Rescuing a patient whose leg was overtaken by a truck, with complex open wounds

Patient N.T.N N (66 years old, living in Hoc Mon district, Ho Chi Minh City) was transferred to the Military Hospital 175 after a serious traffic accident, was rolled across the right leg, causing complex open wounds in the thigh, leg and feet.Previously, the patient was initially first aid at District 12 Hospital and quickly referred due to serious damage.

At the 175 Military Hospital, doctors recorded a wide area of ​​skin wounds extending from the thighs and legs to the right foot, with the upstream skin in the heel and liver, the area is estimated at about 12% of the body area.The thighs and lower leg muscles are crushed, the bundle of pulse and the right leg nerve are clearly revealed.The bottom of the wound contains many foreign objects.The tip of the pink toes is pale, re -perfusion slowly over 2 seconds; The spo₂ index is 99%, but the pubic and posterior baseball circuits are difficult to catch.

The initial judgment shows that this is a wide -scale skin that is at high risk of necrosis, accompanied by severe blood vessel and nervous damage, threatening injuries, acute blood loss, widespread infection and the risk of limb amputation.The focus of treatment is saving the life of the skin, a major challenge due to complicated lesions, crushed tissue, large area and unsatisfactory blood source.

After the consultation, the Department of Micro-Surgery Department, Military Hospital 175 quickly conducted emergency surgery.Treatment directions include: moderate filtration of crushed lesions, positive washing pumps; The technique of assembling skin flap has been thinly thin; Create on -site flap to cover the circuit bundle; Application of negative pressure suction system (VAC) to support wound healing; Comprehensive comprehensive medical resuscitation: antibiotics, compensation, reduction, nutrition care.

In the following days, the patient is continued to add skin grafting in the knee, heel and lower leg area to cover the entire skin loss area and restore body shape.

After nearly a month of active treatment, the skin flap has been successfully covered with 6% of the initial lesions.The remaining areas are treated by negative force suction machine (VAC) and multi -layer leather transplant.Up to now, the entire thighs, legs, feet have been completely covered, good toes, knee areas are limited and are continuing to restore function.