Monday, October 17, 2005

Tales from the Trauma Service XIII.......
A post a few weeks in the making. 20-ish man in a motor vehicle collision. Open right elbow fracture and a severe degloving imjury to his calf.
After some debridement here is what I was left with:

A bit more distal from the drain you see on the right was the extent of the degloving. I washed out the flap with about 3 liters of antibiotic containing saline. The drains were placed and the free edge sutured to the fasica with interrupted Vicryl sutures.

Over the open defect I placed a VAC dressing. The whole leg was then wrapped with an ACE bandage and he was placed in a knee immobilizer. After about 10 days of QOD trips to the OR for dressing changes under anesthesia it was finally time to graft. Here is what it looked like on that day:

I debrided the inferior skin edge slightly and took the grafts from his poterior thigh. I also removed the JP drains. Applied another VAC over some Adaptic and let it sit for four days. Here is what it looked like:

Close to a 100% take. He is out of the knee immmobilizer now and ambulating.


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