摘要:

The incidence of chondritis after burns of the ear is very low if pressure is avoided and silver sulfadiazene or Sulfamylon applied. However, because the treatment of chondritis usually results in markedly distorted external ears, burn care must be aimed at achieving an incidence of zero. We reviewed the cases of patients with chondritis and our treatment of patients with ear burns in an effort to determine why we continue to have a few cases of chondritis. We found that in our Burn Center chondritis after significant ear burns occurs only when we discontinue the standard treatment before total healing or when the standard method is never initiated. Therefore, we now continue pressure prevention and silver sulfadiazene until the ears are totally reepithelialized and use this method even on less significant injuries.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A retrospective study of breast reductions in 268 patients by two plastic surgeons was performed. Particular attention was paid to those patients treated by inferior pedicle techniques; these patients were compared with those treated by free nipple grafts. According to our findings, patients with skin loss were heavier and had longer suprasternal notch-to-nipple distances. Patients who had free nipple grafts were older and heavier and had larger specimen weights and longer suprasternal notch-to-nipple distances. Fifty-four of the original 268 patients were included in a substudy of larger breasts, defined as those with a specimen weight of over 700 g. Nineteen patients underwent free nipple grafts, and 35 underwent inferior pedicle techniques. None of the 19 patients having free nipple grafts developed complications, whereas 6 of the 35 undergoing inferior pedicle techniques sustained significant complications. We conclude that free nipple grafts should be considered over inferior pedicles in heavier patients with breast ptosis.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The nasal reconstruction in 8 patients and cheek reconstruction in 1 using a free flap from the deltoid region has been successfully undertaken in our department since August 1987. The flap has a direct cutaneous artery—the acromial artery—as its vascular axis. The experiences and a brief anatomical review of the donor site are reported.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The efficacy of using hydrodistention and vasodilatory drugs to relieve spasm in arteries was investigated. The femoral arteries of 64 rabbits (divided into five groups) were placed in spasm by the topical application of epinephrine (1 mg/ml). In group A (controls) vasospasm was induced without further treatment. In group B vasospasm was induced, and the arteries were hydrodistended with normal saline. In three additional groups vasospasm was induced and either 10% lidocaine hydrochloride (group C), verapamil hydrochloride (group D), or chlorpromazine hydrochloride (group E) was applied. Thirty minutes later the vessels were hydrodistended. All vessels were measured at set intervals, and some specimens were retained for light and electron microscopy. All methods of spasm relief were successful, although to varying degrees. Hydrodistention alone produced the widest dilation for the longest time. Lidocaine was the most successful drug treatment alone. Verapamil followed by hydrodistention was the most successful combination regimen, but did not produce better results than hydrodistention alone. Hydrodistention alone produced significant arterial wall damage, resulting in permanent structural modifications. Prior vasodilatory drug treatment reduced but did not eliminate hydrodistention damage. Although hydrodistention dilates for longer periods than vasodilatory drugs, the arterial wall damage associated with hydrodistention indicates that it should be used only when all other methods of vasodilation have failed.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Accidental injection of local anesthetics containing epinephrine into a digit can cause distal tissue necrosis. Norepinephrine infiltration in subcutaneous tissue also causes tissue necrosis. Phentolamine has been used to prevent necrosis from norepinephrine. Because both epinephrine and norepinephrine are alpha- and beta-adrenergic stimulators, the rat foot model was developed to study the possible use of phentolamine or labetalol in protection against tissue necrosis after injection of epinephrine in the extremity.Phentolamine was found to be useful in preventing tissue necrosis after the injection of local anesthetic containing epinephrine in the skin of the rat foot. Labetalol was found to be less effective in preventing tissue necrosis. Phentolamine may be useful in preventing tissue necrosis after the inadvertent injection of epinephrine containing local anesthetics in the digit.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The effect of pentoxifylline, a hemorheological agent that increases erythrocyte flexibility and augments capillary blood flow, on the survival of the dorsal skin flap of the rat was studied. An experimental group received intraperitoneal injections of pentoxifylline twice daily, 50 mg/kg/day, and a control group was given identical volumes of saline. Standard McFarlane flaps sized 4 × 9 cm (n = 22) and narrower 2 × 6-cm flaps (n = 18) were constructed 14 days later. After a postoperative observation period of 7 days, no significant difference in tissue survival between the pentoxifylline-treated animals and the controls was found in either flap model. Fourteen days preoperative treatment with pentoxifylline appeared to have no effect on flap survival.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Burn wound sepsis can be due to exogenous or endogenous bacteria. When rare organisms cause infection, exogenous sources are implicated. This sets into motion hospital infection control team searches, which are both exhausting and harassing to patients and staff. This study examines the skin bacteria present at admission and the frequency of endogenous infection in burn patients. Sixty-two patients with burns up to 92% of the total body surface area underwent unburned skin bacterial surveillance on admission and at weekly intervals using RODAC contact plates. Burn wounds were biopsied for quantitative and qualitative analyses. Morphologically dissimilar colonies were isolated and identified using standard gram-positive and gram-negative identification strips (Analytab Products, Inc. [API]). On admission, the patients harboredStaphylococcusspecies, many of which were unusual and virulent strains. Ten of 11 patients with burn wound sepsis were infected with the same organisms cultured from their unburned skin on admission. A subset of patients (14) grew methicillin-resistantStaphylococcus aureusfrom their wounds or other sites. A comparison with admission isolates showed identical susceptibilities. These data suggest skin is an endogenous source of infection in the burned patient.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The absorption of onlay membranous and enchondral bone graft struts and paste was studied in immature New Zealand rabbits using a volume-displacement technique to determine the volume change in the grafts 8 weeks and 21 weeks after grafting. Membranous and enchondral bone paste does not survive as an onlay graft. Both enchondral and membranous bone graft struts undergo significant resorption (78% decreased volume in the enchondral grafts and 50% in the membranous bone grafts). These data support the clinical experience that both types of onlay bone grafts lose significant volume, and are in relative contradistinction to prior animal studies comparing membranous and enchondral onlay bone grafts.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

An experimental study was designed using domestic pigs to evaluate the effect of high-voltage pulsed galvanic stimulation (HVPGS) on the rate of healing of full-thickness thermal burns. Twenty animals were used in the study; each one received two standardized burns over the paravertebral region. In half of the animals, HVPGS was performed daily for the study period. One of the burn wounds in each pig was used to evaluate wound contraction by measuring the wound surface weekly for four weeks. The second burn wound had weekly tissue biopsies to evaluate fibroblast population. The data showed a significantly faster rate of wound contraction (p < 0.001) and a higher fibroblast response (p < 0.001) in the HVPGS group when compared with controls.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Reanimation of the face following facial nerve paralysis, especially the socially important smile, presents a complex surgical challenge requiring an individualized approach. Both neural and non-neural operative procedures have been used in an attempt to achieve the goal of a symmetrical synchronous smiling expression.A retrospective review of the results of both neural and non-neural methods was made to determine the relative efficacy of various methods. Of the neural techniques, early direct nerve repair primarily consistently achieved the best functional recovery. Double nerve grafts were found to be superior to a single nerve graft in nerve severance with a nerve gap at the facial nerve trunk bifurcation in delayed cases. In long-standing cases, ipsilateral or cross-face nerve grafting followed by functioning muscle transfer gives the most acceptable synchronous smile. Although cross-face nerve graft only, hypoglossal facial transfer, or non-neural techniques such as temporal muscle transfer achieved restoration of the smile, their inconsistent results and asynchronous action still limited the patient's confidence in social interactions.

ISSN:0148-7043    

出版商:OVID    

年代:1989

数据来源: OVID