一家三级医疗中心治疗的软组织损伤(DSTI)的流行病学、管理、结果和术后残疾情况:方法:对软组织损伤患者进行了为期 15 个月的前瞻性研究。采用世界卫生组织残疾评估表(WHODAS)2.0分析了脱臼损伤的类型、损伤机制和任何相关损伤,并分析了3个月随访时的管理、结果和残疾情况:在 75 名 DSTI 患者中,平均年龄为 27.5 岁,80.0% 为男性,76.0% 曾在交通事故中受伤。大多数(93.3%)为开放性脱体损伤。下肢最常见(62.7%),其次是上肢(32.0%)。骨折是最常见的相关损伤(72.0%)。大多数患者需要进行两次以上的手术,包括二次清创(41.3%)、分割植皮(80.0%)、皮瓣覆盖(12.0%)或真空辅助闭合(24.0%),另有五名患者接受了闭合性脱皮损伤的保守治疗。术后并发症包括手术部位感染(14.7%)和皮肤坏死(10.7%)。两名患者死于脓毒性休克和多器官功能障碍综合征。平均住院时间为(11.5±8.1)天,影响下肢和会阴的损伤需要更长的住院时间。3 个月时,WHODAS 2.0 残疾评分平均为 19 分。大多数患者的残疾程度较轻。缺勤时间主要取决于受伤部位和严重程度。约75%的患者恢复了之前的工作或学习,14%的患者更换了工作,8%的患者因残余残疾完全停止了工作:DSTI是创伤中常见的损伤,其治疗具有挑战性。虽然开放性 DSTI 在二次调查时临床表现明显,但闭合性脱骨损伤可能会在初次调查时被漏诊,因此需要高度怀疑、彻底临床检查和基于方案的管理。此外,还需要制定初级预防策略(如道路安全协议、上岗前培训和在工业中使用适当的防护设备),以降低此类伤害的发生率。
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引用次数: 0
Successful minimally invasive management using transcatheter arterial embolization in a hemodynamically stable elderly patient with mesenteric vascular injury in a hybrid emergency room system cin Korea: a case report. 在混合急诊室系统中,经导管动脉栓塞成功微创治疗一例血流动力学稳定的老年肠系膜血管损伤患者
Pub Date : 2023-12-01 Epub Date: 2023-07-25 DOI: 10.20408/jti.2023.0018
So Ra Ahn, Joo Hyun Lee, Sang Hyun Seo, Chan Yong Park

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.

肠系膜损伤很少发生在与腹部钝性创伤相关的病例中。尽管发生率很低,但肠系膜损伤可导致致命的后果,例如因腹腔积血导致的低血容量性休克、因肠道缺血导致的败血症或与穿孔相关的腹膜炎。对于肠系膜损伤,尤其是涉及大量出血、肠缺血和穿孔的损伤,标准治疗方法是手术。然而,在手术治疗的情况下,应注意手术过程中和手术后可能会出现并发症和死亡。经导管动脉栓塞术(TAE)对实体器官的作用众所周知,但对肠系膜损伤的作用却存在争议。我们为您介绍一名因腹部钝性创伤导致肠系膜损伤的 75 岁男性。最初的腹部计算机断层扫描显示无腹腔积血,但在肠系膜上动脉起源附近观察到肠系膜挫伤和直径为 17 毫米的假性动脉瘤。由于没有发现游离气体或肠道缺血等需要紧急手术的情况,因此决定在混合急诊系统中使用微线圈进行非手术治疗,即 TAE。TAE 成功实施,没有出现出血、肠缺血或延迟性肠穿孔等并发症。他在入院后第 23 天出院,经皮导管引流术引流了肠系膜血肿。作者认为,考虑到全身麻醉的负担以及各种可避免的术中和术后并发症,对高度选择的老年肠系膜损伤患者采用 TAE 治疗具有微创管理的积极意义。
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引用次数: 0
A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study 韩国单中心治疗创伤性胸骨骨折十年的经验:回顾性队列研究
Pub Date : 2023-11-30 DOI: 10.20408/jti.2023.0027
N. Lee, Seon Hee Kim, Jae Hun Kim, Hohyun Kim, Sang Bong Lee, C. Park, G. Kim, Dongyeon Ryu, Sun Hyun Kim
Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encom-passed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5–18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3–23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3–48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with off-set-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.
目的:目前缺乏有关胸骨骨折治疗效果的临床报告。本研究详细介绍了一家医疗机构 10 年来与创伤性胸骨骨折相关的临床特征、治疗方法和疗效。方法:回顾性队列研究对 2012 年 1 月至 2021 年 12 月期间在一家地区创伤中心住院的患者进行了回顾性队列研究。在 7918 名胸部受伤患者中,有 266 人被诊断为创伤性胸骨骨折。收集的患者数据包括人口统计学、受伤机制、严重程度、相关损伤、胸骨骨折特征、住院时间、死亡率、呼吸系统并发症和手术细节。手术适应症包括涉及胸内损伤、不稳定骨折、严重脱位、胸部外翻、骨折愈合不良和持续性剧烈疼痛的急诊病例。结果:266名胸骨外伤性骨折患者中有260人接受了手术治疗,其中98人接受了胸骨骨折手术治疗,162人接受了保守治疗。手术指征包括胸腔内器官或血管损伤,需要进行开胸手术,以及不稳定骨折和严重脱位。影响手术治疗的因素包括外翻运动和肋骨骨折。非手术组在重症监护室的中位住院时间为5.4天(四分位距[IQR]为1.5-18.0天),手术组为8.6天(四分位距[IQR]为3.3-23.6天)。非手术组的住院时间中位数为 20.9 天(IQR,9.3-48.3 天),手术组为 27.5 天(IQR,17.0-58.0 天)。组间差异无统计学意义。手术干预非常成功,骨结合稳定,并发症极少。肋骨骨折时的畸形运动是手术干预的重要考虑因素。结论胸骨骨折的手术治疗建议因胸廓外翻、移位程度和肋骨骨折而异。对于伴有肋骨和胸骨节段性骨折的偏移型胸骨骨折患者,建议进行手术治疗。手术治疗可使骨结合稳定,并发症极少。
{"title":"A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study","authors":"N. Lee, Seon Hee Kim, Jae Hun Kim, Hohyun Kim, Sang Bong Lee, C. Park, G. Kim, Dongyeon Ryu, Sun Hyun Kim","doi":"10.20408/jti.2023.0027","DOIUrl":"https://doi.org/10.20408/jti.2023.0027","url":null,"abstract":"Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encom-passed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5–18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3–23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3–48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with off-set-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Various injury patterns due to combustion (typical but unfamiliar to physicians and easy to miss) in Korea: a case report 韩国因燃烧造成的各种伤害模式(典型但医生不熟悉且容易遗漏):病例报告
Pub Date : 2023-11-30 DOI: 10.20408/jti.2023.0060
Hyung-Il Kim
{"title":"Various injury patterns due to combustion (typical but unfamiliar to physicians and easy to miss) in Korea: a case report","authors":"Hyung-Il Kim","doi":"10.20408/jti.2023.0060","DOIUrl":"https://doi.org/10.20408/jti.2023.0060","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139204534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A rare and unique experience of a blunt intrathoracic traumatic injury of the trachea and its management in South Africa: a case report 南非罕见的气管钝性胸腔内创伤及其处理:病例报告
Pub Date : 2023-11-30 DOI: 10.20408/jti.2023.0036
R. Pswarayi, Anna Katariina Kerola
Blunt intrathoracic tracheal injuries are rare, even among blunt chest trauma patients. An early diagnosis based on a high index of suspicion allows for timely surgical management of potentially fatal airway trauma, thereby improving overall outcomes. Diagnosing these injuries can be difficult due to their nonspecific clinical features and the occasional difficulty in radiologic diagnosis. If a patient exhibits respiratory compromise with difficult ventilation and poor lung expansion, despite the insertion and management of an intercostal drain following high-energy blunt trauma, there should be a heightened suspicion of potential airway trauma. The aim of primary repair is to restore airway integrity and to minimize the loss of pulmonary parenchyma function. This case report discusses the rare clinical presentation of a patient with blunt trauma to the intrathoracic airway, the surgical management thereof, and his overall outcome. Although blunt traumatic injuries of the trachea are extremely rare and often fatal, early surgical intervention can potentially reduce the risk of mortality.
即使在钝性胸部创伤患者中,钝性胸腔内气管损伤也很少见。基于高度怀疑指数的早期诊断可及时对可能致命的气道创伤进行手术治疗,从而改善总体预后。由于这些损伤的临床特征不具特异性,而且有时难以进行放射学诊断,因此诊断这些损伤非常困难。如果患者在高能量钝性创伤后尽管插入并处理了肋间引流管,但仍表现出呼吸困难和肺扩张不良的呼吸衰竭症状,则应高度怀疑可能存在气道创伤。初级修复的目的是恢复气道的完整性,尽量减少肺实质功能的丧失。本病例报告讨论了一名胸内气道钝性创伤患者的罕见临床表现、手术治疗及其总体预后。尽管气管钝性外伤极为罕见,而且往往是致命的,但早期手术干预有可能降低死亡风险。
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引用次数: 0
Expediting venous drainage in large anterolateral thigh flaps for scalp electrical burns in India: a case report on the use of primary vein grafts for second vein anastomosis 加快印度头皮电烧伤大腿前外侧皮瓣的静脉引流:关于使用原生静脉移植物进行第二静脉吻合的病例报告
Pub Date : 2023-11-30 DOI: 10.20408/jti.2023.0054
Jyotica Jagadish Chawaria, Parvati Ravula, Nazia Tabassum, Srikanth Rangachari
{"title":"Expediting venous drainage in large anterolateral thigh flaps for scalp electrical burns in India: a case report on the use of primary vein grafts for second vein anastomosis","authors":"Jyotica Jagadish Chawaria, Parvati Ravula, Nazia Tabassum, Srikanth Rangachari","doi":"10.20408/jti.2023.0054","DOIUrl":"https://doi.org/10.20408/jti.2023.0054","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study 印度近端腓肠肌皮瓣用于膝关节周围和腿部近三分之一处软组织缺损的重建:一项临床研究
Pub Date : 2023-11-23 DOI: 10.20408/jti.2023.0042
Palukuri Lakshmi, Shreedharala Srinivas, D. Madhulika, Sanujit Pawde, Ajo Sebastian, Swati Sankar, Sandeep Reddy Chintha
Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm 2 , and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm 2 , and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for re-constructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications
目的:重建膝关节周围和腿部近端三分之一处的缺损需要薄而柔韧的皮肤以及稳定而有感觉的软组织覆盖。本研究分析了使用近端腓肠肌皮瓣覆盖此类缺损的方法。方法:这项前瞻性临床干预研究涉及 10 名膝关节和腿部近端三分之一处有软组织缺损的患者。这些患者接受了基于近端腓肠肌皮瓣的重建手术。研究分析了各种因素,包括年龄、性别、病因、缺损位置和表现、缺损尺寸、皮瓣细节、术后并发症和随访。研究结果共有 10 个病例,均为 20 至 65 岁的男性。最常见的受伤原因是道路交通事故造成的外伤。大部分缺损位于腿的近三分之一处,尤其是前外侧。缺损大小从6×3到15×13厘米2不等,使用这种皮瓣可以覆盖16厘米×14厘米的大面积缺损。皮瓣的大小从7×4到16×14平方厘米不等,蒂长为10到15厘米。在所有病例中,供体部位都是通过分割植皮来实现闭合的。这种皮瓣始终能在缺损处提供薄、柔韧、稳定和持久的软组织覆盖,且无功能障碍,供体部位发病率极低。有两个病例出现了并发症,包括远端皮瓣坏死和供体部位移植物脱落。结论:以近端为基础的腓肠肌筋膜皮瓣是重建膝关节周围和腿部近三分之一处中大型软组织缺损的主要方法。这种技术能提供纤薄、可靠、敏感和稳定的软组织覆盖,并能覆盖较大的缺损,并发症极少。
{"title":"Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study","authors":"Palukuri Lakshmi, Shreedharala Srinivas, D. Madhulika, Sanujit Pawde, Ajo Sebastian, Swati Sankar, Sandeep Reddy Chintha","doi":"10.20408/jti.2023.0042","DOIUrl":"https://doi.org/10.20408/jti.2023.0042","url":null,"abstract":"Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm 2 , and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm 2 , and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for re-constructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bleeding control of an injury to the infrarenal inferior vena cava and right external iliac vein by ipsilateral internal iliac artery and superficial femoral vein ligation after blunt abdominal trauma in Korea: a case report 韩国腹部钝挫伤后通过同侧髂内动脉和股浅静脉结扎控制肾下腔静脉和右侧髂外静脉损伤的出血:病例报告
Pub Date : 2023-11-17 DOI: 10.20408/jti.2023.0019
Hoonsung Park, Maru Kim, D. Lee, T. H. Hong, Doohun Kim, Hang joo Cho
{"title":"Bleeding control of an injury to the infrarenal inferior vena cava and right external iliac vein by ipsilateral internal iliac artery and superficial femoral vein ligation after blunt abdominal trauma in Korea: a case report","authors":"Hoonsung Park, Maru Kim, D. Lee, T. H. Hong, Doohun Kim, Hang joo Cho","doi":"10.20408/jti.2023.0019","DOIUrl":"https://doi.org/10.20408/jti.2023.0019","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139262460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Trauma and Injury
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