The management of compound leg injuries in the West Midlands (UK): are we meeting current guidelines?
Br J Plast Surg
; 58(5): 640-5, 2005 Jul.
Article
em En
| MEDLINE
| ID: mdl-15927147
ABSTRACT
The joint British Association of Plastic Surgeons and British Orthopaedic Association (BAPS/BOA) guidelines for the management of patients with open tibia fractures were published in 1991 and 1997 and provided a synopsis of injury epidemiology and best care. We present a retrospective review of 66 patients treated over a 2-year period (January 2001-February 2003) at a regional plastic surgery unit. There were 33 direct admissions and 33 transfers from other hospitals in which the average delay in transfer was 7.8 days (1-28) and in whom 26 (79%) patients had already undergone surgery. Plastic surgeons were involved in 46 (62%) of the 66 patient cohort and 27 (82%) transferred patients. The delay after admission until soft tissue cover was 3.8 days (0-15). Twenty-nine (44%) complications were recorded, 20 (69%) of these were in the transferred group and additional orthopaedic intervention was needed in 11 (42%) of patients who had been operated on in other hospitals. Despite widespread dissemination and teaching of the BAPS/BOA guidelines, complex extremity trauma is often not managed well in our region. There are unacceptable delays in admission, late communication, poor note keeping and follow up. The initial surgery/fixation is often sub-optimal and soft tissue reconstruction has to be considered at the least advantageous time period for the patient, leading to an increased hospital stay and complications.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Guias de Prática Clínica como Assunto
/
Fidelidade a Diretrizes
/
Procedimentos de Cirurgia Plástica
/
Fraturas Expostas
/
Traumatismos da Perna
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Br J Plast Surg
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Reino Unido