CUTANEOUS NECROSIS AND ULCERS
Cutaneous loxoscelism or corner spider bite
Drug extravasations from a venous line
The corner spider bite (Loxoscele Laeta bite) can cause alterations in the blood, kidneys and skin necrosis. In the event of skin necrosis, attention by a surgeon is necessary for its reconstruction.
Extravasation of the venous line
Some medications are at risk of skin necrosis when the medication escapes into the subcutaneous and does not enter the vein. That needs attention from a surgeon and advance wound care treatment.
Pressure wounds o ulcers
Long lying or sitting in the same position can cause pressure sores. Depending on the depth and type of ulcer, it can be managed with advance wound care treatment or surgery to close the ulcer.
Gluteal Pressure Ulcers
Crushing the Skin of the Foot or Ankle by Bicycle Rays
Bicycle Foot and Ankle Attrision
Riding a child on a bicycle as a co-pilot but not in the proper seat or safety system can cause children's feet to come in contact with spokes of a moving bicycle. This produces an abrasive wound with or without fracture that can be deep and require surgical treatment.
Soft tissue Wounds
The skin tears occur as a cap and is attached only at one end to the rest of the body. Many times these wounds evolve with lack of irrigation in the most distal portion of the flap and the skin turns black or gray and needs evaluation by a surgeon.
Electrical, chemical and acid burns, among others, can cause a burn to compromise the full thickness of the skin. It look hard white, black or brown eschar. In these cases it is recommended to remove the clearly damaged skin and perform some type of closure or skin graft.
Necrosis of the fingers and amputations
Skin necrosis on the hand (crush trauma)
Strangling of the eye with hair.
Necrosis of the Fingers or Toes
Necrosis of the fingers or toes can be due very tight circular bandage or when children needs special drug therapy in the intensive care unit. Unfortunately, the blackness of the fingertips is suggestive of necrosis (tissue death) and inevitably that finger will be shorter. Many times it can be managed with advance wound care and other times it requires surgery to cover the phalanx (the bone).
Strangulation of the toes by hair
A hair can wrap around the toes of an infant and cause pain, a circular wound on the skin, infection and necrosis of the finger if it is neglected. It is a cause of consultation to the emergency due to irritability of the infant and can go unnoticed if the infant is not completely undressed.
Crushing Wounds of Hands and Feet
Crushing of the limb can be due a car accident, accident in a mixer or the fall of a blunt object on the limb. This type of mechanism makes bone and soft tissue injury (skin and muscles). It must be treated with the orthopedic surgeon and will require multiple surgeries and subsequent rehabilitation.
Ecthyma is a bacterial infection of the skin, which exceptionally requires surgical treatment. It can be confused with cutaneous loxocelism, but the ecthyma presents as an ulcer quickly (3 days), unlike loxoscelism that presents with livedoid plaque, eschar, and then an ulcer within 2-3 weeks.