External Fixator Principles and Simple Flaps for Battlefield Casualties

Description

In this presentation, Shehan Hettiaratchy discusses foundational principles of external fixation in trauma cases, emphasizing the need for improvisation and adaptability in surgical scenarios. He categorizes injuries into absolute and relative indications for using external fixation, such as bony injuries accompanied by vascular trauma. Hettiaratchy outlines a cerebral approach to surgical planning, framed by the questions of 'what,' 'who,' and 'when.' He advises that trauma cases often require collaboration among multiple surgical teams, especially in complex scenarios typical in military contexts. He also mentions the emotional rollercoaster associated with trauma surgery, pointing out that decision-making can significantly impact patient outcomes.



Further elaborating on technical aspects, he highlights the importance of thorough communication in the surgical setting and details a strategy for managing injuries with external fixation. He shares insights into various types of external fixators and discusses how to manage surgical complications, particularly in military settings.



The talk also covers specific surgical techniques such as the gastrocnemius muscle flap for lower limb coverage, discussing its safety and reliability due to its vascular supply. Hettiaratchy illustrates procedural steps to effectively execute this flap, emphasizing meticulous dissection to prevent damage to critical neurovascular structures. Additionally, he explains a fasciocutaneous flap's utility for middle third tibia defects and strategies for ensuring successful flap survival. Throughout the presentation, he stresses the value of learning from surgical outcomes, both positive and negative, to improve practice.

Specialties