Introduction: Soft tissue injuries of the lower extremity are the result of high-energy trauma, such as road accidents, and remain challenging for most orthopedic surgeons. Proper selection of the treatment is important considering the risk of delayed necrosis and wound sepsis. Negative pressure wound therapy (NPWT) has improved complex wound treatment since 1997, but all treatments present advantages and limits.
Case Report: A 21-year-old male presented with a high-energy soft tissue injury of the lower extremity. Three days after surgical debridement, complete skin necrosis developed. Successive surgical debridement was done in combination with traditional NPWT for 2 weeks; yet the wound did not progress toward healing, and the bone remained exposed. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) was used with a novel reticulated open cell foam dressing (ROCF-CC) because further surgical debridement was not possible, and the use of NPWT was not recommended by the French high authority for health. Growth of granulation tissue was fast (9 days), even over the bone, without any surgical debridement and despite the presence of nonviable and fibrinous tissue. After that, traditional NPWT was discontinued and a split-thickness skin graft then was used to cover the defects. Four weeks following the accident, all wounds were completely healed.
Conclusions: Surgical debridement remains irreplaceable; however, when debridement is not feasible, NPWTi-d with ROCF-CC might be the treatment of choice. This strategy allowed the authors to ensure coverage of an extensive loss of soft tissue when the traditional NPWT limit was reached.
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Indian J Med Res
November 2024
Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).
View Article and Find Full Text PDFCureus
November 2024
Nephrology, Colchester Hospital, Colchester, GBR.
Calciphylaxis is a rare and serious disorder almost exclusively seen in patients on dialysis or those with advanced chronic kidney disease (CKD) not on dialysis and is associated with very high mortality. We present the case of a 50-year-old male with a background of end-stage renal disease (ESRD) compliant with dialysis, parathyroid adenoma, secondary hyperparathyroidism, and high body mass index (BMI). Whilst receiving 31 doses of intravenous sodium thiosulphate (STS) over an 11-week period, the patient underwent surgical debridement of multiple painful ulcerative lesions in his lower abdomen and left thigh and then subsequently a subtotal parathyroidectomy at 70 days from admission.
View Article and Find Full Text PDFCureus
November 2024
Pathology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, USA.
()is a gram-variable obligate anaerobe. In this case report, we describe the first documented case of bacteremia in a patient with sepsis resulting from lower extremity cellulitis without concomitant osteomyelitis. During the inpatient course, the patient was treated with IV vancomycin, cefepime, and ertapenem, in addition to surgical debridement and incision and drainage of his foot wound.
View Article and Find Full Text PDFJ Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, No. 519, Kunzhou Rd, Kunming, Yunnan, 650106, China.
Background: Chronic empyema after total pneumonectomy is a potentially fatal complication.The aim of the study is to explore the treatment strategy and clinical efficacy of chronic empyema after pneumonectomy.
Methods: A retrospective analysis of 6 patients with chronic empyema after pneumonectomy in our hospital.
BMC Musculoskelet Disord
December 2024
Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China.
Background: The purpose of this study was to report the clinical and psychological outcomes of using a locking compression plate (LCP) as a sequential external fixator following the distraction phase in the treatment of tibial bone defects caused by fracture-related infection (FRI).
Methods: We retrospectively analyzed the clinical records and consecutive X-ray images of patients with tibial bone defects who were treated with an LCP as a sequential external fixator following the distraction phase, between June 2017 and December 2022. The ASAMI criteria were applied to assess the bone and functional outcomes, and postoperative complications were evaluated by using the Paley classification.
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