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。

Journal of Trauma and Injury Pub Date : 2023-12-01 Epub Date: 2023-11-17 DOI:10.20408/jti.2023.0032
Divij Jayant, Atul Parashar, Ramesh Sharma
{"title":"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。","authors":"Divij Jayant, Atul Parashar, Ramesh Sharma","doi":"10.20408/jti.2023.0032","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309239/pdf/","citationCount":"0","resultStr":"{\"title\":\"Traumatic degloving injuries: a prospective study to assess injury patterns, management, and outcomes at a single center in northern India.\",\"authors\":\"Divij Jayant, Atul Parashar, Ramesh Sharma\",\"doi\":\"10.20408/jti.2023.0032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":52698,\"journal\":{\"name\":\"Journal of Trauma and Injury\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309239/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Trauma and Injury\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20408/jti.2023.0032\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Trauma and Injury","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20408/jti.2023.0032","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/17 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Traumatic degloving injuries: a prospective study to assess injury patterns, management, and outcomes at a single center in northern India.

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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
58
审稿时长
11 weeks
期刊最新文献
A starry night: a case report of severe liver injury due to a close-range shotgun blast in Argentina. Acute irreducible anterior shoulder dislocation due to interposition of the subscapularis muscle and the lesser tuberosity: a case report. Purtscher retinopathy following isolated chest compression: a case report. Endoscopic transorbital approach for the removal of a frontal lobe foreign body: a case report. Experience of vascular injuries at a military hospital in Korea.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1