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Open Access

Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip

Christina Colosimo, Charles Fredericks, James R Yon, John C Kubasiak, Faran Bokhari, Stathis Poulakidas
DOI: 10.1136/tsaco-2020-000502 Published 1 September 2020
Christina Colosimo
1Department of Trauma, Sky Ridge Medical Center, Lone Tree, Colorado, USA
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Charles Fredericks
2Department of General Surgery, Rush University Medical Center, Chicago, Illinois, USA
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James R Yon
3Department of Trauma and Acute Care Surgery, Swedish Medical Center, Englewood, Colorado, USA
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John C Kubasiak
2Department of General Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Faran Bokhari
4Department of Trauma And Burn, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
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Stathis Poulakidas
4Department of Trauma And Burn, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
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  • Figure 1
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    Figure 1

    Femoral head is dissected free.

  • Figure 2
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    Figure 2

    A large medial myocutaneous flap is created.

  • Figure 3
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    Figure 3

    The flap is closed to cover the defect, with drains to prevent a seroma.

Tables

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  • Table 1

    Demographic information

    PatientAge range (yearsSexDiagnosisOperative indicationComorbid conditionsUrinary tract infection
    155–60FVulvar cancerNSTIStroke, DMYes
    240–45FSacral ulcerNSTIHTN, DM, recent cardiac arrestNo
    325–30MTraumaTraumaNoneNo
    455–60MIschial ulcerNSTIGSW, paraplegiaNo
    530–35MSacral ulcerNSTIGSW, paraplegiaYes
    640–45MSacral ulcerNSTIGSW, paraplegia, UTIYes
    720–25MSacral ulcerNSTIGSW, paraplegiaYes
    830–35MIschial ulcerNSTIGSW, paraplegiaNo
    950–55MSacral ulcerNSTIGSW, paraplegiaNo
    • DM, diabetes mellitus; F, female; GSW, gunshot wound; HTN, hypertension; M, male; NSTI, necrotizing soft tissue infection; UTI, urinary tract infection.

  • Table 2

    Operative and postoperative information

    PatientLOS (days)OR visitsVentilator daysAcute respiratory distress syndromeSelf-transfer to wheelchair
    1220517YesNo
    255450NoNo
    31520NoYes
    42420NoYes
    532226YesYes
    61730NoNo
    74832NoYes
    85220NoYes
    92520NoYes
    • LOS, length of stay; OR, operating room.

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Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip
Christina Colosimo, Charles Fredericks, James R Yon, John C Kubasiak, Faran Bokhari, Stathis Poulakidas
Trauma Surg Acute Care Open Sep 2020, 5 (1) e000502; DOI: 10.1136/tsaco-2020-000502

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Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip
Christina Colosimo, Charles Fredericks, James R Yon, John C Kubasiak, Faran Bokhari, Stathis Poulakidas
Trauma Surg Acute Care Open Sep 2020, 5 (1) e000502; DOI: 10.1136/tsaco-2020-000502
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Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip
Christina Colosimo, Charles Fredericks, James R Yon, John C Kubasiak, Faran Bokhari, Stathis Poulakidas
Trauma Surgery & Acute Care Open Sep 2020, 5 (1) e000502; DOI: 10.1136/tsaco-2020-000502
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