Du Nan News "Help"! Natalie (pseudonym) was knocked down by a big truck while riding a motorcycle in Panyu Shiqiao, and the front and rear wheels ran over his calf in turn, bleeding. The skin of legs is like stockings, which can be "peeled off" in the whole layer, leaving bones, blood vessels, muscles, nerves and ligaments exposed and facing the danger of amputation. After four debridements and two skin grafting operations, the team of the Orthopedic Center of Qifu Hospital transplanted 100 pieces of skin as thin as paper. Natalie stood up again. On April 18, Natalie, who was able to walk independently, was discharged from the hospital.

The big truck ran over his legs, and the treatment faced the dilemma of amputation.

20 19 10 at 9 o'clock in the evening, at Panyu Shiqiao, a truck knocked down Natalie (a pseudonym) who was riding a motorcycle home, and the front and rear wheels crushed her left and right calves in turn.

Kind passers-by dialed 120, and Natalie was taken to a nearby hospital.

The film taken by the hospital showed that the patient had multiple fractures in the right tibia, lateral ankle and middle fibula, and was temporarily treated with limb salvage. 10 10 in the morning, Natalie was told that because the skin necrosis of her calf was too serious, she was advised to transfer to hospital for treatment, otherwise her leg might be in danger.

"I'm only 34 years old. I am old and young, and my daughter is only 7 years old. What if I amputate my child? What about work? What about life after that? " A friend who was at a loss introduced Natalie to the case that the team of director Chu Xiaochao of Qifu Hospital successfully created a difficult case of replantation of broken arm, so she found the orthopedic center of Qifu Hospital with her family.

10 at night 10, Natalie was admitted to the orthopedics department of integrated traditional Chinese and western medicine by the emergency department. At that time, there were blisters and exudation on a large area of skin on calves, ankles and feet, and the skin was dark purple necrosis. The admission examination assessed the injury, and the severity met the amputation indication.

Under the support and guidance of Chu Xiaochao, director of the Orthopedic Department of Integrated Traditional Chinese and Western Medicine, Li Yannan decided to spare no effort to save the limbs for patients. Natalie and the orthopedic center need to work together to overcome multiple difficulties: debridement to remove necrotic tissue and reduce toxin absorption; Fracture reduction; Closed negative pressure drainage (VSD) promotes granulation growth; Then, combined with ozone and platelet-rich filling (PRP) technology, skin transplantation was carried out in stages.

Skin can be stripped four times like socks for debridement and repair.

At half past four in the afternoon, Natalie was taken to the operating room.

Almost all the skin on Natalie's legs has been peeled off, just like taking off stockings, the whole layer can be peeled off, and it gives off a strong smell. There is a wound about 20 cm long in the right calf. From the knee joint to the sole of the foot, the skin, subcutaneous tissue, some muscle tissue and fascia were all peeled off, the subcutaneous tissue degenerated, the achilles tendon was broken, the blood vessels were occluded, and the nerves were peeled off and dissociated. There is a wound about 15 cm long on the left foot, and the skin edge turns black and necrotic, and there is also skin shedding from about 15 cm below the knee to the instep.

"Zhang Wei's lower limb skin injury is a degloving injury, and bones, blood vessels, muscles, nerves and ligaments are directly exposed." Li Yannan removed the necrotic skin and tissue, reset and fixed the fracture site, anastomosed the achilles tendon and cleaned the wound repeatedly. Finally, he covered the wound protection material and connected the negative pressure device for continuous drainage.

Li Yannan explained that closed negative pressure drainage can promote granulation growth, suck away toxins produced by necrotic tissues in time, and prevent toxins from entering the blood and causing systemic symptoms and infections. After operation, ozone therapy in Clifford Hospital can speed up the process of wound repair. According to Wang Wei, director of Ozone Department, ozone autologous blood and ozone wrapping therapy can improve blood supply, control infection and lay the foundation for skin grafting in the next step.

Li Yannan led the orthopedic surgery team and performed four debridements and VSD negative pressure suction for her. The wounds of both lower limbs are fresh, granulation grows satisfactorily, and the original bare tendons and bones are completely covered. Natalie can finally move on to the next step-skin grafting.

The size of the stamp is paper, and more than 100 "skins" have been planted twice.

The orthopedic center team of Qifu Hospital provided 4 debridements and 2 skin grafting operations for patients.

Because some leg wounds are large, there are many skin, muscle and soft tissue defects, and the wounds are unevenly covered with granulation, skin grafting is carried out twice.

For the first time, skin grafting was carried out where the granulation was flat. 165438+1On the morning of October 22nd, Li Yannan performed the first "free skin grafting +VSD negative pressure suction" for Natalie. Take pieces of skin from Natalie's bilateral thighs and abdomen, only the size of a stamp, as thin as a piece of paper, and then carefully transplant it to his calf like a puzzle. "The thickness of skin graft is moderate, which not only ensures the survival of skin graft, but also ensures the texture after survival." The operation was a great success. After 10, 99% of the skin grafts survived, and the wounds of both lower limbs were completely covered with fresh skin.

On June 38, 2020+10/October 3, Natalie received the second skin graft to fill the remaining skin defects, transplanted more than 100 skin grafts in two operations, and performed platelet-rich filling surgery to promote granulation growth and skin graft survival. On June 65438+1October 65438+March 3, the wound almost healed. In the following days, in order to prevent joint stiffness, the rehabilitation technician helped Natalie with ankle rehabilitation every day.

After putting on high heels, I can walk independently.

Now, after putting on her shoes, Natalie can walk independently.

On April 18, Natalie was discharged from the hospital with gratitude and recovered her optimism. She said: "I am very grateful to the doctor. Although the skin doesn't look good now, you can go and it won't affect your function in the future. I am still very happy and satisfied. "