Extensive traumatic detachment of soft tissue after accident: clinical experience of a multidisciplinary hospital

Abstract

Relevance. Each case of traumatic skin detachment is specific due to localization and severity of lesions, as well as the decision-making algorithm of treatment remains a subject of discussion. Nowadays the Ministry of Health of the Russian Federation has not produced clinical recommendations or standards for the treatment of such trauma patients. The scope of examination, treatment methods, and efficiency criteria in such injuries are very controversial. Due to errors in the diagnosis of traumatic detachment, difficulties and complications arise during plastic closure of such wound defects.Objective. The study objective is to demonstrate clinical observations of our multidisciplinary hospital in the treatment of patients with traumatic skin detachment, to assess factors affecting surgery outcomes, to propose an algorithm for the treatment of patients with traumatic skin detachment.Materials and methods. 20 patients with traumatic skin detachment underwent wound defect closure upon admission according to Krasovitov surgery. Here the results of 3 clinical cases are presented. Types of traumatic skin detachment, timespan between the injury and start of surgical treatment were analyzed to identify the factors affecting graft healing.Results and discussion. The study reports 33 % of unfavorable treatment outcomes in multidisciplinary hospital. To improve the results, strategy for the management of traumatic skin detachments was proposed. Patients operated according to these recommendations reported satisfactory treatment results.Conclusion. Active introduction a dedicated algorithm for traumatic skin detachment diagnosis and treatment in clinical practice and high-tech methods allowed to achieve significant improvement in immediate and long-term treatment outcomes.