1/70. upper extremity salvage using the tensor fascia lata flap: report of two cases.The tensor fascia lata pedicled flap was successfully used to salvage 3 severely injured upper extremities in 2 patients. Both patients had undergone 3 prior free tissue transfers without complete closure of their wounds. All 3 tensor fascia lata flaps (2 myocutaneous, 1 myofascial) survived entirely. We believe this flap offers a distinct advantage compared with the groin flap when pedicled flap coverage of the upper extremity is required.- - - - - - - - - - ranking = 1keywords = wound (Clic here for more details about this article) |
2/70. Suicidal incised wound of a fistula for hemodialysis access in an elderly woman: case report.A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed.- - - - - - - - - - ranking = 10.061831911134keywords = stab, wound (Clic here for more details about this article) |
3/70. Reconstruction of burn scar of the upper extremities with artificial skin.The management of upper-extremity burn contractures is a major challenge for plastic surgeons. After approval by the food and Drug Administration, artificial skin (Integra) has been available in taiwan since 1997. From January of 1997 to July of 1999, the authors applied artificial skin to 13 severely burned patients for the reconstruction of their upper extremities, resulting in an increased range of motion in the upper-extremity joints and improved skin quality. An additional benefit was the rapid reepithelialization of the donor sites. There were no complications of infection throughout the therapeutic course, and the overall results were satisfactory. During the 2-year study, scar condition was monitored between 8 and 24 months, and a good appearance and pliable skin were obtained according to the Vancouver Scar Scale. According to this evaluation of Oriental skin turgor, normal pigmentation was restored about 6 months after the resurfacing procedure. For patients with severe burns in whom there is insufficient available skin for a full-thickness skin graft or another appropriate flap for scar revision, Integra is an alternative. The two major concerns in dealing with artificial skin are (1) a 10- to 14-day waiting period for maturation of the neo-dermis, necessitating a two-stage operation, and (2) prevention of infection with antibiotics and meticulous wound care.- - - - - - - - - - ranking = 1keywords = wound (Clic here for more details about this article) |
4/70. Trans-thoracic venous bullet embolism.Bullet emboli from peripheral wounds occur with sufficient frequency that they must be considered in every case of missile injury not accompanied by an exit wound. A case is presented which demonstrated a venous migration of such a bullet from the axillary vein into the femoral vein through the heart, presumably by gravity.- - - - - - - - - - ranking = 2keywords = wound (Clic here for more details about this article) |
5/70. Early decompression fasciotomy in the treatment of high-voltage electrical burns of the extremities.Based on a knowledge of electropathophysiology, a recommended treatment has been proposed for the management of extensive high-voltage electrical burns. Early, aggressive, surgical intervention consisting of adequate decompression fasciotomy and wound debridement has been emphasized as the first line of treatment. Frequent redebridements under general anesthesia are important to the preservation of viable tissue. Early coverage procedures or attempts at primary closure following decompression are contraindicated in high-voltage injuries. This method of treatment in eight cases of high-voltage, electrical injury has preserved viable tissue, decreased the incidence of fatal sepsis and renal shutdown, decreased patient morbidity, and generally facilitated patient rehabilitation.- - - - - - - - - - ranking = 1keywords = wound (Clic here for more details about this article) |
6/70. The use of manual edema mobilization for the reduction of persistent edema in the upper limb.Management of persistent edema with the common treatment methods reported in the literature is not always successful. Manual edema mobilization (MEM) is a relatively new treatment regimen derived from established European and Australian lymphedema reduction regimens. It includes the use of exercises, light skin-tractioning massage techniques following the lymphatic pathways, and the use of low-compression garments. The typical patient who may benefit from the use of MEM has a presumed healthy lymphatic system, is an active participant, and performs some of the techniques independently between therapy sessions. This case report describes the use of MEM on a patient with multiple trauma, which resulted in a significant reduction--78%--of the persistent edema in the affected upper limb. A theoretic rationale is offered for each MEM technique.- - - - - - - - - - ranking = 1.0206106370448keywords = stab (Clic here for more details about this article) |
7/70. Temporary external shunt bypass in the traumatically amputated upper extremity.The technique of temporary external shunt bypass offers early perfusion of a traumatically amputated extremity, thus decreasing the total anoxic time, permitting bony fixation after perfusion is established, and allowing arterial revascularization with good venous outflow and minimal blood loss. This technique may increase the survival of these severely damaged limbs.- - - - - - - - - - ranking = 1.0206106370448keywords = stab (Clic here for more details about this article) |
8/70. Heroic procedures in vascular injury management: the role of extra-anatomic bypasses.The insertion of an extra-anatomic bypass graft is an accepted operative technique in highly selected patients with atherosclerotic occlusive disease and contraindications to in situ grafting. In similar fashion, the technique should be considered in injured or septic patients with large soft tissue defects or wound infections overlying arterial repairs or involving native arteries. The combination of vigorous debridement of injured or infected soft tissue and insertion of an extra-anatomic bypass graft allows for appropriate care of the wound without concern for further injury to the now-displaced arterial repair.- - - - - - - - - - ranking = 2keywords = wound (Clic here for more details about this article) |
9/70. Pedicled groin flaps for upper-extremity reconstruction in the elderly: a report of 4 cases.The pedicled groin flap is a useful, versatile flap for coverage of wounds of the hand and distal forearm. It produces predictable results with a procedure that is much less difficult to perform and takes less time than a free-tissue transfer. Contrary to the general belief that the groin flap should not be used in the elderly because of the risk of shoulder stiffness, we found satisfactory results with this procedure in 4 elderly patients (age range, 59-75 y) when immediate shoulder mobilization was instituted and physical therapy was continued during flap maturation and pedicle division.- - - - - - - - - - ranking = 1keywords = wound (Clic here for more details about this article) |
10/70. Upper thoracic spinal cord injury without vertebral bony lesion: a report of two cases.STUDY DESIGN: Case report. OBJECTIVES: To describe a rarely reported type of upper thoracic spinal cord injury without vertebral bony lesion in two cases with multiple trauma. SUMMARY OF BACKGROUND DATA: Because it is supported by the stiffness of the rib cage, the upper thoracic spine has greater stability than the cervical and lumbar regions, and thus its fracture or fracture dislocation is less frequent. Nevertheless, when fracture or fracture dislocation of upper thoracic spine occurs, spinal cord involvement and severe concomitant injuries are frequently associated. methods: Two cases who were suspected to have thoracic spinal cord injuries were referred to our emergency center: a 19-year-old girl presented with paraparesis after her motorcycle collided with a truck, and a 63-year-old male involved in an industrial accident presented with paraplegia. RESULTS: Radiograph and computed tomography scan showed no abnormality or dislocation in the vertebral bodies in these two cases, although the upper thoracic spinal cord injuries were suspected by clinical features. Magnetic resonance images detected abnormal signals, suggesting spinal cord injuries, and these signals each emanated from levels that coincided with the observed clinical features. CONCLUSIONS: Transient subluxation or displacement might have caused the upper thoracic spinal cord injuries after the support of the rib cages was temporarily lost on application of excessive force, although such findings could not be confirmed by imaging procedures.- - - - - - - - - - ranking = 1.0206106370448keywords = stab (Clic here for more details about this article) |
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