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Journal Article

Citation

Maurya S, Srinath N, Bhandari PS. Med. J. Armed Forces India 2017; 73(4): 321-327.

Affiliation

Consultant (Plastic Surgeon), Brij Lal Hospital, Haldwani, Uttrakhand, India.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.mjafi.2016.06.002

PMID

29386704

PMCID

PMC5771719

Abstract

BACKGROUND: Mine blast injuries of foot are devastating injuries that result in composite tissue loss or amputations. Negative pressure wound therapy has helped in the management of such combat-related wounds. The aim of this study was to report experiences gained in managing such injuries at a tertiary care center.

METHODS: 17 combatants who sustained mine blast injuries were included in this study. Severity of foot injury was assessed as per Foot and Ankle Severity Score. After wound debridement, negative pressure wound therapy was started and foot defect was appropriately reconstructed. Following wound healing, the foot was assessed for Foot and Ankle Severity Score in terms of impairment. The patients were then suitably rehabilitated by shoe modifications, orthosis, or custom-made prosthesis.

RESULTS: Mean age of soldiers who sustained mine blast injuries was 30.2 years. The mean Foot and Ankle Severity Score was 3.76. Temporary wound closure was achieved using negative pressure wound therapy and it prevented local and systemic infection. The defect could be reconstructed appropriately using split skin graft, regional fasciocutaneous flap, or microvascular free flap. Mean time to definitive reconstructive procedure was 16.5 days. Mean Foot and Ankle Severity Score in terms of impairment was 4.11. All soldiers could be rehabilitated and were returned to their respective units and were able to perform sedentary duties assigned to them.

CONCLUSION: The negative pressure wound therapy was helpful in preventing proximal amputations due to mine blast injury and was helpful in satisfactory reconstruction of foot defects.


Language: en

Keywords

Delayed reconstruction; Foot defects; Mine blast injuries; Negative pressure wound therapy; Prosthetic rehabilitation

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