Annals of plastic surgery
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Pediatric plantar burns present with significant and unique characteristics. The treatment of choice remains controversial, and any alteration of the anatomy will lead to alteration in gait. To study the outcome of conservative treatment of plantar burns and determine risk factors, 40 pediatric patients affected with isolated plantar burns were studied. ⋯ Five patients presented with late sequelae, and all had in common complete healing with conservative treatment, young age, and a longer healing time (24.4 days). We conclude that conservative treatment of pediatric plantar burns has a negligible complication rate. Burns that do not heal within 3 weeks are best managed with excision and autografting, which had a 0% incidence of complication rate in this series.
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Annals of plastic surgery · Nov 2004
The use of free anterolateral thigh flap for reconstructing soft tissue defects of the lower extremities.
The goal of soft tissue reconstruction in the lower extremities is to provide a functional and cosmetically acceptable limb. The anterolateral thigh flap has become one of the most popular options for soft tissue defect reconstruction recently because of the large amount of skin available and the reliable and versatile nature of this material. The purpose of this article is to present our experiences with the free anterolateral thigh flap for the reconstruction of soft tissue defects of the lower extremity. ⋯ Sixteen cases underwent split-thickness skin grafting of the donor site. No infection or hematomas were observed. We conclude that the anterolateral thigh flap is an ideal and versatile material, especially for lower extremity reconstructions, with its functional and cosmetic advantages, and it can be considered a suitable alternative to the most commonly used conventional soft tissue flaps.
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Annals of plastic surgery · Sep 2004
Case ReportsComposite plate and wire fixation for complicated sternal closure.
Many techniques have been described to achieve closure of complicated median sternotomy wounds. The standard method of closure uses stainless steel wiring of the sternal halves; however, in complicated sternal closures, sternal cut-through and wire failure can occur. Recent literature advocates the use of fixation plates that achieve bony union, with plating across the median sternal osteotomy site as a singular method. ⋯ Successful wound closure without complication was achieved in all cases. The technique and the clinical series with an illustrative example are presented. The use of plate and wire fixation represents an alternate method to conventional techniques to achieve sternal closure, stability, and uncomplicated wound healing in these difficult-to-manage cases.
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Annals of plastic surgery · Sep 2004
Case ReportsThe use of subcutaneous pedicle rhomboid flap in the treatment of postburn scar contractures.
To investigate the efficacy and versatility of subcutaneous pedicle rhomboid flap in the treatment of linear or wide postburn scar contractures located in various parts of the body. ⋯ Clinical results indicated that subcutaneous pedicle rhomboid flap is a simple, efficient, and versatile technique in release of any postburn scar contracture. As no undermining is carried out, the flaps are more reliable than commonly used Z-plasty. Again contrary to Z-plasty, displacement of anatomic landmarks such as axillary hair and areola is rare with the technique.
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Tetanus in the United States is decidedly rare, and most of us will not see a case of it during our careers. Given its lethality, it is a disease about which one must be aware. Be willing to consider it as a diagnosis, no matter the immunization status of the patient, if clinical signs and symptoms warrant. ⋯ Using mechanical ventilation, paralysis, narcotics, and muscle-relaxing sedatives, the authors supported him until his tetany subsided. He survived and was discharged to home when complete coverage of his burns and left leg anterior compartment was obtained. The authors discuss the presentation, diagnosis, and treatment of tetanus, as well as its incidence in the general population and in the previously immunized patient.