The risk factors for abdominal wall hernia after surgery are an increase in body mass index, midline incision, incisional surgical-site infection, preoperative chemotherapy, blood transfusion, increasing age, female sex, and increasing thickness of subcutaneous tissue. Reconstructing the abdominal wall defect becomes a challenge in multiple risk factor patients. Many new mesh implants have been invented, but all fail in case of infections. We modified and re-evoked an old technique of fascia lata free graft reinforced with tensor fascia lata pedicled flap.
More than half of the fingertip injuries in children are due to door jamming injuries.1)2) There have been several studies on door crush injuries (DCI) but they pertain to either the paediatric age group or form a part of study of fingertip injuries in a large population. This article caters solely to studying the epidemiology, mechanism of injury, associated risk factors and suggests few simple techniques to avoid DCI.MaterialsComparative analysis of the epidemiological data of all the patients with door crush injuries who presented to the Emergencies and the Out Patient Department in the Tertiary care centre was obtained from the MRD. This is a retrospective cohort study between January 2021 to December 2021. Patients with serious concomitant injuries, machine crush injury, heavy falling objects, window crush injury were excluded from the study.ResultsOf the 34 patients, 27 were male and 7 females. In 33 patients DCI was in the hinge side while only 1 had lock-side, entrance door being the commonest. 35% had first-aid done in a local nursing home before arriving at the hospital. 4 patients left against medical advice, 4 were conservatively treated and 2 had double finger injury. DCI was most common in preschool children. Right side and middle finger were most susceptible. 25% of the injuries happened on Mondays. Of the 36 fingers injured, 69% had pulp, 58% had nailbed and 22% had bony involvement. Primary suturing, local flap cover and K-wiring were the main modalities of treatment. Complications included altered sensation, nail deformity and contracture.ConclusionDoor crush injury is a major contributor for finger crush injuries in both children and adults. Awareness among parents, the use of safety appliances to prevent accidental door closing, counselling by doctors and nurses greatly help to bring down the number of door crush injuries.
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