Split hand foot malformation: Presentation of a rare case and description of a novel technique in management of split hand Study design: Case report

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 26-28 | Sudhir Kumar Mahapatra


Authors: Sudhir Kumar Mahapatra [1]

[1] Department of Orthopaedics, IMS & SUM Hospital, Bhubaneswar, Odisha India.

Address of Correspondence

Dr. Anurag Singh,
IMS & SUM Hospital, Bhubaneswar, Odisha India.
E-mail: goanurag007@gmail.com


Abstract

Introduction: High-energy musculoskeletal trauma with extensive soft tissue loss is difficult to treat and underlying fracture makes it more cumbersome. This prolongs hospitalization and regular conventional dressings increase socio-economic burden. Vacuum assisted closure (VAC) was developed to prepare wound for early definitive management. It acts by decreasing edema, exudates, bacterial counts and promotes granulation tissue formation, neovascularization, approximates wound edges.
Aim: To evaluate outcomes, efficacy and limitations of low-cost VAC for management of extensive soft tissue loss and infected wounds.
Materials and Methods: This study was conducted in Dept. Of Orthopedics of a tertiary care hospital from December 2018 to July 2019 on 53 patients, either with extensive soft tissue injury following acute trauma or those with infected-necrotic wound. Forty two patients had acute trauma history while remaining 11 had infected non healing wound. Cultures were sent pre and post VAC application and antibiotic coverage was administered. Low cost VAC was applied after debridement and changed after every 3 – 4 days.
Results: Forty eight cases treated with low-cost VAC were ready for skin graft/flap/secondary suture after 1 to 3 cycles (4 to 12 days) of therapy. Another two cases developed spontaneous re-epithelization. The wound infection was controlled in 70% of the cases. Three patients did not achieve desired result due to limitations of the procedure.
Conclusion: Low-cost VAC has proved to be effective while being substantially cheaper (1/16th of conventional VAC). Its role is limited when the depth of wound is far greater than its length.
Keywords: Low cost VAC, Vacuum assisted closure, wound management, Negative pressure wound therapy, Soft tissue loss, Compound fracture.


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How to Cite this Article: Singh A, Panda D, Mishra J, Dash A. | Low-cost vacuum assisted closure therapy for extensive musculoskeletal trauma and infection: Outcomes, efficacy and limitations . | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 21-25.

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