Ulus Travma Acil Cerrahi Derg. 2000; 6(2): 114-117

TRAVMATÝK DÝZ ALTI AMPUTASYONLARDA PRÝMER VE GEÇ PRÝMER KAPATMA SONUÇLARI

Mahmut Kömürcü¹, Ali Þehirlioðlu¹, A Sabri Ateþalp¹, Ethem Gür¹
Gata Ortopedi ve Travmatoloji Ad

509 olgunun; 519 diz altý amputasyonu bu çalýþmada deðerlendirildi. 482 olgu kara mayýnlarý nedeniyle yaralanmýþtý. 6 saatten daha kýsa sürede olay yerinden bölge cerrahi hastanelerine getirilen 421 amputasyon güdüðü, radikal debridmaný takiben primer olarak kapatýldý (Grup 1). Yeterli debridman yapýldýðýna karar verilemeyen ya da 6 saatten sonra getirilen 98 amputasyon güdüðüne ise açýk aýnputasyon uygulandý(Grup II). Ortalama 3-6gün sonra bütün olgular GATA Ortopedi ve Travmatoloji A.D'na nakledildiler. Grup IIde 14 olgu(%2.9) güdük ucundaki enfeksiyon nedeniyle tekrar opere edildi. Grup II de hiçbir olguda güdük ucu enfeksiyonuna rastlanýlmadý. Grup II' de güdüklerin %86.7 si, Grup II'de güdüklerin %79.6'sý problemsiz iyileþti. Gazlý gangren ve tetanus hiçbir olguda görülmedi.

Anahtar Kelimeler: DÝZ ALTI AMPUTASYONU, PRÝMER KAPATMA, GECÝKMÝÞ PRÝMER KAPATMA

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TRAUMATIC BELOW KNEE AMPUTATION IN WAR SURGERY: THE RESULTS OF PRIMARY CLOSURE AND DELAYED PRIMARY CLOSURE

Mahmut Kömürcü¹, Ali Þehirlioðlu¹, A Sabri Ateþalp¹, Ethem Gür¹
Gata Ortopedi ve Travmatoloji Ad

The results of 519 below knee amputations of 509 war wounded cases were reviewed. 482 cases were wounded by land mine. If the delay in evacuation between the injury and arrival to the battlefield hospital was less than 6 hours, 421 amputation stumps (Group I) contrary to classical fashion were closed primarily after meticulous debridement. Open amputation was performed after debridement in the remaining 98 amputation stump (Group II) After an average of 3.6 days, all the cases were evacuated back to our center where the primary delayed closure was done to Group II. 14 patients in Group I (2.9%) were reoperated because of wound sepsis of the stump. Wound sepsis was not encountered in Group 11.86.7% of stumps in Group I and 79.6% of stumps in Group 11 had healed without a problem. No gas gangrene or tetanus was encountered in any cases.

Keywords: LOWER LIMB AMPUTATION, PRIMER CLOSURE, DELAYED PRIMER CLOSURE

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ATIF KOPYALA