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- 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
- 4,666 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
- Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw
- Han Joo Choi
- J Trauma Inj. 2019;32(3):168-171. Published online September 30, 2019
- DOI: https://doi.org/10.20408/jti.2019.027
- 8,747 View
- 141 Download
- 2 Citations
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Abstract
PDF
The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.
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Citations
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- Thoracoabdominal injury with evisceration from a chainsaw assault: a case report
Babatunde Abayomi Salami, Babatunde Adeteru Ayoade, El-Zaki Abdullahi Shomoye, Chigbundu Collins Nwokoro
Journal of Trauma and Injury.2022; 35(2): 118. CrossRef - Unusual Chainsaw Related Penetrating Neck Injury: Initial Management
& Surgical Repair, Case Report
Woohyen Jin, Sang-Wook Park, Seong Jun Won, Jung Je Park
Journal of Clinical Otolaryngology Head and Neck .2022; 33(4): 259. CrossRef
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