Annals of plastic surgery
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Dorsoradial wrist neuromas diagnosed and treated by traditional techniques remain the most difficult for which to achieve satisfactory pain relief. Between 1981 and 1985, 52 patients with dorsoradial wrist neuromas were treated by neuroma resection and implantation of the nerves innervating the neuroma into the brachioradialis muscle. Critical to this treatment schema was preoperative use of nerve blocks to diagnose overlapping patterns of the cutaneous nerves in this region. ⋯ The apparent susceptibility of the superficial branch of the radial nerve (SBRN) to form painful neuromas has been well documented. Once established, the neuroma appears particularly resistant to treatment. Based on experimental and cadaveric studies, we have formulated a treatment plan for patients with dorsoradial wrist neuromas.(ABSTRACT TRUNCATED AT 250 WORDS)
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Annals of plastic surgery · Jun 1987
The treatment of amputation neuromas in fingers with a centrocentral nerve union.
The centrocentral nerve union with an interposed autologous nerve graft was used for the treatment of 32 symptomatic neuromas in the fingers of 18 patients. The technique was applied to bilateral as well as unilateral neuromas, using the dorsal branch of the proper digital nerve in the later. All 18 patients showed definite objective and subjective improvement, and no loss on the early result (approximately thirty-six weeks) was found in the remainder of the follow-up (average, eighteen months).
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An overview of the various methods available for treatment of mandibular fractures is presented; these range from the application of arch bars and intermaxillary fixation alone to open reduction with compression plating. Whenever possible, particularly in young patients, mandibular fractures requiring open reduction are approached transorally.
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Annals of plastic surgery · Aug 1986
Comparative StudyA dressing system providing fluid supply and suction drainage used for continuous or intermittent irrigation.
In this article a dressing system is described that is capable of providing continuous or intermittent wound irrigation. It is based on a felt dressing provided with an adhesive cover and ports for fluid supply and suction drainage. At continuous irrigation (approximate rate, 70 ml/h), a 1-L fluid bag and a siphon about 30 cm in height are used; at intermittent irrigation (approximate rate, 60 ml/min), a 60-ml fluid bag and a suction balloon are used. ⋯ The drainage of particles, while relatively impeded at low flow rates, was satisfactory at rates recommended for clinical use. The dressing felt was inert to adherence of bacteria and white blood cells. This dressing system would seem to provide access to the whole wound surface for active therapy through fluid supply and suction drainage.
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A total of 246 consecutive burn patients younger than 2 years and older than 70 years of age admitted to a burn center were reviewed retrospectively to study morbidity and mortality specific to these two age groups. Of these patients, 165 were less than 2 years of age and 81 were over 70 years of age, representing 16% and 8% of the total patient population respectively. In patients under 2, scald burns occurred in 127 (77%) and flame burns in 18 (11%). ⋯ A total of 36 complications occurred in the younger age group (0.2 complications per patient) and 111 in the older age group (1.4 per patient). Burn wound sepsis was the most common complication in each group, occurring in 28 patients under 2 and 42 elderly patients, and was responsible for the 1 death in the younger age group. Although burn wound sepsis was the most common complication in those patients over 70, cardiovascular and pulmonary complications were the most deadly, accounting for 68% (28 patients) of total deaths in this group.