Annals of plastic surgery
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Annals of plastic surgery · Jul 2006
An alternative dressing material for the split-thickness skin graft donor site: oxidized regenerated cellulose.
The split-thickness skin graft (STSG) donor sites have been treated with various and plenty of dressing techniques and materials. An ideal STSG donor site dressing should have antibacterial, hemostatic, and promoting epidermal healing properties. We have performed a prospective study to evaluate the effect of the oxidized regenerated cellulose on STSG donor site healing. ⋯ There was a statistical significance between the oxidized regenerated cellulose side and the fine mesh gauze side (P < 0.001) in group I and group II separately. The difference between group I and group II was statistically significant in the oxidized regenerated cellulose side (P < 0.001), and the difference between group I and group II was statistically significant in the fine mesh gauze side (P < 0.005). The antibacterial, hemostatic, and absorbable property of the oxidized regenerated cellulose could ensure the utilization as an alternative STSG donor site dressing, especially because the positive influence over the wound healing was proven.
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Annals of plastic surgery · Jul 2006
Hand knife versus powered dermatome: current opinions, practices, and evidence.
Some surgeons prefer to use powered dermatomes when harvesting split-thickness skin grafts, while others prefer the hand knife. We conducted a postal survey of British plastic surgery units, contacted medicolegal departments, and investigated the literature to explore the reasoning for any preferences and the existing evidence to support such practices. ⋯ We found no evidence to support such clinical or medicolegal views and conclude that numerous misconceptions exist about skin-graft harvesting instruments. We suggest that surgeons should use whichever instrument they feel will, in their hands, provide the optimum result and not be directed by unfounded opinions.
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Annals of plastic surgery · Jul 2006
Electrosurgery in patients with pacemakers/implanted cardioverter defibrillators.
Despite improved protective mechanisms, pacemakers and implanted cardioverter defibrillators are subject to interference from various sources. An effective means of hemostasis, electrocautery generates electromagnetic interference and may be problematic in this patient population. ⋯ Recommendations regarding the management of patients with implanted cardiac devices become increasingly significant both as the number of patients with devices increases and the number of out-of-hospital/minor surgery procedures performed increases. This article provides surgeons and anesthetists with practical recommendations for use of electrocautery in patients with pacemakers or implantable cardiac defibrillators.
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Annals of plastic surgery · Jul 2006
ATP-sensitive potassium channels mediate the anti-ischemic properties of ischemic and pharmacologic preconditioning in rat random-pattern skin flap.
Ischemic preconditioning (IPC) and pharmacologic preconditioning by morphine and adenosine may significantly decrease the amount of necrosis in rat random pattern skin flaps. We examined the role of ATP-sensitive potassium channels (K(ATP) channels) in mediating these protective phenomenon by using glibenclamide a nonspecific blocker of these channels. We also investigated whether administration of diazoxide an opener of the K(ATP) channels could mimic the same protective effect. ⋯ IPC and pharmacologic preconditioning with morphine, adenosine, and diazoxide (in higher doses; 1, 5, and 15 mg/flap) improved survival area compared with the control group. Glibenclamide abolished their protective effect. K(ATP) channels may have a key role in anti-ischemic properties of IPC and pharmacologic preconditioning.