Topics
Negative Pressure Wound Therapy (NPWT)
A wound management technique applying controlled negative pressure via a sealed dressing system Promotes wound healing by: Removing exudate Reducing oedema Improving local perfusion Commonly used as a temporary bridge in orthoplastic management
Open Tibia Fractures – Orthoplastic Approach
Open fracture of the tibial shaft with associated soft tissue disruption Characterised by bone exposure and contamination Requires combined orthopaedic stabilisation + plastic surgical soft tissue management
Infection and Biofilm in Orthoplastic Surgery
Infection in orthoplastic surgery refers to microbial colonisation of bone, soft tissue, or implants, often complicated by biofilm formation, which makes bacteria resistant to antibiotics and host immunity.
Debridement Principles
Surgical removal of devitalised, contaminated, and non-viable tissue The most critical step in managing open fractures and complex limb injur
Bone Defect Management (Masquelet vs Bone Transport)
Management of segmental bone defects resulting from: Trauma Infection Tumour resection Requires restoration of: Mechanical stability Biological environment
Limb Salvage vs Amputation
Decision-making process between attempting to preserve a severely injured limb or proceeding with primary amputation
Flap Selection
Selection of appropriate soft tissue coverage technique for defects involving: Skin Muscle Bone (exposed structures) Goal: Provide durable, well-vascularised coverage to support healing and prevent infection
Timing of Soft Tissue Coverage
Refers to the optimal timing of definitive soft tissue reconstruction (flap or graft) after trauma A key determinant of outcomes in open fractures and complex limb injuri
Fix and Flap Principle
Combined approach involving: Early skeletal stabilisation (fixation) Early soft tissue coverage (flap) Typically performed in a single stage or closely timed stages Core concept in orthoplastic management of open fractures
Flap Selection for Tibial Defects
Soft tissue reconstruction in open tibial fractures is primarily guided by the location of the defect, the size of the defect, and the condition of surrounding tissues.