Management of a large traumatic hemipelvectomy defect following a truck crush injury: a case report

Ulus Travma Acil Cerrahi Derg. 2024 May;30(5):370-373. doi: 10.14744/tjtes.2024.64226.ABSTRACTThis case report explores the management of a traumatic hemipelvectomy-a rare and devastating injury characterized by a high mortality rate. The patient, a 12-year-old male, suffered right lower extremity amputation and right hemipelvectomy due to a deglov-ing injury from a non-vehicle-related accident at another institution. Initially, an urgent reconstruction of the right pelvic region and suprapubic tissue defects was performed using a posterior-based fasciocutaneous flap. Following this, the patient was transferred to the pediatric intensive care unit at our hospital with a suspected diagnosis of necrotizing fasciitis. Treatment included broad spectrum antibiotics and multiple debridements to avert the onset of sepsis. Eventually, reconstruction of a 60 x 25 cm defect covering the lower back, abdomen, gluteal, and pubic regions was achieved through serial split-thickness skin grafts and a pedicled anterolateral thigh flap. The patient made a remarkable recovery, regained mobility with the aid of a walker, and was discharged in good health 22 weeks after the initial accident. This case report underscores the importance of serial debridements in preventing sepsis, the use of negative pres-sure vacuum dressing changes, the initiation of broad-spectrum antibiotics based on culture results during debridements, and prompt closure of the defect to ensure survival after traumatic hemipel...
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - Category: Emergency Medicine Authors: Source Type: research