Specificities of hand trauma in agriculture

Abstract

Background/Aim. Hand injuries in agriculture are characterized by massive destruction of all tissues, frequent amputations of finger, hand and often the whole extremity. These injuries are mutilant and can cause death. The aim of this paper was to show the specificities of hand injuries in agriculture in regard to hand injuries of other etiology. Methods. We analyzed patients that were treated in the Department for Plastic and Reconstructive Surgery, Clinical Center Vojvodina, during a five-year period (2003-2007) because of hand injuries. Results. In a five-year period there were 366 patients hospitalized because of hand injuries, out of whom 36 injuries were related to agricultural machinery use. In both groups the number of patients trended to increased, with male gender being dominant. Most of the patients were young or middle-aged men. In agricultural injuries most of the patients were in the group of 41-50-year old (30%), while in the other group, the patients were younger (21-30-year old). Hand injuries in agriculture resulted in finger amputation in 92%, while in the other group that number was much smaller (13%). Skin defect reconstruction in agricultural injuries required complex methods of skin grafting or skin flaps in more than 71%, while this was necessary in only 10% of other hand injuries. Conclusion. Hand injuries in agriculture are very mutilant and often result in conquassation and finger amputation. A possibility to preserve tissue damaged in this way is very limited, and skin closer usually requires complex methods.Uvod/Cilj. Povrede sake koje nastaju u radu sa poljoprivrednim masinama karakterisu se velikim destrukcijama tkiva, cestim amputacijama prstiju, sake, nekad i celog gornjeg ekstremiteta, izuzetno su mutilantne i mogu dovesti do smrtnog ishoda. Cilj rada bio je da se ukaze na specificnosti povreda sake u poljoprivredi u odnosu na povrede sake druge etiologije. Metode. Analizom su bili obuhvaceni bolesnici sa povredama sake leceni na Klinici za plasticnu i rekonstruktivnu hirurgiju Klinickog centra Vojvodine u petogodisnjem periodu, od 2003. do 2007. godine. Rezultati. U posmatranom periodu leceno je 366 bolesnika zbog povreda sake, od cega 36 bolesnika zbog povreda nastalih u radu sa poljoprivrednim masinama. U obe grupe bolesnika odrzavao se trend porasta broja povreda sa dominantnim ucescem muskog pola. Povrede su najcesce pogadjale muskarce mladjeg i srednjeg zivotnog doba, sa najvecim brojem bolesnika u grupi od 41-50 godina za poljoprivredni traumatizam (30%), odnosno od 21-30 godina za povrede sake ostale etiologije (22%). Povrede poljoprivrednog traumatizma kod 92% bolesnika dovodile su do konkvasacije sa amputacijom prstiju, dok je procenat povreda druge etiologije bio znatno manji (13%). Zatvaranje rane kod preko 71% bolesnika sa povredama sake u poljoprivredi bilo je moguce samo koznim transplantatom ili reznjem, dok je to bilo neophodno kod svega 10% bolesnika sa povredama sake druge etiologije. Zakljucak. Povrede sake u poljoprivredi predstavljaju izrazito mutilantne povrede, najcesce predstavljene konkvasacijom sa amputacijom prstiju ili cele sake. Mogucnosti prezerviranja ovako destruisanog tkiva veoma su male, a zatvaranje koznog defekta zahteva kompleksnije metode rekonstrukcije.