Avulsion injuries of the lower extremities are caused mainly by heavy vehicles and the majority of the casualties are children. Treatment should be by resuscitation, excision of the avulsed skin and immediate coverage of the exposed areas with split-thickness skin grafts, mesh grafts or skin and muscle flaps. Fixation of fractures and repair of damaged blood vessels should be performed as early as possible. Though these principles of treatment were laid down 40 years ago, current treatment is still often deficient, replacement of the avulsed skin being the most common error. 22 patients suffering from avulsion injuries of the lower extremities were treated according to these principles during the years 1974-75. With the introduction of microvascular techniques, the repair of small damaged vessels by implantation of veins to missing arteries and veins may become practical.
|State||Published - 1979|