Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Oct 2011
Randomized Controlled Trial Comparative StudyThe ideal split-thickness skin graft donor-site dressing: a clinical comparative trial of a modified polyurethane dressing and aquacel.
The almost single disadvantage of conventional polyurethane film dressings, uncontrolled leakage, is probably as often described as its numerous advantages for split-thickness skin graft donor sites. This shortcoming can be overcome by perforating the polyurethane dressing, which permits controlled leakage into a secondary absorbent dressing. The study was conducted to compare the polyurethane dressing system and Aquacel, a hydrofiber wound dressing, which also seems to fulfill all criteria of an ideal donor-site dressing. ⋯ Therapeutic, II.
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Plast. Reconstr. Surg. · Oct 2011
Occipital artery vasculitis not identified as a mechanism of occipital neuralgia-related chronic migraine headaches.
Recent evidence has shown that some cases of occipital neuralgia are attributable to musculofascial compression of the greater occipital nerve and improve with neurolysis. A mechanical interaction at the intersection of the nerve and the occipital artery may also be capable of producing neuralgia, although that mechanism remains one theoretical possibility among several. The authors evaluated the possibility of unrecognized vasculitis of the occipital artery as a potential mechanism of occipital neuralgia arising from the occipital artery/greater occipital nerve junction. ⋯ Therapeutic, IV.
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Plast. Reconstr. Surg. · Oct 2011
Randomized Controlled Trial Comparative StudyPressure garment therapy alone and in combination with silicone for the prevention of hypertrophic scarring: randomized controlled trial with intraindividual comparison.
Published trials evaluating pressure garment and/or silicone therapy as a treatment for hypertrophic burn scarring are of poor quality and highly susceptible to bias. The authors' aim was to compare the efficacy of pressure garment therapy alone and in combination with silicone gel sheet or spray therapy for the prevention of hypertrophic scarring. ⋯ Therapeutic, II.
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Plast. Reconstr. Surg. · Oct 2011
Review Case ReportsThe bioethics of separating conjoined twins in plastic surgery.
The incidence of craniopagus twins approximates four to six per 10 million births. Although rare, surgical separation of conjoined twins poses significant technical and ethical challenges. The present report uses the case of craniopagus twins AD and TD to examine the bioethical issues faced by a multidisciplinary medical team in planning the separation of craniopagus twins. ⋯ This case report reviews one approach to analyzing and solving complex ethical dilemmas in pediatric plastic surgery. The principles reviewed are (1) autonomy and informed consent, focusing especially on the role of children in the informed consent process; (2) beneficence and nonmaleficence, two intricately intertwined principles because separation could potentially cause irreversible harm to one twin while improving the quality of life for the other (as separation is not a life-saving procedure, is it ethical to perform a procedure with unknown surgical risk to improve children's quality of life?); and (3) justice (is it fair to allocate excessive medical resources for the twins' separation?). The present report explores the ethics behind such decisions with respect to the separation of conjoined twins.