Annals of plastic surgery
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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.
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Annals of plastic surgery · Apr 1997
Tissue expansion in children: a retrospective study of complications.
We retrospectively reviewed 105 consecutive children in whom 191 tissue expanders were placed by the Plastic Surgical Service at The Children's Hospital from 1987 to 1995. The age range was 1 month to 28 years. The series included 68 females and 37 males. ⋯ These complication rates were not related to either the gender, site of implantation, number of expanders, use of closed suction drains, or the indication for expansion. The complications were related to age, being higher in children (age 1-12 years) compared with infants and adolescents. Tissue expanders can be successfully used in children to construct and reconstruct a variety of cutaneous defects, but there is an irreducible minimum for the three major complications.
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The purpose of this paper is to examine the rate of accidental extubation in the burn patient population and to propose solutions. We found that the extubation rate was higher in burn patients (27%) than in the general surgical intensive care patient population (6%). ⋯ Methods of endotracheal tube stabilization are reviewed. Two techniques for stabilization in the patient with a burned face are presented.
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Annals of plastic surgery · Jan 1997
Case ReportsOne-stage reconstruction for defects caused by cancrum oris (noma).
Cancrum oris is a disease process that has been described for centuries, but now presents primarily in developing countries. The disease in known to occur in association with poor nutrition and exanthematous infections. The acute disease occurs usually in young children, and the infectious process causes destruction of the involved orofacial tissues with variable degrees of tissue loss and scar reaction in those who are affected and survive. ⋯ Because of the socioeconomic situation inherent with these patients and the volume of patients in need of treatment with this disease, innovative and efficient treatment is required. We have demonstrated methods of reconstructive surgery that differ from the multiple staged procedures described in previous studies by allowing for one-stage surgical reconstruction of even the most complex cases. This allows for treatment of the majority of patients in their native countries in a cost-effective and safe manner, and treatment of more severely afflicted individuals in modern medical centers without their having to spend a long time period away from their homes.
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Annals of plastic surgery · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe role of DDAVP (desmopressin) in orthognathic surgery.
Desmopressin (1-deamino-8-D-argininevasopressin, DDAVP) is a synthetic analog of the antidiuretic hormone L-argininevasopressin. DDAVP has been shown to increase the plasma concentration of endothelial factor VIII, thus increasing coagulant activity. There is evidence from controlled clinical trials indicating that DDAVP can reduce blood loss and transfusion requirements for individuals with normal coagulation profiles undergoing various surgical procedures. ⋯ When collated, this hematocrit drop of 11.61 for group II and 6.17 for group I (recipients of DDAVP) proved to be significantly different (p < 0.01). It is concluded from this study that patients receiving a standard dose of DDAVP prior to bimaxillary osteotomy would experience reduced intraoperative blood loss, providing that blood pressure is well controlled and fluid replacement is carefully managed. No significant adverse side effects of desmopressin acetate were observed.