Journal of plastic surgery and hand surgery
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J Plast Surg Hand Surg · Apr 2012
Comparative StudyFormation of hypertrophic scars: evolution and susceptibility.
Formation of hypertrophic scars is a common complication of wound healing, and at present little is known about the incidence and risk factors. Our aim was to analyse the incidence, progression, and regression of postoperative hypertrophic scars over time and to identify risk factors of hypertrophic scars. Patients who had had bilateral reduction mammoplasty or median sternotomy incision were included in the study. ⋯ In conclusion, 60% of patients developed hypertrophic scars postoperatively, typically during the first three months. Most hypertrophic scars that are present after three months are still hypertrophic after 12 months. Young, non-smoking patients are more susceptible to formation of hypertrophic scars.
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J Plast Surg Hand Surg · Feb 2012
Comparative StudyReconstruction of soft tissue defects in the extremities with a pedicled perforator flap: series of 25 patients.
Since the introduction of perforator-based flaps, new flaps have been described for reconstruction of soft tissue defects in the extremities. Pedicled perforator flaps, often called propeller flaps, are based on a single perforator and are local axial flaps that can be rotated up to 180(0) with the single perforator as the pivotal point. Pedicle perforator flaps have gained popularity because they have a shorter operating time than free flaps. ⋯ The operation is quick and can be done under regional anaesthesia. The flap is thin and has a local texture that gives a good functional and aesthetic result. The pedicled perforator flap is a little unpredictable in the lower leg, probably because the directions of the vessels that arise from the perforator are not consistent.
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J Plast Surg Hand Surg · Sep 2011
Comparative StudySuprathel(®) causes less bleeding and scarring than Mepilex(®) Transfer in the treatment of donor sites of split-thickness skin grafts.
Split-thickness skin grafts are routine in the treatment of deep dermal burns and various other wounds. Healing of the donor site of the graft has an impact on the total recovery of the patient. We conducted a prospective clinical study at Tampere University Hospital to compare the effect of two adhesive wound dressings, Suprathel(®) and Mepilex(®) Transfer. ⋯ Significantly less pain and bleeding was associated with Suprathel(®) treatment compared with Mepilex(®) Transfer (p < 0.05). Suprathel(®) produced a better scar at the three months' follow-up as measured using the Vancouver Scar Scale (VSS). The results show that Suprathel(®) is a better dressing for the donor sites than Mepilex(®) Transfer.
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Dog bites to the hand and forearm are common. Although bites are usually minor, aggressive dogs may cause extensive bites developing to a public health problem. In a database review of dog bites to the hand applied to Emergency Department or to the Department of Hand Surgery in Malmö, Sweden 2008-2009, we found 81 cases [42 men and 39 women; median age 45 (range 2-88) years]. ⋯ Serious infections were found independently of size of dog. We suggest that education of owners and the public, reporting of all bites, and control of animals are some of the actions to reduce the number of attacks. At least one serious case could have been prevented if the dog had been put down after a previous serious attack.
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J Plast Surg Hand Surg · Feb 2011
Spatial measurement for safe placement of screws within the scaphoid using three-dimensional analysis.
The placement of a headless screw within the scaphoid is important for successful fixation of fractured scaphoids. We ascertained the safe position of a screw using virtual collision experiments on a three-dimensionally reconstructed scaphoid bone and screw model, and applied measured angles to simple radiographs. ⋯ In all experiments, the safe angle between the screw and the anteroposterior scaphoid line (defined from the most distal portion of the scaphoid where it met the capitate to the proximal position where the lunate and capitate meet) ranged from 8° to 27° in the anteroposterior view, and the safe angle between the screw and the lateral scaphoid line (defined from the most volar portion of the scaphoid tuberosity to the volar position where the scaphoid faced the radius) ranged from 2° to 26° in the lateral view. These ranges can be used as a guide for a safe position of the screw within the scaphoid in volar percutaneous fixation of screws in scaphoid fractures.