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Trauma plastics

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https://www.readbyqxmd.com/read/29773764/degloving-lower-leg-injury-the-importance-of-additional-treatment-negative-pressure-and-hyperbaric-oxygen-therapy
#1
Piotr Stabryła, Joanna Kulińska, Łukasz Warchoł, Anna Kasielska-Trojan, Wojciech Gaszyński, Bogusław Antoszewski
Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss. In this article, we present the management and therapeutic outcomes of a patient admitted due to the degloving injury of the lower extremity caused by workplace accident. We described the complexity of treatment including surgical intervention as well as additional treatment, which combined brought good esthetic outcome...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29772982/randomized-pilot-study-to-compare-metal-needles-versus-plastic-cannulae-in-the-development-of-complications-in-hemodialysis-access
#2
Rosa M Marticorena, Niki Dacouris, Sandra M Donnelly
BACKGROUND: Hemodialysis requires needle insertions every treatment. Needle injury (mechanical or hemodynamic) may cause complications (aneurysms/stenosis) that compromise dialysis delivery requiring interventions. Metal needles have a sharp slanted "V"-shaped cutting tip; plastic cannulae have a dull round tip and four side holes. Preliminary observations demonstrated a difference in intradialytic blood flow images and mean Doppler velocities at cannulation sites between the two devices...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29771884/-exophthalmometry-with-computed-tomography
#3
M B Gushchina, D S Afanasyeva, S A Borzenok
Bone abnormalities of orbit seen in patients with trauma or radiolesion are accompanied by enophthalmos or exophthalmos. Conventional measurements of eyeball protrusion with Hertel's exophthalmometer or with computed tomography do not provide accurate and reliable data, especially in patients with asymmetry of lateral orbital rims. PURPOSE: To develop a method of computed exophthalmometry that provides accurate and reliable measurements in patients with various orbital conditions. MATERIAL AND METHODS: Medical records and computerized axial tomography scans of 25 patients' orbits without false enophthalmos or exophthalmos were analyzed posthoc...
2018: Vestnik Oftalmologii
https://www.readbyqxmd.com/read/29759498/the-extent-of-mechanical-esophageal-deviation-to-avoid-esophageal-heating-during-catheter-ablation-of-atrial-fibrillation
#4
Chandrasekar Palaniswamy, Jacob S Koruth, Alexander J Mittnacht, Marc A Miller, Subbarao Choudry, Rahul Bhardwaj, Dinesh Sharma, Jonathan M Willner, Sujata S Balulad, Elizabeth Verghese, Georgios Syros, Anurag Singh, Srinivas R Dukkipati, Vivek Y Reddy
OBJECTIVES: This study sought to determine the extent of lateral esophageal displacement required during mechanical esophageal deviation (MED) and to eliminate luminal esophageal temperature elevation (LETElev ) during pulmonary vein (PV) isolation. BACKGROUND: MED is a conceptually attractive strategy of minimizing esophageal injury while allowing uninterrupted energy delivery along the posterior left atrium during PV isolation. METHODS: MED was performed using a malleable metal stylet within a plastic tube placed within the esophagus...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29757045/combination-therapy-for-bulky-auricular-keloids-a-clinical-experience
#5
Yanqing Yang, Changyan Jiang, Qijun Xu
Auricular keloids are common following ear piercing, infection, trauma, burns, or spontaneously, and they are highly resistant for treatment and are followed by severe cosmetic problems, especially for patients with bulky auricular keloids. The risk of recurrence and the need to return to the normal anatomy of external ear following resection is a challenge to the plastic surgeon. The authors present their experience of treating bulky auricular keloids with surgical excision, followed by immediate postoperative radiotherapy and intralesional steroid injection...
May 14, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/29738289/tgf%C3%AE-3-msx1-and-mmp3-as-candidates-for-nscl%C3%A2-p-in-an-indian-population
#6
Priyanka Kumari, Subodh Kumar Singh, Rajiva Raman
OBJECTIVE: To evaluate the association of transforming growth factor β3 ( TGFβ3), muscle segment homeobox 1 ( MSX1), Metalloproteinases 3 ( MMP3), and MMP9 genes as candidates for nonsyndromic cleft lip and/or palate in an Indian population. DESIGN: Case-control association study, mutational screening, and functional evaluation of obtained mutations. SETTING: Mutational screening of the developmental genes, TGFβ3 and MSX1, along with functional evaluation and association of promoter region SNPs-one each in MMP3 and MMP9...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29697631/facial-fractures-pearls-and-perspectives
#7
Obaid Chaudhry, Matthew Isakson, Adam Franklin, Suhair Maqusi, Christian El Amm
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the A-frame configuration of anterior facial buttresses, recognize the importance of restoring anterior projection in frontal sinus fractures, and describe an alternative design and donor site of pericranial flaps in frontal sinus fractures. 2. Describe the symptoms and cause of pseudo-Brown syndrome, describe the anatomy and placement of a buttress-spanning plate in nasoorbitoethmoid fractures, and identify appropriate nasal support alternatives for nasoorbitoethmoid fractures...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29674970/hypothesis-the-psychedelic-ayahuasca-heals-traumatic-memories-via-a-sigma-1-receptor-mediated-epigenetic-mnemonic-process
#8
Antonio Inserra
Ayahuasca ingestion modulates brain activity, neurotransmission, gene expression and epigenetic regulation. N,N -Dimethyltryptamine (DMT, one of the alkaloids in Ayahuasca) activates sigma 1 receptor (SIGMAR1) and others. SIGMAR1 is a multi-faceted stress-responsive receptor which promotes cell survival, neuroprotection, neuroplasticity, and neuroimmunomodulation. Simultaneously, monoamine oxidase inhibitors (MAOIs) also present in Ayahuasca prevent the degradation of DMT. One peculiarity of SIGMAR1 activation and MAOI activity is the reversal of mnemonic deficits in pre-clinical models...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29672784/successful-replantation-of-the-scalp-with-a-good-aesthetic-outcome-and-return-of-sensation-a-case-report-and-literature-update
#9
Lukasz Ulatowski, Anna Kaniewska
Replantation of a totally avulsed scalp is a demanding microsurgical procedure with no good alternatives. Here, we present a case of successful scalp replantation after 11 hours of cold ischemia in a 24-year-old woman. The steps of the procedure, the outcomes, and a review of the literature are presented. Adhering to the steps outlined in this report during replantation is vital for success, and allows the serious complications and pitfalls associated with this procedure to be avoided. Following basic plastic surgery principles leads to better aesthetic outcomes...
April 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29666944/macrophages-play-an-essential-role-in-trauma-induced-sterile-inflammation-and-tissue-repair
#10
REVIEW
Moritz Peiseler, Paul Kubes
Severe trauma is accompanied by a profound activation of the immune system. Patients with polytrauma develop systemic inflammatory response syndrome (SIRS) and often sepsis, which contributes substantially to high mortality of this condition. On a cellular level, necrosis and loss of plasma membrane integrity lead to the release of endogenous "damage-associated molecular patterns" (DAMPs) as danger signals, which in turn activate innate immune cells. Inflammation that occurs in the absence of invading pathogens has been termed sterile inflammation and trauma with tissue damage represents an acute form of sterile inflammation...
April 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29663410/the-negotiated-equilibrium-model-of-spinal-cord-function
#11
Jonathan R Wolpaw
The belief that the spinal cord is hardwired is no longer tenable. Like the rest of the CNS, the spinal cord changes during growth and aging, when new motor behaviours are acquired, and in response to trauma and disease. This paper describes a new model of spinal cord function that reconciles its recently appreciated plasticity with its long recognized reliability as the final common pathway for behaviour. According to this model, the substrate of each motor behaviour comprises brain and spinal plasticity: the plasticity in the brain induces and maintains the plasticity in the spinal cord...
April 16, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29656802/impact-on-the-brain-of-the-inflammatory-response-to-surgery
#12
Sarah Saxena, Mervyn Maze
The brain is both the orchestrator as well as the target of the innate immune system's response to the aseptic trauma of surgery. When trauma-induced inflammation is not appropriately regulated persistent neuro-inflammation interferes with the synaptic plasticity that underlies the learning and memory aspects of cognition. The complications that ensue, include postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) at two poles of a constellation that is now termed perioperative neurocognitive disorders...
April 12, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29651387/synchronous-soleus-and-reverse-sural-flap-for-large-soft-tissue-defect-reconstruction-of-leg
#13
Seyed Esmail Hassanpour, Masoud Yavari, Amir Reza Motabar
BACKGROUND: Extended Soft tissue defect of leg including middle and distal parts always has been a challenge for many plastic surgeons and also a frustrated problem for patients and families. To introduce the use of the soleus muscle and reverse sural flaps as synchronous surgical treatment alternative of the leg bone exposure with large soft tissue defect, this study was conducted. METHODS: The medical records of patients undergoing transposition of the soleus muscle for treating exposed bone in the leg and simultaneous sural flap were retrospectively analyzed from January 2009 to July 2014, while gathering information on the used muscle was to cover the lesion...
January 2018: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29626545/hypoxia-selective-allosteric-destabilization-of-activin-receptor-like-kinases-a-potential-therapeutic-avenue-for-prophylaxis-of-heterotopic-ossification
#14
Guorong Lu, Mary R Tandang-Silvas, Alyssa C Dawson, Trenton J Dawson, Jay C Groppe
Heterotopic ossification (HO), the pathological extraskeletal formation of bone, can arise from blast injuries, severe burns, orthopedic procedures and gain-of-function mutations in a component of the bone morphogenetic protein (BMP) signaling pathway, the ACVR1/ALK2 receptor serine-threonine (protein) kinase, causative of Fibrodysplasia Ossificans Progressiva (FOP). All three ALKs (-2, -3, -6) that play roles in bone morphogenesis contribute to trauma-induced HO, hence are well-validated pharmacological targets...
April 4, 2018: Bone
https://www.readbyqxmd.com/read/29620609/the-use-of-closed-incision-negative-pressure-wound-therapy-in-orthopaedic-surgery
#15
Denis Nam, Robert A Sershon, Brett R Levine, Craig J Della Valle
Wound complications and surgical site infections after orthopaedic procedures result in substantial morbidity and costs. Traditional postoperative wound care consists of applying sterile, dry gauze and abdominal pads to the surgical site, with more frequent dressing changes performed in cases in which wound drainage is excessive. Persistent incisional drainage is of particular concern because it increases the risk of deep infection. The use of closed incision negative-pressure wound therapy (ciNPWT) to manage delayed wound healing was first reported a decade ago, and the benefits of this treatment modality include wound contraction with diminished tensile forces, stabilization of the wound environment, decreased edema and improved removal of exudate, and increased blood and lymphatic flow...
May 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29588023/managing-soft-tissues-in-severe-lower-limb-trauma-in-an-ageing-population
#16
Timothy M Noblet, Philippa C Jackson, Patrick Foster, David Martin Taylor, Paul J Harwood, Jay D Wiper
PURPOSE: With an ageing population, the incidence of trauma in those aged over 65 years is increasing. Strategies for dealing with these patients must be developed. At present the standard management of open tibial fractures in the UK is described by the BOAST4 guidelines (from the British Orthopaedic Association and British Association of Plastic & Aesthetic Surgeons). It is not clear to what extent these are appropriate for older patients. We describe our experience of managing elderly patients presenting with open tibial fractures...
March 13, 2018: Injury
https://www.readbyqxmd.com/read/29577778/management-of-postfasciotomy-wounds-and-skin-defects-following-complex-vascular-trauma-to-the-extremities-using-the-external-tissue-extender-system
#17
Christos D Karkos, Ioakeim Papoutsis, Ioakeim T Giagtzidis, Ioannis Pliatsios, Maria-Aphroditi Mitka, Konstantinos O Papazoglou, Apostolos G Kambaroudis
Management of large postfasciotomy wounds and/or skin and soft tissue defects after major vascular trauma to the extremities can be challenging. The External Tissue Extender (Blomqvist; ETE), a skin-stretching device, which consists of silicone tapes and plastic stoppers, approximates wound margins and facilitates delayed primary closure. We describe our experience with the use of ETE in 5 patients (4 males) with a total of 8 wounds (7 postfasciotomy, 1 soft tissue defect) over the past 12 years. The mean patient age was 32 (range 17-61) years...
March 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29574815/reconstruction-of-major-defects-of-the-jaws
#18
M D Batstone
Prosthetic replacements in the 19th and early 20th century were superseded by pedicled flaps and obturators. These have subsequently been superseded by free tissue transfer which currently is the mainstay of reconstructive jaw surgery. Although malignant and benign processes of the jaws are the predominant cause of segmental defects, a significant proportion still occurs due to trauma, or even iatrogenic causes such as radiotherapy. The varied aetiologies demand a nuanced approach to reconstruction and although the techniques remain similar the timing can be quite different...
March 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29554062/traumatic-bony-ankylosis-of-temporomandibular-joint-as-a-complication-after-reduction-malarplasty
#19
Malavika Subu, Jun-Young Paeng
Reduction malarplasty is one of the most commonly performed cosmetic and plastic surgery in Asian countries. Bony ankylosis of the temporomandibular joint (TMJ) occurs usually as a result of trauma, infection, failed surgeries, and autoimmune diseases. Reduction malarplasty has low incidence of TMJ-related complications. A 33-year-old female patient came with complaint of restricted mouth opening around 18 mm, which was developed immediately after the reduction malarplasty 2 years before. On computed tomography image, bony adhesion and the defect from the surgical drilling were found around right TMJ...
March 16, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29536742/neuronal-regeneration-in-injured-rat-spinal-cord-after-human-dental-pulp-derived-neural-crest-stem-cell-transplantation
#20
S Kabatas, C S Demir, E Civelek, I Yilmaz, A Kircelli, C Yilmaz, Y Akyuva, E Karaoz
OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (hDP-NCSCs) delivery on lesion site after spinal cord injury (SCI), and to observe the functional recovery after transplantation. METHODS: Neural Crest Stem Cells (NCSCs) were isolated from human Dental Pulp (hDP). The experimental rat population was divided into four groups (n = 6/24). Their behavioral motility was scored regularly. After 4-weeks, rats were sacrificed, and their spinal cords were examined for Green Fluorescent Protein (GFP) labeled hDP-NCSCs by immunofluorescence (IF) staining...
2018: Bratislavské Lekárske Listy
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