plastic surgery emergencies
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Plastic Surgery Emergencies. Dr. Shane KF Seal CORE Lecture August 27, 2008. What are some ‘true’ emergencies?. Topics. Necrotizing Fasciitis Compartment Syndrome Ischemic Limb / Amputated Part Suppurative Flexor Tenosynovitis Septic Joint Major Burn. Necrotizing Fasciitis. - PowerPoint PPT PresentationTRANSCRIPT
Plastic Surgery Emergencies
Dr. Shane KF Seal
CORE Lecture
August 27, 2008
What are some ‘true’ emergencies?
Topics
1. Necrotizing Fasciitis
2. Compartment Syndrome
3. Ischemic Limb / Amputated Part
4. Suppurative Flexor Tenosynovitis
5. Septic Joint
6. Major Burn
Necrotizing Fasciitis
• NF vs. NSTI
• Travels along fascial planes
• Types:– I– II– III
Necrotizing Fasciitis
• Appearance
• Presentation/CC
• Investigations (relevant)
Necrotizing Fasciitis
• Management– Surgical – Medical– Monitoring
• Long term plans
Compartment Syndrome
• Definition– Absolute vs. Relative
• Signs/Symptoms– Early vs. late– Most reliable sign– Most reliable symptom
Compartment Syndrome
• Investigations (relevant)
• ‘Whitesides’ technique
• Abdominal Compartment measurements
Compartment Syndrome
• Management– Know the anatomy!
• Closure options
• Late management
Ischemic Limb/Amputated Part
• Ischemic Limb– Why?– Acute vs. Chronic?
• Investigations
• Consults
Ischemic Limb/Amputated Part
• Traumatic ischemic limb– Management options
• Rheumatologic ischemic limb– Management options
• Medical• Surgical
Ischemic Limb/Amputated Part
• Amputation– Mechanism of injury– Timing– Level of injury
• Investigations
Ischemic Limb/Amputated Part
• To replant or not to replant????
– Issues that will affect decisions
Suppurative Flexor Tenosynovitis
• Closed system• Can spread quickly
along sheath
Suppurative Flexor Tenosynovitis
• Presentation
• Signs/Symptoms– Kanavel’s 4 Findings– Most reliable sign
• Management– Medical– Surgical
Septic Joint
• Mechanism– Animal/human bite
• Examination– Position of joint– Most reliable way to test– Other associated conditions
Septic Joint
• Investigations
• Management– Surgical – Medical
Major Burn
• Definition
• Criteria for admission to a Burn Unit
• Management– Fluids ‘Parkland’
• Assessing Depth
Major Burn
• Acute issues to deal with
• Consults
• Medical management• Topical Management• Surgical Management
– timing