Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Nutritional support in critically ill patients has an impact on both prevention and treatment. Development of complications and organ failure can be prevented, good status of gut mucosa kept and positive nitrogen balance induced. Inflammatory response can be modulated. ⋯ There is a need for an active nutritional screening to find patients in the risk. Other important points are the following: a progressive approach to early enteral nutrition combined with PN, multiprofessional cooperation and protocol implementation.
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Covering soft-tissue injuries on the lower third of the leg, ankle joint and on the calcaneal part of the foot has so far been the domain for free flap use. The distally based superficial sural artery flap with vascular axis of the sural nerve was first described by Masquelet. We treated 31 patients after injuries with this method. ⋯ Most flaps showed slight venous congestion. The authors present their clinical experience using this technique. The advantages are the following: the blood supply is reliable, elevation is easy and quick and major arteries are not sacrified.