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Burns, lower leg

Manuel P Pereira, Sebastian Mühl, Esther M Pogatzki-Zahn, Konstantin Agelopoulos, Sonja Ständer
In recent years, measurement of the intraepidermal nerve fiber (IENF) density has gained relevance in the diagnostics of chronic pruritus. This method allows the objectification and quantification of a small-fiber neuropathy, which may manifest clinically with pruritus, pain or dysesthetic sensory symptoms, such as burning, stinging and tingling sensations or numbness. Upon suspicion of a small-fiber neuropathy as a cause for chronic pruritus, targeted diagnostic procedures are essential for the early detection of the neuroanatomical changes...
October 11, 2016: Dermatology and Therapy
Mansher Singh, Hehuan Li, Kristo Nuutila, K C Collins, Jennifer Wall, Robert Riviello, Michael J Weaver, Matthew J Carty, Julian Pribaz, Simon G Talbot
Concurrent injuries to multiple extremities present unique challenges to the reconstructive surgeon. The primary goal in such scenarios is to optimize functional outcomes. The goal of this article is to present an overview of various techniques necessary to provide sufficient soft tissue and preserve amputation limb lengths and function. The concept of innovative techniques for maximizing limb savage and function is presented using an index patient with multiple extremity third- and fourth-degree burn injuries resulting in nonsalvageable lower extremities and severe left-hand wounds...
September 9, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
M G Faruque, M U Mollah, T H Siddiquee, S Bari
Ilizarov method is the best weapon for the treatment of the limb length discrepancy, especially in traumatic or congenital shortening of long bones. Post burn bony defect can be corrected by osteosynthesis. Here we treated a 7 years old boy, suffering from 33% electric burn affecting face, trunk, left upper limb & both lower limbs with loss of soft tissue of medial side of right leg along with dead and exposed of some segment (about 14cm) of Left tibia . Initially the patient was managed by plastic surgeons in the form of surgical toileting, wound debridement and wound coverage by split thickness skin graft...
July 2016: Mymensingh Medical Journal: MMJ
Olivier Espitia, Brigitte Dréno, Elisabeth Cassagnau, Quentin Didier, Thibaut Quillard, Christelle Nicol, Yann Le Bouch, Bernard Planchon, Marc-Antoine Pistorius
Although exercise-induced vasculitis (EIV) is usually misdiagnosed, it is not uncommon. Occurring mostly after prolonged exercise, especially in hot weather, EIV is an isolated cutaneous vasculitis with stereotypical presentation. This article reviews the clinical characteristics, treatments, and outcomes of EIV based on the published literature. We report 99 patients who developed EIV after walking, dancing, swimming, or hiking especially during hot weather, including the records of 16 patients with EIV treated at our hospital from 2007 to 2015...
September 3, 2016: American Journal of Clinical Dermatology
Burhan Özalp, Mustafa Aydınol
BACKGROUND: Perforator-based propeller flaps provide adequate soft tissue coverage for leg reconstruction. The aim of this study was to assess the versatility and reliability of the use of propeller flaps for leg reconstruction in pediatric patients. METHOD: Seven male pediatric patients ranging in age from 2 to 13 years with a mean age of 6.7 underwent perforator-based propeller flap surgery over a four-year period. The defects resulted from burn injuries (n = 4) and traffic accidents (n = 3)...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Zoe Diana Draelos
INTRODUCTION: Irritation, such as burning and stinging, on the site of application, is a common side effect of topical dermatologic products including creams, lotions, sprays, and foams. This effect may be more pronounced when applying products to atopic or psoriatic skin. The composition of the vehicle may affect the extent of the irritation. This study compared the irritation and erythema potential of 7 different topical dermatologic products to determine the products with the least likelihood of causing discomfort when applied...
July 1, 2016: Journal of Drugs in Dermatology: JDD
M P Pereira, S Mühl, S Ständer
BACKGROUND: Small fiber neuropathy arises from injury of small C and Aδ fibers and leads to pruritus as well as positive (pain, burning, tingling or stinging sensation) and negative neurological (numbness) symptoms. OBJECTIVES: To give an overview on small fiber neuropathy as a cause for chronic pruritus, the diagnostic approach to this condition, and therapeutic options. MATERIALS AND METHODS: A literature search using the terms "small fiber neuropathy", "pruritus", "itch", and "pain" was performed...
August 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Ryan R Konwinski, Ajay Singh, Jorge Soto
The goal of this study is to describe the imaging features of lower extremity blast injuries in patients encountered in the radiology departments from the Boston Marathon bombings. A total of 115 patients presented to four acute care hospitals on April 15, 2013, 43 of whom presented with lower extremity injuries and were included in this study. The imaging findings of primary, secondary, tertiary, and quaternary blast injuries were evaluated. Forty-one of 43 patients sustained secondary blast injuries to the lower extremities with 31 patients (70 %) having retained shrapnel, seven patients (16 %) having soft tissue lacerations without retained shrapnel, and ten patients (23 %) having lower extremity amputation (7 % double amputees)...
October 2016: Emergency Radiology
Iulia Tevanov, Dan M Enescu, Radu Bălănescu, G Sterian, Alexandru Ulici
Negative pressure wound therapy is a non-invasive treatment that uses under atmospheric pressure to increase blood supply to the wound, stimulating the formation of granulation tissue, angiogenesis, proliferation of fibroblasts and endothelial cells. Negative pressure therapy has also the ability to decrease the bacterial load, reduce swelling and decrease exudate while maintaining a moist environment that facilitates healing. Our patient, a 17 year old male, suffered major third and fourth-degree high voltage electrical burns on 60% of the body surface, in November 2011...
March 2016: Chirurgia
R A Kagan
Decades after the problem was first identified, power line electrocution continues to be a cause of avian mortality. Currently, several federal laws protect eagles and other migratory birds, meaning that utility companies may be liable for electrocution-related deaths. Veterinarians and veterinary pathologists called upon to diagnose and treat electrocuted birds should keep this in mind when conducting clinical and postmortem examinations. This review details necropsy findings and methods used to diagnose electrocution...
September 2016: Veterinary Pathology
Cengiz Eser, Erol Kesiktaş, Eyüphan Gencel, Emrah Efe Aslaner, Metin Yavuz
BACKGROUND: High voltage electrical injuries can cause devastating results especially in distal extremities. Although free flaps are the golden standards for the reconstruction of these defects, sometimes local flap alternatives are more useful. One of the most favorable local flap is distally based sural flap (DBSF), which can be used in cross-leg fashion when ipsilateral extremity is affected by a high voltage electrical injury. The purpose of this study was to evaluate long term results of eleven patients who underwent a reconstruction to the lower extremity with cross-leg DBSF due to high voltage electrical burn injury between the years of 2003-2013...
January 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Austin Sanders, Lindsay Andras, Alison Lehman, Nancy Bridges, David L Skaggs
STUDY DESIGN: Prospective review of consecutive patients. OBJECTIVE: To evaluate the incidence and raise awareness of electrode discoloration that can occur in the operating room when using neuromonitoring. SUMMARY OF BACKGROUND DATA: To our knowledge there are no papers that discuss dermal discolorations following spine surgery. METHODS: Following recognition of dermal discolorations in some patients, a prospective evaluation of all patients undergoing spine surgery with SSEP and MEP neuromonitoring using subdermal needle electrodes was carried out over a 16 month period for quality assurance and improvement...
April 21, 2016: Spine
Muhammad Sheraz Raza, Umer Nazir, Hamid Hussain Ansari, Farid Ahmad Khan
OBJECTIVE: To assess the reliability of non-islanded distally based sural artery flap, in terms of number of flap failure (partial and major flap necrosis), number of surgeries related to the problem for which flap surgery was performed, hospital stay and return to work, for coverage of soft tissue defects of the distal one-third of leg, ankle and heel. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Department of Plastic Surgery and Burn Unit, Mayo Hospital, KEMU, Lahore, Pakistan, from January 2003 to March 2014...
April 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Keith J Burns, Brandon S Pollock, John McDaniel
The cardiovascular responses to passive limb movement (PLM) at the knee are well established, however, responses to PLM at other joints involving smaller muscle volume are unknown. To compare the cardiovascular responses to passive movement at other joints, 10 participants underwent a PLM protocol in which the wrist, elbow, ankle, and knee joints were passively extended and flexed at 1 Hz for 1 min. Heart rate (HR), mean arterial blood pressure (MAP), and arterial blood flow to that limb segment (BF) were measured and vascular conductance (VC) was calculated for a 30-sec baseline period and for 3-sec intervals throughout PLM protocols...
March 2016: Physiological Reports
Takaaki Ito, Ryuichi Kukino, Masakazu Takahara, Miki Tanioka, Yasuhiro Nakamura, Yoshihide Asano, Masatoshi Abe, Takayuki Ishii, Taiki Isei, Yuji Inoue, Shinichi Imafuku, Ryokichi Irisawa, Masaki Ohtsuka, Mikio Ohtsuka, Fumihide Ogawa, Takafumi Kadono, Tamihiro Kawakami, Masakazu Kawaguchi, Takeshi Kono, Masanari Kodera, Keisuke Sakai, Takeshi Nakanishi, Akira Hashimoto, Minoru Hasegawa, Masahiro Hayashi, Manabu Fujimoto, Hiroshi Fujiwara, Takeo Maekawa, Koma Matsuo, Naoki Madokoro, Osamu Yamasaki, Yuichiro Yoshino, Andres Le Pavoux, Takao Tachibana, Hironobu Ihn
Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions...
August 2016: Journal of Dermatology
Lindy Begg, Patrick McLaughlin, Mauro Vicaretti, John Fletcher, Joshua Burns
BACKGROUND: The total contact cast (TCC) is an effective intervention to reduce plantar pressure in patients with diabetes and a plantar forefoot ulcer. The walls of the TCC have been indirectly shown to bear approximately 30 % of the plantar load. A new direct method to measure inside the TCC walls with capacitance sensors has shown that the anterodistal and posterolateral-distal regions of the lower leg bear the highest load. The objective of this study was to directly measure these two regions in patients with Diabetes and a plantar forefoot ulcer to further understand the mechanism of pressure reduction in the TCC...
2016: Journal of Foot and Ankle Research
A Grandjean, C Romana, F Fitoussi
BACKGROUND: Coverage of soft-tissue defects of the ankle and foot is often challenging. The distally based sural fascio-cutaneous flap is useful for reconstructing the lower leg, ankle, heel, and foot but has rarely been evaluated in paediatric patients. The objectives of this study were to assess the reliability of this flap in paediatric patients, to describe the complications associated with its use, and to define its indications in paediatric patients with soft-tissue defects of the ankle and foot...
February 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jing Gao, Qi Wang, Shaoxiang Xian, Yue-mei Feng, Wei-xin Cao, Jing-yun Ye, Qing-qing Zhang, Cai-lian Zou, Qing-guang Wu, Si-jun Liu
OBJECTIVE: To investigate the effect of moxibustion on alleviating menstrual pain and relieving the symptoms of dysmenorrhea in a cohort of young nursing students in China. METHODS: A randomized double blind clinical trial of crossover design was used. In the two-phase study, a total of 56 nursing students with menstrual pain in Guangzhou University of Chinese Medicine in China was randomly allocated into two groups. In the first treatment phase, the participants in Group A (n=28) received moxibustion therapy from five days before the menstrual period to the onset through a specific heating box in which burning moxa stick was fixed, the participants in Group B (n=28) received the same heating box but with a paper-wrapped stick incense fixed inside (placebo therapy) during the same intervention period...
December 2015: Complementary Therapies in Medicine
Pouran Layegh, Masoud Maleki, Seyed Reza Mousavi, Hadis Yousefzadeh, Akram Momenzadeh, Shiva Golmohammadzadeh, Mahdi Balali-Mood
BACKGROUND: Despite almost the three decades passed since the chemical attacks of Iraqi's army against the Iranian troops, some veterans are still suffering from long-term complications of sulfur mustard (SM) poisoning, including certain skin complaints specially dryness, burning, and pruritus. We thus aimed to evaluate the skin's water and lipid content in patients with a disability of >25% due to complications of SM poisoning and compare them with a matched control group. MATERIALS AND METHODS: Sixty-nine male participants were included in this study; 43 SM-exposed patients, and 26 normal controls from their close relatives...
July 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Kaveh Zakeri, Gagik Oganesyan, Robert A Lee, Joseph V Lillis
Erythema induratum of Bazin (EIB) is a rare tuberculid that typically affects middle-aged women. We report a unique case of EIB in a 57-year-old Hispanic woman who presented with recurrent painful plaques and nodules on the lower extremities, specifically on the pretibial area of the legs and dorsal aspect of the feet, with a severe burning sensation on the feet that resolved after antituberculosis therapy. We review the characteristics of EIB and examine how the unique presentation of peripheral neuropathy may relate to the pathophysiology of this disease...
September 2015: Cutis; Cutaneous Medicine for the Practitioner
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