Annals of plastic surgery
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There has long been a need for a potent, nonaddicting analgesic for the treatment of certain patients who have intractable pain that cannot be controlled by the more commonly used oral analgesics. Pentazocine was introduced on the market in I967 and has been reported to be a potent analgesic, comparable to meperidine and morphine but without their addicting properties. Consequently, this drug has been used on a long-term basis, and on many occasions the injections have been given by the patient or by nonprofessionals. ⋯ We have seen 14 patients with extensive cutaneous ulcerations, subcutaneous fibrosis, and multiple fistulous tracts due to the abuse of parenterally administered pentazocine. The tissue changes have a characteristic appearance and course, and it has been our experience that conservative treatment results in a poor response. We have had the best results with aggressive excision of the involved areas and coverage of the resultant defect with split-thickness skin graft.
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Annals of plastic surgery · Apr 1979
The Second Rule of Nines: a guide for resuscitation of burn patients.
A simplified version of the Parkland burn therapy fluid formula is described. The rule states that for the first 8 hours after burn, the hourly rate of Ringer's lactate solution (in milliliters per hour) equals the patient's weight in pounds multiplied by the percent burn and divided by 9.
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Annals of plastic surgery · Apr 1979
Biography Historical ArticleDuchenne de Boulogne and clinical photography.
In an absorbing monograph entitled Mécanisme de la physionomie humaine, Duchenne de Boulogne proposed that each emotion has its own specific facial muscle. Employing the most recent and exciting technical inventions of the mid nineteenth century, Duchenne used faradism to stimulate the facial muscles and photography to record their actions. Using electrical stimulation, he virtually dissected by this novel method the sheets of facial musculature into a number of emotional entities. ⋯ The first use of photography to illustrate clinical cases was in the middle of the nineteenth century. In 1862 Duchenne de Boulogne published two albums of photographs with accompanying text which appear to have been the first publicly published volumes using photographs of clinical material. The Album de photographies pathologiques contained photographs of clinical entities later linked eponymously with Duchenne, while the Mécanisme de la physionomie humaine presented scores of original prints, some including Duchenne himself in photograph.