Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial

Virani, Siddharth; Dahapute, Aditya Anand; Bava, Surendar Singh; Muni, Saurabh

doi:10.1016/j.jcot.2016.05.007

Cited by 40 publications

(50 citation statements)

References 35 publications

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“…These procedures have indeed yielded satisfactory results and extremely low failure rates, but the techniques are remarkably demanding and often lead to complications of the donor site. Studies on lower limb injuries have recently proposed successful options using appropriate surgical debridement and vacuum dressings, thus reducing the possibility to use free soft tissue transfer yielding equally optimal outcomes [ 38 , 39 ]. The possibility for HBOT to diminish edema and avoid necrosis and infection will enable a less complicated soft tissue closure with sufficient opportunity to plan relevant orthopedic interventions and plastic surgery.…”

Section: Discussionmentioning

confidence: 99%

A Multistep Iter for Functional Reconstruction in Mangled Upper Limb: A Retrospective Analysis of Integrated Surgical and Medical Approach

Francesco¹,

Marchesini²,

Campodonico³

et al. 2020

Medicina

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Background and objectives: Complex limb wounds with multiple tissue involvement are commonly due to high energy trauma. Tissue damage is a dynamic entity and the exact extent of the injury is rarely instantly perceptible. Hence, reconstruction frequently involves a multi-stage procedure concluding with tissue replacement. Materials and Methods: A retrospective study was conducted between 2006 and 2018 and included 179 patients with contaminated multi-tissue injuries treated with hyperbaric oxygen therapy, negative pressure therapy, physiotherapy and drug treatment associated with multiple surgical time in a multistep approach, focusing on pain levels and wound closure rates. Results: Despite the long-term response to traumatic events, a combined approach of delayed surgical reconstructive time in mangled upper limb yielded satisfactory functional outcomes. Conclusions: The complex upper limb wound with deep tissue exposure may be treated with a multi-stage procedure alternatively to immediate reconstruction. The integrated technique enables the preservation of existing healthy tissue and concurrent radical debridement, reducing the risk of infection, as well as avoiding the loss of free flaps and dehiscence due to incorrect wound estimation.

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Section: Discussionmentioning

confidence: 99%

A Multistep Iter for Functional Reconstruction in Mangled Upper Limb: A Retrospective Analysis of Integrated Surgical and Medical Approach

Francesco¹,

Marchesini²,

Campodonico³

et al. 2020

Medicina

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“…Case management has been applied comprehensively to help patients with traumatic injury regain functionality in countries such as Australia ( Arnold & Elder, 2013 ) and China ( Kong et al, 2012 ). In addition, recently generated evidence on trauma care has touched on issues such as wound care ( Virani et al, 2016 ), pain management ( Jennings et al, 2014 ), postinjury rehabilitation ( Faux et al, 2015 ), psychological and cognitive interventions ( Vranceanu et al, 2015 ), and multidisciplinary recovery programs ( Zatzick et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Health Professionals' Perspectives on the Efficacy of Using Comprehensive Care to Improve Outcomes in Patients With Traumatic Injury

Huang

Hsiao³

et al. 2020

Journal of Nursing Research

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Background Barriers related to comprehensive posttrauma care and health outcome monitoring exist. The insights and perspectives of health professionals on this issue may help integrate care experiences to provide continuous care to patients with traumatic injury. Purpose The purpose of this study was to explore the perspectives of health professionals with regard to comprehensive care to improve the outcomes of patients with traumatic injury. Methods Data were collected at two teaching hospitals in Taiwan. In total, 28 health professionals across various disciplines were interviewed in five focus groups. Results Six themes were delineated, including “wound care is a primary concern for patients,” “ineffective health education during the hospital stay,” “patients and families worry about postinjury conditions,” “current continuity of care is not effective,” “lack of standards for discharge planning,” and “incorporation of interdisciplinary care to improve patient outcomes.” Conclusions The experiences of health professionals are useful to the establishment of a foundation for trauma case management and interdisciplinary care for hospitals.

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“…A cast combined with VAC therapy enabled soft tissue healing. Immediate nailing would not have been a prudent choice because of the patient’s highly critical conditions [ 10 ]. This decision allowed the functional recovery of the patient through early mobilisation and an appropriate rehabilitation process.…”

Section: Discussionmentioning

confidence: 99%

Open Tibial Fracture in a Non-Compliant Patient: A Case Report

Pizzolo

Testa

Papotto

et al. 2018

JFMK

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Abstract:Open tibial fractures represent the most frequent fractures of long bones, comprising approximately 1.9% of all fractures. Although locked intramedullary nailing is the gold standard for treating closed and unstable tibia diaphyseal fractures, for most exposed fractures, an external fixator can first be used, followed by conversion through an intramedullary nail. The present report describes the case of a 17-year-old male who presented with a complex multi-segmented displaced tibia fracture, type 42-C3, with exposure of IIIB type according to the Gustilo-Anderson classification, and with an attached disrupted fracture of peroneal malleolus, type 44-B2. External fixation was the preferred treatment method. Before the definitive surgical treatment, the patient had a second accident that caused refracture and damage to the soft tissues and external fixation system. This prolonged the time estimated for the conversion from the external fixator to the intramedullary nail. The reported case shows the use of various treatment steps with different timelines and an intervention with vacuum-assisted closure therapy for soft tissue healing as well as subsequent intramedullary nailing in order to reach the definitive healing of a non-compliant patient. These combined methods achieved an acceptable reduction and good stability of such a complex fracture.

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Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial

Cited by 40 publications

References 35 publications

A Multistep Iter for Functional Reconstruction in Mangled Upper Limb: A Retrospective Analysis of Integrated Surgical and Medical Approach

A Multistep Iter for Functional Reconstruction in Mangled Upper Limb: A Retrospective Analysis of Integrated Surgical and Medical Approach

Health Professionals' Perspectives on the Efficacy of Using Comprehensive Care to Improve Outcomes in Patients With Traumatic Injury

Open Tibial Fracture in a Non-Compliant Patient: A Case Report

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