P179 Innovative approach to upper limb salvage: integrating regional anaesthesia (RA) with ozone therapy. A case report.
Bibliographic record
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Background and Aims Upper limb trauma presents significant challenges, with decision regarding salvage versus amputation crucial due to functional implication. Ozone exhibits beneficial effects as a disinfectant, oxygen donor, inducer of endothelial nitric oxide synthase, and stem cell activator. We hypothesized that combining ozone therapy with surgery could effectively manage mangled upper limbs. Besides optimal control of pain, RA could play a role in improving tissue perfusion due to sympathetic block and switching inflammation off. Methods A 34-year-old man endured severe upper limb trauma with marked tissue loss, multiple fragmented open fractures and muscular necrosis leading to septic shock, rhabdomyolysis, and multi-organ failure. He underwent numerous interventions of surgical curettages, VAC-therapy, iv antibiotic therapy. Considering the high risk of disarticulation, we performed daily autohemotherapy with a 500 ml blood-oxygen-ozone blend (40 mcg/ml) for 10 days, followed by twice-weekly sessions for 2 weeks. We repeatedly performed supraclavicular block using ropivacaine 0.5% 20 ml to allow surgery and manage perioperative pain. Results Significant improvement was noted after the first session, with reduced putrescent tissue and improved limb perfusion. Progressive clinical improvement led to definitive osteosynthesis and flap grafting 42 days after admission. Conclusions Managing major upper extremity trauma is challenging, and the decision between amputation and limb salvage remains controversial due to limited evidence. Ozone therapy could have been synergic to RA in defusing inflammatory cascade and recruiting microcirculation in order to improve mangled tissue perfusion. This case report represents a potentially successful and safe approach to salvage limbs, avoiding destructive amputation surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.011 | 0.006 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".