Treatment Of Soft Tissue Injuries Research Articles

Artificial deformity creation in treatment of soft tissue wounds and lower leg bones defect: a case report

Background. The problem of treating wounded patients with defects of soft tissues and bones of the extremities continues to be relevant. One of the ways to close soft tissue defects, especially in case of bone tissue loss, after open fractures of the extremities is acute shortening and creation of artificial angular deformity of the segment. The aim of the study — to demonstrate the possibilities of acute shortening and angulation of the segment as a technique to replace soft tissue and bone defects in treatment of a patient with a gunshot wound to the lower leg. Case description. A 30-year-old wounded man was admitted to the clinic with an extensive defect in soft tissues and bones of the lower leg in the middle third. To reduce the wound size, acute shortening and angulation of the lower leg was performed. The intentional angular deformation was 24º, shortening — up to 8 cm. The residual soft tissue wound defect was closed with local tissues and split skin autograft. The tibia was fixed by the Ilizarov hinge-distraction apparatus with following gradual correction of the angular deformity. After that, one performed osteotomy of the tibia in order to eliminate shortening with the Ilizarov method (the distraction rate of 1 mm per day). After restoring the length of the lower leg, in order to replace the defect along the anterior surface of the tibia, a marginal “flake” was formed from a displaced fragment. At a follow-up examination, in 18 months after the injury the patient walks with full weight bearing on the injured limb without any additional means of support, continues to perform military service duties in accordance with his position. Conclusions. The presented clinical case demonstrates that acute shortening of a limb segment with creation of artificial angular deformity is an effective method for temporary closure of a gunshot defect of soft tissues. The technique allowed closing critical soft tissue defect of the lower leg and restoring the anatomy (length) of the segment. Consequently, one was able to achieve satisfactory treatment results and restore the functions of an injured limb. Besides, acute temporary shortening technique eliminated the need to perform technically sophisticated and lengthy microsurgical reconstructions, which are associated with a flap replacement for closure of soft tissue defects in a shotgun fracture area.

Pediatric facial trauma management: Emergency case in a toddler

Background: Facial soft tissue trauma cases are often encountered in the emergency room. Soft tissue trauma, especially to the face, is rarely life threatening. It varies in shape, size, and depth and can also affect surrounding organs. The treatment of soft tissue trauma can be complicated and may have a significant impact on facial function and, especially, facial aesthetics. Children are easily injured due to their active nature. Soft tissue trauma to the faces of toddlers is challenging even for experienced surgeons; however, wound debridement and suture management under general anesthesia should be considered. Purpose: The aim of this article is to deliver a thorough overview of the evaluation and treatment of soft tissue injuries in children, covering initial assessments, physical examinations, the application of antimicrobial therapies, and preparation for surgical procedures. Case: An 11-month-old girl went to the emergency department of Hasan Sadikin General Hospital, Bandung, with injuries to her left cheek and upper left lip sustained when she fell, and her face hit the edge of a cement pot at home. There was no history of unconsciousness, nausea and vomiting. The injury was diagnosed as vulnus laceratum of the left face and upper lip region. Case management: Emergency management was carried out by triage, Tetagam injection, and early wound debridement and suture under general anesthesia because the patient was uncooperative. Wounds on the face and lips were primary sutured layer by layer, returning the wound edges to their normal anatomical position. Conclusion: The management of facial soft tissue injuries in toddlers requires general anesthesia for adequate and accurate wound debridement and suture, so that functional and aesthetic effects can be satisfactorily obtained.

Comparison of Cryotherapy Performed With Ice or Gel and Superficial Skin Cooling of Older Women: A Randomized, Crossover, Clinical Trial.

Cryotherapy is an affordable and popular treatment of soft tissue injuries, which can reduce inflammation and pain. Studies have specifically addressed young adults and athletes, and these findings have been extended to older adults in clinical practice. Aging is associated with changes in the skin, including collagen degradation, decreased fat layer thickness, and reduced blood flow, which can alter the skin response to stress. Because of age-related changes, there are concerns about the direct use of ice on the skin of older individuals. Skin injuries were also observed after cryotherapy. This study aimed to assess the most effective and safe cryotherapy for superficial skin cooling among older women. Eighteen older women were enrolled in this blinded, randomized, crossover, clinical trial. The mean values (SD) of their age, height, and weight were 70.0 years (6.0), 156.0 cm (9.1), and 72.8 kg (19.5), respectively. The participants underwent cryotherapy using bagged ice, bagged ice plus a wet towel, or gel pack for 20 minutes. The surface temperature of the skin was measured at the end of a 20-minute cryotherapy session using an infrared thermometer. Repeated-measures analysis of variance was conducted to analyze the effect of cryotherapy modalities and time, as well as the interaction between these 2 factors. The secondary outcome was the presence of cryotherapy-induced lesions. Cryotherapy modalities had significant effects on superficial skin temperature (P = .001). Time points after application also had an effect (P = .0001), and no interaction was observed between cryotherapy modalities and time points (P = .051). Bonferroni post hoc evaluation showed that bagged ice (P = .008) and gel (P = .007) were more effective in decreasing the superficial skin temperature than bagged ice plus wet towel. No difference was observed between bagged ice and gel (P = .32). Three of the 18 patients experienced adverse effects with the gel pack. This study of older women found that ice and gel cooled the skin more effectively than ice wrapped in towels. However, the gel pack had some adverse effects. Therefore, bagged ice is recommended for cryotherapy in older women.

The therapeutic effect of concentrated growth factor gel on skin wounds with bone or tendon exposure.

Treatment of soft tissue wounds with bone or tendon exposure remains a tough clinical challenge for surgeons. The current clinical approaches include various types of flap reconstruction and artificial dermis grafting as well as negative pressure wound therapy (NPWT), which are time-consuming and often result in graft failure or significant scarring. Concentrated growth factor (CGF) is a novel blood extract that contains many growth factors, platelets and fibrin to promote an orderly healing process. However, few reports have focused on wounds with bone or tendon exposure. We present a limited series and two specific cases of skin wound with bone or tendon exposed that received surgical debridement followed by CGF treatment. CGF appeared to facilitate wound closure effectively and also reduced scar formation. Our findings provide a novel therapeutic option for refractory wounds with bone or tendon exposure.

Treatment of Soft Tissue Injury in Athletes by Biological Method

Treatment of Soft Tissue Injury in Athletes by Biological Method

PROBLEMATIC ISSUES OF LIMB AMPUTATION IN WOUNDED WITH COMBAT TRAUMA

Among the wounded with limb injuries admitted to the Military Medical Center of the Western region during the year of Russia’s full-scale war in Ukraine, 29% had a mine-blast injury, 47% had shrapnel wounds, 8% had gunshot bullet wounds, 1.5% – thermal injuries, and14.5% – traumatic injuries. Upper limbs were injured in 22%, lower – in 32%, 15% had two limbs injured, and 31% had combined combat trauma. In all hospitalized with multi-fragment fractures, limbs were fixed with external fixation devices. 2% of patients had vascular damage. All wounded had unhealed wounds with a soft tissue defect. The average age of patients was 30 years. There were no comorbid diseases in the wounded, and concomitant diseases that did not affect the course of injury were found in 10%. Amputations of limbs were performed in 6.5%. Traumatic separation of a limb segment or its destruction with crushed bone and non-viable soft tissues, nerve damage with significant defect, soft tissue and bone defect, as well as thermal ischemia of the limb for more than 6 hours with necrosis of its soft tissues, were indications for primary limb amputation in 3% of wounded and injured, which were in the nature of primary debridement. Progressive wound infection with the development of the septic condition of the wounded despite intensive treatment, total ischemic necrosis, and recrudescent arrosive bleeding from great vessels required a secondary limb amputation in 1.5%. In 1.5% of the wounded, staged operations were performed as re-amputations. Re-amputation had to be performed in 0.6% of patients with an inappropriate limb stump level, which complicated prosthetics. To reduce the number of amputations for secondary indications, a timely diagnosis is needed of compartment syndrome and rational treatment of soft tissue wounds and gunshot fractures with surgical and medical prevention of the infectious process.

Effect of Active Release Technique and Cyriax approach on pain, grip strength and functional performance in individuals with lateral epicondylitis: a randomized clinical trial protocol

Background: Tennis elbow, also known as lateral epicondylitis, is a painful condition characterized by irritation of the tendons that link the forearm muscles on the outside of the elbow, which can result from using the elbow too much. Active Release Technique (ART) is defined as a hands-on approach that manages cases to enable the identification and treatment of soft tissue injuries. Through the removal of fibrosis and adhesions that can develop in tissues as a result of overload from frequent use, the aim of ART, a soft tissue treatment, is to lessen tissue stress. Deep transverse friction (DTF) and Mill's manipulation, which are used shortly after DTF, have been used by Cyriax and Cyriax to successfully treat tennis elbow. ART and Cyriax techniques have shown promise for lateral epicondylitis sufferers. There hasn't yet been any research comparing these two approaches for participants with lateral epicondylitis. The aim is to examine the efficiency of ART with the Cyriax technique on lateral epicondylitis pain, strength, and function. Methods: A total number of 60 participants will be included as per the inclusion criteria and then they will be further divided into 30 in each group. The physiotherapy intervention will be given to Groups A (ART) and Group B (Cyriax technique) along with conventional 12 sessions spread across four weeks, three times per week. Each patient will be evaluated during and after treatment on the baseline and after four weeks using the Visual Analogue Scale (VAS), hand grip strength dynamometer, and Patient-rated Tennis Elbow Evaluation (PRTEE) scale. Conclusions: This physiotherapy intervention could be used in the treatment of lateral epicondylitis if our study's hypothesis is found to be accurate. Registration: CTRI (CTRI/2023/06/053660; 08/06/2023).

Acute and 90-day toxicological safety assessment of Shang-Ke-Huang-Shui lotion in New Zealand White rabbits

Ethnopharmacological relevanceShang-Ke-Huang-Shui lotion (SKHS), an experiential formula based on the theory of traditional Chinese medicine as a hospital preparation, combines Coptidis Rhizoma, Phellodendri Chinensis Cortex, Gardeniae Fructus, Arnebiae Radix, Menthae Haplocalycis Herba and Alumen. While it has acquired positive effects on the treatment of soft tissue injuries, there is no systematic safety assessment in recent studies. Aim of the studyThe study aimed to investigate the acute and long-term toxicity in New Zealand White rabbits using topical administration of SKHS. Materials and methodsIn the acute toxicity study, rabbits were given topical administration of SKHS extract (2.775 g crude drug/mL) 3 times daily in normal and broken skin. In the long-term toxicity study, rabbits underwent topical administration of SKHS extract (1.390, 0.694, 0.139 g crude drug/mL) 1 time per day in normal and broken skin for 90 days. Their general behavior, body weight, food intake, biochemical and hematologic parameters, organ coefficients, and pathological morphology were analyzed. ResultsMild skin irritation was observed in rabbits with normal or broken skin following acute exposure to the high dose of SKHS. Evidence of toxicity was not observed in the rabbits exposed to SKHS for an extended period. Although some parameters have been significant changes, they cannot be considered treatment-related because they have remained within normal limits. ConclusionTopical administration of SKHS could be considered relatively safe and did not reveal any severe toxicity or side effects in this study.

Benefits of platelet rich plasma (PRP) treatment on skin autografts and allografts in a burned patient

Wound healing is promoted by a series of growth factors, secreted from the alpha granules of the platelets. Platelet rich plasma (PRP) emerged as a clinical strategy to increase the physiologic concentration of platelets and its clinical use for a large spectrum of disorders is reported, with good results. Extensive burns represent a promising field for PRP use, those patients confronting challenging wound healing and poor long-term results. We present our initial clinical experience represented by a case of a 51-year-old male patient, severely burned, who benefited from sequential surgical treatment of deep burn wound excisions and coverage using autologous and allogenic skin grafts. PRP was added to this patient’s therapy in two stages, being injected and externally applied on the autografts in functional areas of the hands and the right upper arm region where both autografts and allografts were placed, with the exciting result of promoting allograft integration, long-term persistence and healing. Several literature data validate successful clinical applications of PRP in various therapies, including treatment of soft tissue injuries and chronic wounds, orthopedic surgery, burns, maxillo-facial surgery and elaboration of tissue-engineered products. Based on our preliminary experience and favourable reports in the literature, we encourage wider use of platelet rich plasma for immunomodulation and tissue-engineered constructs, due to its effects on local inflammatory response and role in enhancing the integration of various types of tissue grafts.

Emergency Management of Maxillofacial Soft Tissue Wounds due to Physical Trauma

Introduction: Soft tissue trauma is common in the head and neck, limited to superficial structures or involving deeper anatomical structures. Various types of trauma occur depending on the aetiology and mechanism. Managing oral and maxillofacial soft tissue trauma poses a challenge for surgeons due to the importance of facial esthetics. The purpose of this case report is to report and discuss the emergency management of soft tissue injuries in the maxillofacial region due to physical trauma. Case report: Three cases with diagnoses of abrasive wounds, lacerations, and punctum wounds on the lips, cheeks, eyebrows, chin, and oral cavity were encountered at the emergency department of Hasan Sadikin Hospital, Bandung City, due to a motor accident. Treatment includes debridement, reconstruction, and wound closure. Conclusion: Emergency treatment of soft tissue wounds in the maxillofacial area that is fast and according to the procedure will reduce infection and dehiscence. Keywords: emergency, soft tissue injury, Maxillofacial, Physical trauma

Evaluation of recurrent soft tissue injuries of shoulder after physiotherapy treatment in athletes

Traumatic injuries to the soft tissues of the shoulder are a common cause of shoulder pain and dysfunction in athletes. These injuries have a serious impact on the athlete's work capacity and quality of life, which often causes athletes to withdraw from training and competition. Taking into account modern requirements, a long break in sports activities is almost impossible, because in the majority of cases, the last mentioned is equivalent to the end of the professional career. It should be noted that after conservative treatment of soft tissue injuries of the shoulder (tendinitis of the long head of the biceps muscle, partial damage to the structures of the rotator cuff, glenoid labrum) repeated injuries and relapses often occur, which makes it even more difficult to fully restore the athlete's shoulder function and the athlete's withdrawal from the training process is longer. The purpose of the study is to find the incidence of repeated injuries and pain recurrences in athletes after physical therapy treatment of shoulder soft tissue injuries. The present study involves a quantitative and qualitative evaluation of the emergence of pain reactivity after physical therapy treatment of soft tissue injuries of the shoulder in athletes, 8 and 12 weeks after the athletes' return to normal activity. Monitoring was carried out on 52 athletes at the Sports Medicine and Rehabilitation Clinical Center of TSMU. The average age of the athletes was 23 ± 2 years. Athletes participating in the study were randomly divided into three groups: I main, II and III control groups and appropriate rehabilitation interventions were implemented. In all three groups of patients participating in the study, after 8 and 12 weeks, the occurrence of shoulder function limitation and pain were studied using the PSS (The Penn Shoulder Score), SSPS (Subjective Sport Performance Satisfaction) and the Kerlan-Jobe Shoulder and Elbow Clinical Orthopedic Clinical Scales. Based on the data obtained from the study, 8 weeks after the start of sports activity of 52 athletes, cases of early repeated injuries were detected in 35 percent of athletes, and after 12 weeks, cases of late repeated injuries were observed in 25 percent of the remaining 34 athletes. 8 weeks after the start of sports activity in 52 athletes, 18 cases of recurrent early injury were noted, in the remaining 34 athletes, after 12 weeks, recurrent late injuries were identified in 8 athletes. The study includes evaluation and comparative analysis of repeated injuries in groups I-II and I-III after 8 and 12 weeks of participation in sports activities by means of the specified scales. The study revealed that treatment with combined physical agents significantly reduced the incidence of repetitive injuries in athletes and also demonstrated a significantly lower recurrence rate of emerging pain, thereby optimizing the athlete's performance.

Cold Plasmamed Beam as a Supporting Treatment of Soft Tissue Injuries in Severe Covid-19 Patients: A Preliminary Report

BackgroundCold plasma has many characteristics that allow for effective wound healing. Due to its efficacy, we have applied it in treating patients with severe Covid-19 who have soft tissue skin lesions and diseases including burns, pressure ulcers, shingles, and contact or atopic dermatitis. This study aims to assess the general characteristics of Covid-19 patients with soft tissue lesions and to conduct a fundamental evaluation of the efficacy of cold plasmamed beams in treating soft tissue wounds in patients with severe Covid-19.MethodsThis prospective study was conducted on 20 severe Covid-19 patients with soft tissue lesions at the Intensive Care Center for Covid-19 of Hue Central Hospital in Ho Chi Minh City from September 25 to November 11, 2021. These patients was performed cold plasma irradiation at any stage of wound progression, including new injuries and chronic wounds.ResultsAmong 915 severe Covid-19 patients treated at our center, 20 patients had soft tissue lesions. Grade I, II, and III pressure ulcers accounted for 70% of the 20 cases of soft tissue lesions and 1.53% of the total patients at the time of the survey. Pressure ulcers were present in only 0.55% of patients (5/915 patients). Eleven out of 20 patients (55.0%) had lesions before admission, and 9 (45.0%) had lesions that appeared after admission. After 14 days of treatment, 14/20 patients had complete epithelialization (70%), and in 18/20 patients, wound exudation had ceased. The wounds became painless; after 3 weeks, the rashes had completely disappeared.ConclusionThe study emphasizes that irradiation with cold plasma contributes to the wound healing process.

Immediate Effects of Extracorporeal Shock Wave Therapy in Fascial Fibroblasts: An In Vitro Study.

Extracorporeal shock waves (ESWs) are used in the treatment of soft tissue injuries, but their role in the treatment of myofascial pain has not yet been demonstrated. The aim of this study was to investigate changes in cell biology of fibroblasts derived from deep/muscular fascia following treatment with ESWs. Primary fascial fibroblasts were collected from small samples of human fascia lata of the thigh of three volunteer patients (two men, one woman) during orthopedic surgery, and put in culture. These cells were exposed to 100 impulses of 0.05 mJ/mm2 with a frequency of 2.5 Hz, using 3D-printed support. This study demonstrated for the first time that ESWs can lead to in vitro production of hyaluronan-rich vesicles immediately after the treatment. At 1, 4, and 24 h after treatment, Alcian blue and Toluidine blue staining; immunocytochemistry to detect hyaluronic acid binding protein (HABP), collagen I, and collagen III; and transmission electron microscopy demonstrated that these vesicles are rich in hyaluronan and collagen I and III. The diameter of these vesicles was assessed, highlighting a small size at 1 h after ESW treatment, whereas at 4 and 24 h, they had an increase in the size. Particularly evident was the release of hyaluronan-rich vesicles, collagen-I, and collagen-III starting at 1 h, with an increase at 4 h and maintenance by 24 h. These in vitro data indicate that fascial cells respond to ESW treatment by regulating and remodeling the formation of extracellular matrix.

A modern view of the processes of mechanotransduction in healthy and damaged skin: review

Questions concerning the study of mechanotransduction in the skin are currently of interest to many researchers, especially those engaged in the study of the problem of high-quality surgical treatment of soft tissue wounds. The possibility of developing new ways of treating various pathologies of the integumentary tissues, including wound defects, depends on understanding the processes of transmission and transformation of mechanical stimuli coming to skin cells into chains of biochemical reactions. The review presents the main historical stages of the development of scientific knowledge about mechanotransduction, describes the features of mechanotransduction in integumentary tissues, currently known mediators and signaling pathways that realize the transmission of mechanical influences from the cell surface to its nucleus, and also suggests possible directions for using this phenomenon in practice. The work also noted changes occurring at the cellular level during the recoding of mechanical signals in wounds prone to slowing down natural healing processes chronic wounds. We believe that one of the promising trends in the practical application of mechanotransduction is the possibility of using its effects when stretching the skin during the treatment of wound defects of soft tissues.

Flow Sorption Debridement of Aseptic and Purulent Soft Tissue Wounds

Background: Treatment of isolated and combined open soft tissue wounds remains relevant due to the growth of severe injuries, comorbid pathologies, and immunosuppressive conditions, along with a decrease in antibiotic sensitivity of microorganisms. The aim of this study was to compare the effectiveness of the jet oxygen-sorption treatment (JOST) and flow sorption debridement techniques (FSDT) in the therapy of experimental soft tissue wounds. Methods and Results: The effectiveness of the JOST and FSDT was compared in 2 series of experiments on 288 laboratory Wistar rats with simulated soft tissue wounds. Series 1 (S1) involved 144 animals divided into 2 control groups (CG) and 2 experimental groups (EG); the effectiveness of the developed techniques for the aseptic wound treatment was studied in these groups of animals. Series 2 (S2) involved 144 animals divided into 2 CGs and 2 EGs; in S2, purulent soft tissue wounds were studied. The effectiveness of the developed techniques in the complex treatment of experimental wounds was assessed immediately, on Days 1, 3, 5, 7 and 10 after simulating the pathological process. The assessment included the animals’ condition, the dynamics of the course of reparative processes (local symptoms of inflammation; granulation; epithelialization of wounds; and size and dynamics of the area of the defect), and histological research methods. The use of the JOST has practically no benefits in aseptic wound treatment, compared to FSDT. The use of the JOST and FSDT contributed to a significant acceleration of healing process in aseptic wounds that was expressed in the decreased local inflammatory reactions, higher activity of metabolic processes based on the dynamics of RNA and SH-groups. The most pronounced positive dynamics in the treatment of purulent wounds was observed when applying FSDT. Compared with the findings obtained in CG1-S2, FSDT contributed to a reduction in necrolysis termination by 25.7%, fibrinolysis - by 25.5%, granulation - by 20.0%, epithelization - by 18.9%, wound discharge - by 27.8%. Conclusion: The developed technique of FSDT in the complex treatment of soft tissue wounds provides the most pronounced positive dynamics, accelerates reparative tissue processes, and reduces the duration of wound cleansing and healing for both aseptic and purulent wounds.

Prospective study on vacuum assisted closure therapy in treatment of soft tissue injuries associated with Gustilo Anderson compound grade III fractures

Introduction: The aim of this prospective study is to know the rate of wound infection, number of days required for making the wound fit for skin cover procedures, number of days required for formation of uniform granulation tissue bed in the wound, number of days of hospital stay and healing of soft tissue injury in Gustilo Anderson compound grade III fractures treated by Vacuum Assisted Closure & by stabilization of fracture. Gustilo Anderson compound grade III Fractures are fractures with extensive soft-tissue damage, definite periosteal stripping, massive contamination & the fractured ends are exposed.Methodology: In our institution thirty patients with Gustilo Anderson compound grade III patients were selected for this prospective study. The study period is from July 2020 to October 2021. All patients were selected based on our inclusion and exclusion criteria. Only Gustilo Anderson compound grade III fractures were included in the study.Results: After VAC therapy, SSG was done to cover the healthy granulation tissue in 22 patients and flap cover was done for 4 patients and remaining 4 was done by routine normal dressing.Conclusion: The time duration taken for formation of healthy granulation tissue was less.

Treatment of open fracture of lower limb in high altitude area

To explore the treatment methods and experience of open fracture of lower limb in high altitude area. From January 2016 to January 2021, 62 patients with open fractures of lower limbs were treated by staged surgery with the concept of injury control orthopedics, emphasizing wound treatment and combining various fracture fixation methods. There were 51 males and 11 females, ranging in age from 14 to 59 years old, with a mean of (37.2±12.3) years old; and the course of disease ranged from 7 to 59 days, with a mean of (23.7±15.5) days. According to Gustilo Anderson classification, there were 14 cases of typeⅠ, 24 cases of typeⅡ, 14 cases of typeⅢA, 8 cases of typeⅢB and 2 cases of typeⅢC. The fracture repair and wound healing were observed, and the clinical efficacy was evaluated by Johner-Wruhs evaluation standard. Fifty-five patients were followed up, and the duration ranged from 4 to 36 months, with a mean of (14.7±8.5) months, and 7 cases were lost to follow-up. According to Johner-Wruhs evaluation criteria, 33 cases got an excellent result, 16 good, 4 poor and 2 bad. The wound healing was poor in 2 cases, partial necrosis of Achilles tendon in 1 case, nonunion of fracture in 1 case and delayed healing of fracture in 2 cases. It is an effective method to treat the open fracture of lower extremity in high altitude area to pay attention to the management of soft tissue injury, the management of wound moisturizing, staged operation of fracture and full protection of blood supply at the fracture end. Paying attention to the treatment of soft tissue injury and the management of wound moisturizing, staged operation of fracture and full protection of blood supply at the fracture end are effective methods for the treatment of open fracture of lower limbs in high altitude areas.

A systematic approach to plastic surgical foot reconstruction

Soft tissue defects of the foot are very common sequelae after trauma and require an individual reconstructive approach. Recommendations for the treatment of soft tissue injuries to the foot are given. The criteria of soft tissue reconstruction, postoperative follow-up and complications are first discussed before the therapeutic approach is explained depending on the reconstruction site. Case examples are given for illustration. Decision making for soft tissue reconstruction of the foot is based on the location, the 3‑dimensional extent of the defect, the patient requirements and concomitant diseases. Standardized treatment algorithms are usually applied that need to be adapted according to individual patient factors. Randomized and local pedicled flaps can be applied for foot reconstruction; however, these options involve asignificant risk of complications. Consequently, free flaps are frequently indicated after appropriate preoperative diagnostics of the perfusion of the foot. Due to the vast variety of donor sites, free flaps allow an individualized reconstruction, which is adapted to local and patient requirements. Precise preoperative reconstructive planning and analysis of the vascularization form the foundation for asuccessful soft tissue reconstruction of the foot. The aims of the individualized approach to soft tissue reconstruction of the foot are stable soft tissue coverage, resistance to weight bearing of the sole of the foot, the ability to wear normal shoes and maintenance of sensibility.

Assessment Of The Consequences Of The Ozone For The Treatment Of The Soft Tissue Injuries Of The Maxillofacial Area

As it is clear that wounds of the maxillofacial area are much more different from other parts of the body. Due to the importance of its function and cosmetic value combined soft tissue lesions occupy a special position in human bones and tissues. In this article certain valuable information is shown about ozone’s physical, chemical compositions and its positive effect on the recovery of the combined soft tissue wounds located in the facial region. To evaluate the effectiveness of ozone for the treatment of soft tissue wounds of maxillofacial injuries overall 60 patients investigated [1,2]. As a result of this, ozone tends to be much more effective than traditional ways of treatments

APPLICATION OF CHEN YUANGAO IN THE TREATMENT OF SOFT TISSUE INJURY OF FOOTBALL PLAYERS

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.