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Surgical skin closure

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https://www.readbyqxmd.com/read/28922244/fibular-graft-effective-panorama-for-prosthetic-rehabilitation-of-resected-mandible
#1
Pankaj Kharade, Saidul Islam, Mahesh Verma, Swati Sharma, Ranjeet Bodh
Surgical management of extensive tumors in the mandibular region leads to massive disfigurement of the face. Also the prosthetic outcome of such patients rehabilitated with free soft tissue flaps is very poor. Reconstruction of extensive defects to overcome the disfigurement is a challenging procedure and can be achieved with free fibula flap. Free fibula graft provides sufficient length of bone for the reconstruction of the postsurgical defects. Excellent vascularity of fibula flap allows for easy uptake of the graft and osseointegration of the dental implants...
September 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#2
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#3
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#4
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28885412/outcomes-associated-with-a-five-point-surgical-site-infection-prevention-bundle-in-women-undergoing-surgery-for-ovarian-cancer
#5
Melissa H Lippitt, Melissa Gerardi Fairbairn, Rayna Matsuno, Rebecca L Stone, Edward J Tanner, Elizabeth C Wick, Ana C Angarita, Kara Long Roche, Kimberly L Levinson, Jennifer E Bergstrom, Abdulrahman K Sinno, Melanie S Curless, Stephanie Wethington, Sarah M Temkin, Jonathan Efron, Deborah Hobson, Amanda N Fader
OBJECTIVE: To identify risk factors for surgical site infection and to define rates associated with cytoreductive surgery before and after implementation of an infection prevention bundle. METHODS: We conducted a prospective quality improvement study. Patients who underwent ovarian, fallopian tube, or peritoneal cancer cytoreductive surgery at an academic tertiary care center from April 2014 to April 2016 were prospectively enrolled. Patient demographics, surgical variables, and surgical site infection rates were compared with a historical cohort after introduction of a 5-point infection prevention bundle, including: 1) preoperative and intraoperative skin preparation with 4% chlorhexidine and intraoperative vaginal preparation with 4% chlorhexidine; 2) preoperative use of oral antibiotics and mechanical bowel preparation; 3) appropriate timing of intraoperative antibiotics; 4) adoption of enhanced sterile surgical techniques for colon procedures and incisional closure; and 5) perioperative incision management...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885211/postoperative-control-of-functional-muscle-flaps-for-facial-palsy-reconstruction-ultrasound-guided-tissue-monitoring-using-contrast-enhanced-ultrasound-ceus-and-ultrasound-elastography
#6
A Kehrer, V Mandlik, C Taeger, S Geis, L Prantl, E M Jung
BACKGROUND AND OBJECTIVES: Facial paralysis causes excruciating impairments including facial asymmetry, limited eye closure, oral incontinence and social dysfunction. Modern plastic surgical reconstructions render favorable results with well-perfused dynamic muscle flaps. Post-operative tissue monitoring is a critical determinant for success. Contrast-enhanced Ultrasound (CEUS) and elastography have proven superior properties to evaluate tissue perfusion in various organs. We evaluated their role for functional muscle flaps positioned at the sub-skin level in facial palsy patients...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28881182/surgical-staples-a-superior-alternative-to-sutures-for-skin-closure-after-neck-dissection-a-single-blinded-prospective-randomized-clinical-study
#7
Shrenik Oswal, Rajiv Borle, Nitin Bhola, Anendd Jadhav, Sanidhya Surana, Rajesh Oswal
PURPOSE: To evaluate the efficacy of staples in skin closure after neck dissection in patients with oral squamous cell carcinoma. The authors hypothesized that the use of staples would result in better wound closure compared with the use of nonabsorbable monofilament sutures. MATERIALS AND METHODS: A prospective single-blinded randomized clinical trial was performed to compare various parameters, including time for wound closure, inflammatory changes, pain, cost efficacy, complications, and esthetic outcome of skin closure with surgical staples versus nonabsorbable monofilament sutures and to determine their statistical relevance using χ(2) and Mann-Whitney U tests...
August 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28873104/management-of-trauma-and-burn-scars-the-dermatologist-s-role-in-expanding-patient-access-to-care
#8
Nathanial R Miletta, Matthias B Donelan, Chad M Hivnor
Recent advances in laser surgery and our understanding of wound healing have ushered in a new era of trauma and burn scar management. Traditional therapy has centered around scar excision followed by primary closure or tissue replacement with flaps and grafts. This approach represents a perpetuation of the common fallacy that extensive scar improvement requires extensive surgical intervention. Laser surgery in conjunction with pharmacotherapy and minor tissue-conserving surgery produces well-healed and remodeled existing tissue that provides the most natural appearance and function of the skin...
July 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28873062/a-prospective-randomized-controlled-clinical-trial-to-assess-use-of-2-lidocaine-irrigation-to-prevent-abdominal-surgical-site-infection
#9
Alejandro Quiroga-Garza, Juan Manuel Valdivia-Balderas, Miguel Ángel Trejo-Sánchez, Abraham Guadalupe Espinosa-Uribe, Cynthia Guadalupe Reyes-Hernández, Rodrigo Enrique Elizondo-Omaña
Surgical site infections (SSI) are the third most common nosocomial infection, increasing morbidity and mortality rates of patients as well as their costs of care, but longer-term follow up studies and data are limited. Lidocaine, in addition to being a readily available and accessible local anesthetic, is known to have bacteriostatic properties. A prospective, descriptive, controlled, randomized clinical trial was conducted among patients scheduled to undergo abdominal sur- gery in the general surgical unit of a Mexican hospital...
August 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28872500/simple-septocutaneous-free-flap-design-for-one-stage-reconstruction-of-pharyngocutaneous-and-orocutaneous-fistulae
#10
Soo Hyun Woo, Tae Hui Bae, Woo Seob Kim, Han Koo Kim
Reconstruction of pharyngocutaneous fistula (PCF) or orocutaneous fistula is always a challenging task. It has many causes and is especially related to radiation therapy after resection of head and neck cancers. There are many reports of surgical procedures for fistula repair. For example, 2-stage methods, methods of combining multiple flaps, and methods of using chimeric flaps have been reported. However, there is no established simple method as a treatment of choice. The authors describe 5 patients of head and neck fistulas and recommend a useful 1-stage reconstruction method using a double skin paddle free flap...
September 1, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28870242/intraoperative-wound-irrigation-to-prevent-surgical-site-infection-after-laparotomy-iowisi-study-protocol-for-a-randomized-controlled-trial
#11
Tara C Mueller, Ulrich Nitsche, Victoria Kehl, Rebekka Schirren, Beate Schossow, Ruediger Goess, Helmut Friess, Daniel Reim
BACKGROUND: Postoperative surgical site infection (SSI) is one of the most common hospital infections and contributes substantially to postoperative morbidity and mortality. In addition, SSIs dramatically increase the treatment cost and length of hospital stay. Following visceral surgery by laparotomy, SSI rates are especially high (14-25%). Therefore, measures to prevent SSI in this field are urgently needed. Prophylactic intraoperative wound irrigation (IOWI) of the subcutaneous soft tissue before skin closure hypothetically represents an easy and economical option to reduce SSI rates and is already frequently used in clinical practice...
September 4, 2017: Trials
https://www.readbyqxmd.com/read/28867907/preemptive-analgesia-in-thumb-basal-joint-arthroplasty-immediate-postoperative-pain-with-preincision-versus-postincision-local-anesthesia
#12
Joseph T Labrum, Asif M Ilyas
Purpose  Currently no guidelines exist for the timing of the injection of anesthetics in surgeries performed under general anesthesia to minimize postoperative pain. To better understand the role of timing of the injection of local anesthesia in hand surgery performed under general anesthesia, we evaluated the effect of pre- versus postincisional local analgesic injection on immediate postoperative pain experience. We hypothesize that the preincisional (preemptive) injection will result in decreased immediate postoperative pain experience and analgesic use when compared with postincisional injection...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28862979/negative-pressure-wound-therapy-for-a-giant-wound-secondary-to-malignancy-induced-necrotizing-fasciitis-case-report-and-review-of-the-literature
#13
Jiayi Hu, Serge Goekjian, Nicolas Stone, Alexandra Nelson, Michael James Cooper
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening condition in which rapid diagnosis, debridement of nonviable tissue, and broad-spectrum antibiotics are critical to effective treatment. The debridement required can be extensive, resulting in large wounds that can sometimes be covered with split-thickness skin grafts (STSGs) with the help of negative pressure wound therapy (NPWT), or vacuum-assisted closure, to decrease the wound size. CASE REPORT: The authors report a rare case of NF due to malignancy-associated bowel perforation with a giant lower extremity wound secondary to debridement that involved 20% of the total body surface area (TBSA) in a 64-year-old, previously healthy, nonsmoking man...
August 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28859231/retrospective-8-year-analysis-of-negative-pressure-wound-therapy-in-dermatosurgery-a-single-center-experience
#14
Anja Wertenauer, Stefan Gräber, Cornelia Sigrid Lissi Müller
Negative pressure wound therapy (NPWT) is an established treatment modality in dermatologic surgery, but proof of evidence for efficacy is inconclusive. PURPOSE: To evaluate patient characteristics, treatment modalities, and outcomes in a single dermatosurgery center with NPWT applied over chronic and acute surgical wounds. METHODS: Of all surgical patients between 2008 and 2015, we selected those who were treated and hospitalized due to NPWT for treatment of acute and chronic wounds...
August 31, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28852298/reconstructions-of-small-scalp-defects-with-step-flap
#15
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi
INTRODUCTION: Defects of the scalp arise from several aetiologies including trauma, burn, injury, infection, radiation and surgical excision of tumours. Multiple options for reconstruction of scalp defects exist that included primary closure, skin grafts, local flaps, regional and distal free flaps. PATIENTS AND METHODS: This was a prospective case-series study, which was carried out in the Department of Plastic Surgery of our Hospital. Step flap was used for small (2...
April 2017: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/28852291/effectiveness-of-fibrin-glue-in-adherence-of-skin-graft
#16
Konda Sireesha Reddy, Ravi Kumar Chittoria, Preethitha Babu, Senthil Kumaran Marimuthu, Sudhanva Hemanth Kumar, Elan Kumar Subbarayan, Vinayak Chavan, Devi Prasad Mohapatra, Dinesh Kumar Sivakumar, M T Friji
BACKGROUND: Graft fixation is important for graft take. Fibrin glue has been proposed as an ideal material, because of its human origin and it provides firm adhesion in seconds or minutes. OBJECTIVE: To evaluate the efficiency of fibrin glue, in increasing the take of skin graft. Assessment includes surgical time taken for graft fixation, haematoma/seroma formation, engraftment and wound closure by day 14. METHODS: The study is an observational prospective study conducted in the Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, from January 2016 to June 2016...
April 2017: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/28834402/concise-review-fetal-membranes-in-regenerative-medicine-new-tricks-from-an-old-dog
#17
REVIEW
Rebecca Lim
The clinical application of the fetal membranes dates back to nearly a century. Their use has ranged from superficial skin dressings to surgical wound closure. The applications of the fetal membranes are constantly evolving, and key to this is the uncovering of multiple populations of stem and stem-like cells, each with unique properties that can be exploited for regenerative medicine. In addition to pro-angiogenic and immunomodulatory properties of the stem and stem-like cells arising from the fetal membranes, the dehydrated and/or decellularized forms of the fetal membranes have been used to support the growth and function of other cells and tissues, including adipose-derived mesenchymal stem cells...
September 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#18
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
August 22, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28819614/acute-compartment-syndrome-after-an-olecranon-fracture-in-a-patient-with-mild-hemophilia-b
#19
John M Reynolds, Christy Christophersen, Mary K Mulcahey
INTRODUCTION: Compartment syndrome is a serious condition characterized by compartmental pressures within 20 mmHg of diastolic blood pressure, or clinical signs of pain, paresthesia, pallor, and lack of pulses. Often a surgical intervention is necessary. Increased surveillance for compartment syndrome is important when a patient with a bleeding disorder sustains a traumatic injury. CASE REPORT: We present a case of forearm compartment syndrome in a patient with mild hemophilia B who sustained an olecranon fracture...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28807000/necrotizing-streptococcal-myositis-of-the-upper-extremity-a-case-report
#20
Johannes C Reichert, Götz Habild, Paul Simon, Ulrich Nöth, Jan B Krümpelmann
BACKGROUND: Necrotizing myositis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the affected tissue. The myositis is often caused by toxin-producing, virulent bacteria such as group A β-hemolytic streptococcus and associated with severe systemic toxicity. It is rapidly fatal unless diagnosed promptly and treated aggressively. However, necrotizing myositis is often initially misdiagnosed as a more benign soft-tissue infection as such fulminant, invasive muscle infections are rare with no more than 30 cases reported over the last century...
August 15, 2017: BMC Research Notes
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