Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jun 2009
Case ReportsAn explosion in the mouth caused by a firework.
Explosion and gunshot mouth injuries represent a challenging problem with regard to restoring optimal oral function. These wounds exhibit a spectrum of complexity and mostly include extensive soft tissue trauma complicated by burns, foreign bodies, fractures and concomitant traumas. ⋯ We report the case of a young Caucasian patient who destroyed the middle and lower thirds of the face when a firecracker blasted in his mouth. His clinical history is unusual in terms of the modality of injury, i.e. a Russian roulette game, and the lesions suffered, in the reconstruction of which we used both surgical and microsurgical techniques.
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J Plast Reconstr Aesthet Surg · May 2009
Randomized Controlled TrialPostoperative analgesia and flap perfusion after pedicled TRAM flap reconstruction - continuous wound instillation with ropivacaine 0.2%. A pilot study.
Transverse rectus abdominis musculocutaneous (TRAM) flap surgery is a complex procedure characterised by an extensive wound site. We present a pilot study with 17 patients receiving continuous wound instillation with ropivacaine or isotonic saline. Patients undergoing TRAM flap surgery were included in the study and randomised to the ropi group or the control group. ⋯ Our data show a trend that continuous wound instillation of ropivacaine 0.2% increases pain relief after TRAM flap surgery with earlier bowel movement than intravenous opioid patient controlled analgesia (IV-PCA) alone. A does of 960 mg of ropivacaine daily did not result in toxic plasma concentrations. Ropivacaine 0.2% did not show a vasoconstrictor effect.
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J Plast Reconstr Aesthet Surg · May 2009
Randomized Controlled TrialEffects of high dose corticosteroids in open rhinoplasty.
Although some studies about the effects of steroids on surgical trauma in closed or combined (closed and open together) rhinoplasty have been reported in the literature, still more information is needed in order to enlighten rhinoplasty surgeons. The purpose of this study is to evaluate the anti-inflammatory activity of steroids administered in high doses to prevent and decrease periorbital ecchymosis and oedema in patients who underwent open rhinoplasty with osteotomies by the same surgeon. This is the first study in open rhinoplasty alone. ⋯ We can confidently say that high dose methylprednisolone is effective in preventing and reducing both the periorbital ecchymosis and oedema in open rhinoplasty with osteotomies and it can be used safely for this purpose.