Plastic and reconstructive surgery
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In summary, it is clear that duration of surgery is positively correlated with postoperative morbidity in both major and relatively minor procedures. It should be kept in mind that the reason for this in many cases may be that the preoperative condition of the patient or the nature of the surgical procedure can affect both operative time and postoperative outcome. ⋯ It can be said, too, that the anesthetist will be more likely to see arrhythmias the longer the surgeon operates. The association of myocardial infarction, renal failure, thromboembolic disease, and delirium with prolonged operation time is also a possibility.
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The events that participate in the local pathophysiology of a burn would have not been completely described. This study defines the sequential morphologic changes following untreated partial-thickness burns. Guinea pigs received partial-thickness scald burns by 75 degrees C water immersion for 10 seconds. ⋯ A definite progression of the thermal injury was found, with maximum tissue destruction occurring 8 hours after the burn. At 24 hours after the burn, some improvement in the burn wound was noted, especially in the dermal microvasculature. At 96 hours, the damaged epidermis sloughed, exposing a dermis that contained areas resembling microabscesses.
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The possible neurotoxic effects of five commonly used steroid agents were examined. Using histologic studies and studies of the microneural circulation, it was found the steroids can indeed cause neurotoxicity. The injection site was critical in effecting injury. ⋯ Disturbance in the blood-nerve barrier correlated with the changes noted on light and electron microscopy, but is thought to be coincidentally and not causally related. In conclusion, it was shown that the intrafascicular injection of commonly used steroid agents had a direct toxic effect on peripheral nerve-fibers and caused a disruption of the blood-nerve barrier. Use of the more toxic agents in the vicinity of peripheral nerves should probably be avoided.