Surgical Care in Post-Traumatic Renal Failure

The presence of crushed, necrotic, and infected tissues in a patient with acute renal failure can enormously complicate the management of the patient's hospital course and, in many cases, can lead to a much more rapid progression of uremia and potassium intoxication. This situation has been abundantly documented in recent years.^1-3 While it is generally agreed that necrotic tissue should be immediately debrided in these patients,^4,5 it has been noted that at times little benefit seems to accrue from this procedure.⁴ The following cases are offered as examples of what may be expected of surgery under various circumstances in post-traumatic acute renal failure.

Clinical Material  These patients were treated at a specialized treatment center in Korea where casualties who developed post-traumatic renal insufficiency were referred. An artificial kidney was employed as an adjunct in controlling uremia and potassium intoxication. Many of these patients had received massive wounds.