PDF Archive

Easily share your PDF documents with your contacts, on the Web and Social Networks.

Share a file Manage my documents Convert Recover PDF Search Help Contact

To Cut or not to cut.ppt .pdf

Original filename: To Cut or not to cut.ppt.pdf
Title: To Cut or not to cut:: The surgical decision-making for limb salvaging
Author: Gavish

This PDF 1.5 document has been generated by Microsoft® PowerPoint® 2010, and has been sent on pdf-archive.com on 14/01/2015 at 03:04, from IP address 218.24.x.x. The current document download page has been viewed 659 times.
File size: 1.6 MB (13 pages).
Privacy: public file

Download original PDF file

Document preview

To Cut or not to cut:
The surgical decisionmaking for limb salvaging
WeiFeng Zeng, ZhiHong Tong
Hand and Foot Microsurgery ,The Second Hospital of Dalian
Medical University, China
Email: zengweifeng316@126.com

Case Report
Initial Presentation – Day 1
Plan of Action
Stage I
Stage II – Day 30
Stage III – Day 40
Stage IV – Day 50

Initial Presentation
 March 2014 – Motorvehicular Accident
 Healthy 23 year old male
 2 legs crushed by the truck
 Brought to the ER within 1 hour
 Vitals Unstable
 Hypovolemic Shock
 Tachypnea
 Consequent Blood Loss

 Multiple ribs fracture
 Pulmonary contusion

 AND ALSO……..

Injuries –
Right Leg
 Avulsion from the thigh to the ankle
 Skin degloving of the right ankle and hind foot
 Anterior and posterior tibial neurovascular bundle trauma
 Right ankle dislocation
 Lacerated dorsalis pedis
 Fracture of the tibia
 Fracture of the fibula

Injuries –
Left Leg
 Crushed flat
 Extensive soft tissue damage
 Multiple joint dislocation
 Exposed plantar tendons
 Degloving injury to the lateral, medial and dorsal
 Metatarsal dislocation
 Avascular big toe

Plan of Action
 4-Staged Intervention
 Stage I
 Emergency Intervention

 Stage II
 Debridement

 Stage III
 Free Flap

 Stage IV
 Mesh Skin Grafting
 Micro Skin Grafting

Stage I: Emergency Intervention
 Patient refuse amputation
 Hemostasis
 Correction of Shock
 Packed Cell Volumes, Colloids

K-Wire Fixation
Left 2nd toe amputated
Packed Gauze Dressing
Sent to ICU Post-Op

Stage II: Debridement
 4 sessions of Debridement within 1 month
 Prepare for Free Flap
 Assess Healing Process
 No Rehabilitation Started

Stage III: Anterolateral Thigh Flap (ALTF)
 Left foot and ankle defect of 26cm x 19cm
 26cm x 18cm anterolateral thigh flap
 Abdominal skin grafting
 Malleolus left untouched for now

Related documents

to cut or not to cut ppt
past medical history
ijar an analysis of foot trophic ulcers
b15m1 fractures in children dr troncillo group 4
shah et al 2013

Related keywords