Search PubMed⌕ Search

Biomedical subjects

R J Mann

Publications and source records attributed to R J Mann.

At least 91 records · Page 5Linked to original sources

Human bites of the hand: twenty years of experience.

A retrospective study of the records of 20 years of experience with injuries from human bites reviewed the results of treatment of 42 patients during the first 10 years and 94 in the second 10 years. In the later series there was less delay in the treatment due to better education of primary physicians as well as of patients. There were fewer complications also. A prospective study of 38 patients, whose treatment consisted of soap and water cleansing, thorough exploration and debridement, hospitalization for at least 48 hours, and administration of antibiotics, showed this treatment resulted in a reduction of the incidence of amputation and stiff fingers despite the fact that 61% of the patients still delayed seeking treatment.

Adolescent↗

Hand infections in patients with diabetes mellitus.

In a study of diabetic patients with hand infections reviewed at Jackson Memorial Hospital, University of Miami School of Medicine, 20 such diabetic patients with hand infections were found. The most outstanding result was that seven of the 20 had amputation either to control infection or because the function of the extremity was impaired by the remaining ravaged part. Pathologic examination of tissue removed showed the same changes commonly seen in diabetic gangrene of the lower extremity. Electromyographic studies, when done, have been confirmatory of a peripheral neuropathy with delayed nerve conduction studies. The bacterial organisms of the infections were variable, but a predominance of Gram-negative organisms were cultured in twelve of the 20 patients. Early aggressive management, including surgical debridement and intravenous antibiotics, is recommended to prevent unnecessary amputations and improve residual function.

Adult↗

Propeller injuries.

Water skiing, boat racing, skin and scuba diving, and pleasure boat cruising are increasing in popularity. As a result the incidence of injuries secondary to motor propellers is becoming more frequent. In a ten-year period from 1963 to 1973, I collected a total of nine cases. In some amputations were necessary, and in other cases amputations occurred at the time of injury. Problems with bacterial flora occurring in open sea water versus salt water enclosed near docks and fresh lake water are discussed. A review of the orthopedic literature revealed sparse information regarding propeller injuries.

Accidents↗

Early decompression fasciotomy in the treatment of high-voltage electrical burns of the extremities.

Based on a knowledge of electropathophysiology, a recommended treatment has been proposed for the management of extensive high-voltage electrical burns. Early, aggressive, surgical intervention consisting of adequate decompression fasciotomy and wound debridement has been emphasized as the first line of treatment. Frequent redebridements under general anesthesia are important to the preservation of viable tissue. Early coverage procedures or attempts at primary closure following decompression are contraindicated in high-voltage injuries. This method of treatment in eight cases of high-voltage, electrical injury has preserved viable tissue, decreased the incidence of fatal sepsis and renal shutdown, decreased patient morbidity, and generally facilitated patient rehabilitation.

Adult↗