Early versus Late Flap Coverage for Open Tibial Fractures

Chua, Wei Jin; De, Soumen Das; Wong, Keng Lin; Kagda, Fareed; Murphy, Diarmuid

doi:10.1177/230949901402200305

Cited by 34 publications

(30 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Using the algorithm developed in our clinic (the algorithm of emergency leg soft tissue reconstruction in patients with severe open tibia fractures), we obtain results which are consistent with the results of other studies in frequency flap necrosis and frequency of wound infection (see Table 5 ) [ 3 , 4 , 8 , 12 , 23 ]. The stated above proves the standardized approach (algorithm) of treatment patients with severe open tibia fractures to be effective and allow to decrease significantly the complication rate and to improve the treatment results.…”

Section: Discussionsupporting

confidence: 86%

Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures

Иванов

Shibaev²,

Nevedrov

et al. 2016

TOORTHJ

View full text Add to dashboard Cite

Introduction:Tactic of emergency closing of soft tissue defect allows to significantly improve the treatment results concerning patients with severe open fractures. However, a number of certain factors make the implementation of this tactic rather difficult. Injured people’s unstable conditions are mong these crucial factors which include, polytrauma in lots of cases, absence of exact recommendations for recovery terms, choice of definite tissue flaps and a type of circulation.The Aim of Study:is to develop exact, usable and in practice algorithm of emergency reconstruction of leg soft tissues in patients with severe open tibia fractures, based on the usage of the most foolproof and simple methods.Data (Patients) and Methods:85 patients with open tibia fractures complicated by soft tissue defects were included in our study. Patients were divided into two groups. The control group consisted of 56 patients. Soft tissue reconstruction in this group was provided without an exact algorithm, after continuous attempts on local healing. After analyzing the treatment process and the treatment results we have developed the algorithm of emergency soft tissue reconstruction. It was used in 29 patients (the study group). This algorithm allows choosing optimal timing for tissue reconstruction and appropriate method to be applied, depending on the patient’s condition, the mechanism of soft tissue defect formation, and its square and localization.Results:We observed a statistical decrease in deep wound infection frequency, partial tibia necrosis frequency, chronic osteomyelitis frequency, duration of hospitalization in patients with severe open tibia fractures because of using our algorithm.

show abstract

Section: Discussionsupporting

confidence: 86%

Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures

Иванов

Shibaev²,

Nevedrov

et al. 2016

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…In the study by Ivanov et al [ 5 ], 15 cases (17.6%) were female and 70 (82.4%) cases were male, which is a comparable ratio to that of our study. In the study conducted by Chua et al [ 9 ], 6.74% of the patients were female patients and 93.36% were male. Neither of those studies compared complications according to sex.…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Kamath et al [ 10 ] that analyzed 151 cases, patients who presented within 10 days, from 10 days to 6 weeks, and at > 6 weeks had complication rates of 26.6%, 73.68%, and 52.6%, respectively [ 10 ]. In another study by Chua et al [ 9 ], among 30 early flap coverage cases ( < 72 hours), 15 cases (54%) had no complications and 14 cases (46%) had complications, while among 59 late flap coverage cases ( > 72 hours), 42 had complications. That study suggested that early coverage (within 72 hours) yielded more favorable results in terms of better outcomes, a lower rate of infections, and shorter hospital stays.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of pedicled flaps for type IIIB open fractures of the tibia at a tertiary care center

et al. 2021

View full text Add to dashboard Cite

Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center.Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation.Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03).Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

show abstract

“…Fractures managed with flaps were at a higher risk of infection that is similar to other studies. 23 - 25 Furthermore, delayed wound closure was found to be associated with deep infection. These findings are likely driven by the severity of the injury because simpler wounds are closed initially.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Infection in Open Fractures of the Upper and Lower Extremities

et al. 2020

View full text Add to dashboard Cite

Early versus Late Flap Coverage for Open Tibial Fractures

Cited by 34 publications

References 25 publications

Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures

Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures

Evaluation of pedicled flaps for type IIIB open fractures of the tibia at a tertiary care center

Risk Factors Associated With Infection in Open Fractures of the Upper and Lower Extremities

Contact Info

Product

Resources

About