Akademik Veri Yönetim Sistemi
Ulusal Travma ve Acil Cerrahi Dergisi, cilt.31, sa.11, ss.1119-1129, 2025 (SCI-Expanded, Scopus, TRDizin)
BACKGROUND: Earthquakes stand as the most devastating form of natural disaster. Türkiye, situated within a fault zone, has witnessed numerous catastrophic earthquakes throughout its history. On February 6, a powerful earthquake severely impacted eleven cities in the southeastern part of the country. The purpose of this study is to evaluate the treatment management of a specific group of patients who were initially advised amputation but rejected this procedure and were referred to our clinic for reconstruction. METHODS: This single-center retrospective analysis included 15 patients (8 female, 7 male) with 17 flaps. Cases not requiring microsurgery were excluded. Data on admission conditions, time spent under debris, debridement surgeries, flap surgeries, anastomosis details, lab values, angiography, reoperations, wound closure times, complications, flap outcomes, hospitalization duration, and amputations or death were collected. RESULTS: The average age of the 15 patients was 30.67±18.51, with 5 patients being pediatric (33.33%). Patients spent an average of 41.77±40.68 hours under debris, with an 11.40±5.80-day admission delay. They underwent an average of 4.41±3.02 debridement surgeries before flap surgery, which occurred around 21.06±18.24 days post-admission. Wound closure took about 37.93±37.58 days on average, with an average hospital stay of 77.33±36.67 days. Forty-six percent received hyperbaric oxygen treatment. Various flap types were used, with no failures in anterolateral thigh (ALT) or sural artery flaps. Latissimus dorsi + serratus anterior chimeric flaps were used for larger defects, required more blood product replacements, and were fraught with difficulties. In total, 4 of the flaps failed, 3 patients required amputation despite all efforts, and 1 patient died. CONCLUSION: Earthquake victims with injuries that are “worse than they seem” due to vascular and infectious concerns require careful microsurgery. Proximal anastomosis, venous complication monitoring, meticulous debridement, VAC therapy, and adjuvant treatments such as hyperbaric oxygen therapy are crucial in managing these complex cases.