Annals of plastic surgery
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Annals of plastic surgery · Feb 1990
Nonmicrosurgical transfer of the radial forearm flap for head and neck reconstruction.
In this article I present a nonmicrosurgical technique for transferring the radial forearm flap for reconstruction of defects in the head and neck. The technique is described briefly and experience with 7 patients is presented. The advantages of this method are discussed.
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The critical need to maintain closed-circuit airways during maxillofacial surgery has led to a number of innovations in anesthetic tube placement and stabilization. Several redesigns and alterations of endotracheal tubes have been described and are currently in use. ⋯ In this report, a readily available and easy method of securing anesthetic tubes is described. This technique has been used successfully in hundreds of patients at our institutions.
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Annals of plastic surgery · Nov 1989
Utilization of the burn unit for nonburn patients: the "wound intensive care unit".
Burn units and experienced burn nurses are valuable, expensive resources that are underutilized when the burn census is low. Burn facilities can be used to treat other conditions or injuries to provide optimum wound management or to provide overflow intensive care unit beds. We studied via a questionnaire survey the admission profiles of 120 burn units in the United States to determine frequency of utilization for nonburn injuries. ⋯ Seventy-seven burn units also accept overflow patients from other critical care units. A significant amount of nonburn wound care is being provided by burn units in the United States, with potential benefit to both the patient and the burn unit. The implications of the use of burn facilities as "wound intensive care units" are discussed.
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Annals of plastic surgery · Sep 1989
Comparative StudyEfficacy of debridement and primary closure of contaminated wounds: a comparison of methods.
Proper management of highly contaminated traumatic wounds frequently requires delayed primary closure of healing by secondary intention to prevent subsequent infection. This animal study compares the efficacy of various wound debridement methodologies to prevent infection following primary closure of treated contaminated wounds. Forty-four Sprague-Dawley rats with uniform, paravertebral incisions were studied. ⋯ The control group uniformly developed infection (100%). The average amount of induration after ultrasonication (1.35 +/- 0.56 cm) was also significantly less than irrigation (2.07 +/- 0.75 cm), scrubbing (1.95 +/- 0.34 cm), and soaking (1.73 +/- 0.22 cm). Our data demonstrate that ultrasonic wound debridement has exciting potential as a new debridement technique for contaminated traumatic wounds.
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Annals of plastic surgery · Aug 1989
Case ReportsClinical application of the free scapular fascial flap.
Seven free scapular fascial flaps with a skin graft on top were used to cover soft tissue defects of the hand and foot in 6 patients during the past two years. The size of the flap ranged from 7 x 8 cm to 8 x 12 cm. All flaps survived well, but one had partial loss as a result of infection. The advantages, disadvantages, indications, and important technical points of the surgery are discussed.