Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jan 2007
ReviewOrbital exenteration for advanced periorbital skin cancers: 20 years experience.
Orbital exenteration is a disfiguring procedure that results in a significant deformity which poses a reconstructive challenge, especially in elderly patients with significant comorbidities. We reviewed our experience of orbital exenteration. ⋯ Though there are various options available for reconstruction after orbital exenteration, a split skin graft and orbital prosthesis provide a simple solution for a very difficult problem of advanced periorbital skin cancer in the elderly population with significant comorbidities. The final outcome is comparable to that of more complex flap reconstruction with comparable satisfaction rates.
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J Plast Reconstr Aesthet Surg · Jan 2007
Pyogenic granuloma - the quest for optimum treatment: audit of treatment of 408 cases.
Pyogenic granuloma is a common, acquired, benign vascular lesion of skin and mucous membranes which may occasionally present intravascularly or subcutaneously. Pyogenic granuloma occur in all age groups and although they may eventually regress, removal of unsightly, bleeding or uncomfortably positioned lesions is usually sought before this takes place. This is a retrospective study of 408 cases of pyogenic granuloma that were analysed by the Stoke Mandeville Histopathology laboratory between 1994 and 2004. ⋯ Head and neck was the most common anatomical location, in particular the cheek and intraoral locations. Fewest recurrences were noted following excision and direct closure although all techniques investigated showed an acceptably low recurrence rate. Whatever technique is used it must yield material for histopathological analysis to ensure the exclusion of differential diagnoses.
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J Plast Reconstr Aesthet Surg · Jan 2007
Multicenter StudyResuscitation of thermal injuries in the United Kingdom and Ireland.
The purpose of this study was to examine the consistency of burns resuscitation practice throughout UK and Ireland. Twenty-six Burns Units were identified via the National Burn Bed Bureau and surveyed via a postal questionnaire. Twenty-three units returned a completed questionnaire, covering all of the units treating children and 17 out of 20 units that treat adults. ⋯ Resuscitation is discontinued after 24h in 35% of units and after 36 h in 30% of units. Approximately half of the units do not routinely change the type of intravenous fluid administered after the initial period of resuscitation. This survey illustrates that resuscitation of thermally injured patients in UK and Ireland Burns Units is fairly consistent with a shift towards crystalloid resuscitation.
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J Plast Reconstr Aesthet Surg · Jan 2007
Current concepts of microvascular reconstruction for limb salvage in electrical burn injuries.
Microvascular reconstruction is rarely indicated in burn injuries. As the versatility and variability of free flaps have increased significantly during recent years so, the indications for this procedure have been expanded for limb salvage after electrical injuries. ⋯ Our data demonstrate that electrical burn injuries are distinct entities requiring individual reconstructive solutions for limb salvage. Even if our flap failure rate is relatively high it should not be forgotten that this type of reconstruction represents an opportunity for limb salvage as opposed to early amputation.