Crush Injury

 

 
   Patient was treated at Memorial
   Hermann Baptist Beaumont
   Hospital Wound Healing Center
   which is affiliated with Praxis
   Clinical Services..

 
Crush Injury
Center for Wound Healing
and Hyperbaric Medicine
240 Williamson Street, Suite 104 - Elizabeth, NJ 07207
(908) 994-5480
HISTORY:
11year-old male involved in 4-wheeler accident seen in center 3 days after trauma. Right foot involved in degloving injury with broken metatarsal head, muscle, tendon, and fascial involvement. Surgical closure with fixation pins done prior to first visit.
INITIAL PRESENTATION::
- Peri-wound area erythematous
- Moderate sero-sanguinous exudate
- Intense pain with touch.
- Strong pedal pulses
- 2+ pitting edema
- Room-air TCpO2- 20 mmHg
COMPREHENSIVE WOUND HEALING CENTER MANAGEMENT:
03/21/02 Initial assessment. HBO initiated BID. Inchamber TCpO2 achieved 760 mmHg at 2.5 ATA. Wound measurements are 12 cm x 8.2 cm x 0.2cm.
03/22/02 Infectious disease consult resulted in IV clindamycin and cefotaxime.
03/25/02 HBO reduced to once daily treatments.
04/01/02 Surgical debridement.
04/07/02 Wound measurements 3.2 cm x 5.0 cm x .4 cm. Surgical debridement.
04/08/02 Plastic surgery consult for split-thickness skin graft.
04/13/02 HBO discontinued.
05/15/02 Discharged to outpatient care.
05/23/02 Wound resolved. Wound healed with maturing, contracting skin graft. Referral to orthotics for custom insole.
RESULTS:
05/23/02 Child able to return to school and playing baseball by mid-summer. He wrote us a long, sweet letter stating “Thanks for everything. If it wasn’t for the oxygen treatments, I would have lost my foot. At least that’s what Mom says but I think it was all of the love from you guys”.

Referral Information
Patients should be referred to the Center for Wound Healing and Hyperbaric Medicine at Trinitas Hospital for aggressive, outcome based wound management. Our center is designed to compliment the attending physician’s services by providing expert wound management consultation and care including the application of advanced wound care technology and hyperbaric oxygen treatment as indicated based on a comprehensive system of evidence based clinical practice guidelines. The referring physician will continue to treat comorbid conditions and provide for the patient’s overall medical care. Hyperbaric oxygen treatment is available specifically for the treatment of soft tissue radionecrosis, osteoradionecrosis, osteomyelitis, clostridial myonecrosis and other necrotizing soft tissue infections, compromised skin grafts and flaps, crush injuries and other acute traumatic ischemias, and diabetic wounds of the lower extremities. All etiologies of wound healing failure are accepted for evaluation and care.

Types of wounds treated include Diabetic, Venous Stasis, Ischemic, Pressure, Traumatic, Surgical and other wounds that resist healing.
Problem wound patients should be referred to the Center when:
The wound has failed to show significant progress in 4 weeks of standard care
When the wound involves deep tissue structures or is limb or life threatening
When the wound is complicated by significant comorbidities including peripheral
    vascular disease, persistent edema, persistent infection, prior radiation treatment
   to the area, or compromised immune status of the patient

To refer a patient, please call (908) 994-5480 or visit us at www.trinitashospital.com


 
 

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