gms | German Medical Science

Objectives/Interrogation:

1.

Is it possible to achieve good results with certain non conventional treatments for severe hand injuries?

2.

Is it possible for serious wounds to heal in presence of bacteria?

Methods: Between Sept 24/14 and Sept 24/18 90 patients consulted of important injuries in the upper limb. Among them were selected 5 with tissue loss, so important that despite complex surgical procedures would be performed it was predictable that there would persist very limiting sequelae. The 5 patients, lucid hand worker males, who averaged 32 y/o (23-41) (2 wounds by circular saw of thumb; 1 blast injury in hand; 1 gunshot on wrist; 1 devascularization of half a phalanx of the thumb by motorcycle chain), were warned about the possibility of not achieving good results by any indicated conventional treatment; the alternative to implementing non-conventional methods which had provided excellent results in previous less severe cases and, in the event of adverse evolution, would not impede the resolution by the same traditional procedure already indicated.

All fractures were stabilized, and tendons and nerves repaired or replaced by convenient grafts. In all cases, the open wounds were covered by a waterproof element that acted as a secretion-preserving chamber, keeping the exposed tissues in a liquid environment. Patients did not receive antibiotics even when they presented purulent secretion, except in cases of deep infection. The wounds were cleaned only when their odor was fouled and the purulent secretions overflowed in outer bandages.

Results and Conclusions: Two patients required intravenous anthibiotics for a short time, due to systemic infection.

In 4 of the 5 patients was achieved the regeneration of cutaneous tissues in an average of 14 weeks (8-32), despite the contamination with Pseudomona Aeruginosa and/or Staphilococus Coagulasa Neg. The finger degloved by the blast had to be rescued by a skin-graft. No signs of infection have been detected since then in any patient.

Conclusions:

1.

It is possible to heal serious wounds in presence of bacteria.

2.

Maintaining wounds moist facilitates joints mobility during the healing process.

3.

It is possible to achieve the regeneration of some tissues maintaining a humid environment.

4.

Bacteria such as Pseudomona or Staphilococus does not prevent the healing of hand and wrist wounds.

5.

A history of infection does not preclude survival of bone, tendon, or nerve grafts in hand and wrist.

6.

Is it possible to achieve good results with certain non conventional treatments.