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https://www.readbyqxmd.com/read/28285897/arthrofibrosis-associated-with-total-knee-arthroplasty
#1
REVIEW
Victor A Cheuy, Jared R H Foran, Roger J Paxton, Michael J Bade, Joseph A Zeni, Jennifer E Stevens-Lapsley
The purpose of this article is to review the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after total knee arthroplasty (TKA). Arthrofibrosis is a debilitating postoperative complication of TKA. This condition is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. Characterized by the excessive proliferation of scar tissue during an impaired wound healing response, the resulting stiffness of arthrofibrosis causes functional deficits in activities of daily living, such as walking, stair climbing, and standing from a chair...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285012/two-stage-treatment-of-ischial-pressure-ulcers-in-spinal-cord-injury-patients-technique-and-outcomes-over-8-years
#2
Sumanas W Jordan, Mauricio De la Garza, Victor L Lewis
BACKGROUND: Despite newly introduced techniques, reconstruction of ischial pressure ulcers remains a difficult problem with high-reported failure rates. METHODS: A retrospective chart review was performed on all spinal cord injury patients who underwent ischial pressure ulcer reconstruction by the senior author (V.L.) between 2004 and 2012. The two-stage procedure consisted of debridement and bone biopsy, followed by bursectomy, partial ischiectomy, fascial release, and gluteus maximus and hamstring advancement flaps...
January 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28252584/-the-constitutional-approach-to-the-choice-of-the-surgical-strategy-for-the-treatment-of-chronic-post-traumatic-laryngeal-stenoses
#3
S V Starostina
We have developed the algorithm for the choice of the surgical strategy for the treatment of chronic post-traumatic laryngeal stenosis with the purpose of enhancing the effectiveness of the management of the patients presenting with this condition. The proposed approach envisages obtaining anthropometric characteristics of the patients, determination of the type of his (her) neck and constitution, construction of the regressive models of the clinically significant laryngometric parameters based on the results of the clinical observations including the dimensions of the glottal fissure and the position of the vocal folds, calculations of the size of the autotransplant and the length of the T-shaped tube based on the results of the mathematical analysis of the anthropo- and organometric characteristics of the concrete patient, the laryngoplastic and prosthetic treatment of the newly formed laryngo-tracheal passage...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28181797/a-thermosensitive-heparin-poloxamer-hydrogel-bridges-afgf-to-treat-spinal-cord-injury
#4
Qingqing Wang, Yan He, Yingzheng Zhao, Huixu Xie, Qian Lin, Zili He, Xiaoyan Wang, Jiawei Li, Hongyu Zhang, Chenggui Wang, Fanghua Gong, Xiaokun Li, Huazi Xu, Qingsong Ye, Jian Xiao
Acidic fibroblast growth factor (aFGF) exerts a protective effect on spinal cord injury (SCI) but is limited by the lack of physicochemical stability and the ability to cross the blood spinal cord barrier (BSCB). As promising biomaterials, hydrogels contain substantial amounts of water and a three-dimensional porous structure and are commonly used to load and deliver growth factors. Heparin can not only enhance growth factor loading onto hydrogels but also can stabilize the structure and control the release behavior...
March 1, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28129292/persistent-epithelial-defects-and-corneal-opacity-after-collagen-cross-linking-with-substitution-of-dextran-t-500-with-dextran-sulfate-in-compounded-topical-riboflavin
#5
Roland Höllhumer, Stephanie Watson, Peter Beckingsale
PURPOSE: Collagen cross-linking (CXL) is a commonly performed procedure to prevent the progression of keratoconus. Riboflavin is an essential part of the procedure, which facilitates both the cross-linking process and protection of intraocular structures. Dextran can be added to riboflavin to create an isotonic solution. This case report highlights the importance of compounding riboflavin with the correct dextran solution. METHODS: A retrospective case series. RESULTS: Six eyes of 4 male patients with keratoconus aged from 20 to 38 years underwent CXL with substitution of 20% dextran (T-500) with 20% dextran sulfate in a compounded riboflavin 0...
March 2017: Cornea
https://www.readbyqxmd.com/read/28112411/medial-sural-artery-as-a-salvage-recipient-vessel-for-complex-post-traumatic-microvascular-lower-limb-reconstruction
#6
Amresh Baliarsing, Shivprasad Date, Pedro Ciudad
BACKGROUND: Complex lower extremity trauma still poses a formidable challenge for micro vascular reconstruction. The extensive surrounding zone of trauma can make it difficult to find a suitable recipient pedicle for anastomosis. A need was felt for exploration of newer recipient vessels in lower extremity which could be harnessed for reliable and tension free micro anastomosis. The purpose of the present report is to highlight the possibility of using medial sural artery for safe micro vascular anastomosis in selected scenarios like vessel depleted extremity...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28103995/-advances-in-the-research-of-prevention-and-treatment-of-postburn-contractures-of-hand
#7
K A Wang, G S Wu, Y Sun, Z F Xia
Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy...
January 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28067245/effect-of-hierarchically-aligned-fibrin-hydrogel-in-regeneration-of-spinal-cord-injury-demonstrated-by-tractography-a-pilot-study
#8
Zhenxia Zhang, Shenglian Yao, Sheng Xie, Xiumei Wang, Feiyan Chang, Jie Luo, Jingming Wang, Jun Fu
Some studies have reported that scaffold or cell-based transplantation may improve functional recovery following SCI, but no imaging information regarding regeneration has been provided to date. This study used tractography to show the regenerating process induced by a new biomaterial-aligned fibrin hydrogel (AFG). A total of eight canines subjected to SCI procedures were assigned to the control or the AFG group. AFG was implanted into the SCI lesion immediately after injury in 5 canines. A follow-up was performed at 12 weeks to evaluate the therapeutic effect including the hindlimb functional recovery, anisotropy and continuity of fibers on tractography...
January 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28009695/elastin-is-differentially-regulated-by-pressure-therapy-in-a-porcine-model-of-hypertrophic-scar
#9
Bonnie C Carney, Zekun Liu, Abdulnaser Alkhalil, Taryn E Travis, Jessica Ramella-Roman, Lauren T Moffatt, Jeffrey W Shupp
Beneficial effects of pressure therapy for hypertrophic scars have been reported, but the mechanisms of action are not fully understood. This study evaluated elastin and its contribution to scar pliability. The relationship between changes in Vancouver Scar Scale (VSS) scores of pressure-treated scars and differential regulation of elastin was assessed. Hypertrophic scars were created and assessed weekly using VSS and biopsy procurement. Pressure treatment began on day 70 postinjury. Treated scars were compared with untreated shams...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27857656/reverse-flow-anterolateral-thigh-perforator-an-ad-hoc-flap-for-severe-post-burn-knee-contracture
#10
H A Ismail, L E El-Bassiony
We evaluate function outcomes of the reverse-flow ALT perforator flap to reconstruct severe post-burn knee contracture. Between October 2012 and December 2014, 10 patients with severe post-burn knee contracture were subjected to reconstruction with 10 ipsilateral reversed-flow ALT perforator flaps. All the patients were male. Ages ranged from 15 to 47 years (mean = 32 years). Time from burn injury to patient presentation ranged from 2-8 months. All patients demonstrated post-burn flexion contracture of the knee joint, ranging from 35 to 75 degrees...
March 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/27843652/implant-retained-obturator-for-an-edentulous-patient-with-a-hemimaxillectomy-defect-complicated-with-microstomia
#11
Pravinkumar G Patil, Smita Nimbalkar-Patil
Patient. A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture. This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant. Discussion. Severe limitation in the oral opening may occur in clinical situations following the postsurgical management of oral and maxillofacial defects...
2016: Case Reports in Dentistry
https://www.readbyqxmd.com/read/27806772/-endoscopic-thyroid-surgery-the-past-the-present-and-the-future
#12
P Wang, Q Z Zhao
Thyroid diseases are much more common in women than in men. The traditional open thyroidectomy brings almost patients significant visible scars in the anterior neck. The demand for cosmesis after surgery promotes the occurrence and development of endoscopic techniques. Various endoscopic techniques were designed to minimize the visible scar and promote the rehabilitation after surgery. In order to achieve these, two distinct ideas have developed. One is committed to shorten the length of surgical incision as much as possible...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27805532/visual-rehabilitation-after-penetrating-keratoplasty
#13
Leyla Asena, Dilek D Altınörs
OBJECTIVES: Here, our aim was to report our treatment strategies and their results performed for visual rehabilitation after penetrating keratoplasty. MATERIALS AND METHODS: The medical records of 98 patients (54 male/44 female), with results from 104 eyes, who underwent penetrating keratoplasty between January 2013 and January 2015 at the Baskent University Faculty of Medicine, Department of Ophthalmology were reviewed. Patient age, indication for penetrating keratoplasty, interventions performed for visual rehabilitation, follow-up duration, topographic and refractive astigmatism at the end of follow-up, and final best corrected visual acuity results were recorded...
2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27777134/is-there-any-place-for-spontaneous-healing-in-deep-palmar-burn-of-the-child
#14
J Chateau, M Guillot, L Zevounou, F Braye, J-L Foyatier, J-P Comparin, D Voulliaume
Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010...
October 21, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27712756/challenges-posed-by-delayed-presentation-of-mutilating-hand-injuries
#15
REVIEW
Samir M Kumta, Rajendra Nehete, Leena Jain
Management of mutilating hand injury is a challenge for any hand surgeon. Delay in presentation makes management even more challenging, usually because of inadequate initial assessment, inadequate debridement leading to infection, and secondary loss of tissues from exposure and desiccation. The aim is to obtain a functional hand by radical debridement, adequate assessment of the injury, appropriately timed reconstruction, and physiotherapy and rehabilitation. The hand surgeon must pay attention to the appearance of the hand by elimination of deformities, unsightly scars and bulky flaps to help to restore confidence in the patient to face the demands of daily living...
November 2016: Hand Clinics
https://www.readbyqxmd.com/read/27707499/hypertrophic-scarring-the-greatest-unmet-challenge-after-burn-injury
#16
REVIEW
Celeste C Finnerty, Marc G Jeschke, Ludwik K Branski, Juan P Barret, Peter Dziewulski, David N Herndon
Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. Approaches to optimise healing potential of burn wounds use targeted wound care and surgery to minimise the development of hypertrophic scarring. Such approaches often fail, and modulation of the established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established...
October 1, 2016: Lancet
https://www.readbyqxmd.com/read/27685196/two-year-follow-up-of-outcomes-related-to-scarring-and-distress-in-children-with-severe-burns
#17
Paul Wurzer, Abigail A Forbes, Gabriel Hundeshagen, Clark R Andersen, Kathryn M Epperson, Walter J Meyer, Lars P Kamolz, Ludwik K Branski, Oscar E Suman, David N Herndon, Celeste C Finnerty
PURPOSE: We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. METHODS: Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models...
August 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27682299/median-nerve-biodegradable-wrapping%C3%A2-clinical-outcome-of-10-patients
#18
S T Kokkalis, A F Mavrogenis, C Vottis, L Papatheodorou, P J Papagelopoulos, P N Soucacos, D G Sotereanos
Nerve wrap protectors are bioabsorbable synthetic materials made of collagen or extracellular matrix that provide a non-constricting encasement for injured peripheral nerves. They are designed to be used as an interface between the nerve and the surrounding tissue. After hydrated, they transform into a soft, pliable, nonfriable, easy to handle porous conduit. The wall of the nerve wrap has a longitudinal slit that allows to be placed around the injured nerve. Τhis article presents the surgical technique for median nerve neurolysis and nerve coverage using a collagen or an extracellular matrix nerve wrap protector in 10 patients with recurrent or persistent carpal -tunnel syndrome...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27639006/diagnosis-and-treatment-of-effort-induced-thrombosis-of-the-axillary-subclavian-vein-due-to-venous-thoracic-outlet-syndrome
#19
REVIEW
Chandu Vemuri, Payam Salehi, Jaime Benarroch-Gampel, Lauren N McLaughlin, Robert W Thompson
Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal stenosis, and eventual thrombosis. Clinical evaluation includes a history and physical examination followed by catheter-based venography, for definitive confirmation of the diagnosis and initial treatment with pharmacomechanical thrombolysis...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27606559/cutaneous-functional-units-predict-shoulder-range-of-motion-recovery-in-children-receiving-rehabilitation
#20
Ingrid Parry, Soman Sen, Kelly Sattler-Petrocchi, David Greenhalgh, Tina Palmieri
Cutaneous functional units (CFUs) are fields of skin that functionally contribute to range of motion (ROM) at an associated joint. When replaced with scar tissue, the skin is less extensible and may result in loss of movement at the joint. Consideration of the amount of CFU affected by burn injury is increasingly being used to predict the development of burn scar contracture (BSC) in burn survivors. Previous work established that, in adults, burn rehabilitation time per CFU was the greatest predictor of preventing BSC...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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