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Falco Hietbrink, Lonneke G Bode, Louis Riddez, Luke P H Leenen, Marijke R van Dijk
BACKGROUND: Necrotizing fasciitis is an uncommon, rapidly progressive and potential lethal condition. Over the last decade time to surgery decreased and outcome improved, most likely due to increased awareness and more timely referral. Early recognition is key to improve mortality and morbidity. However, early referral frequently makes it a challenge to recognize this heterogeneous disease in its initial stages. Signs and symptoms might be misleading or absent, while the most prominent skin marks might be in discrepancy with the position of the fascial necrosis...
2016: World Journal of Emergency Surgery: WJES
Sylwia Szotek, Joanna Dawidowicz, Brian Eyden, Natalia Matysiak, Aleksander Czogalla, Grzegorz Dudzik, Anna Leśniewicz, Krzysztof Maksymowicz
Fascia lata is an important element of the fascial system, which forms the continuum of connective tissue throughout the body. This deep fascia envelops the entire thigh and hip area and its main function is to transmit mechanical forces generated by the musculoskeletal system of the lower extremities. Fascia lata is also known as a useful and easily harvested graft material. Despite its crucial role in lower extremity biomechanics and wide-ranging applications in plastic and reconstructive surgery, both the structure of fascia lata and particularly the cells populating this tissue are relatively unexplored and therefore poorly understood...
October 20, 2016: Ultrastructural Pathology
Matteo Bonatti, Norberto Vezzali, Antonio Frena, Giampietro Bonatti
Incisional hernia represents a rare complication after ventriculoperitoneal shunt positioning due to failure of the fascial suture in the site of abdominal entrance of ventriculoperitoneal catheter. Clinical presentation can be extremely variable, according to patient's performance status, herniated material constitution (i.e. mesenteric fat, bowel loops or both) and complication occurrence (e.g. strangulation or intestinal obstruction). Early diagnosis is fundamental in order to surgically repair the defect and prevent further complications...
June 2016: Journal of Radiology Case Reports
Pona Park, Hong-Ryul Jin
BACKGROUND: Warping remains a primary issue in the use of autologous costal cartilage for nasal augmentation. To mitigate such issues, diced cartilage in fascia (DCIF) has been proposed as an alternative for use in rhinoplasty. The objective of this study was to assess the efficacy of DCIF in nasal dorsal augmentation for Asian patients, with particular focus on the strengths and weaknesses of this material. MATERIALS AND METHODS: Fifteen patients who underwent major dorsal augmentation with DCIF during the last 2 years were retrospectively reviewed...
October 17, 2016: Aesthetic Plastic Surgery
Stephanie Tan, Dimitrios Nikolarakos
Although less frequently encountered in dental practices, subcutaneous emphysema of the face and neck has been reported in patients following dental extractions, particularly when lower molar teeth are extracted with the use of a high speed air turbine drill designed for restorative treatment, which forces air into the cervical fascial spaces. As facial swelling and pain are the most common presentations, subcutaneous emphysema can often be misdiagnosed as an allergic reaction or odontogenic infection. While usually a benign and self limiting condition, subcutaneous emphysema may have life threatening complications such as tension pneumothorax, cardiac tamponade, air embolism, tracheal compression and mediastinitis, which are important to recognise in an emergency setting...
October 14, 2016: Australian Dental Journal
Dhananjaya Sharma, Shuji Isaji
Focused pathological attention to tumor invasion of the retroperitoneal resection margin after pancreaticoduodenectomy for cancer of head of the pancreas led to the knowledge of strong tendency of cancer cells to infiltrate into the retropancreatic tissue and to spread along the peripancreatic neural plexuses as the cause of local recurrence. The term 'mesopancreas' was coined to describe perineural lymphatic layer located dorsally to the pancreas and it was suggested that its complete resection will minimize loco-regional recurrence and improve outcome...
October 12, 2016: Journal of Hepato-biliary-pancreatic Sciences
Arvind Kumar Pandey, Pramod Kumar, Srinivas Kodavoor Aithal, Sushma R Kotian, Honnegowda Thittamaranahalli, Hemalatha Bangera, Keerthana Prasad, Anne D Souza
The advancement of liposculpturing and fascial flaps in reconstructive surgery has renewed interest in the superficial fascia of abdomen. Its histological and biochemical composition may play a vital role in maintaining strength and elasticity of the fascia. Hence, study of abdominal fascia for the elastic, collagen, and hydroxyproline contents is desirable to understand asymmetrical bulges and skin folds and in improving surgical treatment of obesity. Samples of superficial fascia were collected from of upper and lower abdomen from 21 fresh cadavers (15 males and 6 females)...
September 2016: Anatomy & Cell Biology
Adam M Butensky, Leah P Gruss, Zachary L Gleit
BACKGROUND: A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. CASE PRESENTATION: A case of pseudohernia due to fractures of the 10(th) and 11(th) ribs in a 68-year-old white woman is presented...
October 1, 2016: Journal of Medical Case Reports
Alvin C Kwok, Jayant P Agarwal
PURPOSE: We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS: Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure...
October 7, 2016: Microsurgery
M-P Bernardi, A L A Bloemendaal, M Albert, M Whiteford, A R L Stevenson, R Hompes
PURPOSE: Transanal total mesorectal excision (taTME) requires specific technical expertise, as it is often difficult to ascertain the correct dissection plane. Consequently, one can easily enter an incorrect plane, potentially resulting in bleeding (sidewall or presacral vessels), autonomic nerve injury and urethral injury. We aim to demonstrate specific visual features, which may be encountered during surgery and can guide the surgeon to perform the dissection in the correct plane. METHOD: Specific features of dissection in the correct and incorrect planes are demonstrated in the accompanying video...
October 1, 2016: Techniques in Coloproctology
Mohamed El-Shazly, Mohamed Aziz, Hamdy Aboutaleb, Shady Salem, Eid El-Sherif, Mohamed Selim, Mohamed Sultan, Mohamed Omar, Tarek Abd Elbaky, Fouad Zanaty, Talal Alenezi, Abdelazeem Ghobashi, Adel Allam
BACKGROUND: Fournier's gangrene (FG) is an acute progressive necrotizing fasciitis of the genital area and perineum with possible extension to the abdominal wall. Surgical debridement is the gold standard management modality of established patients. Equivocal (early) FG represents a challenge in diagnosis. The objective of this study was to compare conservative management and early exploration in cases of equivocal (early) FG. METHODS: This was an observational study where data of all patients diagnosed as early FG in our departments over 4 years (2011-2015) were enrolled...
October 2016: Therapeutic Advances in Urology
Il Ho Park, Chul Hoon Chung, Yong Joon Chang, Jae Hyun Kim
BACKGROUND: The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. METHODS: We used a scapular fascial free flap in 12 cases for soft tissue coverage of the extremities or facial soft tissue augmentation...
September 2016: Archives of Plastic Surgery
R L Lassiter, E L Simmerman, J Sol Oh, C J Mentzer, N E Burkart, S B Holsten
OBJECTIVE: Necrotising soft tissue infection is a rare surgical emergency, which requires immediate and aggressive surgical debridement. Following control of the infection, patients are often left with large defects, with wound reconstruction and closure creating significant challenges. Here we describe a case of extensive thoracoabdominal necrotising soft tissue infection and provide a discussion on the standard of care and treatment based on a current literature review. METHOD: A 53-year-old female presented with bilious and feculent discharge from her surgical incision two weeks after a total abdominal hysterectomy...
October 2016: Journal of Wound Care
S P Puntambekar, S Puntambekar, Y Gadkari, S Naval
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
A Lyapis, R LaMonica, D E Luciano, A Ulrich, L Kaye, A A Luciano
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Alfin Okullo, Mehan Siriwardhane, Tony C Y Pang, Jane-Louise Sinclair, Vincent W T Lam, Arthur James Richardson, Henry Pleass, Emma Johnston
INTRODUCTION: Achieving primary fascial closure after damage control laparostomy can be challenging. A number of devices are in use, with none having yet emerged as best practice. In July 2013, at Westmead Hospital, we started using the abdominal reapproximation anchor (ABRA; Canica Design, Almonte, Ontario, Canada) device. We report on our experience. METHODS: A retrospective review of medical records for patients who had open abdomens managed with the ABRA device between July to December 2013 was done...
September 26, 2016: Surgical Innovation
Andre S Madsen, George Oosthuizen, Grant L Laing, John L Bruce, Damian Luiz Clarke
BACKGROUND: The purpose of this study was to audit our experience with computed tomography angiography (CTA) for the detection of aerodigestive tract injury (ADTI) following penetrating neck injury (PNI) and to assess the significance of deep surgical emphysema on CTA. METHODS: A prospectively maintained trauma registry at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa was retrospectively interrogated. The data of all patients with PNI investigated with CTA over a 4-y period were reviewed...
October 2016: Journal of Surgical Research
Iago Pinal-Fernandez, Maria Casal-Dominguez, John A Carrino, Arash H Lahouti, Pari Basharat, Jemima Albayda, Julie J Paik, Shivani Ahlawat, Sonye K Danoff, Thomas E Lloyd, Andrew L Mammen, Lisa Christopher-Stine
OBJECTIVES: The aims of this study were to define the pattern of muscle involvement in patients with immune-mediated necrotising myopathy (IMNM) relative to those with other inflammatory myopathies and to compare patients with IMNM with different autoantibodies. METHODS: All Johns Hopkins Myositis Longitudinal Cohort subjects with a thigh MRI (tMRI) who fulfilled criteria for IMNM, dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) or clinically amyopathic DM (CADM) were included in the study...
September 20, 2016: Annals of the Rheumatic Diseases
Muhamed Hamid Majid, Babak Meshkat, Haseeb Kohar, Sherif El Masry
BACKGROUND: Since the introduction of laparoscopic surgery for gallbladder disease different types of retrieval devices have been used to extract the gallbladder from the peritoneal cavity. These devises infer additional costs and may lead to associated risks and complications. We aimed to evaluate the safety of gallbladder retrieval without the use of a retrieval device. METHODS: A prospective study was conducted across two teaching hospitals in the Republic of Ireland from July 2010-2013...
2016: BMC Surgery
Timothy J Kovanda, Ecaterina Pestereva, Albert Lee
INTRODUCTION: Intrathecal baclofen pumps are valuable treatment options for those with cerebral palsy. Although subfascial baclofen pump placement is generally preferred over a subcutaneous pump placement due to lower infection rates, rare complications can occur with the subfascial approach such as pump migration. CASE PRESENTATION: The authors here describe a case of baclofen pump migration into the peritoneal cavity of a 26-year-old male patient with cerebral palsy, shunted hydrocephalus, and epilepsy...
June 2016: Anesthesiology and Pain Medicine
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