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Surgical skin closure

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https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#1
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27901645/fenestrated-adipofascial-reverse-flap-a-modified-technique-for-the-reconstruction-of-fingertip-amputations
#2
Francesco Idone, Andrea Sisti, Juri Tassinari, Giuseppe Nisi
AIMS OF THE STUDY: Fingertip injuries can be treated in different ways, including shortening with primary closure, skin graft, and local or distant flaps. Several local flaps for the reconstruction of the amputated fingertip were described. We present our experience with a new concept of homodigital adipofascial reverse flap that avoids the second surgical stage and allows a complete and anatomically perfect reconstruction of nail bed, with preservation of the nail lamina. MATERIALS AND METHODS: Between March 2014 and February 2015, five patients with digital amputations (distally to the nail matrix) were treated using the Fenestrated Adipofascial Reverse (F...
November 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27900320/the-golden-spiral-flap-a-new-flap-design-that-allows-for-closure-of-larger-wounds-under-reduced-tension-how-studying-nature-s-own-design-led-to-the-development-of-a-new-surgical-technique
#3
Sharad P Paul
This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is nature's own pattern for rapid expansion. Given the relationship between tissue expansion and stretch has been shown to cause deformation gradients that have both elastic and growth factors, the author set out to test the hypothesis that a golden spiral pattern therefore would be more efficient at closing wounds under less tension when compared with standard semicircular rotational flap patterns...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27896188/foot-syndactyly-a-clinical-and-demographic-analysis
#4
Jong Ho Kim, Byung Jun Kim, Sung Tack Kwon
BACKGROUND: Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. METHODS: We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27895538/syndactyly-release
#5
REVIEW
Tara L Braun, Jeffrey G Trost, William C Pederson
Syndactyly is one of the most common congenital hand anomalies treated by pediatric plastic surgeons. Established principles of syndactyly separation dictate the timing and order of syndactyly release, with the goals of surgery being the creation of an anatomically normal webspace, tension-free closure of soft tissue, and return of function to the fingers. Numerous surgical methods have been described, many of which involve the use of local flaps to reconstruct the commissure and full-thickness skin grafts for coverage of raw areas...
November 2016: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/27893159/modified-technique-for-common-carotid-artery-transposition-in-standing-horses
#6
Heidi Tapio, David Argüelles, Luis A Gracia-Calvo, Marja Raekallio
OBJECTIVE: To describe a modified technique for permanent translocation of the common carotid artery (CCA) to a subcutaneous position in standing horses. STUDY DESIGN: Experimental study. ANIMALS: Healthy adult Standardbred and Warmblood horses (n = 8). METHODS: Surgery was performed with the horses standing under sedation and with local anesthesia. A combination of previously described techniques was used modifying the approach and closure of the incision...
November 28, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27886972/the-resident-run-minor-surgery-clinic-a-pilot-study-to-safely-increase-operative-autonomy
#7
REVIEW
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, Roy Phitayakorn
OBJECTIVE: General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27879604/effects-of-incisional-negative-pressure-wound-therapy-on-primary-closed-defects-after-superficial-circumflex-iliac-artery-perforator-flap-harvest-randomized-controlled-study
#8
Hyun-Suk Peter Suh, Joon Pio Hong
BACKGROUND: Prolonged hematoma or seroma after primary closure is a causative element in wound complications. This study evaluated the effects of negative-pressure wound therapy on primary closed wounds after superficial circumflex iliac artery perforator flap harvest. METHODS: This study was a prospective, randomized, clinical trial comparing conventional dressing against a single application of negative-pressure wound therapy for 5 days after primary closure. A total of 100 patients who had superficial circumflex iliac artery perforator flap harvest were enrolled...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27857653/immediate-tangential-excision-accelerates-wound-closure-but-does-not-reduce-scarring-of-mid-dermal-porcine-burns
#9
L K Macri, A J Singer, S A McClain, L Crawford, A Prasad, J Kohn, R A F Clark
Current evidence supports the use of excision to remove eschar from deep dermal and full-thickness burns. However, the role of excision of mid-dermal burns remains unclear. This study aimed to develop a porcine model that could produce reproducible middermal thermal burns that undergo tangential excision; and investigate the effects of immediate tangential excision (30 minutes postburn) on healing and scarring. An aluminum bar preheated in hot water (70°C) was applied for 20 or 30 s to produce a total of sixteen mid-dermal burns per pig on each of six pigs...
March 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/27856389/mini-laparoscopy-of-removal-partial-adnexae-at-the-time-of-hysterectomy
#10
António Gutierrez Setúbal, João Sequeira Alves, Olga Lavado, Joana Faria
STUDY OBJECTIVE: To describe our technique of mini laparoscopic adnexectomy or salpingectomy at the time of total laparoscopic hysterectomy DESIGN: Step-by-step video explanation of our technique SETTING: The advantages of laparoscopic surgery have been widely recognised in the past two decades: improved vision, exposure, reduction in operative trauma because of smaller incisions and more gentle tissue´s handling, that result in a faster postoperative recovery. The technology development has allowed the use of smaller caliber instruments while maintaining the high standard surgical performance...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27852504/bilateral-rib-based-distraction-to-the-pelvis-for-the-management-of-congenital-gibbus-deformity-in-the-growing-child-with-myelodysplasia
#11
John T Smith
BACKGROUND: Congenital gibbus deformity of the spine associated with myelodysplasia is a challenging problem in the growing child and is commonly associated with skin breakdown and chronic infection. Surgical solutions including kyphectomy, flap closure of the skin, and early spinal fusion are associated with a high rate of complications and, ultimately, a short trunk due to stoppage of spinal growth. The purpose of this article is to describe our early results in using a rib-based distraction to the pelvis without vertebral resection and fusion to manage this deformity...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27844118/the-cost-of-infection-in-severe-open-tibial-fractures-treated-with-a-free-flap
#12
Ulrik Kähler Olesen, Nicolas Jones Pedersen, Henrik Eckardt, Line Lykke-Meyer, Christian Thorsten Bonde, Upender Martin Singh, Martin McNally
PURPOSE: Open tibial fractures needing soft tissue cover are challenging injuries. Infection risk is high, making treatment difficult and expensive. Delayed skin closure has been shown to increase the infection rate in several studies. We aimed at calculating the direct and indirect cost of treatment, and to determine the effect of delayed skin closure on this cost. METHODS: We reviewed all records of patients treated with a free flap in our institution for an open tibial fracture from 2002 to 2013...
November 14, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27836568/the-surgical-management-of-head-and-neck-sarcoma-the-newcastle-experience
#13
R W F Breakey, T P Crowley, I B Anderson, R H Milner, M Ragbir
INTRODUCTION: Head and neck sarcomas are rare and difficult to manage surgically. Factors that influence the prognosis include the type and grade of tumour, resection margins, the anatomical site and patient-specific parameters. We review our experience as plastic surgeons working in a bone and soft-tissue tumour multidisciplinary team (MDT) in managing these tumours surgically. METHODS: Data on all patients with sarcoma of the head or neck managed surgically from 2004 to 2015 was reviewed...
October 5, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27836205/effectiveness-of-cyanoacrylate-microbial-sealant-in-the-reduction-of-surgical-site-infection-in-gynecologic-oncology-procedures-a-phase-iii-single-institution-prospective-randomized-trial
#14
Eric D Thomas, Elizabeth K Nugent, Matthew C MacAllister, Katherine M Moxley, Lisa Landrum, Joan L Walker, D S McMeekin, Robert S Mannel, Gerald McGwin, Kathleen N Moore
OBJECTIVES: Surgery is a cornerstone for patients with gynecologic malignancies. Surgical site infections (SSI) remain a source of post-operative morbidity. Consequences range from escalated costs, delay in adjuvant therapy, and increased morbidity. Our primary objective was to evaluate the effectiveness of a cyanoacrylate microbial sealant (CMS) to reduce post-operative SSI following laparotomy for suspected gynecologic malignancy. METHODS: Patients were randomized using a 1:1 allocation to receive either standard skin preparation or standard preparation with CMS and stratified by BMI...
November 8, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27811633/wingtip-flap-for-reconstruction-of-full-thickness-upper-and-lower-eyelid-defects
#15
Ivan Vrcek, Eva Chou, Sean Blaydon, John Shore
PURPOSE: Pentagonal wedge resection is a technique used to address a wide variety of eyelid pathology. This procedure frequently results in excess skin at the apex of the wound, commonly known as a "dog ear." A variety of methods have been described to address the cutaneous redundancy, the most classic of which is the Burow's triangle repair. The authors present a technique to address the anterior lamellar excess that avoids placement of a vertical scar traversing the pretarsal and preseptal portion of the affected eyelid...
November 2, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27810207/are-horse-age-and-incision-length-associated-with-surgical-site-infection-following-equine-colic-surgery
#16
S J M Darnaud, L L Southwood, H W Aceto, D Stefanovski, L Tomassone, L Zarucco
It is our clinical impression that age and incision length are more strongly associated with surgical site infection (SSI) following colic surgery than skin closure or wound protection method. Therefore, the objective of this observational clinical cohort study was to identify the risks for SSI in horses undergoing colic surgery. Data collection included pre-, intra-, and postoperative variables. Variables with P < 0.2 following univariable analysis were used in a logistic regression multivariable model...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27803084/severe-soft-tissue-infection-masquerading-as-necrotising-fasciitis-in-a-31-year-old-woman-with-a-background-of-right-thigh-arteriovenous-malformation
#17
Pennylouise Hever, Naveen Cavale, Paul Harnett
A 31-year-old woman with a history of a right thigh arteriovenous malformation presented with an acute history of right thigh pain and swelling. This rapidly progressed to gross sepsis. She was intubated, requiring inotropic support and renal replacement therapy. She was considered disproportionately unwell, with the impression one of necrotising fasciitis (NF). She was taken to theatre for emergency exploration and debridement. There was no evidence of NF to note in theatre. Tissue samples cultured group C Streptococcus, with histopathological examination confirming group C Streptococcal soft tissue infection...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27788928/primary-reattachment-of-avulsed-skin-flaps-with-negative-pressure-wound-therapy-in-degloving-injuries-of-the-lower-extremity
#18
G Sakai, T Suzuki, T Hishikawa, Y Shirai, T Kurozumi, M Shindo
Large avulsed skin flaps of the lower extremity caused by degloving injuries eventually develop skin necrosis in most cases. The current treatment option involves excision of the degloved skin and reapplication as a full- or split-thickness skin graft. We considered that reattachment of avulsed skin flaps without excision would be theoretically beneficial, since some circulation may remain around the connected pedicle and thus facilitate graft take. Furthermore, securing the skin to the original anatomic position is much easier using retained landmarks...
October 22, 2016: Injury
https://www.readbyqxmd.com/read/27779970/national-outcomes-after-pressure-ulcer-closure-inspiring-surgery
#19
Shawn Diamond, Hassan S Moghaddas, Stephen S Kaminski, Jonathan Grotts, Lisa Ferrigno, Wesley Schooler
Over two million Americans receive treatment for pressure ulcers (PUs) annually, but national surgical outcomes are not well described. This study investigated rates and risk factors of postoperative complications in patients with PU. The 2011 and 2012 American College of Surgeons-National Surgical Quality Improvement Project database was queried and PU patients undergoing flap closure were identified. Descriptive statistics and multivariate regression analysis was used and reported as odds ratios (ORs) if (P < 0...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27757350/body-builder-s-nightmare-black-market-steroid-injection-gone-wrong-a-case-report
#20
Or Friedman, Ehud Arad, Oded Ben Amotz
In the pursuit of success in sports, some athletes are not deterred by health risks associated with the (mis)use of black market preparations of dubious origin as performance-enhancing agents. Several studies published in the recent years demonstrated that anabolic-androgenic steroids, but also stimulants and growth hormones, are misused by numerous recreational athletes from all over the world. Trenbolone is an anabolic steroid routinely used in the finishing phase of beef production to improve animal performance and feed efficiency...
September 2016: Plastic and Reconstructive Surgery. Global Open
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