Lower Third Leg Trauma Management Algorithm; Kasr Alainy Protocol

Area of Science:

• Orthopedics
• Wound Healing
• Regenerative Medicine

Background:

• Lower leg soft tissue defects pose significant surgical challenges.
• Existing coverage options are limited by potential complications.
• Decision-making algorithms are needed for managing lower leg trauma.

Purpose of the Study:

• To evaluate a novel algorithm for managing traumatic lower leg and ankle soft tissue defects.
• To assess the algorithm's efficacy in achieving wound coverage and patient recovery.
• To determine the role of negative pressure wound therapy and dermal substitutes within the algorithm.

Main Methods:

• Prospective observational cross-sectional study of 53 patients with lower third leg and ankle traumatic injuries.
• Application of a management algorithm incorporating negative pressure wound therapy and dermal substitutes.
• Assessment of outcomes including complete coverage, complication rates, hospital stay duration, and return to daily activities.

Main Results:

• The algorithm achieved complete coverage in 98.1% of cases.
• Mean duration to definitive coverage was 21.89 days.
• 81.1% of patients returned to normal daily activity within a mean of 60.69 days; dermal substitutes were effective for wounds with exposed structures (mean size 11.39 cm²).

Conclusions:

• The proposed algorithm offers a safe and effective strategy for managing traumatic lower leg and ankle defects.
• The algorithm considers patient condition and wound complexity for optimal treatment.
• Effective utilization of dermal substitutes and negative pressure wound therapy is integral to the algorithm's success.