Method of closing fasciotomies by progressive tissue traction / Método de fechamento de fasciotomias por tração tecidual progressiva

High-energy trauma has increased significantly in the last decade, mostly in the lower limbs, in many cases requiring fasciotomy due to the subsequent compartment syndrome. In this context, its closure often leads to a delay in the patient's comprehensive treatment and the return to their activities and may lead to local infection, in addition to generating high costs. There are many options for the plastic surgeon to try to bring the edges together and reconstruct the extremities, such as flaps, grafts, vacuum dressings, and elastic sutures, in addition to expansion devices, sometimes with a combination of the above.

O trauma de grande energia vem aumentando de maneira expressiva na última década, em boa parte de membros inferiores, necessitando, em muitos casos, de fasciotomia devido à síndrome compartimental subsequente. Neste contexto muitas vezes seu fechamento acaba por levar a um retardo no tratamento integral do paciente, do retorno a suas atividades e podendo levar a infecção local, além de gerar altos custos. Há muitas opções ao cirurgião plástico para a tentativa de aproximação de bordos e reconstrução das extremidades, como retalhos, enxertos, curativo a vácuo e sutura elástica, além de dispositivos de expansão, sendo, às vezes, com combinação das anteriores. O método de fechamento apresentado através do alongamento progressivo da pele com fio de Kirschnner representa uma forma de baixo custo e facilmente reproduzível para lidar com este tipo de ferida.

Experimental study about migration of wires inserted in rabbits´ shoulder / Estudo experimental sobre migração de cabos inseridos no ombro de coelhos

Metallic wires are used to stabilize clavicle, sternoclavicular joint and acromioclavicular joint in cases of fracture or dislocation. In spite of being unusual, these wires can migrate from its original place to inner side of the chest, going to mediastinum, including the heart and great vessels, and in the lungs, promoting potential death risks. The exact mechanism of this migration is unknown, but the literature suggest that intra-thoracic negative pressure and the gravity force have a significant impact. Objective: Study the migration dynamics of metallic wires inserted near the rabbits? shoulder articulation. Methods: Kirschner wire segments were inserted nearly rabbits? left shoulder articulation and after 60 days these material migration dynamics was evaluated through radiography. Results: The wire segments moved upward in 85% of the rabbits, to cephalic direction and to caudal direction. There was no movement toward the ventral or to inner part of the chest.