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Plastic Surgery Emergencies

Plastic Surgery Emergencies. Dr. Shane KF Seal CORE Lecture August 27, 2008. What are some ‘true’ emergencies?. Topics. Necrotizing Fasciitis Compartment Syndrome Ischemic Limb / Amputated Part Suppurative Flexor Tenosynovitis Septic Joint Major Burn. Necrotizing Fasciitis.

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Plastic Surgery Emergencies

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  1. Plastic Surgery Emergencies Dr. Shane KF Seal CORE Lecture August 27, 2008

  2. What are some ‘true’ emergencies?

  3. Topics • Necrotizing Fasciitis • Compartment Syndrome • Ischemic Limb / Amputated Part • Suppurative Flexor Tenosynovitis • Septic Joint • Major Burn

  4. Necrotizing Fasciitis • NF vs. NSTI • Travels along fascial planes • Types: • I • II • III

  5. Necrotizing Fasciitis • Appearance • Presentation/CC • Investigations (relevant)

  6. Necrotizing Fasciitis • Management • Surgical • Medical • Monitoring • Long term plans

  7. Compartment Syndrome • Definition • Absolute vs. Relative • Signs/Symptoms • Early vs. late • Most reliable sign • Most reliable symptom

  8. Compartment Syndrome • Investigations (relevant) • ‘Whitesides’ technique • Abdominal Compartment measurements

  9. Compartment Syndrome • Management • Know the anatomy! • Closure options • Late management

  10. Ischemic Limb/Amputated Part • Ischemic Limb • Why? • Acute vs. Chronic? • Investigations • Consults

  11. Ischemic Limb/Amputated Part • Traumatic ischemic limb • Management options • Rheumatologic ischemic limb • Management options • Medical • Surgical

  12. Ischemic Limb/Amputated Part • Amputation • Mechanism of injury • Timing • Level of injury • Investigations

  13. Ischemic Limb/Amputated Part • To replant or not to replant???? • Issues that will affect decisions

  14. Suppurative Flexor Tenosynovitis • Closed system • Can spread quickly along sheath

  15. Suppurative Flexor Tenosynovitis • Presentation • Signs/Symptoms • Kanavel’s 4 Findings • Most reliable sign • Management • Medical • Surgical

  16. Septic Joint • Mechanism • Animal/human bite • Examination • Position of joint • Most reliable way to test • Other associated conditions

  17. Septic Joint • Investigations • Management • Surgical • Medical

  18. Major Burn • Definition • Criteria for admission to a Burn Unit • Management • Fluids ‘Parkland’ • Assessing Depth

  19. Major Burn • Acute issues to deal with • Consults • Medical management • Topical Management • Surgical Management • timing

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