Fasciotomy is the definitive treatment for Acute compartment syndrome (ACS). When performed in time, it can prevent irreversible ischemic damage to muscles and nerves. The same principles apply to all affected limbs: identify the at-risk limb, act without delay, and completely release all involved compartments to prevent permanent neuromuscular injury. Introduction ACS is a limb-threatening […]
Split Thickness Skin Grafting (SSG) Split-thickness skin grafting (SSG) can be used1 to cover clean wounds with adequate granulation tissue and a well vascularized wound bed. The skin graft can be used to cover up granulation tissue, fat, muscle or fascia. It cannot be placed over bare bone (stripped of periosteum), bare cartilage or bare […]
Small wounds or wounds that cannot be closed primarily may be left open to heal by themselves, healing by secondary intention1. The spontaneous wound healing process can be supported with conservative wound management. This strategy is often chosen for small wounds with a healthy wound bed, not for wounds with a fracture exposed. It is […]
After the patient has received (local) anesthesia and the wound bed has been debrided and prepared for closure, approximate the wound edges and close with sutures1. Minimize tension to avoid wound dehiscence, scarring and necrosis by not only suturing on an epidermal level, but also on a dermal level. For dermal closure, absorbable sutures can […]
In reconstructive surgery of the extremity, the primary goal1 is to restore or maintain function. Skeletal structure, vascularization, innervation and skin integrity are key factors in attaining this goal. Reconstructive ladder for tissue defects There are various options available for wound closure. We recommend you choose the simplest approach that is expected to be effective2. […]
After cleaning the wound in the emergency room (ER), debridement in the operating theater (OT) is crucial. Debridement is the removal of dead, damaged or infected tissue. It’s one of the most underestimated aspects of surgical care and to perform it well requires a lot of experience. Preferably debridement is performed multidisciplinary with the orthopedic […]
Knowledge and skills to be able to perform basic wound care is important for all soft tissue injuries, not only soft tissue injuries with a broken bone. Choosing your type of wound care Adequate use of wound dressings and topical agents is important for keeping the wound bed moist and clean, which allows wound healing. […]
Wound healing depends on many factors, including its cause, extent, the occurrence of contamination or an infection and on wound treatment. Before thinking about techniques that can help wounds to heal its important to understand the different phases because despite differences in etiology and pathophysiology, all wounds heal in a dynamic process that has four […]
After the primary survey of advanced trauma life support (ATLS), do a secondary assessment of the limb. Pay special attention to neurovascular concerns, motor function of the limb and the soft tissues. To conduct a comprehensive physical examination of the lower limb, you need good knowledge of its anatomy. Physical examination includes three steps 1 […]
Although often discussed separately from fracture management, soft tissue management is an integral part of open fracture care and starts from the moment of injury. Early bleeding control, wound protection, irrigation, temporary dressing, and splinting are all part of this process. The timing of definitive soft tissue coverage is crucial, as delayed management is associated […]
