Annals of plastic surgery
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Annals of plastic surgery · Feb 2005
Comparison of preoperative anxiety in reconstructive and cosmetic surgery patients.
Surgery is a serious stressor and a cause of anxiety for the patients. Reconstructive surgery patients are mostly operated on because of certain functional impairment or disability; on the contrary, cosmetic surgery patients do not have any physical impairment and they are operated on because of mostly psychologic reasons. The aim of this study was to compare the anxiety levels in the reconstructive surgery patients and cosmetic surgery patients preoperatively. ⋯ This study reveals that preoperative anxiety levels in the cosmetic surgery patients are higher than those of the reconstructive surgery patients. Therefore, adequate preoperative preparation for cosmetic surgery should include attempts to cope with anxiety. Anxiolytics may be used more liberally and professional psychologic assistance may be required.
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A system is presented for the application of tie-over dressings. Following skin grafting, the graft is secured with a tie-over dressing covered with a sheath of 3-way stretch fabric. The fabric is secured with the aid of staples. This system is easy to apply and is useful for securing grafts in otherwise difficult anatomic locations.
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Annals of plastic surgery · Feb 2005
Transfusion-free pediatric burn surgery: techniques and strategies.
More than 1.3 million children sustain burns each year, resulting in 40,000 admissions and more than 3000 pediatric deaths. Pediatric burn surgery has been described as excessively bloody. Strategies to reduce intraoperative blood loss include the use of topical thrombin and epinephrine, extremity tourniquets, acute normovolemic hemodilution, and hypotensive anesthesia. ⋯ There was a single mortality secondary to systemic inflammatory response syndrome and acute respiratory distress syndrome. After the proposed pediatric burn treatment protocol, intraoperative blood loss requiring transfusion can be minimized or eliminated. Large TBSA burns must be surveilled for burn wound anemia that may ultimately require blood transfusion.