Post-traumatic cutaneous hematomas in geriatrics hospital: A neglected disease?

Trellu, Laurence Toutous; Herrmann, Françoís; Tarteaut, M.-H.; Kaya, Aysin; Cheretakis, Alexandre; Kaya, Gürkan

doi:10.1016/j.eurger.2012.01.005

Cited by 2 publications

(6 citation statements)

References 19 publications

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“…A single-center retrospective study that included 2092 patients found an incidence rate of 53% (95% CI = 44–64) per year, and among 112 hematomas, 26 were DDH. 8 A skin biopsy is not always required, but it ascertains the diagnosis by confirming the presence of degenerative changes in the dermal and subcutaneous vessels. 3 , 4 The main differential diagnoses are erysipelas, DVT, non-dissecting hematoma, and Morel–Lavallee syndrome.…”

Section: Discussionmentioning

confidence: 99%

Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Hamdan¹,

Zwetyenga²,

Macheboeuf³

et al. 2022

SAGE Open Medical Case Reports

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A deep dissecting hematoma is the most serious complication of dermatoporosis, consisting of a rapidly expanding blood collection that splits the hypodermis from the muscle fascia. A several-week time lapse between a minor trauma-induced superficial hematoma and its sudden evolution into a rapidly spreading deep dissecting hematoma is unusual. We report the case of a 70-year-old woman with long-term oral anticoagulation and dermatoporosis who suddenly developed a rapidly spreading right-leg deep dissecting hematoma 1 month after minor trauma, for which a surgical debridement and drainage were performed. Only local care and absorbent dressings were used to manage the post-operative wound, and within 4 months, the wound had healed. In this report, we emphasize the importance of preventing deep dissecting hematoma in patients who are at risk as well as the need to weigh the benefits and risks of anticoagulants when dermatoporosis cutaneous signs are present. A limb-threatening deep dissecting hematoma may develop suddenly, even weeks after a minor impact. In order to prevent skin necrosis from occurring, caregivers, patients, and carers must be able to identify this condition early on.

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Section: Discussionmentioning

confidence: 99%

Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Hamdan¹,

Zwetyenga²,

Macheboeuf³

et al. 2022

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…To our knowledge, DDH usually arises immediately after an injury, often a minor one (2,5,(7)(8)(9). Data concerning the prevalence and incidence of DDH are rare.…”

Section: Discussionmentioning

confidence: 99%

“…A monocentric retrospective review found an incidence rate of 53% (95% CI = 44.64) per year. Among 112 hematomas observed during the three-year study period, 26 were DDH (5). The differential diagnoses include erysipelas, DVT, non-dissecting hematoma and Morel-Lavallee syndrome (serolymphatic effusion caused by tangential trauma to a highly vascularized tissue) (2,4).…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the extension, age and whether or not the haematoma is closed, Fennira et al described four types of DDH (early closed type, advanced closed, advanced type with necrosis and open type) and highlighted rapid increase in the volume and extent of the haematoma as signs of severity(2). In addition, although it has been reported under direct oral anticoagulants (9), the association of skin frailty and vitamin K antagonists (for which cutaneous complications are well documented(8)) or antiplatelet drugs(4) remains the classical situation where DDH has been observed (1,5).…”

Section: Discussionmentioning

confidence: 99%

“…Medical imaging (magnetic resonance imaging [MRI], computed tomography scan or ultrasonography) is sometimes required to confirm the diagnosis(1,2), especially when medical history fails to explain the onset of the lesion. Long periods of time between the initial trauma and the appearance of a hematoma, which is a main feature in chronic expanding hematoma(3), has seldom been reported for DDH (4)(5)(6). We report a case of a right-leg pretibial DDH occurring one month after a minor trauma.…”

Section: Introductionmentioning

confidence: 95%

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Rapidly Evolving Deep Dissecting Hematoma With Sudden Onset, Developed One Month After A Minimal Trauma.

Hamdan¹,

Zwetyenga²,

Macheboeuf³

et al. 2021

Preprint

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Background: Deep dissecting hematoma is a rapidly extending blood collection that splits the hypodermis from muscle fascia, constituting a medical surgical emergency. The natural history of this condition includes trauma (even minor physical injury) shortly before onset of the lesion, occurring in a patient with advanced dermatoporosis. Case presentation: We report the admission of a 70-year-old woman to the emergency department of our hospital for the onset of a deep dissecting hematoma one month after a negligible trauma in the right leg, complicating secondary iatrogenic dermatoporosis. Bedside ultrasound examination was used to eliminate differential or additional diagnoses and to assess the main features of the hematoma (dimensions, existence of blood supply). Surgical debridement and hematoma drainage were performed due to rapid horizontal extension of the hematoma and unresolved pain, with the operative report confirming the diagnosis. Conclusion: This observation emphasises that in patients with severe dermatoporosis, several weeks can elapse between a minor impact and the sudden development of a limb-threatening deep dissecting hematoma.

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Post-traumatic cutaneous hematomas in geriatrics hospital: A neglected disease?

Cited by 2 publications

References 19 publications

Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Rapidly Evolving Deep Dissecting Hematoma With Sudden Onset, Developed One Month After A Minimal Trauma.

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