Annals of plastic surgery
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A rigid transparent face mask of cellulose acetate butyrate was developed for the control of scar hypertrophy in the burned face. Excellent patient acceptance has been found in a six-year series of 97 patients. Use of the device for at least twenty hours a day for an average of one and a half years per patient has enabled preservation of normal facial contours.
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Annals of plastic surgery · Nov 1980
Comparative Study Clinical TrialTopical and systemic antimicrobial agents in burns.
Infection is the major cause of morbidity and mortality in burns. Burn wound infection is defined as burn wound bacterial proliferation in a density equal to or greater than 10(5) bacteria per gram of tissue. Gram-negative bacteria, notably Pseudomonas aeruginosa, as well as staphylococci and fungal opportunists, have been identified as prominent invaders. ⋯ Topical antimicrobial therapy is indicated in all hospitalized burn patients. Short-term use of systemic antimicrobials for prophylaxis and treatment is required in all moderate and major burns, specifically for early prophylaxis, perioperative prophylaxis, and clinical infection. Antimicrobial choice is based on specific patient or environmental bacteriological data.
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To evaluate the usefulness of nerve grafting we studied 38 patients having 11 median, 7 ulnar, and 33 digital nerve grafts. Group funicular (interfascicular) grafting using magnification was performed in all patients. We followed 12 patients with 8 median and 5 ulnar nerve grafts for at least one year and 18 patients with 27 digital nerve grafts for at least six months. ⋯ Sensory function following median and digital nerve grafting was as good as that following nerve repair. Motor function following ulnar nerve grafting was as good as that following nerve repair. Previously reported patients having median nerve repairs or grafts had significantly better motor function than our patients.
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Little is known about the cause of scar contracture. The contractile capability of myofibroblasts in the early scar provides a partial explanation; however, clinical and experimental findings indicate that the early scar possesses plasticity, and that its size and shape can be altered by mechanical forces. Even if a scar possesses no contractile capability itself, scar contracture may develop if: (1) the affected joint (skin) is kept in flexion (relaxation); (2) the scar is over a contracted wound; or (3) compression is applied to the early scar. Many instances of scar contracture may therefore be attributable not to active motility but to the passive response of scar tissue to mechanical forces.
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Annals of plastic surgery · Feb 1980
Case ReportsMeralgia paresthetica as a complication of the groin flap.
Meralgia paresthetica is not well known in the plastic surgery literature, and consequently the diagnosis of this entity may be overlooked. In view of the frequency with which the groin flap is presently employed, the possibility of damage to the lateral femoral cutaneous nerve of the thigh should be borne in mind. In this paper the clinical picture as well as the anatomy and pathophysiology of this disorder are described.