mr. Amin grand ward round on 21 september 2010

picture:

1. vac dressing
2. vac dressing
3. mottling appearance
4. mottling appearance
5. delta frame (external fixator)

This is merely simple point of what being told by the doctor. Pls do ur own reading regarding those points.

Vac dressing

• · Advantage

1. 1) Closure à prevent infection
2. 2) Suck the blood
3. 3) Shrink the wound

• · Complication à puncture the artery à Kalau balang die banyak darah à stop the vac

External fixator à delta fixator

How to manage external fixator

- Pin side

-Avoid weight bearing (that patient has K-wire insertion, thus he is prohibited to walk using his foot which has external fixator)

-Use crutches à axillary or forarem (mr.amin lebih prefer forarm sebab less axillary injury & more force)

Humified à wet gangrene

Mottling appearance in gangrene.

Ischaemic pain

Sepsis or borderline sepsis gives 2 drips

What do you want to give for patient yg ade sepsis?

-3^rd generation chepalosporin, ceftazidine (broad spectrum)

Sliding scale

- -Infuse insulin hourly dextrose

- - Complication à hypoglycemic attack

- - Not more than 8 hour

Mass swelling more than 6 cm à consider malignant until proven otherwise.