Annals of plastic surgery
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Annals of plastic surgery · Sep 2008
Case ReportsChronic postburn palmar contractures reconstruction using the medial pedis perforator flap.
Chronic flexion contractures of the palm of the hand impair hand function considerably and cause a poor esthetic appearance. Various reconstructive methods have been used for the treatment. However, satisfactory esthetic and functional results are difficult to achieve due to the unique anatomic characteristics of the palmar region, such as thick, cornified, stratified squamous epithelium. ⋯ In one case, the flap required debulking. Postoperative follow-up revealed no marked donor site morbidity. We determined that the medialis pedis flap was a remarkable alternative for palmar reconstruction of the hand and digits due to burn because of its glabrous skin, which was very similar to palmar skin, and low donor site morbidity.
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Annals of plastic surgery · Sep 2008
Risk analysis of deep sternal wound infections and their impact on long-term survival: a propensity analysis.
The objectives of this study are to determine risk factors associated with deep sternal wound infections (DSWIs) following cardiac surgery, and to describe their impact on long-term survival. Data was obtained from a departmental database. Analysis included 7,978 consecutive patients who underwent cardiac surgery between 1997 and 2003. ⋯ There were no differences between groups in 4-year and 8-year survival rates, with 77.2% and 61.8%, respectively, in patients with DSWI compared with 78.0% and 67.5% in patients without DSWI (P = 0.16). After adjustments for preoperative, intraoperative, and postoperative factors, the adjusted hazard ratio of long-term mortality for patients with DSWI was 0.9 (95% CI, 0.6 to 1.2, P = 0.39). Though DSWIs are associated with increased early mortality, patients undergoing cardiac surgery complicated by DSWI do not experience worse long-term survival.