Self-inflicted crossbow injury in the head: A case report.

Injuries and deaths from crossbows are uncommon, especially when self-inflicted. We present here the case of a 45 years old patient with history of mental illness, who attempted suicide with a crossbow. The bolt penetrated the chin, crossed the oral floor, the oral cavity, the bony palate, the left nasal cavity and exited at the level of the nasal bones. The main concern was the management of the airways, before proceeding to the removal of the bolt. A nasotracheal intubation through the right nasal cavity while the patient was conscious was performed, but the instruments needed for an emergency tracheotomy were in the operating room in case of failure. The intubation was successful, he underwent general anesthesia, and the bolt was removed from the face.

[6 years V.A.C. in general surgery -- clinical data from 128 patients]. / 6 Jahre V.A.C.-Therapie in der Allgemein- und Viszeralchirurgie -- 128 klinische Fälle.

Since the introduction of vacuum assisted closure therapy (V.A.C.) at the Department of Surgery/St. Anna-Hospital Herne has taken place in 2000 there was a rapid increase of indications to use this therapy. We present data from 128 patients who were treated with this method from 2000-2005 for different kinds of diseases. We report the management of a 78-year-old male patient who developed a Fournier's gangrene after an acute appendicitis with retroperitoneal perforation and an enterocutaneous fistula of the cecum. Using V.A.C. in surgery, a quick and safe treatment of infection and healing could be achieved.