Annals of plastic surgery
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Annals of plastic surgery · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialRandomized, double-blind trial of dolasetron versus droperidol for prophylaxis of postoperative nausea and vomiting in patients undergoing TRAM flap breast reconstruction surgery.
Clinical observation indicates that patients undergoing transverse rectus abdominus musculocutaneous (TRAM) flap breast reconstruction surgery frequently experience postoperative nausea and/or vomiting (PONV). No controlled trials have evaluated the role of pharmacologic prophylaxis of PONV in this population. A prospective randomized, double-blinded, active-controlled trial comparing intraoperative intravenous droperidol 1 mg with dolasetron 50 mg was conducted. ⋯ Adverse effects were similar between the two groups. No PONV-related complications occurred during the trial period. The incidence of PONV in TRAM flap breast reconstruction surgery patients remains high despite prophylactic intraoperative antiemetic administration.
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Oral burn contractures in children present major reconstructive problem. Only few reports in literature discussed oral burns in children. Electrical, chemical, and thermal agents are the main causative agents for oral burns. ⋯ This report reviews three children; one with posterior, two with total oral cavity contracture. All cases were managed by linear release of scar contracture and skin grafting followed by a prolonged intra-oral splinting with a fixed mouth-block and commissural splint. A successful outcome was observed in all cases.
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Annals of plastic surgery · Oct 2003
Causes of death among Finnish women with cosmetic breast implants, 1971-2001.
Mortality patterns among women with cosmetic breast implants have not been well characterized. We examined cause-specific mortality among women who underwent cosmetic breast implantation at major public hospitals and private clinics in Finland from 1970 through 2000. Causes of death through 2001 were identified through the national mortality register. ⋯ There was a statistically significant excess of suicide, based on 10 deaths, which was most pronounced during the first 5 years of follow-up (SMR, 4.26; 95% CI, 1.56-9.26). In conclusion, although based on small numbers, women with cosmetic breast implants did not experience higher mortality overall than women in the general population. The high suicide risk supports other studies and warrants further detailed investigation.
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Annals of plastic surgery · Aug 2003
A review of emergency department fluid resuscitation of burn patients transferred to a regional, verified burn center.
The purpose of this study was to examine the adequacy of burn patient fluid resuscitation in relationship to the American Burn Association formula before arrival at a regional burn center. Further substratification of the data was undertaken to compare total burn surface area and fluid volume resuscitation as evaluated from the primary hospital's emergency department staff vs. the burn intensive care unit staff. The charts of all patients admitted to the burn center during 1 year were reviewed retrospectively. ⋯ More important, early communication with the referring burn staff has been encouraged. Early communication permits review of estimated TBSA burn evaluations and permits cooperative calculations and optimal delivery of early fluid resuscitation. Burn center practitioners can improve care of patients before arrival by appropriately guiding the referring physician.