Vojnosanit Pregl
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Necrotizing fasciitis (NF) is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. ⋯ Acute NF is a rare but very difficult and sometimes life-threatening disease of superficial fascia and around soft tissue. If acute NF is suspected, early radical excision of all the affected tissue with exploration and excision of superficial fascia with pathological and microbiological assessment are most significant for treatment. Appropriate antibiotics and intensive care set ting to manage other organ failure of NF are recommended at the same time with surgery.
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Case Reports
Surgical treatment of dislocated fracture of the scapula column and glenoid: a 22-year follow-up.
Most scapular fractures are caused by high-impact blunt injuries, often as the result of motor vehicle accidents, fall from height, etc. In 80% to 90% of cases, scapula fractures are associated with multiple injuries (clavicle fracture, rib fractures, humeral fracture, pulmonary injury, brachial plexus injury). ⋯ Displaced intra- articular fractures of the scapula should be treated operatively, with open reduction and internal fixation.
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Hand injuries comprise up to one fourth of all injuries and require excellent skills and aggressive physical therapy with still a high potential to cause long term physical and functional disability which affects one's quality of life. The aim of this study was to evaluate disability and quality of life in patients with different degrees of hand and forearm injuries using the two different scoring sistems and to examine the correlation between them. ⋯ Severity of hand and forearm injuries does not necessarily correlate with patient's perception of disability. The quality of life was less affected by severity of injury than by the patient's per- ception of disability.
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Randomized Controlled Trial Comparative Study
Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine.
Surgical extraction of lower third molars is followed by mild or severe postoperative pain which peaks at maximal intensity in the first 12 hours and has a significant impact on a patient's postoperative quality of life. The use of long-acting local anaesthetics is a promising strategy to improve postoperative analgesia. The aim of the present study was to investigate analgesic parameters and patient satisfaction after using 0.5% levobupivacaine (Lbup), 0.5% bupivacaine (Bup) and 2% lidocaine with epinephrine 1:80,000 (Lid + Epi) for an inferior alveolar nerve block following lower third molar surgery. ⋯ The use of a new and long-acting local anaesthetic 0.5% levobupivacaine is clinically relevant and effective for an inferior alveolar nerve block and postoperative pain control after third molar surgery. In our study Lbup and Bup controled postoperative pain more efficiently after lower third molar surgery compared to Lid + Epi.