BACKGROUND: Gustilo classification system defines IIIC fractures as open fractures associated with an arterial injury that requires repair. The aim of our study was to analyze the early outcome in terms of limb and flap salvage, early amputation, and early complication rate in patients with Gustilo IIIC open fractures treated in an emergency setup. METHODS: We retrospectively reviewed 20 patients with Gustilo IIIC injuries treated by the “fix and flap” principle during the first surgical procedure in the first 24 hours after injury (emergency free flap transfer). All patients underwent surgery with radical debridement, wound irrigation, skeletal stabilization, vascular repair, and immediate free flap coverage. RESULTS: In this study, 18 patients were men (90%) and 2 were women (10%). In all patients, a vascular repair was performed and in 17 cases (85%), the lower limb/foot was avascular and limb salvage was performed. Three patients had one vessels injured (15%) and 17 had two or three vessels injured (85%). In 9 out of 20 (45%), a revision surgery was needed for arterial (10%, 2 patients), arterial–venous (15%, 3 patients), and venous thrombosis (20%, 4 patients), while 4 patients required an early amputation (20%) and 1, a late one (5%). In three patients (15%), a flap loss occurred. Superficial infection occurred in seven cases (35%) and deep infection (osteomyelitis) in one (5%). CONCLUSION: A single-stage procedure performed in an emergency operating room could lead to an effective outcome with a high rate of limb salvage and satisfying long-term results.
Limb and Flap Salvage in Gustilo IIIC Injuries Treated by Vascular Repair and Emergency Free Flap Transfer
Arnež, Zoran Marij
;Papa, Giovanni;Ramella, Vittorio;Novati, Federico Cesare;Stocco, Chiara
2017-01-01
Abstract
BACKGROUND: Gustilo classification system defines IIIC fractures as open fractures associated with an arterial injury that requires repair. The aim of our study was to analyze the early outcome in terms of limb and flap salvage, early amputation, and early complication rate in patients with Gustilo IIIC open fractures treated in an emergency setup. METHODS: We retrospectively reviewed 20 patients with Gustilo IIIC injuries treated by the “fix and flap” principle during the first surgical procedure in the first 24 hours after injury (emergency free flap transfer). All patients underwent surgery with radical debridement, wound irrigation, skeletal stabilization, vascular repair, and immediate free flap coverage. RESULTS: In this study, 18 patients were men (90%) and 2 were women (10%). In all patients, a vascular repair was performed and in 17 cases (85%), the lower limb/foot was avascular and limb salvage was performed. Three patients had one vessels injured (15%) and 17 had two or three vessels injured (85%). In 9 out of 20 (45%), a revision surgery was needed for arterial (10%, 2 patients), arterial–venous (15%, 3 patients), and venous thrombosis (20%, 4 patients), while 4 patients required an early amputation (20%) and 1, a late one (5%). In three patients (15%), a flap loss occurred. Superficial infection occurred in seven cases (35%) and deep infection (osteomyelitis) in one (5%). CONCLUSION: A single-stage procedure performed in an emergency operating room could lead to an effective outcome with a high rate of limb salvage and satisfying long-term results.File | Dimensione | Formato | |
---|---|---|---|
4 2017 JRM Limb and flap salvage in Gustilo IIIC Stocco.pdf
Accesso chiuso
Tipologia:
Documento in Versione Editoriale
Licenza:
Copyright Editore
Dimensione
253.37 kB
Formato
Adobe PDF
|
253.37 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
2921746_4 2017 JRM Limb and flap salvage in Gustilo IIIC Stocco-Post_print.pdf
accesso aperto
Descrizione: Post Print VQR3
Tipologia:
Bozza finale post-referaggio (post-print)
Licenza:
Digital Rights Management non definito
Dimensione
758.46 kB
Formato
Adobe PDF
|
758.46 kB | Adobe PDF | Visualizza/Apri |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.