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 · Dec 2009
Comparative Study[Commentary on the article of P. S. Harenberg and D. Erdmann: academic plastic surgery: a comparison of residency models in Germany and the USA].
The postgraduate training in plastic surgery in Germany has to be considered as young. A direct comparison of the postgraduate training in Germany with that of the United States of America is possible on an equal basis, as the quality of postgraduate training has a high standard in both countries. Nevertheless, further corrections are necessary. In the end only competent and well qualified board certified plastic surgeons are in the position to represent this specific field of surgery on a skilled and a political basis.
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Handchir Mikrochir Plast Chir · Dec 2009
[The Biobrane glove in burn wounds of the hand. Evaluation of the functional and aesthetic outcome and comparison of costs with those of conventional wound management].
While use of biocomposite temporary dressings in burn wounds is common practice, the complex anatomic structures of the hand make this treatment option challenging. For this reason, the Biobrane ((R)) Glove (Smith&Nephew) has been developed. However, limited information regarding burn treatment with Biobrane ((R)) Gloves can be found in the literature. ⋯ Biobrane ((R)) Glove treatment of hand burns resulted in excellent functional and cosmetic outcomes, reduced pain compared to conventional wound management and high overall patient satisfaction. In conjunction with a significant reduction in wound management time, the Biobrane ((R)) Glove is an important and cost neutral tool in the treatment of second degree burn wounds of the hand.
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Due to the improvement of surgery and intensive care more and more patients survive even severe burn injuries. Therefore we have to pay attention not only to survival alone but also to the achievement of a good quality of life. Thereby, one of the most important aspects is sufficient tissue coverage. After appropriate debridement functionally important structures may be exposed. Therefore, these areas require more than split skin coverage. These cases necessitate flap coverage for preservation of function or, respectively, limb salvage. In secondary reconstruction flaps are commonly used for scar revision. The aim of this study is to give more detailed information about the need for flaps in burn surgery. ⋯ Limb salvage was the dominant indication for primary reconstruction compared to the improvement of function and aesthetics for secondary reconstruction. The timing of reconstruction has an important influence on the flap outcome and has to be considered when the decision for reconstruction is made. So, if possible, the period between the 6th and the 21st day should not be chosen for flap coverage.
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Handchir Mikrochir Plast Chir · Oct 2009
[Palmar wrist arthroscopy for evaluation of concomitant carpal lesions in operative treatment of distal intraarticular radius fractures].
Fractures of the distal radius, which currently are treated with palmar locking plates, are often accompanied by carpal lesions. Tears of the scapholunate interosseus ligament (SL) can affect the outcome. Between January 2007 and May 2008, 28 patients with distal intraarticular fractures of the radius were included in a prospective study. ⋯ In this study, an assessment of ulnocarpal structures was not possible. For assessment of the ulnocarpal structures, CT-arthrography was superior to palmar wrist arthroscopy. However, the latter is an alternative during emergency treatment or when CT-arthrography is not available.