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Early soft tissue coverage after complex foot trauma.

P Brenner1, S Rammelt, J M Gavlik

  • 1Department of Plastic and Hand Surgery, University Hospital "Carl Gustav Carus," Fetscherstrasse 74, 01307 Dresden, Germany.

World Journal of Surgery
|May 23, 2001
PubMed
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Early soft tissue coverage for complex foot injuries significantly reduces infection and improves function. This approach, utilizing tissue transfer, yields better outcomes than delayed coverage, highlighting its importance in foot trauma management.

Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Trauma Care

Background:

  • Complex foot injuries necessitate prompt, robust soft tissue coverage to mitigate infection and fibrosis.
  • Delayed wound closure in foot trauma can lead to poorer functional outcomes and increased complications.

Purpose of the Study:

  • To evaluate the efficacy of early soft tissue coverage using tissue transfer in complex foot injuries.
  • To compare functional outcomes and infection rates with delayed coverage methods.

Main Methods:

  • Retrospective analysis of 28 complex foot injury cases treated with early tissue transfer.
  • Application of the Maryland Foot Score and modified Merle d'Aubigné Score at 1-year follow-up.
  • Comparison with a cohort of 18 open calcaneus fractures with delayed soft tissue coverage.

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Main Results:

  • Early tissue transfer achieved definitive wound closure within 24-120 hours in most cases.
  • Mean Maryland Foot Score was 74.2, indicating good to sufficient function, superior to delayed coverage (64.4).
  • Overall infection rate decreased to 7.1% with early coverage, compared to 19.2% in the delayed group.

Conclusions:

  • Early soft tissue coverage with tissue transfer is crucial for improving functional outcomes in complex foot injuries.
  • This approach significantly reduces infection rates and fibrosis compared to delayed coverage.
  • Emergency flap procedures should be prioritized in foot surgery to achieve outcomes comparable to hand surgery.