ABSTRACT
OBJECTIVE: Wound approximation device is an interesting reconstructive option but not well popularised. In this study we present a simple device that can be used for immediate or delayed closure of large dermal wounds in different anatomical areas. METHOD: Patients with acute and chronic wounds were recruited and underwent immediate intra-operative wound approximation and/or delayed wound approximation, with a home-made wound approximation device. RESULTS: Approximation time in the immediate closure group ranged from 20-140 minutes. Satisfactory scars were obtained in 19 patients (76%) and adherent scars developed in 6 patients. Delayed wound approximation was used successfully in closure of 9 defects. CONCLUSION: This simple dermal wound approximation device can be used intraoperatively to successfully close large difficult wounds, located on the trunk and thigh, with minimal complications. The device can also be used to approximate delayed wounds located in regions where closure is particularly problematic, like the lower leg, foot, and scalp. Some modifications of the device are needed to improve its safety and efficacy. Wound tension is detrimental to adequate wound healing and tensile strength, another basic principle that should not be overlooked to avoid wound dehiscence. Wound approximation is adding to reconstructive options, not replacing them, and they must always be considered.
Subject(s)
Dermatologic Surgical Procedures/instrumentation , Soft Tissue Injuries/surgery , Wound Closure Techniques/instrumentation , Adolescent , Adult , Child , Child, Preschool , Egypt , Female , Humans , Male , Tensile Strength , Wound Healing , Young AdultABSTRACT
Bacterial translocation after major burns plays an important role in burn sepsis and can be reduced with SDD. 30 patients with burns of 25-50% TBSA were divided into 2 groups. Group I received SDD regimen in the form of amikacin, miconazole, and colistin sulphate. Group II served as a control group. SDD treatment resulted in significant control of infectious episodes and multi-organ dysfunction syndrome (MODS). It also resulted in a reduction of mortality, although this was not statistically significant. Despite the statistical insignificance of the improved mortality rate, SDD treatment seems to be a useful tool in treating this group of highly critical patients.
La translocation bactérienne après des brûlures ha un rôle important dans le sepsis des brûlures et peut être réduite avec la décontamination sélective du tractus digestif (DSTD). 30 patients souffrant de brûlures de 25% à 50% de la surface corporelle totale (SCT) ont été divisés en 2 groupes. Groupe I a reçu DSDT sous la forme de l'amikacine, le miconazole et le sulfate de colistine. Groupe II a servi de groupe témoin. Le traitement DSTD a donné lieu à un contrôle important des épisodes infectieux et le syndrome de dysfonction d'organes multiples. Il a également entraîné une réduction de la mortalité, même si ce n'était pas statistiquement significative. En dépit la manque de la signification statistique du taux de mortalité amélioré, le traitement DSDT semble être utile pour ce groupe de patients très critiques.
