Polski przeglad chirurgiczny
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Patients with non-occlusive mesenteric ischemia (NOMI) are still confronted with high mortality. The diagnostic is challenging and difficult because of the unspecific symptomatology. The aim of this systematic scientific report on an extraordinary and uncommon single clinical case and its successful course was to demonstrate the great potential of a partially novel non-surgical approach including its periinterventional management. ⋯ Diagnostic of choice is the arterial mesentericography, which allows specifically to exclude vascular occlusion including the consequence of a prompt surgical approach. Simultaneously, using the setting of the mesenteric angiography catheter can be placed for initiation of regional vasodilating treatment in case of NOMI. Only this approach may avoid fatal outcome.
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The role of the anterolateral thigh flap (ALTF) in reconstructive microsurgery grows systematically from mid-eighties of the twenty century until now. Significant anatomic variability of the perforators supplying the ALTF was described in literature. THE AIM OF THE STUDY was ultrasonographic assessment of the ALTF perforators in terms of localization, symmetry, diameter and flow velocity. ⋯ 1. Most of perforators with large diameter and big flow velocity are located in segments 5 and 6. 2. Perforators are more common in men in segments 4 and 5 than in women. 3. No perforators found in 4 thighs suggests that preoperative perforator mapping should become a preoperative routine, which can spare intraoperative dilemmas.
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Despite development of combustiology, infections continue to be the most important cause of death among patients with burns. Sepsis is the most severe clinical presentation of infection in patients after thermal injuries who require immediate treatment. Early diagnosis and proper treatment of sepsis are important in the clinical management that is often hampered for multiple reasons, e.g. impaired patient immunity, problems with microorganisms with multi-antibacterial drug resistance. The aim of the study was to assess effect of type of a microorganism isolated from blood and wound on results of treatment of sepsis in patients with burns. ⋯ 1. The patients with thermal injuries are at higher risk of death in the event of sepsis caused by Gram(-) bacteria versus Gram(+) bacteria. 2. Infection of blood and burn wound caused by the same bacteria Pseudomonas aeruginosa and Acinetobacter baumanni increases the risk of death due to sepsis in patients with burns following thermal injuries.