Shark attack ⚠️🦈
This is a case of a 39-year-old female attacked by a shark while on vacation in Mexico. The patient sustained severe injuries to her left arm and her left thigh. She was transferred to a Canadian institution after ambiguous operative management in Mexico and presented with no clear antibiotic coverage and a Volkman's contracture of the left upper extremity. In total, the patient underwent four washouts of wounds, two split-thickness skin grafts, one free anterolateral thigh flap, and one free transverse rectus abdominus myocutaneous flap for the reconstruction and salvage of the left lower extremity. As with all trauma, hospital-based management of shark attacks initially involves a trauma assesment based on the ATLS guidelines. Once the patient is stable, operative management for further wound exploration is required to better assess all anatomica structures. Copious irrigation and debridement of devitalized tissue is also necessary. The first surgical procedure should be short and goal-oriented. Plain radiographs of all injured sites are necessary to better detect possible fracture, fragments of teeth, or preiosteal injury. Credit: Mélissa Roy, Mathew A Plant, Laura Snell, Archives of plastic surgery 2017
