Clinics in plastic surgery
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Prompt excision of major burn wounds has been repeatedly shown to improve survival, speed closure, and reduce infection. Immediate coverage with autograft skin is the preferred method of definitive closure of these wounds. ⋯ Fresh cadaver allograft is the gold standard for such closure, but other products, including frozen cadaver skin, xenografts, and several synthetic products, are also available. This article reviews the physiology, and types of products, and their uses.
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Neoplasms of the skin are found most often on the face. Malignant tumors of the facial skin pose a challenge in treatment, prohibiting compromises between oncologically responsible surgery and functional plus cosmetic outcome. The incidence of melanoma and nonmelanoma skin cancers is rising. ⋯ For in situ variants there are other options, such as photodynamic therapy and medical treatment. Knowledge of the clinical manifestation, behavior, and prognosis and histopathologic analysis lead to correct diagnosis and choice of suitable treatment. This article presents a synopsis of nonmelanoma, melanoma, and other cancers of the skin.
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Wound healing is a complex process that often becomes problematic in complicated patients. When abnormal wound healing occurs, there are many possible ways to intervene. ⋯ This article is a review of the latest dressings and topical agents available in the United States. Recommendations for use are made based on the most current data in the medical literature.
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Complications in orthognathic surgery may arise at any point in the patient's treatment: during preoperative planning, during perioperative orthodontic care, or during the surgery itself. This article addresses the complications that arise as a result of the intraoperative technique. ⋯ The initial discussion focuses on complications occurring during maxillary surgery, namely the LeFort I type osteotomy. The second section discusses complications occurring during mandibular procedures, the bilateral sagittal split osteotomy and genioplasty.
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The challenge to understand reflex sympathetic dystrophy/complex regional pain syndrome may require a better understanding of the complex relationship between the central and peripheral nervous systems. There is no comprehensive hypothesis that clearly explains the etiology and no uniformly successful treatment method. This brief summary of the challenge reviews some of what is known, hypothesizes a possible etiologic mechanism, and proposes 10 common-sense principles for management that recognizes the handicap of limited knowledge.