Annals of plastic surgery
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Annals of plastic surgery · Jul 2012
Randomized Controlled Trial Comparative StudyA prospective randomized trial comparing subatmospheric wound therapy with a sealed gauze dressing and the standard vacuum-assisted closure device.
Two methods of subatmospheric pressure wound therapy--wall suction applied to a sealed gauze dressing (GSUC) and the vacuum-assisted closure device (VAC)--were compared in hospitalized patients at University of Chicago Medical Center. ⋯ GSUC is noninferior to VAC with respect to changes in wound volume and surface area in an acute care setting. In addition, GSUC dressings were easier to apply, less expensive, and less painful.
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Annals of plastic surgery · Jul 2012
To everything there is a season: impact of seasonal change on admissions, acuity of injury, length of stay, throughput, and charges at an accredited, regional burn center.
Although previous studies have investigated the impact of weather and temporal factors on incidence of trauma admissions, there is a paucity of data describing the effect of seasonal change on burn injury. The purpose of this study was to examine the impact of the changing seasons on admissions to and resource utilization at an accredited burn center, with the goal of optimizing patient throughput and matching supply with demand. ⋯ Summer and winter were the peak seasons of resource utilization at our burn center, in terms of length and variability of ICU and hospital stays, as well as total hospital charges. Such seasonal change may be related to acuity of burn injury but not number of burn admissions. To improve operational efficiency and maximize patient throughput, resource allocation should be structured to anticipate seasonal changes, so that supply of services matches demand.
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Annals of plastic surgery · Jul 2012
Case ReportsBreast implants and minimally invasive cardiac surgery: a case series.
The number of women affected by valvular heart disease and the number of women with breast implants are both on the rise. Minimally invasive heart surgery using a limited thoracotomy offers many potential benefits including reduction in blood loss, shorter hospital stay, faster recovery time, decreased pain, and improved cosmesis. Minimally invasive heart surgery often requires access to the second, third, or fourth intercostal space of the anterior chest wall. The presence of a breast implant may interfere with the surgeon's ability to gain adequate exposure for entry to the appropriate intercostal space. We present a case series of 5 women with breast implants who successfully underwent minimally invasive cardiac valve surgery. ⋯ Our series of 5 patients demonstrates that minimally invasive heart surgery performed through an inframammary incision can be safely performed in those with breast implants.
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The outcome of adult phalangeal neck fractures caused by saws has not been previously investigated. Over a 15-year period, a total of 36 cases of saw-related injuries resulting in phalangeal neck fractures of the middle phalanx of the finger or the proximal phalanx of the thumb were treated. All injuries were industrial and covered by insurance. ⋯ Major complications such as nonunion, malunion, avascular necrosis of the phalangeal head, osteomyelitis, or contractures of the proximal interphalangeal joints were not observed. Two patients (1 in each group) had superficial pin-site infection. It was concluded that adult phalangeal neck fractures caused by saws is a separate entity from the previously reported series of closed phalangeal neck fractures in adults.