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Case Reports
- Hyperbaric oxygen therapy for the treatment of a crush injury of the hand: a case report
- Pedro Henry Neto, Zamara Brandão Ribeiro, Adriano Bastos Pinho, Carlos Henrique Rodrigues de Almeida, Carlos Alberto de Albuquerque Maranhão, Joaquim da Cunha Campos Goncalves
- J Trauma Inj. 2022;35(3):209-214. Published online May 26, 2022
- DOI: https://doi.org/10.20408/jti.2021.0048
- 4,668 View
- 139 Download
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Abstract
PDF - We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host’s responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.
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Summary
- A Fatal Intracerebral Hemorrhage Complicated by Compartment Syndrome of the Upper Arm
- In Bo Han, Young Sun Chung, Dong Eun Shin, Ryoong Huh, Sang Sup Chung, Jung Yong Ahn
- J Korean Soc Traumatol. 2006;19(2):178-182.
- 1,263 View
- 1 Download
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Abstract
PDF
- Compartment syndrome has a wide spectrum from muscle pain to a life-threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.
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Summary
- Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy
- Ji Hoon T Kim, Myung Sik Han, Gun Moo Choi, Hyuck Jae Jang, Jin Ho Kwak, Ji Hoon S Kim
- J Korean Soc Traumatol. 2011;24(1):56-59.
- 1,237 View
- 10 Download
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Abstract
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- Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intraabdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.
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SummaryOriginal Article
- Abdominal Wall Closure Using Artificial Mesh for Patients with an Open Abdomen
- Sung Whan Cha, Hong Jin Shim, Ji Young Jang, Jae Gil Lee
- J Trauma Inj. 2012;25(4):172-177.
- 1,034 View
- 3 Download
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Abstract
PDF
- PURPOSE
After damage control surgery, abdominal wall closure may be impossible due to increased intra-abdominal pressure (IAP), and primary closure may induce abdominal compartment syndrome. The purpose of this study was to investigate changes in the IAP and the feasibility of abdominal wall closure using artificial mesh.
METHODS
From July 2010 to July 2011, 8 patients with intra-abdominal hypertension underwent abdominal wall closure using artificial mesh. Medical data such as demographics, diagnosis, operation, IAP, postoperative complications, mortality and length of hospital stays were collected and reviewed, retrospectively. One patient was excluded because of inadequate measurement of the IAP.
RESULTS
Seven patients, 4 males and 3 females, were enrolled, and the mean age was 54.1 years old. Causes of operations were six traumatic abdominal injuries and one intra-abdominal infection. The IAP was reduced from 21.9+/-6.6 mmHg before opening the abdomen to 15.1+/-7.1 mmHg after fascial closure. Fascial closure was done on 14.9+/-17.5 days after the first operation. The mean lengths of the hospital and the intensive care unit (ICU) stays were 49.6 days and 29.7 days respectively. Operations were performed 3.1+/-1.5 times in all patients. Two patients expired, and one was transferred in a moribund state. Three patients suffered from complications, such as retroperitoneal abscesses, enterocutaneous fistulas, and bleeding that was related to the negative pressure wound therapy.
CONCLUSION
After abdominal wall closure using artificial mesh, intra-abdominal pressure was well controlled, and abdominal compartment syndrome does not occur. When the abdominal wall in patients who have intra-abdominal hypertension is closed, artificial mesh may be useful for maintaining a lower abdominal pressure. However, when negative pressure wound therapy is used, the possibility of serious complications must be kept in mind. -
SummaryCase Reports
- The Occurence of Deep Vein Thrombosis in Abdominal Compartment Patient
- Seong Yup Kim, Sung Chan Jin
- J Trauma Inj. 2013;26(4):312-315.
- 1,024 View
- 1 Download
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Abstract
PDF
- Abdominal compartment syndrome is one cause of deep vein thrombosis of lower extremity. Although prophylactic dose of anticoagulation agent is safely started after 24~48 hours without the evidence of active bleeding, there may be bleeding complication related to invasive procedure which trauma victims undergo. Inferior vena cava filter should be considered in the treatment plan of this complex situation.
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Summary
- Early Definitive Closure of an Open Abdomen by Using Porcine Dermal Collagen Graft: A Case Report
- Sung Jin Park, Jae Hun Kim, Sung Pil Yun, Sun Woo Choi, Seon Hee Kim
- J Trauma Inj. 2013;26(1):14-17.
- 1,353 View
- 6 Download
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Abstract
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- PURPOSE
The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen.
METHODS
A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery.
RESULTS
There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery.
CONCLUSION
Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen. -
Summary
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