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Wound managment

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https://www.readbyqxmd.com/read/29232685/surgical-management-of-deep-brain-stimulator-scalp-erosion-without-hardware-removal
#1
Michael D Staudt, Navid Pourtaheri, Gregory E Lakin, Hooman T Soltanian, Jonathan P Miller
BACKGROUND: Scalp erosion in patients with deep brain stimulation (DBS) hardware is an uncommon complication that lacks a clearly defined management strategy. Previous studies have described various therapies including conservative treatment with antibiotics and surgical debridement with or without hardware removal. OBJECTIVES: The aim of this study was to review the efficacy of a hardware-sparing management strategy for the treatment of scalp erosion. METHODS: Five patients with previous DBS implantation presented with scalp erosion and visible hardware exposure at the calvarial burr hole site, and underwent tension-free, vascularized, rotational scalp flap, with preservation of the leads under the pericranium...
December 13, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29231870/improving-the-care-and-treatment-of-monkeypox-patients-in-low-resource-settings-applying-evidence-from-contemporary-biomedical-and-smallpox-biodefense-research
#2
REVIEW
Mary G Reynolds, Andrea M McCollum, Beatrice Nguete, Robert Shongo Lushima, Brett W Petersen
Monkeypox is a smallpox-like illness that can be accompanied by a range of significant medical complications. To date there are no standard or optimized guidelines for the clinical management of monkeypox (MPX) patients, particularly in low-resource settings. Consequently, patients can experience protracted illness and poor outcomes. Improving care necessitates developing a better understanding of the range of clinical manifestations-including complications and sequelae-as well as of features of illness that may be predictive of illness severity and poor outcomes...
December 12, 2017: Viruses
https://www.readbyqxmd.com/read/29226885/peritoneal-pocket-hernia-a-distinct-cause-of-early-postoperative-small-bowel-obstruction-and-strangulation-a-report-of-two-cases-following-robotic-herniorrhaphy
#3
Sumana Narayanan, Tomer Davidov
Laparoscopic and robotic hernia surgery offers advantages over open herniorrhaphy including faster recover and lower wound infection but is associated with rare but serious complications such as visceral injury and intestinal obstruction. We describe two cases of small bowel obstruction with strangulation that occurred shortly after routine robotic hernia surgery. We define this rare type of strangulating internal hernia as a peritoneal pocket hernia and call attention to its diagnosis and management.
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29225596/il-15-enhances-activation-and-igf-1-production-of-dendritic-epidermal-t-cells-to-promote-wound-healing-in-diabetic-mice
#4
Yangping Wang, Yang Bai, Yashu Li, Guangping Liang, Yufeng Jiang, Zhongyang Liu, Meixi Liu, Jianlei Hao, Xiaorong Zhang, Xiaohong Hu, Jian Chen, Rupeng Wang, Zhinan Yin, Jun Wu, Gaoxing Luo, Weifeng He
Altered homeostasis and dysfunction of dendritic epidermal T cells (DETCs) contribute to abnormal diabetic wound healing. IL-15 plays important roles in survival and activation of T lymphocytes. Recently, reduction of epidermal IL-15 has been reported as an important mechanism for abnormal DETC homeostasis in streptozotocin -induced diabetic animals. However, the role of IL-15 in impaired diabetic wound healing remains unknown. Here, we found that, through rescuing the insufficient activation of DETCs, IL-15 increased IGF-1 production by DETCs and thereby promoted diabetic skin wound repair...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29225120/retained-bullet-in-the-kidney-imaging-and-conservative-management
#5
Guglielmo Mantica, Stephan Kruger, Hilgard Ackermann, Pieter V Spies, Farzana Cassim, Zamira Keyser, Carlo Terrone, André van der Merwe
Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active haemorrhage, peritonitis or hemodynamically unstable patients.1 However, due to the paucity of cases reported in the literature, it is not clear what the best management of patients with a retained bullet is, which have been traditionally treated with surgical retrieval in other organs. We present the radiological findings and a clinical case summary of a patient with Grade IV kidney injury and retained bullet managed conservatively...
December 7, 2017: Urology
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#6
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#7
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#8
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29220299/perioperative-management-of-extremity-soft-tissue-sarcomas
#9
Rick L Haas, Alessandro Gronchi, Michiel A J van de Sande, Elizabeth H Baldini, Hans Gelderblom, Christina Messiou, Eva Wardelmann, Axel Le Cesne
Surgery is potentially curative for primary nonmetastatic extremity soft tissue sarcomas. After surgery alone, patients may remain at risk for local recurrences and/or metastatic disease. To reduce the likelihood of a local relapse, the addition of radiotherapy (RT) to limb-sparing surgery may result in higher local control rates of at least 85%. Generally, it can be stated that local control after both preoperative and postoperative RT is comparable, but that preoperative RT comes with a more favorable toxicity profile after prolonged follow-up, albeit at the cost of a higher wound complication rate...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29219899/clinical-outcomes-using-oversized-back-plates-in-type-i-boston-keratoprosthesis
#10
Aaron R Kaufman, Andrea Cruzat, Kathryn A Colby
OBJECTIVES: To examine clinical outcomes of oversized titanium back plates in type I Boston keratoprosthesis (KPro) implantation. METHODS: Retrospective study of 22 sequential eyes (20 patients) undergoing type I KPro implantation with an oversized titanium back plate (larger than trephined wound diameter by 1.0 mm or more), performed by a single surgeon (K.A.C.) from June 2010 to November 2014. Data were collected regarding preoperative eye characteristics, surgical details, and postoperative clinical outcomes...
December 5, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/29219280/transperitoneal-vs-extraperitoneal-radical-cystectomy-for-bladder-cancer-a-retrospective-study
#11
Jagdeesh N Kulkarni, Himanshu Agarwal
PURPOSE: Conventional transperitoneal radical cystectomy (TPRC) is the standard approach for muscle invasive bladder cancer. But, the procedure is associated with significant morbidities like urinary leak, ileus, and infection. To reduce these morbidities, the technique of extraperitoneal radical cystectomy (EPRC) was described by us in 1999. We compared these two approaches and the data accrued forms the basis of this report. MATERIALS AND METHODS: All patients who underwent radical cystectomy for bladder cancer by the author (JNK) with follow-up for at least 5 years were included...
December 11, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29218292/primary-one-stage-reconstruction-in-complex-facial-avulsion-injury
#12
Abhishek Ghosh
Complex facial injuries with soft tissue degloving and bony avulsion are very devastating to the patient. Partial degloving injuries are described but hemifacial degloving with zygoma avulsion are rare. The author presents a case of post-traumatic degloving of the left upper lip, nose, part of forehead, upper and lower eyelids and cheek with avulsion of the left zygoma. The management included immediate resuscitation and early surgery to reposition the skeletal as well as soft tissue avulsion. The wound was thoroughly washed and primary repositioning and fixation were done...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29218283/early-reconstructions-of-complex-lower-extremity-battlefield-soft-tissue-wounds
#13
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi, Hamid Reza Rasouli
BACKGROUND: Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS: This was a prospective case series study of battled field injured patients which was done in the Department of Plastic Surgery, Baqiyatallah University of Medical Sciences hospitals, Tehran, Iran between 2013-2015...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29217672/digital-ischemia-after-application-of-self-adherent-elastic-wrap-dressing-a-case-series
#14
Christopher A Makarewich, Penelope Lang, Douglas T Hutchinson
Self-adherent elastic wrap dressings are a convenient option to manage pediatric hand and finger injuries. However, when improperly applied, they have the potential to cause devastating complications. We detail in this report 5 cases of dressing-induced ischemic injury to the hand in pediatric patients with a review of the literature. All patients were treated by the senior author between 2007 and 2015 and were retrospectively reviewed for initial injury, frequency of dressing changes, presence of pain, time to evaluation by the orthopedic hand team, treatment, and outcome...
December 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29214396/triple-management-of-cubitus-valgus-deformity-complicating-neglected-nonunion-of-fractures-of-lateral-humeral-condyle-in-children-a-case-series
#15
Yasser Abed, Khaled Nour, Yasser Roshdy Kandil, Abed El-Negery
BACKGROUND: Long standing nonunion of the lateral humeral condyle (LHC) usually results in elbow pain and instability with progressive cubitus valgus and tardy ulnar neuritis. Surgical treatment of long standing nonunion is still a controversial issue due to the reported complications, such as stiffness, loss of elbow motion, and avascular necrosis of the LHC fragment. In this study, we reported the outcomes of treatment of cubitus valgus deformity in long standing nonunion of the LHC in children treated with combined triple management (fixation of the nonunion site, dome corrective osteotomy, and anterior transposition of ulnar nerve) through a modified para-triceptal approach...
December 6, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29214186/a-rare%C3%A2-case-of%C3%A2-failed-healing-in-previously-burned-skin%C3%A2-after-a%C3%A2-secondary-burns
#16
Stephen J Goldie, Shaun Parsons, Hana Menezes, Andrew Ives, Heather Cleland
Background: Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation: We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently...
2017: Burns and Trauma
https://www.readbyqxmd.com/read/29212424/surgical-complications-of-cochlear-implantation-in-a-tertiary-university-hospital
#17
Al Hussein Awad, Usama M Rashad, Nihal Gamal, Mostafa A Youssif
INTRODUCTION: Cochlear implantation remains a popular and effective therapy for patients with sensorineural hearing loss that not get benefit from conventional hearing aids Objective: To analyze the surgical complications obtained in patients that underwent cochlear implantation in a tertiary university hospital. MATERIALS AND METHODS: Retrospective analysis of the medical files of cochlear implant patients who underwent surgery at our institution between October 2014 and July 2016...
December 7, 2017: Cochlear Implants International
https://www.readbyqxmd.com/read/29212042/facial-nerve-injury-and-other-complications-following-retromandibular-subparotid-approach-for-the-management-of-condylar-fractures
#18
Stéphane Bruneau, Delphine S Courvoisier, Paolo Scolozzi
PURPOSE: To estimate the prevalence and identify risk factors for facial nerve paralysis (FNP) and other postoperative complications after the use of the retromandibular subparotid approach (RMSA) for the treatment of condylar fractures. MATERIALS AND METHODS: Radiologic and clinical data from all patients who underwent an RMSA from 2007 through 2015 at the University Hospital of Geneva (Geneva, Switzerland) were retrospectively reviewed. The primary and secondary outcome variables were, respectively, FNP and other complications (unesthetic scars, infection, nonunion, malocclusion, salivary fistula, Frey syndrome, and loosening or breaking of plates and screws)...
December 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29211657/open-to-air-is-a-viable-option-for-initial-wound-care-in-necrotizing-soft-tissue-infection-that-allows-early-detection-of-recurrence-without-need-for-painful-dressing-changes-or-return-to-operating-room
#19
Derek Yang, April Davies, Bailey Burge, Phillip Watkins, Sharmila Dissanaike
BACKGROUND: The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint...
December 6, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29211040/promoting-long-term-health-among-people-with-spinal-cord-injury-what-s-new
#20
Mary Ann McColl, Shikha Gupta, Karen Smith, Alexander McColl
A key ingredient to successful health promotion is a primary care provider who can offer an informed first response to lifestyle issues, emerging problems and chronic challenges. This article aims to assist family physicians to play their role in promoting the health of people with SCI, by summarizing the latest evidence in the management of spinal cord injury in primary care. This study used a scoping review methodology to survey peer-reviewed journal articles and clinical guidelines published between January 2012 to June 2016...
December 6, 2017: International Journal of Environmental Research and Public Health
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