The Experts below are selected from a list of 10674 Experts worldwide ranked by ideXlab platform
Amitabha Mitra - One of the best experts on this subject based on the ideXlab platform.
-
The Use of an Innovative Device for Wound Closure after Upper Extremity Fasciotomy
HAND, 2008Co-Authors: Carlos Medina, Julia Spears, Amitabha MitraAbstract:Introduction The purpose of this paper is to evaluate the Silver Bullet Wound Closure Device (SBWCD, Boehringer Laboratories, Norristown, PA), a new device for delayed primary closure of Fasciotomy wounds. Materials and Methods A retrospective review was performed over a period of 36 months of all patients with an upper extremity Fasciotomy that could not be closed primarily. Cases that underwent Fasciotomy closure with the SBWCD were separated from the patients that had a split thickness skin graft (STSG). Results Seven patients had their wound closed with the SBWCD within 10 days (mean of 7.4 days). The seven patients that underwent STSG had their wound closed in an average of 8.4 days. The average number of days between the day of the Fasciotomy incision and the date of the placement of the SBWCD was 1.9 days. STSGs were placed on the Fasciotomy wounds on an average of 10.3 days after the date of the Fasciotomy incision. We found that the SBWCD allowed for starting to approximate the edges of the Fasciotomy wound at an earlier time when compare to STSG (2.1 vs 10.3 days). Conclusions We feel that the SBWCD as a one-stage procedure provides a consistent and efficacious way to manage upper extremity Fasciotomy wounds while minimizing the morbidity associated with STSG. Elimination of a second-stage procedure reduces hospital costs. Our findings may help to inform surgeons about an available alternative when an upper extremity Fasciotomy wound is not amenable to primary closure.
Carlos Medina - One of the best experts on this subject based on the ideXlab platform.
-
The Use of an Innovative Device for Wound Closure after Upper Extremity Fasciotomy
HAND, 2008Co-Authors: Carlos Medina, Julia Spears, Amitabha MitraAbstract:Introduction The purpose of this paper is to evaluate the Silver Bullet Wound Closure Device (SBWCD, Boehringer Laboratories, Norristown, PA), a new device for delayed primary closure of Fasciotomy wounds. Materials and Methods A retrospective review was performed over a period of 36 months of all patients with an upper extremity Fasciotomy that could not be closed primarily. Cases that underwent Fasciotomy closure with the SBWCD were separated from the patients that had a split thickness skin graft (STSG). Results Seven patients had their wound closed with the SBWCD within 10 days (mean of 7.4 days). The seven patients that underwent STSG had their wound closed in an average of 8.4 days. The average number of days between the day of the Fasciotomy incision and the date of the placement of the SBWCD was 1.9 days. STSGs were placed on the Fasciotomy wounds on an average of 10.3 days after the date of the Fasciotomy incision. We found that the SBWCD allowed for starting to approximate the edges of the Fasciotomy wound at an earlier time when compare to STSG (2.1 vs 10.3 days). Conclusions We feel that the SBWCD as a one-stage procedure provides a consistent and efficacious way to manage upper extremity Fasciotomy wounds while minimizing the morbidity associated with STSG. Elimination of a second-stage procedure reduces hospital costs. Our findings may help to inform surgeons about an available alternative when an upper extremity Fasciotomy wound is not amenable to primary closure.
William M Stahl - One of the best experts on this subject based on the ideXlab platform.
-
a critical reappraisal of indications for Fasciotomy after extremity vascular trauma
Archives of Surgery, 1998Co-Authors: Ziad Abouezzi, Zahi Nassoura, Rao R Ivatury, John M Porter, William M StahlAbstract:Objective: To critically reevaluate the indications for Fasciotomy in vascular trauma of the extremities. Design: Case-control study. Setting: Level I trauma center. Materials and Methods: One hundred sixty-three vascular injuries to the extremeties were analyzed. Fasciotomy as an adjunct to vascular repair was performed in 45 limbs (28%), based either on the nature of injury or measured compartment pressure of greater than 35 mm Hg. Main Outcome Measures: Need for Fasciotomy or limb amputation. Results: Fasciotomy was performed for 29.5% of isolated arterial injuries, 15.2% of isolated venous injuries, and 31.6% of combined arterial and venous injuries, and was not related to venous repair or ligation. Seven delayed fasciotomies were performed either for vascular repair failure (5 patients) or compartment syndrome (2 patients). The highest incidence was for popliteal vessel injury (arterial 57%, combined 61%). Of the 33 lower-extremity fasciotomies, 58% were for popliteal vessel injury. In 51 combined injuries of the lower extremity, only 7 (19%) of 38 patients with injury above the knee required Fasciotomy, as compared with 8 (62%) of 13 with injury to the popliteal vessels (P<.001), with or without venous repair. There were 3 amputations, all resulting from vascular repair failure. Conclusions: The presence of a combined vascular injury or the need for venous ligation does not necessitate routine Fasciotomy. The need for Fasciotomy may be maximal for injuries to popliteal vessels.
-
A Critical Reappraisal of Indications for Fasciotomy After Extremity Vascular Trauma
Archives of surgery (Chicago Ill. : 1960), 1998Co-Authors: Ziad Abouezzi, Zahi Nassoura, Rao R Ivatury, John M Porter, William M StahlAbstract:Objective: To critically reevaluate the indications for Fasciotomy in vascular trauma of the extremities. Design: Case-control study. Setting: Level I trauma center. Materials and Methods: One hundred sixty-three vascular injuries to the extremeties were analyzed. Fasciotomy as an adjunct to vascular repair was performed in 45 limbs (28%), based either on the nature of injury or measured compartment pressure of greater than 35 mm Hg. Main Outcome Measures: Need for Fasciotomy or limb amputation. Results: Fasciotomy was performed for 29.5% of isolated arterial injuries, 15.2% of isolated venous injuries, and 31.6% of combined arterial and venous injuries, and was not related to venous repair or ligation. Seven delayed fasciotomies were performed either for vascular repair failure (5 patients) or compartment syndrome (2 patients). The highest incidence was for popliteal vessel injury (arterial 57%, combined 61%). Of the 33 lower-extremity fasciotomies, 58% were for popliteal vessel injury. In 51 combined injuries of the lower extremity, only 7 (19%) of 38 patients with injury above the knee required Fasciotomy, as compared with 8 (62%) of 13 with injury to the popliteal vessels (P
Julia Spears - One of the best experts on this subject based on the ideXlab platform.
-
The Use of an Innovative Device for Wound Closure after Upper Extremity Fasciotomy
HAND, 2008Co-Authors: Carlos Medina, Julia Spears, Amitabha MitraAbstract:Introduction The purpose of this paper is to evaluate the Silver Bullet Wound Closure Device (SBWCD, Boehringer Laboratories, Norristown, PA), a new device for delayed primary closure of Fasciotomy wounds. Materials and Methods A retrospective review was performed over a period of 36 months of all patients with an upper extremity Fasciotomy that could not be closed primarily. Cases that underwent Fasciotomy closure with the SBWCD were separated from the patients that had a split thickness skin graft (STSG). Results Seven patients had their wound closed with the SBWCD within 10 days (mean of 7.4 days). The seven patients that underwent STSG had their wound closed in an average of 8.4 days. The average number of days between the day of the Fasciotomy incision and the date of the placement of the SBWCD was 1.9 days. STSGs were placed on the Fasciotomy wounds on an average of 10.3 days after the date of the Fasciotomy incision. We found that the SBWCD allowed for starting to approximate the edges of the Fasciotomy wound at an earlier time when compare to STSG (2.1 vs 10.3 days). Conclusions We feel that the SBWCD as a one-stage procedure provides a consistent and efficacious way to manage upper extremity Fasciotomy wounds while minimizing the morbidity associated with STSG. Elimination of a second-stage procedure reduces hospital costs. Our findings may help to inform surgeons about an available alternative when an upper extremity Fasciotomy wound is not amenable to primary closure.
Kimberley Lentz - One of the best experts on this subject based on the ideXlab platform.
-
A simple device for closure of Fasciotomy wounds
American journal of surgery, 1996Co-Authors: Mark G. Mckenney, Itzhak Nir, Timothy Fee, Larry Martin, Kimberley LentzAbstract:Early decompressive Fasciotomy is essential in the prevention of the sequelae of compartment syndrome. Many techniques have been described for the closure of the Fasciotomy wound, and controversy exists as to which method is the best. Primary closure is often impossible secondary to tissue retraction and edema. Split-thickness skin grafting leaves a thin, insensate, and often aesthetically unpleasing result. Gradual mechanical dermal apposition has been used with increasing frequency, and has been shown to be effective in the closure of fasciotomies, but often takes 7–10 days for closure. We present our experience with the STAR, a mechanical method of Fasciotomy wound closure that is effective in 2–4 days, and is extremely simple to use.