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Surgical skin closure

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https://www.readbyqxmd.com/read/28541880/reconstruction-of-a-large-leg-defect-with-a-combined-hatchet-flap-technique
#1
Roberto Cecchi, Laura Bartoli, Luigi Brunetti, Giovanni Troiano
The repair of lower leg defects, not amenable to primary closure, may be challenging, since the skin at this level is scarcely elastic and difficult to mobilize. Local skin flaps are generally utilized only to restore moderately sized losses, whereas grafting becomes a realistic choice in presence of larger wounds. We present the case of a 70-year-old man with a wide defect on his right leg following the surgical excision of a squamous cell carcinoma. The wound was successfully closed with a combination of three hatchet flaps...
April 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28506450/utility-and-versatility-of-the-supraclavicular-artery-island-flap-in-head-and-neck-reconstruction
#2
José A González-García, Carlos M Chiesa-Estomba, Jon A Sistiaga, Ekhiñe Larruscain, Leire Álvarez, Xabier Altuna
INTRODUCTION: The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended. MATERIAL AND METHODS: We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours...
May 12, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28505360/comparative-total-and-unbound-pharmacokinetics-of-cefazolin-administered-by-bolus-versus-continuous-infusion-in-patients-undergoing-major-surgery-a-randomized-controlled-trial
#3
B I Naik, C Roger, K Ikeda, M S Todorovic, S C Wallis, J Lipman, J A Roberts
Background.: Perioperative administration of cefazolin reduces the incidence of perioperative infections. Intraoperative re-dosing of cefazolin is commonly given between 2 and 5 h after the initial dose. This study was undertaken to determine whether intraoperative continuous infusions of cefazolin achieve better probability of target attainment (PTA) and fractional target attainment (FTA) than intermittent dosing. Methods.: Patients undergoing major surgery received cefazolin 2 g before surgical incision...
May 15, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28497247/-medial-closed-wedge-osteotomy-of-the-distal-femur-in-biplanar-technique-and-a-specific-plate-fixator
#4
REVIEW
P Lobenhoffer, K Kley, D Freiling, R van Heerwaarden
OBJECTIVE: Correction of distal femur deformity by closed-wedge biplanar osteotomy. INDICATIONS: Metaphyseal frontal plane deformities of the femur. CONTRAINDICATIONS: Osteoarthritis of the contralateral compartment, total loss of the contralateral meniscus, acute/chronic infection, limited range-of-motion, poor soft-tissue conditions at site of surgery. SURGICAL TECHNIQUE: Skin incision at metaphyseal area of femur...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28491439/mycobacterial-panniculitis-caused-by-mycobacterium-thermoresistibile-in-a-cat
#5
Polina Vishkautsan, Krystle L Reagan, M Kevin Keel, Jane E Sykes
CASE SUMMARY: A domestic shorthair cat was evaluated for chronic, bilateral, ulcerative dermatitis affecting the inguinal region and lateral aspects of both pelvic limbs. Histopathologic examination of skin biopsies collected throughout the course of disease revealed chronic pyogranulomatous ulcerative dermatitis. Aerobic bacterial skin cultures yielded growth of a methicillin-resistant Staphylococcus aureus and Corynebacterium amycolatum. Upon referral the clinical findings were suggestive of a non-tuberculous Mycobacterium species infection...
July 2016: JFMS Open Rep
https://www.readbyqxmd.com/read/28487090/a-meta-analysis-and-systematic-review-evaluating-skin-closure-after-total-knee-arthroplasty-what-is-the-best-method
#6
Kelvin Y Kim, Afshin A Anoushiravani, William J Long, Jonathan M Vigdorchik, Ivan Fernandez-Madrid, Ran Schwarzkopf
BACKGROUND: Many cost drivers of total knee arthroplasty (TKA) have been critically evaluated to meet the heightened quality-associated expectations of performance-based care. However, assessing the efficacy of the different modalities of skin closure has been an underappreciated topic. The present study aims to provide further insight by conducting a meta-analysis and systematic review evaluating the rates of common complications and perioperative quality outcomes associated with different suture and staple skin closure techniques after TKA...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#7
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28483631/a-retrospective-analysis-of-surgical-femoral-artery-closure-techniques-conventional-vs-purse-suture-technique
#8
Mehmet Cakici, Levent Yazicioglu, Cagdas Baran, Evren Ozcinar, Alper Ozgur, Canan Soykan, Sadik Eryilmaz, Sadik Bilgiç, Bulent Kaya, A Ruchan Akar
INTRODUCTION: Different techniques have been reported for the exploration and repair of femoral artery (FA) in patients who undergo minimally invasive cardiac surgery (MICS) and endovascular aortic surgery. We used a modified approach alternative to the conventional technique (group CT) since May 2013, which specifies a shorter groin incision and diamond shaped hemostatic purse sutures for arteriotomy closure without the requirement of cross-clamping (group PT) and evaluated early outcomes and the complication profiles of the two techniques for femoral access...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28480840/aplasia-cutis-congenita-type-i-a-case-series
#9
U Wollina, A Chokoeva, Sh Verma, G Tchernev, F Handjani
Aplasia Cutis Congenita is a rare disorder with circumscribed, partial or widespread absence of skin and subcutaneous soft tissue; in about 20% it also causes skull defects. The disease is heterogeneous in its clinical presentation with nine major subtypes. Type I represents nonsyndromic Aplasia Cutis Congenita. We report 5 infants with skin defects of the scalp and limbs presented to dermatologists. Pediatric workup ruled out any other malformations or genetic disorders. All patients were treated by conservative wound and skin care without complications...
March 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28456441/surgical-treatment-and-management-of-the-severely-burn-patient-review-and-update
#10
P Gacto-Sanchez
Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult...
April 26, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28448311/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#11
Maciej Rysz, Dariusz Grzelecki, Maciej Mazurek, Stanisław Starościak, Romuald Krajewski
BACKGROUND: Surgery for scalp malignancies is aimed at the complete resection and a good aesthetic outcome. The goal was to develop an algorithm for scalp reconstruction based on the authors' surgical experience. METHODS: This is a retrospective analysis of 123 procedures of scalp malignancies in 105 patients. Twenty eight procedures were for resection of squamous cell carcinoma, 54 for basal cell carcinoma, and 41 for suspected melanomas. RESULTS: Primary closure (27 procedures), local flap (LF; 19), split-thickness skin graft (SG; 64), rotated LF and SG (9), and free vascularized flaps (4) were used...
April 12, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28448267/endogenous-thymosin-%C3%AE-4-expression-in-sacrococcygeal-pilonidal-sinus-disease-a-retrospective-immunohistochemical-analysis-of-excisional-skin-biopsy-samples
#12
Sevinc Sahin
Thymosin beta 4 (Tβ4) is a peptide that has been shown in dermal, corneal, and cardiac preclinical injury models to potentially affect tissue protection, regeneration, and repair. Sacrococcygeal pilonidal sinus disease (SPSD) is a chronic inflammatory disorder associated with a high incidence of recurrence, chronic fistulation, and a challenging postoperative surgical wound healing process. Retrospectively, an immunohistochemical analysis was conducted to evaluate endogenous Tβ4 expression in excisional skin biopsies from patients with SPSD...
April 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28441303/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#13
Maciej Rysz, Dariusz Grzelecki, Maciej Mazurek, Stanisław Starościak, Romuald Krajewski
BACKGROUND: Surgery for scalp malignancies is aimed at the complete resection and a good aesthetic outcome. The goal was to develop an algorithm for scalp reconstruction based on the authors' surgical experience. METHODS: This is a retrospective analysis of 123 procedures of scalp malignancies in 105 patients. Twenty eight procedures were for resection of squamous cell carcinoma, 54 for basal cell carcinoma, and 41 for suspected melanomas. RESULTS: Primary closure (27 procedures), local flap (LF; 19), split-thickness skin graft (SG; 64), rotated LF and SG (9), and free vascularized flaps (4) were used...
May 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#14
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424290/skin-derived-precursors-from-human-subjects-with-type-2-diabetes-yield-dysfunctional-vascular-smooth-muscle-cells
#15
Sarah Katherina Steinbach, Terrence M Yau, Maral Ouzounian, Husam Abdel-Qadir, Mark Chandy, Thomas Waddell, Mansoor Husain
Objective: Few methods enable molecular and cellular studies of vascular aging or type-2 diabetes (T2D). Here we report a new approach to studying human vascular smooth muscle cell (VSMC) pathophysiology by examining VSMCs differentiated from progenitors found in skin. Approach and Results: Skin-derived precursors (SKPs) were cultured from biopsies (N=164, ~1 cm(2)) taken from the edges of surgical incisions of older adults (N=158; males 72%; mean age 62.7±13 years) undergoing cardiothoracic surgery, and differentiated into VSMCs at high efficiency (>80% yield)...
April 19, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28416989/immediate-breast-reconstruction-of-a-nipple-areolar-lumpectomy-defect-with-the-l-flap-skin-paddle-breast-reduction-design-and-contralateral-reduction-mammoplasty-symmetry-procedure-optimizing-the-oncoplastic-surgery-multispecialty-approach
#16
Mitchell Buller, Adee Heiman, Jared Davis, Thomas J Lee, Nicolás Ajkay, Bradon J Wilhelmi
Objective: We describe a modification of the inferior pedicle reduction mammoplasty for oncoplastic reconstruction of a central tumor defect. Our technique involved a deepithelialized L-shaped medial inferior based flap with removal of lateral breast tissue after central lumpectomy with a contralateral Wise-pattern mastopexy with inferior pedicle for symmetry. This technique is ideal for patients with large, ptotic breasts that desire breast conservation with immediate reconstruction. Methods: A 47-year-old woman with size 38 DD breasts presented with a palpable 2-cm subareolar mass of the left breast...
2017: Eplasty
https://www.readbyqxmd.com/read/28416345/laryngeal-function-preserving-operation-for-t4a-laryngeal-cancer-with-vocal-cord-paralysis-a-case-report
#17
Yukinori Asada, Koreyuki Kurosawa, Ko Matsumoto, Takahiro Goto, Kengo Katoh, Takayuki Imai, Shigeru Saijo, Kazuto Matsuura
For locally advanced laryngeal cancers, the standard treatment of choice is chemoradiotherapy if organ function needs to be conserved. Surgical treatment with larynx preservation is conducted only for limited cases. For locally advanced laryngeal cancers such as those with vocal cord fixation and/or cricoid cartilage destruction, there is no apparent standardized organ-preserving surgery keeping the essential laryngeal functions, viz. the airway, deglutition and articulation, uncompromized. Recently, our surgical team saw a patient with T4a advanced laryngeal cancer with vocal cord fixation who aspired to maintain his laryngeal function...
April 14, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28405603/mtor-inhibition-by-everolimus-does-not-impair-closure-of-punch-biopsy-wounds-in-renal-transplant-patients
#18
Shelley B Dutt, Josephine Gonzales, Megan Boyett, Anne Costanzo, Peggy P Han, Steven Steinberg, Dianne B McKay, Julie M Jameson
BACKGROUND: Mammalian target of rapamycin (mTOR) inhibitors are approved to prevent allograft rejection and control malignancy. Unfortunately, they are associated with adverse effects, such as wound healing complications that detract from more extensive use. There is a lack of prospective wound healing studies to monitor patients treated with mTOR inhibitors, such as everolimus or sirolimus, especially in nondiabetics. METHODS: Patients receiving everolimus with standard immunosuppressant therapy or standard immunosuppressant therapy without everolimus were administered 3-mm skin biopsy punch wounds in the left scapular region...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28399024/immediate-reconstruction-for-plantar-melanoma-a-paradigm-shift
#19
Hunter Oliver-Allen, Merisa Piper, Carolyn Vaughn, Hani Sbitany
INTRODUCTION: Plantar melanoma tumors are traditionally treated with wide local excision based on depth of invasion, followed by delayed reconstruction once negative surgical margins are confirmed. However, delayed reconstruction requires care for an open wound, a prolonged treatment course, and the need for an additional surgery. Immediate reconstruction has been shown to be oncologically safe in head and neck melanoma, but little is described in the literature regarding immediate reconstruction in plantar melanoma...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28395685/the-benefit-of-pharmacological-venous-thromboprophylaxis-in-foot-and-ankle-surgery
#20
N P Saragas, P N F Ferrao, B F Jacobson, E Saragas, A Strydom
BACKGROUND: Ten percent of patients with a deep-vein thrombosis (DVT) will develop a fatal pulmonary embolism (PE), often initially asymptomatic. The risks and benefits of pharmacological thromboprophylaxis are well documented in respect of total joint arthroplasty and hip fractures, but little is understood about the incidence of venous thromboembolism (VTE) or the potential risks and benefits of chemoprophylaxis in foot and ankle surgery. OBJECTIVE: To determine whether prophylactic chemoprophylaxis had any impact on the prevention of VTE in a cohort of foot and ankle surgical patients requiring the combination of below-knee cast immobilisation and non-weightbearing for ≥4 weeks...
March 29, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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