Biomedical subjects

J Rautio

Publications and source records attributed to J Rautio.

21 records · Page 2Linked to original sources

PubMed1989

[Reconstruction of the foot using free flaps].

Microvascular free-flap reconstruction of the foot was performed during a seven-year period in 25 patients to repair soft tissue loss caused mainly by traumatic injury. A scapular flap was used in fifteen cases, a dorsalis pedis in three, a radial forearm in two, a latissimus dorsi in two, and a gluteal thigh, rectus abdominis and tensor fascia lata each in one case. Two flaps were lost because of postoperative vascular complications. Soft-tissue stability was excellent or good in all of the seven patients with a successful free-flap transfer to the non-weightbearing part of the foot and in eleven of the sixteen patients with a flap on the weightbearing part of the foot. Four patients had frequent superficial ulcerations of the graft but only one flap was completely unstable. Sixteen patients had normal or near normal ability to walk. Significant gait problems in seven patients were caused by skeletal deformity of the reconstructed foot or other associated injuries of the lower limb rather than the reconstruction itself. The best fit and contour was provided by thin skin flaps such as the dorsalis pedis and radial forearm flaps while the scapular flap offered a more inconspicuous donor site and could be used to cover large defects. Sensibility of the flaps assessed by clinical methods was less than normal in all cases. Good sensibility was found in the flaps of two children, fair in six, poor or very poor in fifteen, and two flaps had no sensibility. The level of sensibility was not related to the soft-tissue stability of the flap.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

Afghan war wounded: experience with 200 cases.

The injuries seen in 200 Afghan war wounded in the International Committee of the Red Cross (ICRC) hospital in Quetta are reported. Evacuation took several days and no proper initial first aid was available. Therefore few of those reaching us had serious multiple injuries. The anatomic distribution of wounds was remarkably similar to that seen in other conflicts: 38% of the injuries were caused by bullets, 50% by fragmentation weapons, and 10% by mines. Two thirds of the patients had limb injuries. Of all wounded, patients with fractures of long bones needed the greatest number of repeated operations and the longest hospitalization time. Twenty-five patients had abdominal or perineal wounds and 12 needed laparotomy. Of 25 with head injuries 14 had penetrating brain trauma. Thoracic, vascular, and burn injuries were rare. The eight patients with spinal cord injury could fortunately be referred to the ICRC rehabilitation center in Peshawar within a week. Wound sepsis was the major problem due to the extraordinarly long delay in the initiation of treatment. In spite of the often grossly infected wounds, radical debridement usually led to good recovery for most patients, with a hospital mortality rate of only 2.5%.

Abdominal Injuries↗

PubMed1987

Delayed treatment of complicated fractures in war wounded.

The initial treatment of complicated fractures several days old when first seen in Afghan war wounded is reported for 52 limbs in 47 patients. External fixation was the method of choice for stabilizing fractures in adults. In children, traction and plaster-of-Paris were preferred. In 30 cases (58 per cent) tissue damage was classified as moderate. With radical wound toilet and delayed closure, infection could be controlled in most of these limbs. In 15 fractures (29 per cent) there was severe laceration and exposure of bone. After operation, deep infection persisted in three-quarters of these cases and the fate of these limbs often seemed doubtful. The patients usually refused amputation. However, of seven limbs (13 per cent) in which the fracture was associated with an arterial injury, only one could be saved. The brief period of observation of only 11 weeks does not permit assessment of time to healing, frequency of late osteitis or definitive amputation rate. It seems, however, that in spite of the lack of any proper first aid for these severe injuries, a functional limb could be salvaged in over two-thirds of the cases, even with our modest resources.

Adolescent↗