Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 1994
Collagenase during burn wound healing: influence of a hydrogel dressing and pulsed electrical stimulation.
Epithelialization of second-degree burn wounds is known to be accelerated by topical treatment with hydrogel dressings and further enhanced by pulsed electrical stimulation compared with no treatment (air exposure). Tissue collagenase has been proposed to be involved during the process of epithelialization. In the present study collagenase levels were examined in partial-thickness burn wounds in the skin of four domestic pigs. ⋯ Early application of hydrogel dressing to the burn wounds was accompanied by elevated collagenase activities and an increased inflammatory reaction in dermis. Addition of pulsed electrical stimulation increased (p < 0.001) collagenase levels twofold above those with hydrogel alone during initiation of epithelialization (postburn days 3 and 4). These results suggest that collagenase is closely linked to wound epithelialization.
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In Third World countries, there is a desperate need for basic medical supplies. Surgeons are responsible for a significant amount of medical waste in operating rooms, and much of that waste comes from partially used prepackaged sterile operative sets. In October 1992, InterVol established a regional pilot program in Rochester, N. ⋯ In the process, a data base was created, which could be analyzed to find new ways of limiting unused materials that needed to be discarded. This project operated in four phases: (1) setup and education, (2) collection, (3) sorting and inventory, and (4) distribution. The program was proved to be effective and may serve as a model to help other communities establish similar programs.
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Plast. Reconstr. Surg. · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialOral premedication for local anesthesia in plastic surgery: prospective, randomized, blind comparison of lorazepam and temazepam.
Patients undergoing plastic surgical procedures under local anesthesia as inpatients were entered into a phase III randomized, blind trial designed to compare two commonly used oral premedications, lorazepam and temazepam. The effects of the drugs on each patient's memory, pain, sedation, and anxiety were assessed by questions asked of the patient, the nurse, and the surgeon. ⋯ There was no significant difference in anxiolysis between the two premedications (p = 0.20). If premedication is indicated, we advocate the use of lorazepam rather than temazepam as premedication for plastic surgical procedures to be performed under local anesthesia, provided there is adequate postoperative supervision.
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Plast. Reconstr. Surg. · Feb 1994
Case ReportsFibula osteoseptocutaneous flap for reconstruction of composite mandibular defects.
The fibula osteoseptocutaneous flap is a versatile method for reconstruction of composite-tissue defects of the mandible. The vascularized fibula can be osteotomized to permit contouring of any mandibular defect. The skin flap is reliable and can be used to resurface intraoral, extraoral, or both intraoral and extraoral defects. ⋯ There were no instances of isolated partial or complete skin necrosis. All osteotomy sites healed primarily. The contour of the mandibles was good to excellent.
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Plast. Reconstr. Surg. · Sep 1993
Verification of a free vascularized nerve graft model in the rat with application to the peripheral nerve allograft.
We report a vascularized sciatic nerve graft in the rat, based upon the femoral popliteal superior muscular artery pedicle. The pedicle may be raised from the common femoral artery via the popliteal artery, with accompanying venous drainage to the femoral vein. We have characterized two vessels: the middle tibial artery to the posterior tibial nerve and the arteria comitas nervus peroneus to the peroneal nerve. ⋯ The model was used to evaluate regeneration across allogeneic (ACI to Lewis, n = 12) versus syngeneic (Lewis to Lewis, n = 6) nerve grafts. Electrophysiologic and histomorphometric assessments demonstrated that the vascularized immunosuppressed allograft was similar to the vascularized syngeneic graft. Both were superior to the vascularized allograft without immunosuppression.