Soft Tissue Disease

Question 1

What factors make up LRINEC score

Answer 1

Hb
WCC
CRP
Sodium
Creatinine
Glucose

Question 2

Interpret the LRINEC score

Answer 2

Max score is 13

> 8 is highly suggestive
6 should raise suspicion

Below 6 does not rule it out

Question 3

Risk factors for Gas gangrene (often nec fasc in general)

Answer 3

Diabetes
Intestinal malignancy
Trauma
PVD
Blood disorder
Recent diarrhoea
Immunocompromised

Question 4

Managment of NEC FSC or GG

Answer 4

Analgesia, IV fluids and IV broad spectrum Abx

Early surgical debridement

Question 5

Classification of open fractures

Answer 5

Gustilo- Anderson

Type 1- <1cm wound and clean
Type2- 1-10 cm wound and clean

3A- more than 10cm with soft tissue coverage
3B- more than 10 cm with inadequate soft tissue coverage
3c- any wound with vascular injury

Question 6

Principles of BOAST 4 guideline for open fractures

Answer 6

Should always for inital primary surgery as per ATLS (a-e)

IV coamoxiclav

Assess neurovascular damage- vascular injury needs surgery with 6 hours

Wound covered in saline soaked gauze and impermeable film

Surgery with plastics and ortho within 3024 hours