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Biomedical subjects

C P Giordano

Publications and source records attributed to C P Giordano.

7 recordsLinked to original sources
PubMed1995

Treatment of fracture blisters: a prospective study of 53 cases.

From June 1987 to January 1993, 53 fractures complicated by overlying blisters were identified and prospectively followed. Data concerning the mechanism of injury, time course in the development of the fracture blisters, clinical characteristics of the blister, fracture type and management, and soft-tissue treatment and outcome were collected. Clinically, two types of blisters were identified: clear fluid filled and blood filled. Methods used to treat the skin blister were: aspiration of the blister, deroofing of the blister with subsequent application of Silvadene cream or coverage with a nonadherent dressing, and leaving the blister intact and covered by a loose gauze or exposed to the air. No significant difference was found in the outcome of the skin injury treated with the various modalities. Nineteen patients underwent early open reduction and internal fixation in the presence of intact fracture blisters. In 17 cases the incision healed within 3 days, sealing off the deeper structures, and reepithelialization of the blister bed then occurred at a later date. Two of the patients who had incisions pass through blood-filled blisters developed wound healing complications. Although there was no significant difference in the outcome of the soft-tissue treatment techniques, our present practice is to leave all fracture blisters intact. If the blisters rupture spontaneously, they are deroofed and covered with a nonadherent dressing. Early surgery is contemplated in patients with intact blisters and without severe swelling.

Adolescent↗
PubMed1995

Fracture blister formation: a laboratory study.

A biomechanical study was performed to examine a proposed mechanism of fracture blister formation. Sixty cadaver ankle skin specimens were subjected to several levels of uniaxial strain and examined histologically. Dermal-epidermal separation patterns similar to those found histologically in previous studies of biopsied fracture blisters were seen in specimens strained 152% and greater. These findings support the hypothesis that fracture blisters can result from strain developed in the skin during initial fracture deformation.

Biomechanical Phenomena↗
PubMed1994

The perioperative course of combined anterior and posterior spinal fusion.

A retrospective study was undertaken to characterize and compare the perioperative course of 91 cases of one- and two-stage combined anterior and posterior spinal fusions over a 7-year period. The two patient populations were similar regarding preoperative characteristics and the number of levels fused. Significantly decreased operative and anesthesia time, operative blood loss, and postoperative hospital days were seen in the one-stage population compared to the two-stage cases (P < 0.05). For the spinal deformity subgroup, a longer chest-tube duration, decreased anesthesia time, and decreased postoperative hospital stay in the one-stage group were the only significant differences. Surgical treatment delays were noted in 8% of one-stage cases and in 23% of two-stage cases. Complications occurred in 53% of all cases, with a significantly higher major complication rate in patients with preoperative medical comorbidities who underwent two-stage combined fusion versus one-stage reconstruction. Higher complication rates were also associated with an age greater than 40 years, the presence of medical comorbidities, and cases treated with a thoracoabdominal anterior approach.

Adult↗
PubMed1994

Fracture blisters.

A clinical and histological study was performed on fracture blisters found in association with 13 surgically treated ankle fractures. The timing of surgery was dependent upon soft tissue swelling; the status of the blister did not affect this aspect of the decision making process. The average time from injury to surgery was 2.1 days (range, 1-3 days). At the time of surgery all blisters were intact. Skin biopsies were obtained from the edge of the incision in proximity to the blister, and from the bed of the blister when the incision was made through the blister. Clinically, 2 blister types were identified: (1) clear fluid filled, and (2) blood filled. Histologically, both blister types demonstrated a cleavage injury at the dermoepidermal junction. However, the dermis of the clear fluid filled blister retained occasional epithelial cells, while the dermis of blood filled blisters was completely devoid of epidermis. Minimal to no evidence of dermal injury was found in histologic sections from the blister beds or from the skin in close proximity to blisters. All incisions made through and around skin blisters went on to heal without evidence of infection or wound breakdown. Delayed wound healing occurred in 1 patient in whom an incision was placed through a blood filled blister. The blood filled blister appears to represent a slightly deeper injury than the clear fluid blister and had a higher risk of poor healing of surgical incisions.

Adult↗
PubMed1994

Use of the orthofix limb alignment grid in the treatment of infantile tibia vara.

The use of a dome osteotomy in the treatment of infantile tibia vara is reportedly associated with insufficient intraoperative assessment of the correction achieved. This article discusses a method to overcome this problem and the long-term advantages of using a dome osteotomy in the treatment of this disease.

Bone Diseases, Developmental↗