Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen
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Handchir Mikrochir Plast Chir · Oct 2007
Case Reports[Clinical experiences using the Versajet system in burns: indications and applications].
Early debridement and early skin grafting are the "Gold standard" in the surgical treatment of burns. There are different debridement methods available. ⋯ Especially for debridement of difficult to treat areas - face, neck, lips, fingers, interdigital spaces, convex and concave areas the Versajet System shows its benefits. With the Versajet System, tissue excision is precise; moreover it helps to avoid the damage of viable tissue and its vascular supply.
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Debridement describes the removal of devitalised tissue and debris (to reduce the toxic and bacterial burden) from a wound. In thermally injured tissue, the adoption of excisional strategies has been shown to improve both morbidity as well as mortality, albeit at the expense of creating new donor wounds. Tangential debridement is performed with surgical steel (i.e., Humby or Goulian knife). Other modalities like enzymatic ointments and hydrosurgical systems have shown promise in refining the debridement process, affording a measure of control with respect to the depth of debridement.
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Handchir Mikrochir Plast Chir · Oct 2007
[New strategies for the treatment of thermally injured hands with regard to the epithelial substitute Suprathel].
The treatment of thermally injured hands has changed in the last 20 years. An early necrectomy and grafting with split-skin grafts is recommended by most burn specialists. The outcome in regard to cosmetic and functional results could be improved by early grafting. ⋯ Suprathel was applied primarily in 78 hands (71.6 %). 3 hands were treated otherwise. 8 of the hands which were primarily treated by Suprathel (10.3 %) required a well-aimed grafting after one or two weeks, 70 (89.7 %) had a complete epithelisation without grafting. Many skin grafts could be avoided. We modified our strategy for the treatment of burned hands by our excellent experiences with Suprathel.
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Handchir Mikrochir Plast Chir · Oct 2007
Case Reports[Use of V.A.C. Therapy in the surgical treatment of severe burns: the Viennese concept].
General principle in the treatment of severe burns is early wound closure. A good take of split-thickness-skin-grafts is essential for fast wound healing and thereby for the outcome of the patient. The aim of the study was to evaluate the impact of V.A.C. therapy in the field of acute burn surgery. ⋯ In our opinion, split-thickness skin-fixation by using V.A.C. therapy is suitable for moist and irregular wound surfaces, for areas exposed to movements and especially for the treatment of older patients with co-morbidities.
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Handchir Mikrochir Plast Chir · Oct 2007
Case Reports[Mesenteric ischemia: a severe complication in burn patient].
Gastrointestinal complications are a common problem in severe burned patients. Reported complications include paralytic ileus, gastrointestinal tract bleeding, gastric ulcers and acute necrotizing cholecystitis. Although there are no exact data concerning the frequency and outcome of acute intestinal necrotizing ischemia in severe burned patients, it is a well known complication in specialized burn centers. ⋯ The ABSI-score (Abbreviated burn severity index) was 10. The combination of a thrombus at the aortic valve with an tachycardic dysrhythmia was the cause for an embolisation with acute intestinal ischemia. The necrotic part of the small intestine was resected, the further course was uncomplicated.