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Wound debridement

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https://www.readbyqxmd.com/read/28933699/pyoderma-gangrenosum-an-uncommon-case-report-and-review-of-the-literature
#1
António Carlos Lemos, Debora Aveiro, Natália Santos, Vítor Marques, Luís Filipe Pinheiro
BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative condition that is diagnostically and therapeutically challenging, as debridement leads to ulcer deterioration (pathergy phenomenon); immunosuppression is considered the gold standard therapy. CASE REPORT: The authors present the case of a 42-year-old woman with PG and uncontrolled iatrogenic diabetes, secondary to a total pancreatectomy performed in another hospital in 1998 due to nesidioblastosis. In 2008, she was referred to the diabetic foot consultation at Centro Hospitalar Tondela-Viseu (Viseu, Portugal) due to an infected wound on the left leg thought to be related to a trauma from footwear, but the injury worsened despite treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28929035/porcine-urinary-bladder-matrix-for-management-of-infected-radiation-mastectomy-wound
#2
Yana Puckett, Theophilus Pham, Shirley McReynolds, Catherine A Ronaghan
We present a case report on the successful healing of a Pseudomonas infection wound in a 52-year-old female with morbid obesity, noninsulin dependent diabetes mellitus and a history of tobacco use, who presented with Stage IIIA (T3, N2, Mo) infiltrating ductal carcinoma. The patient received neoadjuvant chemotherapy prior to her bilateral skin-sparing total mastectomies with right axillary sentinel lymphadenectomy. She also had staged reconstruction with temporary breast implants and plans for deep inferior epigastric perforator flaps...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28926877/-clinical-effects-of-repair-of-wounds-in-fingers-after-electrical-burn-with-wrist-perforator-free-flaps
#3
H P Di, C D Xia, P P Xing, Q Li, D W Han, J D Xue, D Y Cao
Objective: To explore the clinical effects of repair of wounds in the fingers after electrical burn with wrist perforator free flaps. Methods: Twelve patients (13 fingers) with electrical burn were hospitalized in our burn ward from January 2016 to January 2017. After radical debridement, the size of wounds ranged from 5.0 cm×2.0 cm to 10.0 cm×7.0 cm. Wounds with size below or equal to 6.0 cm ×2.5 cm were repaired with free flaps based on the superficial palmar branch of radial artery, with flap area ranging from 2...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926875/-effects-of-perforator-flaps-combined-with-muscle-flaps-for-repairing-grade-%C3%A2-pressure-ulcers-in-ischial-tuberosity-of-elderly-patients
#4
W G Su, D P Li, P P Xing, L G Xu, F C Shi, B Wen, X H Niu
Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#5
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28918465/congenital-lumbar-kyphosis-with-skin-ulceration-and-osteomyelitis-in-a-myelomeningocele-child-a-case-report
#6
Benoit Vibert, Marco Turati, Pierre-Yves Rabattu, Marco Bigoni, Ahmad Eid, Aurélien Courvoisier
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#7
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28906298/a-simple-flap-design-for-the-salvage-of-immediate-implant-based-breast-reconstruction
#8
Sukru Yazar, Altug Altinkaya, Emine Cigdem Karadag, Halil Kara, Cihan Uras
BACKGROUND: Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant. In this article, the use of local pedicled flap for the management of these situations was discussed. METHODS: Between April 2010 and July 2015, 54 patients underwent breast reconstruction by inverted-T skin-reducing mastectomy and immediate implant-based breast reconstruction at our clinic...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28894663/deltopectoral-and-pectoralis-musculocutaneous-flap-technique-for-cervical-esophageal-reconstruction-after-free-jejunal-flap-necrosis
#9
Hajime Matsumine, Kazuyuki Kubo, Atsumori Hamahata, Hiroyuki Sakurai
BACKGROUND: Free jejunal transfer has a high success rate, but if vascular thrombosis occurs, the salvage of failing flap with reanastomosis is difficult. This study described a combined deltopectoral (DP) and pectoralis major musculocutaneous (PMMC) flap 2-step technique for cervical esophageal reconstruction after free-jejunal-flap necrosis. METHODS: In step 1, the detection of free jejunal flap with the subsequent debridement of necrotic and infected tissue was followed by the construction of external fistula on the pharyngeal side with the hole in cervical skin and the construction of another external fistula on the esophageal side and tracheal stoma with a single or double DP flap...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28877804/use-of-antibiotic-impregnated-absorbable-beads-and-tissue-coverage-of-complex-wounds
#10
MULTICENTER STUDY
Terris L White, Alfred T Culliford, Martin Zomaya, Gary Freed, Christopher P Demas
The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28877672/chronic-lower-extremity-wound-infection-due-to-kerstersia-gyiorum-in-a-patient-with-buerger-s-disease-a-case-report
#11
Irmak Baran, Arife Polat Düzgün, İpek Mumcuoğlu, Neriman Aksu
BACKGROUND: Kerstersia gyiorum is an extremely rare pathogen of human infection. It can cause chronic infection in patients with underlying conditions. It can easily be misdiagnosed if proper diagnostic methods are not used. CASE PRESENTATION: A 47-year-old male patient with a history of Buerger's Disease for 28 years presented to our hospital with an infected chronic wound on foot. The wound was debrided, and the specimen was sent to Microbiology laboratory. Gram staining of the specimen showed abundant polymorphonuclear leukocytes and gram-negative bacilli...
September 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28876688/management-of-myelomeningocele-in-the-province-of-kwazulu-natal-south-africa
#12
M N Mnguni, B Enicker, T E Madiba
BACKGROUND: Spina bifida is the most common of congenital anomalies of the central nervous system that are compatible with life. The most frequent form is myelomeningocele. METHOD: Setting: Neurosurgery Unit, Inkosi Albert Luthuli Central Hospital. Patients: Consecutive children with diagnosis myelomeningocele who were managed at from January 2006 to December 2014. Design: Retrospective analysis of children with myelomeningocele. Multiple logistic regression analysis identified clinical, demographic and surgical variables that were associated with outcome...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873059/traction-assisted-internal-negative-pressure-wound-therapy-with-bridging-retention-sutures-to-facilitate-staged-closure-of-high-risk-wounds-under-tension
#13
Michael V DeFazio, James M Economides, Ersilia L Anghel, Ryan K Mathis, John R Barbour, Christopher E Attinger
BACKGROUND/OBJECTIVE: Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. MATERIALS AND METHODS: Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28871507/delayed-post-operative-tension-pneumocephalus-and-pneumorrhachis
#14
D C Kieser, D T Cawley, C Tavolaro, T Cloche, I Obeid, V Pointillart, J M Vital, O Gille
INTRODUCTION: The incidence of pneumocephalus and pneumorrhachis after spinal surgery is unknown, with a paucity of literature on this complication. MATERIALS AND METHODS: We present the first published case of delayed onset tension pneumocephalus and pneumorrhachis associated with spinal surgery. RESULTS: This complication occurred from a cerebro-spinal fluid (CSF) leak after posterior instrumentation removal and was successfully treated with emergent wound debridement and the formation of a CSF fistula...
September 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28862979/negative-pressure-wound-therapy-for-a-giant-wound-secondary-to-malignancy-induced-necrotizing-fasciitis-case-report-and-review-of-the-literature
#15
Jiayi Hu, Serge Goekjian, Nicolas Stone, Alexandra Nelson, Michael James Cooper
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening condition in which rapid diagnosis, debridement of nonviable tissue, and broad-spectrum antibiotics are critical to effective treatment. The debridement required can be extensive, resulting in large wounds that can sometimes be covered with split-thickness skin grafts (STSGs) with the help of negative pressure wound therapy (NPWT), or vacuum-assisted closure, to decrease the wound size. CASE REPORT: The authors report a rare case of NF due to malignancy-associated bowel perforation with a giant lower extremity wound secondary to debridement that involved 20% of the total body surface area (TBSA) in a 64-year-old, previously healthy, nonsmoking man...
August 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28862977/healing-rate-of-chronic-and-subacute-lower-extremity-ulcers-treated-with-contact-ultrasound-followed-by-noncontact-ultrasound-therapy-the-vip-ultrasound-protocol
#16
Lisley Viana, Matthew Pompeo
BACKGROUND: Contact and noncontact ultrasounds are types of low-frequency ultrasonic treatments for wound care. OBJECTIVE: The purpose of this research was to collect data in order to see if healing rates are accelerated when both forms of ultrasound therapies are utilized. MATERIALS AND METHODS: The Viana-Pompeo (VIP) Ultrasound Protocol consists of high-intensity, low-frequency, contact ultrasound therapy followed by low-intensity, low-frequency, noncontact ultrasound therapy...
August 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28862974/clostridial-collagenase-for-the-management-of-diabetic-foot-ulcers-results-of-four-randomized-controlled-trials
#17
John C Lantis Ii, Ian Gordon
BACKGROUND: Despite major treatment advances, diabetic foot ulcers (DFUs) remain a frequent and debilitating complication of diabetes mellitus and a major cause of significant morbidity and mortality. OBJECTIVE: This study evaluates and compares clinical effectiveness of clostridial collagenase ointment (CCO) with standard care (SC) in patients with DFUs, with the goal to define best clinical criteria under which to use CCO in the DFU population. MATERIALS AND METHODS: This is a pooled data analysis of 4 randomized controlled trials that compared clinical effectiveness of CCO to SC...
August 25, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28862056/the-use-of-engineered-bilayered-skin-myderm-tm-in-the-management-of-massive-skin-defect-in-grade-iii-gustilo-anderson-open-fracture
#18
Nor Hazla Mohamed Haflah, Min Hwei Ng, Mohd Heikal Mohd Yunus, Amaramalar Selvee Naicker, Ohnmar Htwe, Muhammad Fahmi, Mohamad Fikeri Ishak, Wan Tai Seet, Khairul Anuar Khairoji, Manira Maarof, Kien Hui Chua, Sharen Aini Shamsuddin, Ruszymah Idrus
Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect...
September 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28860830/economic-analysis-and-budget-impact-of-clostridial-collagenase-ointment-compared-with-medicinal-honey-for-treatment-of-pressure-ulcers-in-the-us
#19
Elizabeth S Mearns, Michael Liang, Brendan L Limone, Adrienne M Gilligan, Jeffrey D Miller, Kathleen D Schaum, Curtis R Waycaster
OBJECTIVES: Pressure ulcer (PU) treatment poses significant clinical and economic challenges to health-care systems. The aim of this study was to assess the cost-effectiveness and budget impact of enzymatic debridement with clostridial collagenase ointment (CCO) compared with autolytic debridement with medicinal honey (MH) for PU treatment from a US payer/Medicare perspective in the hospital outpatient department setting. METHODS: A cost-effectiveness analysis using a Markov model was developed using a 1-week cycle length across a 1-year time horizon...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28854408/wound-dehiscence-after-total-knee-arthroplasty
#20
Mohammad Ali Sazegari, Fateme Mirzaee, Fateme Bahramian, Zohreh Zafarani, Hamidreza Aslani
INTRODUCTION: Wound dehiscence is one of the most common complications of surgical ulcer, involving the breaking open of the surgical incision along the stitch. This condition is a severe complication of total knee arthroplasty. PRESENTATION OF CASE: We report a case of a 59-year-old female patient with diabetes who underwent a total knee arthroplasty in which all layers of wounds were dehiscence and prosthetic was exposed. DISCUSSION: Wound dehiscence is a complication after total knee arthroplasty especially in diabetic patient...
August 23, 2017: International Journal of Surgery Case Reports
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