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The use of vacuum assisted closure (VAC™) in soft tissue injuries after high energy pelvic trauma


Labler, Ludwig; Trentz, Otmar (2007). The use of vacuum assisted closure (VAC™) in soft tissue injuries after high energy pelvic trauma. Langenbeck's Archives of Surgery, 392(5):601-609.

Abstract

Background: Application of vacuum-assisted closure (VAC™) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. Materials and methods: Between 2002 and 2004, 13 patients were treated for severe soft tissue injuries in the pelvic region. All musculoskeletal injuries were treated with multiple irrigation and debridement procedures and broad-spectrum antibiotics. VAC™ was applied as a temporary coverage for defects and wound conditioning. Results: The injuries included three patients with traumatic hemipelvectomies. Seven patients had pelvic ring fractures with five Morel-Lavallee lesions and two open pelviperineal trauma. One patient suffered from an open iliac crest fracture and a Morel-Lavallee lesion. Two patients sustained near complete pertrochanteric amputations of the lower limb. The average injury severity score was 34.1 ± 1.4. The application of VAC™ started in average 3.8 ± 0.4days after trauma and was used for 15.5 ± 1.8days. The dressing changes were performed in average every 3days. One patient (8%) with a traumatic hemipelvectomy died in the course of treatment due to septic complications. Conclusion: High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC™ as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closure

Abstract

Background: Application of vacuum-assisted closure (VAC™) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. Materials and methods: Between 2002 and 2004, 13 patients were treated for severe soft tissue injuries in the pelvic region. All musculoskeletal injuries were treated with multiple irrigation and debridement procedures and broad-spectrum antibiotics. VAC™ was applied as a temporary coverage for defects and wound conditioning. Results: The injuries included three patients with traumatic hemipelvectomies. Seven patients had pelvic ring fractures with five Morel-Lavallee lesions and two open pelviperineal trauma. One patient suffered from an open iliac crest fracture and a Morel-Lavallee lesion. Two patients sustained near complete pertrochanteric amputations of the lower limb. The average injury severity score was 34.1 ± 1.4. The application of VAC™ started in average 3.8 ± 0.4days after trauma and was used for 15.5 ± 1.8days. The dressing changes were performed in average every 3days. One patient (8%) with a traumatic hemipelvectomy died in the course of treatment due to septic complications. Conclusion: High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC™ as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closure

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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:8 August 2007
Deposited On:20 Dec 2018 16:44
Last Modified:04 Jan 2019 12:59
Publisher:Springer
ISSN:1435-2443
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00423-006-0090-0
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencespringer101007s0042300600900 (Library Catalogue)
PubMed ID:16983575

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