Journal
SURGICAL CLINICS OF NORTH AMERICA
Volume 90, Issue 6, Pages 1181-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.suc.2010.08.001
Keywords
Complex wound; Necrotizing fasciitis; Ischemia; Dressing
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Complex wounds present a challenge to both the surgeon and patient in operative management long-term care cosmetic outcome and effects on lifestyle, self-image and general health Each patient with complex wounds usually manifests multiple risk factors for their development This article focuses on complex wounds involved with traumatic and orthopedic blunt or penetrating injuries particularly in the extremities, as well as massive soft tissue infections including necrotizing fasciitis gas gangrene and Fournier gangrene The principles of management of complex wounds involve assessing the patient s clinical status and the wound itself appropriate timing of intervention providing antibiotic therapy when necessary and planning and executing surgical therapy including the establishment of a clean wound bed and closure/reconstructive strategies
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