Figure 1434502x

Figure Legend: Crush and avulsion wounds typically have combined effects of indeterminate or inadequate vascularity and widespread contamination. Infection following such wounds is due to inadequate debridement, and primary wound closure increases the chance of marginal wound necrosis.  This patient presented after primary closure of a dorsal hand crush-avulsion injury in which the extensor pollicis longus had been repaired.  The wound margins became necrotic (1) and the extensor pollicis longus tendon underwent a progressive septic liquifaction necrosis (2).  He was treated with wide debridement (3), and then was lost to follow up.  He performed his own wound care and healed uneventfully with the wound nearly closed one month after debridement (4).
 
e-Hand Go Back Search Textbook