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Introduction: Groin and lower trunk defects are common problems, especially for elderly patients. While groin defects are often due to prior vascular interventions, trochanteric defects are mainly caused by pressure sores. Plastic reconstructive methods are manifold; however, the pedicled anterolateral thigh (ALT) flap is supposed to be reliable with sustainable results. Objective: We present our experiences using the pedicled ALT flap for soft tissue reconstruction in patients with large wounds of the medial and lateral proximal thigh. Materials and methods: A total of 16 patients with groin and lower trunk defects due to prior vascular surgery or pressure sores received locoregional soft tissue reconstruction using a proximal pedicled ALT flap. Patient characteristics, defect size, surgery time, clinical outcome and complication rate were assessed. Results: With the exception of two cases, sufficient soft tissue reconstruction was achieved. In all, 81,3% of patients were categorized as ASA (American Society of Anesthesiologists) 3. The average duration of surgery was 149 min. Length of stay was 18,3 days. A total of 31% needed revision surgery due to limited wound healing problems. Two patients died. All patients showed healed wound conditions when they were discharged. Conclusion: The proximal pedicled ALT-flap is a reliable method for soft tissue reconstruction in groin and lower trunk defects. This reconstructive procedure enables reliable wound closure, especially in elderly patients with substantially reduced general health condition. [ABSTRACT FROM AUTHOR]

The term perioperative antibiotic prophylaxis stands for a short-term, usually one-off administration of an antibiotic shortly before, at the beginning or at the latest during the operative procedure. A perioperative antibiotic prophylaxis should always be given in the surgical treatment of a patient with abdominal trauma. The optimal time of administration is 30-60 min before incision. For interventions lasting more than 2 h, a repeated dose should be given depending on the half-life of the substance being used. An extension of the antibiotic prophylaxis beyond 24 h does not reduce the postoperative infection rate and should only be continued in the sense of a therapy in the case of a surgically uncleansed infection focus. [ABSTRACT FROM AUTHOR]

The term perioperative antibiotic prophylaxis stands for a short-term, usually one-off administration of an antibiotic shortly before, at the beginning or at the latest during the operative procedure. A perioperative antibiotic prophylaxis should always be given in the surgical treatment of a patient with abdominal trauma. The optimal time of administration is 30-60 min before incision. For interventions lasting more than 2 h, a repeated dose should be given depending on the half-life of the substance being used. An extension of the antibiotic prophylaxis beyond 24 h does not reduce the postoperative infection rate and should only be continued in the sense of a therapy in the case of a surgically uncleansed infection focus. [ABSTRACT FROM AUTHOR]

The need for treatment of chronic and infected wounds has increased during recent years due to demographic changes and the increasing number of patients with severe comorbidities. An increasingly larger selection of treatment options as well as wound dressings for the treatment of acute and chronic wounds have become available in recent years. Due to the diversity of increasingly specialized bandages and wound dressings, a standardized, phase-adapted treatment of acute, chronic and infected wounds is useful and recommended. The comprehensive treatment of problematic wounds should also include treatment of any comorbidities present as well as the elimination of noxious agents that may compromise wound healing. For these reasons, treatment of complicated wounds should be interdisciplinary and in close cooperation with the nursing staff. This article presents excerpts from our phase-adapted wound treatment concepts of the 'Wound Compendium Boberg', by which we are able to maintain a standardized and high quality treatment for problematic wounds. [ABSTRACT FROM AUTHOR]

Pyoderma gangrenosum is rarely seen in the surgical disciplines. In the described case the patient was initially diagnosed with necrotizing fasciitis and admitted to the intensive care unit suffering from septic shock. The automated implantable cardioverter defibrillator (AICD), the suspected focus for infection, had already been removed. Following weeks of broad spectrum antibiotics and wound debridement without clinical improvement the alternative diagnosis of pyoderma gangrenosum was reached. Consequently the patient was treated with immunosuppressive therapy and his condition improved rapidly such that he was ultimately discharged to rehabilitation. [ABSTRACT FROM AUTHOR]