Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following high-energy trauma to the lower extremity. Mechanism of injury involves [shear/avulsion/crush] force. Patient reports severe pain, inability to bear weight, and visible soft tissue detachment. Onset is acute. Associated symptoms include paresthesia, localized hematoma, and skin necrosis. No prior history of vascular insufficiency or peripheral neuropathy.
Clinical Examination Findings
Physical examination reveals extensive degloving of the [thigh/leg/foot]. Skin flap integrity is compromised with evidence of undermining and subcutaneous shearing. Capillary refill is [brisk/delayed/absent] in the flap. Neurovascular assessment: distal pulses [palpable/diminished/absent], sensation [intact/impaired] in the [dermatome] distribution. Wound bed shows [viable/necrotic] tissue with [minimal/significant] contamination.
Treatment Protocol
Immediate management includes irrigation, debridement of non-viable tissue, and stabilization of the extremity. Surgical plan: [Primary closure/Split-thickness skin graft/Full-thickness skin graft/Free flap reconstruction]. Prophylactic antibiotics initiated. Negative pressure wound therapy (NPWT) applied to promote granulation. Pain management and DVT prophylaxis strictly maintained.