title: Dermal Fenestration With Negative Pressure Wound Therapy: A Technique for Managing Soft Tissue Injuries Associated With High-Energy Complex Foot Fractures.
abstract: Military casualties can sustain complex foot fractures from blast incidents. This frequently involves the calcaneum and is commonly associated with mid-foot fracture dislocations. The foot is at risk of both compartment syndrome and the development of fracture blisters after such injuries. The amount of energy transfer and the environment in which the injury was sustained also predispose patients to potential skin necrosis and deep infection. Decompression of the compartments is a part of accepted practice in civilian trauma to reduce the risk of complications associated with significant soft tissue swelling. The traditional methods of foot fasciotomy, however, are not without significant complications. We report a simple technique of dermal fenestration combined with the use of negative pressure wound therapy, which aims to preserve the skin integrity of the foot without resorting to formal fasciotomy.
authors.affiliation: Royal Centre for Defence Medicine, Birmingham, United Kingdom. Electronic address: hpoonie@doctors.net.uk.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Poon
authors.affiliation: Leeds Teaching Hospital National Health Services Trust, Birmingham, United Kingdom.
authors.forename: Heather
authors.initials: H
authors.lastname: Le Cocq
authors.affiliation: Royal Centre for Defence Medicine, Birmingham, United Kingdom.
authors.forename: Alistair J
authors.initials: AJ
authors.lastname: Mountain
authors.affiliation: Royal Centre for Defence Medicine, Birmingham, United Kingdom.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Sargeant
mesh_terms: D000328:Adult; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D000071938:Fasciotomy; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices
keywords: blister; calcaneum; compartment syndrome; dermis; fasciotomy; pilon fracture