ABSTRACT
Major soft tissue injuries including the skin, the subcutaneous and muscle layers, and occasionally involving additional damage to nerves, vessels, and bones, are a therapeutic challenge at pediatric trauma centers. Owing to the variety of anatomical structures involved, these injuries frequently require multidisciplinary management. Soft tissue wounds occur at a similar frequency in all children, but a marked rise in the incidence is noted when adolescents start to use motorcycles. Boys are more frequently affected than girls, the male female ratio being 3:2. The predominant causes of these injuries are falls with a major crush of the body on a hard surface, e.g. after skateboard, bicycle, motorcycle or car accidents. Extensive soft tissue damage may occur after accidents with a lawn mower, or when using other equipment with fast-spinning parts (such as those used in farming) and after gunshots. Another cause of extensive soft tissue injury is avulsions, which may occur when a child is run over by a car, or bitten by a dog.
