title: Emergency Soft Tissue Reconstruction Algorithm in Patients With Open Tibia Fractures.
abstract: BACKGROUND
  Tactic of emergency closing of soft tissue defect allows to significantly improve the treatment results concerning patients with severe open fractures. However, a number of certain factors make the implementation of this tactic rather difficult. Injured people's unstable conditions are mong these crucial factors which include, polytrauma in lots of cases, absence of exact recommendations for recovery terms, choice of definite tissue flaps and a type of circulation.
  
  
  OBJECTIVE
  is to develop exact, usable and in practice algorithm of emergency reconstruction of leg soft tissues in patients with severe open tibia fractures, based on the usage of the most foolproof and simple methods.
  85 patients with open tibia fractures complicated by soft tissue defects were included in our study. Patients were divided into two groups. The control group consisted of 56 patients. Soft tissue reconstruction in this group was provided without an exact algorithm, after continuous attempts on local healing. After analyzing the treatment process and the treatment results we have developed the algorithm of emergency soft tissue reconstruction. It was used in 29 patients (the study group). This algorithm allows choosing optimal timing for tissue reconstruction and appropriate method to be applied, depending on the patient's condition, the mechanism of soft tissue defect formation, and its square and localization.
  
  
  RESULTS
  We observed a statistical decrease in deep wound infection frequency, partial tibia necrosis frequency, chronic osteomyelitis frequency, duration of hospitalization in patients with severe open tibia fractures because of using our algorithm.
authors: Sklifosovsky Clinical and Research Institute for Emergency Medicine, Polytrauma Department, Moscow, Russia.
authors: P A
authors: PA
authors: Ivanov
authors: Sklifosovsky Clinical and Research Institute for Emergency Medicine, Emergency Reconctructive and Plastic Surgery Department, Moscow, Russia.
authors: E U
authors: EU
authors: Shibaev
authors: Sklifosovsky Clinical and Research Institute for Emergency Medicine, Polytrauma Department, Moscow, Russia.
authors: A V
authors: AV
authors: Nevedrov
authors: Sklifosovsky Clinical and Research Institute for Emergency Medicine, Emergency Reconctructive and Plastic Surgery Department, Moscow, Russia.
authors: A P
authors: AP
authors: Vlasov
authors: Sklifosovsky Clinical and Research Institute for Emergency Medicine, Emergency Reconctructive and Plastic Surgery Department, Moscow, Russia.
authors: M P
authors: MP
authors: Lasarev
keywords: Algorithm of emergency soft tissues reconstruction; Bone necrosis prevention; Local and free flap; Polytrauma; Severe open tibia fractures; Treatment result