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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 1998 October;39(5):587-91

lingua: Inglese

Temporary ­wound cov­er­ing ­with a sil­i­con ­sheet for the ­soft tis­sue ­defect fol­low­ing ­open fas­cio­to­my. Technical ­note

Bail D. H. L., Schnei­der W., Kha­li­ghi K., Seboldt H.

From the Department of Thoracic and Cardiovascular Surgery University of Tübingen,Tübingen, Germany (Medical Director: Prof. Dr. G. Ziemer)


Objective. Temporary cov­er­ing of a ­defect of the ­soft tis­sues ­with a sil­i­con ­sheet ­after fas­cio­to­my in the treat­ment of com­part­ment syn­drome.
Design. Retrospective ­study.
Setting. University Hospital, Tübingen.
Patients. From January 1991 to June 1996, ­open fas­cio­to­my was per­formed a ­total of 18 ­times on 17 ­patients ­with com­part­ment syn­drome. In 17 of the 18 cas­es ­acute vas­cu­lar ische­mia was the ­cause of the com­part­ment syn­drome.
Interventions. For the 18 nec­es­sary fas­cio­to­mies, a sil­i­con ­sheet was tem­po­rar­i­ly ­used to cov­er the ­defect of the ­soft tis­sue tem­po­rar­i­ly a ­total of 9 ­times. The sil­i­con ­sheet was grad­u­al­ly ­drawn togeth­er and the ­wound was final­ly ­closed ­with a sec­on­dary ­suture.
Results. In 6 of the 9 cas­es a sec­on­dary ­suture ­could be per­formed with­out any dif­fi­cul­ties ­after the swell­ing had sub­sid­ed, and a mesh­graft cov­er­ing was not nec­es­sary. Only one ­patient suf­fered ­from ­wound infec­tion ­because the sil­i­con ­sheet had not ­been ­sutured cor­rect­ly. In the oth­er cas­es ­there was no ­sign of infec­tion. The ­wound dress­ing was ­changed pain­less­ly and fur­ther­more, an ­improved cos­met­ic ­result was ­observed.
Conclusions. There are con­sid­er­able advan­tag­es in the use of a sil­i­con ­sheet as a tem­po­rary cov­er­ing for the defe­ct of the ­soft tis­sues in the treat­ment of com­part­ment syn­drome: low­er ­costs ­because of short­er hos­pi­tal­isa­tion and the dress­ing ­change is prac­ti­cal­ly pain­less. A ­reduced ­risk of infec­tion and ­improved cos­met­ic ­results are fur­ther advan­tag­es of ­this meth­od.

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