Articles: surgery.
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Annals of plastic surgery · Apr 1997
Tissue expansion in children: a retrospective study of complications.
We retrospectively reviewed 105 consecutive children in whom 191 tissue expanders were placed by the Plastic Surgical Service at The Children's Hospital from 1987 to 1995. The age range was 1 month to 28 years. The series included 68 females and 37 males. ⋯ These complication rates were not related to either the gender, site of implantation, number of expanders, use of closed suction drains, or the indication for expansion. The complications were related to age, being higher in children (age 1-12 years) compared with infants and adolescents. Tissue expanders can be successfully used in children to construct and reconstruct a variety of cutaneous defects, but there is an irreducible minimum for the three major complications.
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Perioperative complications in obstructive sleep apnea (OSA) patients are described in a small series of case reports. No study to date systematically evaluates perioperative complications in a large number of OSA patients receiving surgeries other than those involving the pharynx. ⋯ The incidence of respiratory complications related to difficulties in airway management in OSA patients was higher than that reported in a recent study for all patients receiving general anesthesia (4%). The perioperative complications observed in these OSA patients are consistent with the underlying pathogenesis of OSA, pharyngeal obstruction. The absence of observed perioperative arrhythmias and myocardial ischemia is consistent with previous findings that sleep-related cardiac ischemia is uncommon in OSA patients. Our results suggest it is prudent to cautiously manage all OSA patients receiving surgeries involving general anesthesia.
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Cranioplasty is among the oldest surgical procedures. Trauma, infections, tumors and compression caused by brain edema are some of the reasons for the removal of bone. ⋯ However, there are many theories suggesting that an underlying physiological alteration may occur which may require the correction of the bone defect; many patients improve after surgery. We discuss the physiopathological basis of the "syndrome of the trephined" and try to achieve a better understanding of the present status of cranioplasty and its possible therapeutic role.