Pretibial flab wounds: early grafting under regional anaesthesia as an outpatient procedure

Ramnani, Shewak R.; Weston, Peter

doi:10.1016/0020-1383(81)90003-6

Cited by 13 publications

(8 citation statements)

References 4 publications

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“…Traditionally these wounds were treated under general anaesthetic followed by bed rest; however, the prolonged period of hospitalization that frequently ensued (Tandon and Sutherland, 1973) led several investigators to evaluate an alternative approach. Ramnani and Weston (1981) performed primary excision and split skin grafting under local anaesthetic. Of 40 patients, 38 achieved a good graft take and all required no more than a minimal dressing by 16 days.…”

Section: Methods Of Treatmentmentioning

confidence: 99%

Pretibial wounds: a review of current practice

Batchelor

Alagappan

2003

Trauma

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Pretibial wounds are often associated with prolonged wound healing, particularly in the elderly female population. The wounds characteristically have either a proximally or distally based flap. Delayed wound healing has been attributed to flap necrosis and poor blood supply to this area. The aim of this review article is to examine the vascular anatomy, pathology and management options of patients with pretibial wounds.

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Section: Methods Of Treatmentmentioning

confidence: 99%

Pretibial wounds: a review of current practice

Batchelor

Alagappan

2003

Trauma

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“…The physical risks of venous thrombosis (Ramnani & Weston, 1980) were decreased by the immediate mobilization and no patient suffered this complication. In addition, the possibility of mental disorientation in elderly patients following general anaesthesia and admission to hospital was avoided, and care was successfully shared with the general practitioner and the district nurse in the community.…”

Section: Discussionmentioning

confidence: 99%

Lower limb skin loss: simple outpatient management with meshed skin grafts with immediate mobilization.

Shankar

Khoo

1987

Emergency Medicine Journal

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SUMMARYTraumatic skin loss is a common problem in elderly patients presenting to an accident and emergency department.The authors report their experience with 25 patients in whom pretibial wounds were debrided, and covered with skin grafts taken under local anaesthetic and meshed by hand. All were immediately mobilized and discharged home. Healing was satisfactory in every case and there were no complications.All the patients found the treatment acceptable, and were delighted to avoid admission to hospital. This is a simple and effective outpatient procedure which can readily be carried out in the accident and emergency department.

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“…1,9 However, whether to treat PLs conservatively or operatively remains a matter of debate. 1,[15][16][17] PHs are associated frequently with anticoagulants and can be regarded as cutaneous complications of such medication. 3,4,7,10,18 The clinical presentation appears primarily as a closed swelling and ischemic pain of the affected area of the leg.…”

Section: Introductionmentioning

confidence: 99%

“…Split‐thickness skin grafts are common when skin defects are significant and primary closure is impossible 1,9 . However, whether to treat PLs conservatively or operatively remains a matter of debate 1,15‐17 …”

Section: Introductionmentioning

confidence: 99%

Bumping to a rollator walker: How pretibial hematomas create more costs than pretibial lacerations

Seppälä

Grünthal

Koljonen

2023

International Wound Journal

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Pretibial lacerations (PL) and pretibial hematomas (PH) are debilitating traumas among the elderly and infirm. The injuries are frequently grouped together despite differences in treatment and symptoms. Patients are known to have multiple contacts in health care, perhaps because of inadequate treatment. Despite the burden, financial costs have not been assessed. Calculate and compare the treatment costs of PLs and PHs for differences and provide economic incentives to treat and diagnose patients optimally. From linkage to ICD10 diagnoses, we analysed NordDRG product invoices generated by the treatment of the patients. We calculated and compared the costs of treatment in both cohorts from the invoices. This method has not been previously used for analysing wound care costs. Mean treatment costs were 1800€ (PL) and 3300€ (PH). The total costs, emergency room, surgical treatment, and inpatient care of PHs were higher than PLs (P = .0486, P = .0002, P = .0058, P = .6526). PLs generate more costs from the outpatient clinic but were not statistically significant (P = .6533). PHs cause a higher economic burden than PLs. Costs arise from repeat ER visits and the need for surgeries because of delayed treatment. PLs have multiple contacts in the wound clinic. Improvement in the diagnosis and treatment of both injuries is needed.

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Pretibial flab wounds: early grafting under regional anaesthesia as an outpatient procedure

Cited by 13 publications

References 4 publications

Pretibial wounds: a review of current practice

Pretibial wounds: a review of current practice

Lower limb skin loss: simple outpatient management with meshed skin grafts with immediate mobilization.

Bumping to a rollator walker: How pretibial hematomas create more costs than pretibial lacerations

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