Annals of plastic surgery
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Annals of plastic surgery · Sep 1982
Accidental hypothermia treated with rapid rewarming by immersion.
Eighteen consecutive hypothermia patients were treated with rapid rewarming by immersion. Continous electrocardiographic monitoring, acid-base and central venous pressure measurements, vital signs, and fluid resuscitation with lactated Ringer's solution (tritrated to urine output) were employed as part of the therapeutic regimen. This regimen was associated with a single mortality. Rapid rewarming by immersion appears to be a safe, effective, and relatively simple method for treating accidental hypothermia victims.
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A new technique is presented that combines the use of two juxtaposed Y-V plasties which, when advanced, create a W-shaped sutured wound used to correct bridle-burn scar deformities. Since a considerable amount of the scar can be removed and there are two Y-V advancements, the cosmetic results are better than those obtained with traditional or modified Z-plasty when contracted scars are wide, severe, and unsuitable for Y-V advancement.
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Facial dermabrasion produces a raw, painful, partial-thickness wound, quite similar to a split-thickness skin graft donor site. The various methods of dressing such wounds employing ointments, impregnated gauze, bulky absorptive dressings, xenografts, or allografts are time consuming, uncomfortable for the patient, and not infrequently characterized by localized purulence and delayed healing. Experience with amniotic membranes as biologic dressings, both experimental and clinical, prompted a trial of these membranes as a dressing following facial dermabrasion. ⋯ The results following this dressing method were excellent. The biologic basis and the techniques of preparing and applying amniotic membranes as dressings following facial dermabrasion are presented. The advantages of amniotic membranes over the other presently employed dressing techniques following facial dermabrasion are discussed.
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The United States leads industrialized nations in per capita fire deaths. The most recent U. S. statistics are from 1978. ⋯ Burn care has traditionally been the general surgeon's responsibility. However, the interest and commitment of plastic and reconstructive surgeons has increased considerably over the past fifteen years. During this time, major advancements have occurred in five areas: assessment, resuscitation, control of burn wound sepsis, wound closure, and burn team management.