TY  - INPR
T1  - The difficult case: NPWT for extensive soft tissue defects of the lower extremity
T5  - Poster presented at EWMA 2022
LA  - English
AU  - Stanek, Rainer
AU  - Pointer, Eva
AU  - Canigiani de Cerchi, Katja
AU  - Pomberger, Gerhard
AU  - Hölzenbein, Thomas
AU  - Mousavi, Mehdi
AB  - Aim:
We report on the case of a 14-year-old girl with extensive soft tissue defects on the right lower extremity up to the right hip following a traffic accident. The patient suffered a subtotal amputation of the right lower extremity with a rupture of the external iliac artery and the iliac vein.

Method:
After CTA, the pulseless, ischemic leg was treated with autologous arterial und venous vascular graft. Perfusion resumed 4 hours post-accident. Osteosynthesis was carried out using an external fixator. Despite fasciotomy, extensive soft tissue necrosis occurred on the right lower extremity. Due to pre-terminal multiple organ failure caused by SIRS, a large-area necrosectomy was performed and NPWT started. The occlusive dressing was applied to the entire right lower extremity including the anogenital area up to the iliac crest using a tubular bandage*.

Results / Discussion:
This method allowed for sufficient negative pressure on the entire hip area and the entire right lower extremity. Septic condition improved immediately. After stimulating wound granulation, the secondary, serial split skin coverage of the defects was possible.

Conclusion:
In the case of extensive soft tissue defects on the lower extremity with deep substance defects in the area of the hip and simultaneous external fixation on the pelvic ring as well as cystofix and colostoma creation, the establishment of an NPWT system typically is difficult and time-consuming. With the tubular bandage it was possible to use a reliable, reproducible, time-saving occlusive and elastic system for the NPWT.
CY  - Paris, France
Y2  - 1653256800
KW  - Suprasorb CNP P3
KW  - Suprasorb EasyDress Fixateur Externe
ER  -