Articles: surgery.
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Ann Chir Plast Esthet · Jun 1995
Historical Article[Reconstruction of the nose in deep extensive facial burns].
The nose is in the medial portion of the face and is frequently injured in trauma of this area. Due to its situation its structure and shape, and its essential function, this organ is particularly exposed in the case of facial burns. ⋯ They then recall the fascinating story of rhinopoiesis through the ages. The third part is devoted to their personal approach to reconstruction of the nose in severe panfacial burns, using a forehead flap with one or several tissue expanders.
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The face is one of the areas of the body most frequently affected by burns. Pressure therapy maintains facial scars until maturation is achieved to present hypertrophic scars or contractures. Elastic pressure garments are usually used, but they do not provide adequate pressure on areas such as naso-labial folds or labio-chin folds. ⋯ Follow up is necessary to prevent complications and to revise the mask as the scars change. Nostril and oral commissures are treated with inserts which maintain adequate size or corrected contractures. Satisfactory results can be obtained with cooperative patients.
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This study was conducted on patients undergoing third molar surgery to evaluate their opinions on surgery and the follow-up period. Two groups were formed, as patients were able to choose between local anaesthesia alone or with additional conscious sedation by means of intravenous Midazolam. ⋯ Following the evaluation of surgery as more "pleasant" by sedated patients, it might be expected that this would contribute to a similar experience of the follow-up period. In this study, however no such connection was found. It is possible that preoperative self-selection of the patients (more sensitive and cautious persons preferred conscious sedation) might be responsible for these results.
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Aust N Z J Obstet Gynaecol · May 1995
ReviewContemporary transatlantic developments concerning compelled medical treatment of pregnant women.
This paper had identified a contemporary ethicolegal dilemma concerning the circumstances, if any, in which a pregnant woman's refusal of medical treatment may be judicially overridden either in her interests or those of the unborn child. On the one hand, the obstetrician will be concerned about the interests of both his patients in potentially life-threatening situations when they can be protected by what might be regarded as relatively straightforward procedures and where to fail to take those steps might expose the practitioner (at least outside New Zealand where its accident compensation legislation has impact in this regard) to allegations of negligence. ⋯ In such cases also, the conduct of medical procedures in the face of an express prohibition by the woman may give rise to liability for battery. (In New Zealand, such a potential liability would not, in the writer's view, be affected by the prohibition on proceedings for damages for medical misadventure as contained in the Accident Rehabilitation and Compensation Insurance Act 1992.) At the heart of an analysis of this issue is the status of the fetus as it is the fact of the woman patient's pregnancy which distinguishes the cases discussed in this paper from others in which the Courts have had to deal with refusals of treatment by those competent to do so. In regard to this aspect, the approach of the Courts in various jurisdictions has arguably been confused and contradictory.(ABSTRACT TRUNCATED AT 250 WORDS)