Management Of Earthquake Related Injuries

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  • Earthquake injuries are a major challenge for emergency medicine.
  • The injuries commonly include open and closed fractures. Moreover, require surgeons to be prepared to deal with fractures and wounds effectively to minimise complications.
  • The surgical protocol for earthquake victims includes repairing tissue defect, closing the wound, promoting wound healing and preventing infection.

Case of Gustillo classification, type III fracture

This case study highlights the management of a patient injured in the Wenchuan earthquake. The patient was brought to the emergency with a Gustillo classification, type III fracture. In addition, the medial side of the tibia and more than 5 cm of the fracture received fixed pressure with external fixation pins and shelves.

Similarly, vacuum sealing drainage (VSD) was performed combined with external fixation after thorough debridement. After the initial extensive debridement, the wounds were either covered or filled with a Poly (vinyl alcohol) shrink formaldehyde bubble using 16 silica gel, according to the size of the wound. The wound was then closed with Poly amino acid ethyl ester films after the Poly (vinyl alcohol) shrink formaldehyde bubble was stuck to the healthy skin.

External fixation combined with VSD

The VSD was linked with a negative pressure aspirator followed by secondary sutures until significant wound healing.

Secondary sutures were followed by treatment by external fixation

During this time period, the dressings were not changed and negative pressure bottles were observed. Similarly, the regression of symptoms and limb swelling was also noted. The polyvinyl formaldehyde foam was removed after seven to ten days and wound infection control was assessed. In case the infection is not well controlled, further debridement is performed.

References

Liu, L., Tan, G., Luan, F., Tang, X., Kang, P., Tu, C., & Pei, F. (2012). The use of external fixation combined with vacuum sealing drainage to treat open comminuted fractures of tibia in the Wenchuan earthquake. International orthopaedics36(7), 1441-1447.

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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