Meirizal, Meirizal and Magetsari, Rahadyan and Anwar, Sumadi Lukman and Chaidir, Mohammad Rizal and Muhammad, Hilmi and Baskara, Anak Agung Ngurah Nata and Pradipta, Muhammad Fadhil Wasi and Huwaidi, A Faiz (2024) Utilizing Low-cost Vacuum-assisted Closure as Adjuvant Therapy in Soft Tissue Reconstruction for a Mangled Upper Extremity. Plastic and Reconstructive Surgery - Global Open, 12 (5). E5826. ISSN 21697574
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Abstract
Soft tissue reconstruction using flaps in managing mangled injuries is occasionally insufficient due to large defects and low flap viability. Conversely, delaying the closure of the defect can elevate the risk of infection. Adjuvant therapy becomes essential in the management of mangled injuries. We aim to present the use of low-cost vacuum-assisted closure (VAC) as an adjuvant therapy for mangled injuries. We reported the case of a 20-year-old man who sustained a mangled injury to his left forearm in a traffic accident 4 hours before admission. The mangled extremity severity score was 9; however, the patient declined amputation. Although the initial reconstruction was done, the flap could only cover vital structures. VAC was utilized to address the uncovered portion of the defect, to promote optimal granulation and prevent infection. The reconstruction proceeded with a skin graft and wrist arthrodesis. At 1-year follow-up, viable tissue was obtained but contracture occurred at the metacarpophalangeal and proximal interphalangeal joints. We intend to perform functional reconstruction at a later stage. Although the benefits of VAC in wound management are well established, reports regarding its advantages in mangled injury management remain relatively scarce. The high cost of VAC is a limiting factor, particularly in developing countries. This prompts the need for an affordable VAC innovation with comparable efficiency to the commercial model. Reverse Aqua Pump VAC, our innovative low-cost VAC, shows satisfactory outcomes in managing patients with mangled injuries with mangled extremity severity score indicating amputation. © 2024 Lippincott Williams and Wilkins. All rights reserved.
Item Type: | Article |
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Additional Information: | Cited by: 0; All Open Access, Gold Open Access, Green Open Access |
Uncontrolled Keywords: | Soft tissue reconstruction, mangled injuries, vacuum-assisted closure |
Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) |
Divisions: | Faculty of Medicine, Public Health and Nursing > Non Surgical Divisions |
Depositing User: | Ngesti Gandini |
Date Deposited: | 11 Mar 2025 01:29 |
Last Modified: | 11 Mar 2025 01:29 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/15685 |