Abstract
Objectives: The authors report on the patients treated in a clinic who were injured in the earthquake that took place in north western part of Turkey in 1999 and was reported to be measured at 7.4 on the Richter scale. This catastrophe killed over 16 000 people while injuring more than 23 000 people. The type of housing was varied and entrapment occurred in single, two or more storey buildings.
Methods: 35 patients were admitted to the plastic surgery department after the earthquake. The hospital is about 400 km from the disaster site. Although all the transported victims had intravenous lines, few had adequate volume replacement. Sixteen had an urgent fasciotomy at the time of admission. The procedures were performed between 8 and 21 hours after extrication. After fasciotomy, all non-viable muscle content was removed but an attempt was made to retain as much viable muscle as possible.
Results: Amputation was required on four patients (25%). Fasciotomy incisions were closed with skin grafting in eight cases, and with primary closure in four cases.
Conclusion: Prompt fasciotomy in earthquake victims will be both life saving and can prevent some of the severe and dangerous complications after crush syndrome.
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Selected References
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- Agarwal N., Shah P. M., Clauss R. H., Reynolds B. M., Stahl W. M. Experience with 115 civilian venous injuries. J Trauma. 1982 Oct;22(10):827–832. doi: 10.1097/00005373-198210000-00004. [DOI] [PubMed] [Google Scholar]
- Better O. S., Stein J. H. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med. 1990 Mar 22;322(12):825–829. doi: 10.1056/NEJM199003223221207. [DOI] [PubMed] [Google Scholar]
- Better O. S. The crush syndrome revisited (1940-1990). Nephron. 1990;55(2):97–103. doi: 10.1159/000185934. [DOI] [PubMed] [Google Scholar]
- Better O. S. Traumatic rhabdomyolysis ("crush syndrome")--updated 1989. Isr J Med Sci. 1989 Feb;25(2):69–72. [PubMed] [Google Scholar]
- Matsuoka Tetsuya, Yoshioka Toshiharu, Tanaka Hiroshi, Ninomiya Norihisa, Oda Jun, Sugimoto Hisashi, Yokota Junichiro. Long-term physical outcome of patients who suffered crush syndrome after the 1995 Hanshin-Awaji earthquake: prognostic indicators in retrospect. J Trauma. 2002 Jan;52(1):33–39. doi: 10.1097/00005373-200201000-00008. [DOI] [PubMed] [Google Scholar]
- Michaelson M. Crush injury and crush syndrome. World J Surg. 1992 Sep-Oct;16(5):899–903. doi: 10.1007/BF02066989. [DOI] [PubMed] [Google Scholar]
- Rollins D. L., Bernhard V. M., Towne J. B. Fasciotomy: an appraisal of controversial issues. Arch Surg. 1981 Nov;116(11):1474–1481. doi: 10.1001/archsurg.1981.01380230088014. [DOI] [PubMed] [Google Scholar]
- Sheng Z. Y. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. J Trauma. 1987 Oct;27(10):1130–1135. [PubMed] [Google Scholar]
- Sheridan G. W., Matsen F. A., 3rd Fasciotomy in the treatment of the acute compartment syndrome. J Bone Joint Surg Am. 1976 Jan;58(1):112–115. [PubMed] [Google Scholar]
- Storgaard M., Rasmussen K., Ebskov B. Traumatisk rabdomyolyse. Patofysiologi og behandling. Ugeskr Laeger. 1998 Feb 9;160(7):987–990. [PubMed] [Google Scholar]
- Vitale G. C., Richardson J. D., George S. M., Jr, Miller F. B. Fasciotomy for severe, blunt and penetrating trauma of the extremity. Surg Gynecol Obstet. 1988 May;166(5):397–401. [PubMed] [Google Scholar]
- Whitesides T. E., Haney T. C., Morimoto K., Harada H. Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop Relat Res. 1975 Nov-Dec;(113):43–51. doi: 10.1097/00003086-197511000-00007. [DOI] [PubMed] [Google Scholar]