Management of Avulsion Injuries

Sophie Boettcher-Haberzeth; Clemens Schiestl

doi:10.1055/s-0033-1353493

European Journal of Pediatric Surgery, Inhaltsverzeichnis

Eur J Pediatr Surg 2013; 23(05): 359-364
DOI: 10.1055/s-0033-1353493

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Management of Avulsion Injuries

Authors

Sophie Boettcher-Haberzeth

¹Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland

²Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland
Clemens Schiestl

¹Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland

Abstract

The optimal management sequence to treat avulsion injuries in children is particularly difficult because of the following problems: (1) Assessment of these rare but frequently massive injuries can be very difficult and treacherous, as the extent of the injury is often underestimated and treatment therefore considered inappropriate; (2) Avulsion injuries have a high risk of infection: lesions are always contaminated due to the mechanism of injury (mostly vehicle accidents) and subsequent long-term hospitalization adds an additional risk for nosocomial infections; (3) Children with avulsion injuries have an increased risk to develop functional deficits: although the body grows, scars and reconstructed tissues may not adapt sufficiently and this may lead to serious constraints. Because of these problems, avulsion injuries may lead to a high morbidity and even mortality, especially if the injury is mismanaged. Reviewing the most recent data regarding the management of avulsion injuries yields the following key points: (1) A scoring system may help to assess the primary dimension of the defect; (2) Innovative techniques such as the use of a Vacuum Assisted Closure system may lower the risk of infection; (3) Choosing a comprehensive, reconstructive approach taking the growth of the child into consideration, may reduce the development of serious functional deficits and improve cosmetic outcome.

Keywords

avulsion injury - children - Vacuum Assisted Closure system - Integra Dermal Regeneration Template

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Referenzen

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