Vijay Langer
Army Hospital (Research and Referral)| India
Title: Coverage of complex limb wounds: the plastic surgeon to the rescue
Biography
Biography: Vijay Langer
Abstract
Limb trauma is a global health concern and indeed is fairly commonly tackled by the military surgeon. While some patients have associated life threatening injuries, a lot of them have isolated but usually complex soft tissue defects. Decision making for managing these patients often requires the aggressive plastic surgeon to step in. From appropriate debridement to arduous but gratifying reconstruction can be planned right at reception of the patient. We in the Indian Armed Forces have taken the initiative to mitigate the suffering of the combatant by this technique and present our 3-year experience of management of such injuries at a large tertiary referral trauma center. 942 consecutive patients with major limb trauma were included in the study. At reception, life saving measures were instituted first followed by limb saving action. Wounds were prepared by debridement during which devitalized tissue was excised. Immobilisation of possible fractures was then done. If there was no exposure of bone, the wounds were resurfaced with autogenous split thickness skin grafts. If bone was exposed, flaps were raised and inset into the defects. If at debridement, it was thought that a second-look was required, then the definitive coverage of the wound was effected then. Lives and limbs were both saved with such timely intervention.
It is indeed a tough challenge to treat patients with major limb trauma. If the patient presents early, the services of the aggressive plastic surgeon are paramount in markedly reducing mortality and significant morbidity in the wounded soldier and the members of his family