Annals of plastic surgery
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Annals of plastic surgery · May 1997
Randomized Controlled Trial Clinical TrialA controlled, randomized, double-blind study of ketorolac for postoperative analgesia after plastic surgery.
The present study was designed to evaluate the efficacy and safety of ketorolac compared with metamizol (Nolotil) in the control of pain after plastic surgery. Almost no literature exists on postoperative pain control in this specialty. A multiple-dose, randomized, double-blind study of parallel design was carried out. ⋯ Ketorolac and metamizol were found to be equally safe and effective in reducing postoperative pain after plastic surgery. It should be noted that 52% of patients in the ketorolac group and 48% in the metamizol group considered their postoperative analgesia to be very good. Nevertheless, for surgical procedures or for patients in whom postoperative hematoma formation is a particular concern, ketorolac probably should not be used.
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Annals of plastic surgery · May 1997
Case ReportsAneurysm of the radial artery following blunt trauma to the wrist.
Aneurysms involving the distal radial artery are rare lesions which are usually secondary to penetrating trauma or iatrogenic injury. Blunt trauma is an extremely uncommon cause. ⋯ Excision of the aneurysm is recommended. The decision to ligate or reconstruct the radial artery remains controversial.
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Ischemic time (the time between the interruption and reestablishment of blood supply) was reviewed for 700 free flaps used for breast or head and neck reconstruction. Flaps that failed had a mean ischemic time of 111.64 minutes, while flaps that survived had a mean ischemic time of 91.25 minutes. The difference was not statistically significant (p = 0.189). ⋯ Flap survival was also similar when 75 minutes and 120 minutes were used to segregate the longer and shorter ischemic time groups. When 180 minutes was used to segregate the groups, there was a slight trend toward more flap loss in the group with longer ischemic time, but the difference was not significant. We conclude that ischemic time is irrelevant to flap survival, provided that ischemia is not prolonged past 3 hours or to the point where the no-reflow phenomenon occurs.
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Simple function, wide view, and safety are three important properties of a good retractor. Since conventional retractors are not specifically designated for extraocular or neurovascular operations, particularly on the head and neck, we hereby introduce our self-retaining retractor. ⋯ This retractor has the previously mentioned properties of a good retractor. We have used this type of retractor for a variety of plastic surgical operations.