Clinical characteristics and treatment of soft tissue crush injury caused by an earthquake

Abstract

Objective To investigate the characteristics and treatment methods of crush injury of extremities caused by the Wenehuan earthquake. Methods We retrospectively analyzed the 202 cases of the Wenchuan earthquake casualties who had been hospitalized in our hospital for extremity crush injury. Wound characteristics, difficulties, problems and treatments were summarized. Results There were 16 cases (7.9%) of smashed crush wound, 60 cases (29.7%) of open injury, and 126 cases (62.4%) of closed injury. By injury severity score (ISS), there were 98 (34. 7% ) cases of mild injury, 54 cases (17.1%) of moderate injury, 36 (44.9%) cases of severe injury, and 14 cases (3.3%) of extremely severe injury. Decompressive fasciotomy was performed for 32 cases, 31 procedures of excising necrotic muscle for 15 cases, and 14 procedures of stump debridement for 8 extremities. SPSS 10.0 software was used to inves-tigate the correlation between crush time and ISS scores, and the rank sum test revealed a significant dif-ference (P < 0.05) . Conclusions The severity of crush injury is related to crushing power and is-chemic time. Necrosis is usually massive and indistinctly defined. Necrotic muscle bundles are interlaced with normal ones. Necrosis is usually wider and more severe in the deeper layer. Multiple excisions are needed to remove the necrotic tissues. Continuous renal replacement treatment is helpful for dealing with raw wounds and prognosis of crush injury. Key words: Earthquake; Crush injury; Soft tissue; Continuous renal replacement treatment(CRRT)