Abstract
Severe trauma to the soft tissue and/or underlying structures needs specialized wound care. Local debridement of devitalized tissue, wound irrigation, local and systemic antibiotics, as well as vacuum-assisted dressing is the mainstays of initial therapy. The secondary strategy after achieving clean structures often consists in using skin grafts or local or distant flaps. Early diagnosis of a compartment syndrome is essential in order to avoid severe complications. Degloving injuries, as well as soft tissue injuries of the face or the extremities, impose difficult problems and might need specialized care.
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Arnez ZM, Khan U, Tyler MP. Classification of soft-tissue degloving in limb trauma. J Plast Reconstr Aesthet Surg. 2010;63:1865–9.
Edwards MJ, Lustik M, Carlson T, et al. Surgical interventions for pediatric blast injury: an analysis from Afghanistan and Iraq 2002–2010. J Trauma Acute Care Surg. 2014;76:854–8.
Erdös J, Dlaska C, Szatmary P, et al. Acute compartment syndrome in children: a case series in 24 patients and review of the literature. Int Orthop. 2011;35:569–75.
Formby P, Flint J, Gordon WT, et al. Use of continuous external tissue expander in the conversion of a type IIIB fracture to a type IIIA fracture. Orthopedics. 2013;36:e249–51.
Halvorson EG, Disa JJ. Principles of wound management and soft tissue repair. In: ACS surgery- principles and practice: breast, skin and soft tissue, American College of Surgeons annually. vol. 3. 2009. p. 1–19.
Ho CA, Podeszwa DA, Riccio AI, et al. Soft tissue injury severity is associated with neurovascular injury in pediatric supracondylar humerus fractures. J Pediatr Orthop. 2018;38(9):443–9.
Hurst PJ, Hoon Hwang MJ, Dodson TB et al. Children have an increased risk of periorbital dog bite injuries. J Oral Maxillofac Surg. 2020. pii: S0278-2391(19)31046-8.
Jaindl M, Grünauer J, Platzer P, et al. The management of bite wounds in children – a retrospective analysis at a level I trauma centre. Injury. 2012;43:2117–21.
Klein C, Plancq MC, Deroussen F, et al. Lawnmower accidents involving children: characteristics and suggested preventive measures. Arch Pediatr. 2018;25(8):493–4.
Laing TA, Cassell O, O’Donovan D, et al. Long-term functional results from major limb replantations. J Plast Reconstr Aesthet Surg. 2012;65:931–4.
Lee TS, Luhmann JD, Luhmann SJ, et al. Pediatric lawnmower injuries. Pediatr Emerg Care. 2017;33(12):784–6.
Levin LS. Principles of definite soft tissue coverage with flaps. J Orthop Trauma. 2008;22(Suppl):S161–6.
Li R, Ren G, Tan XJ, et al. Free flap transplantation combined with skin grafting and vacuum sealing drainage for repair of circumferential or sub-circumferential soft-tissue wounds of the lower leg. Med Sci Monit. 2013;19:510–7.
Liu DS, Sofiadellis F, Ashton M, et al. Early soft tissue coverage and negative pressure wound therapy optimizes patient outcome in lower limb trauma. Injury. 2012;43:772–8.
Mc Gregor IA, Mc Gregor AD. Fundamental techniques of plastic surgery: and their surgical applications. London: Churchill Livingstone; 2000.
McLoughlin RJ, Cournoyer L, Hirsh MP et al. Hospitalizations for pediatric dog bite injuries in the United States. J Pediatr Surg. 2019. pii: S0022-3468(19)30453-1.
McQueen MM, Duckworth AD, Aitken SA, et al. The estimated sensitivity and specificity of compartment pressure monitoring for acute compartment syndrome. J Bone Joint Surg Am. 2013;95:673–6.
Nickerson TP, Zielinski MD, Jenkins DH, et al. The Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline. J Trauma Acute Care Surg. 2014;76:493–7.
Park JJ, Campell KA, Mercuri JJ, et al. Updates in the management of orthopedic soft-tissue injuries associated with lower extremity trauma. Am J Orthop. 2012;41:E27–35.
Ren KS, Chounthirath T, Yang J, et al. Children treated for lawn mower-related injuries in US emergency departments, 1990–2014. Am J Emerg Med. 2017;35(6):893–8.
Rha EY, Kim DH, Jung SN. Morel-Lavallée lesion in children. World J Emerg Surg. 2013;8:60.
Safe Kids Austria (Austrian Committee of Accident Prevention in Childhood). www.grosse-schuetzen-kleine.at
Santiago GF, Bograd B, Basile PL, et al. Soft tissue injury management with continuous external tissue expander. Ann Plast Surg. 2012;69:418–21.
Schalamon J, Ainoedhofer H, Singer G, et al. Analysis of dog bites in children who are younger than 17 years. Pediatrics. 2006;117(3):e374–9.
Tu YK, Tong GO, Wu CH, et al. Soft-tissue injury in orthopedic trauma. Injury. 2008;39(S4):S3–S17.
Vasconez HC, Buseman JL, Cunningham LL. Management of facial soft tissue injuries in children. J Craniofac Surg. 2011;22:1320–6.
Yan H, Gao W, Li Z, et al. The management of degloving injury of lower extremities: technical refinement and classification. J Trauma Acute Care Surg. 2013;74:604–10.
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Höllwarth, M.E. (2020). Soft Tissue Trauma. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_125-1
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DOI: https://doi.org/10.1007/978-3-642-38482-0_125-1
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