ABSTRACT
BACKGROUND: Large abdominal wall defect (LAWD) caused by shotgun wound is rarely reported. CASE SUMMARY: Herein, we describe a case of LAWD caused by a gunshot wound in which the abdominal wall was reconstructed in stages, including debridement, tension-reduced closure (TRC), and reconstruction with mesh and a free musculocutaneous flap. During a 3-year follow-up, the patient recovered well without hernia or other problems. CONCLUSION: TRC is a practical approach for the temporary closure of LAWD, particularly in cases when one-stage abdominal wall restoration is unfeasible due to significant comorbidities.
ABSTRACT
OBJECTIVE: To evaluate the effectiveness and complications of an ultrasound-aided biodegradable osteosynthesis system in the treatment of midfacial fractures. METHODS: From January 1, 2010 to March 1, 2013, a total of 193 midfacial fractures patients were recruited. There were 120 males and 73 females. Among them, 93 patients were treated with SonicWeld Rx system (KLS Martin, Tuttlingen, Germany) while 100 patients FIXSORB MX (Takiron Co., Ltd, Osaka, Japan). The effectiveness, short-term and long-term complications were assessed by clinical examinations and computed tomography during an average follow-up period of 18 months. RESULTS: All fractures healed well without dislocation, malunion, delayed union or nonunion. Pin insertion was completed with a total success rate of 99% in SonicWeld Rx group versus 98% in FIXSORB MX group. Three patients in SonicWeld Rx group and 2 in FIXSORB MX group developed postoperative local inflammation and healed with antibiotics therapy. Hardware visibility or palpability occurred in 3 and 8 patients in two groups respectively. One patient in SonicWeld Rx group and 4 in FIXSORB MX group experienced sterile abscess at Months 12-15 postoperatively and resolved by the removal of biodegradable materials. Two cases of implant looseness were observed in FIXSORB MX group. No other procedure-related complication was noted in either group. CONCLUSION: The ultrasound-aided biodegradable osteosynthesis of SonicWeld Rx system is both effective and safe in the treatment of midfacial fractures. And its complication rate is equal to that of traditional biodegradable fixation.
