Postoperative edema management with external compression for successful treatment of shredder injuries of the hand: a report of two cases

Abstract

Shredder injuries have a poor prognosis and are a problematic type of hand trauma. The authors describe the successful management of two cases of shredder injuries, one involving a child and the other involving an adult. In the child, the authors performed loose skin sutures for closure in the initial surgery and adjusted the degree of intensity of the external compression daily. According to the degree of tissue swelling, the skin sutures were gradually tightened. In the adult, the authors used external compression rather than sutures and adjusted the degree of intensity every day. When treating a shredder injury, the most crucial task is balancing perfusion and tissue pressure to reduce edema while preserving viability, thereby healing and restoring the original function and shape of the injured body part. This paper suggests that external compression may be an important postoperative edema management method in patients with hand shredder injuries.