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At least 1,423 records · Page 79Linked to original sources
PubMed1982

Secondary burn reconstruction: recent advances with microvascular free flaps, regional flaps, and specialized grafts.

A representative series of cases are presented which demonstrate secondary reconstructive plastic surgery procedures for the burn victim utilizing microvascular free flaps, regional flaps, and specialized skin grafts. The unstable burn scar of the lower extremity could be managed either by a microvascular free-flap transfer, a muscle transfer, a myocutaneous flap transfer, or a reverse dermis graft, or overgrafting. In the present day, there are many treatment modalities available to us. Long-term wearing of the Jobst pressure stocking is essential in many cases to minimize the hypertrophic burn scar. In our experience, Kenalog injection into a hypertrophic burn scar always has resulted in improvement of the condition although it is usually necessary to give multiple injections into the hypertrophic burn scar at eight week intervals. We have never known Kenalog to fail to improve a hypertrophic scar by flattening it out to a significant extent, but it may take a year or more of injections to accomplish this goal. Microvascular surgery is most definitely a team effort requiring at least two fully trained microvascular surgeons, plus experienced operating room personnel. One microvascular surgeon harvests the free flap, and the other microvascular surgeons prepares the recipient area. Both microvascular surgeons participate in the multiple anastomoses that are required. A microvascular laboratory is essential to the success of a microvascular team, and constant practice is mandatory to maintain and enhance these precision skills. The primary burn surgeon ideally must always keep in mind ways to minimize functional and aesthetic deformity and to continue to improve the quality of life of the burn victim.

Adolescent↗
PubMed1995

[Anatomy and clinical application of transcervicothoracic polyphyletic blood supply skin flap].

Transcervicothoracic skin flap was used to repair the faciocervical scars left after burns in 56 cases. Anatomy and clinical application proved that the transverse cervical artery branches out a constant skin artery before it enters the trapezius muscle and this artery, after crossing the clavicle, is divided into two branches, one extending outwards, and the other downwards. The internal thoracic artery branched out an intercostal perforator on the spot 1 cm to the parasternum. The perforator extended along the intercostal plane and belonged to the direct skin artery. The rate for perforation between the second and third ribs was the highest and the diameter of the perforator the greatest. The thoracoacromial skin artery perforated through the medialsemis between the greater pectoral muscle and the deltoid muscle, and extended toward the shoulder, supplying the skin of the infraclavicular, deltoid and upper greater pectoral regions with blood. Anatomy and contrast examination showed that there are extensive anastomoses between the three groups of blood vessels. On the basis of these anastomotic branches, transregional skin flaps can be designed to repair faciocervical damages. These flaps were successfully used in the 56 cases, with 32 cases having the the branch of cervical segment of the trasverse cervical artery as the pedicle, and 24, the second and third perforators of the internal thoracic artery as the pedicle. It was proved that the transregional flaps can be successfully transferred regardless of the sites of the pedicles.

Adolescent↗
PubMed1957

Whiplash injuries.

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Neck Injuries↗
PubMed1957

Whiplash injuries.

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Neck Injuries↗
PubMed1957

Whiplash injuries.

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Neck Injuries↗
PubMed1997

A wooden foreign body in the neck.

Foreign bodies in the throat and/or neck are uncommon and transpharyngeal impaction of a wooden foreign body in the neck without vascular injury is very rare. The patient presented in this communication, reported to our center five days after severe physical assault with a pharyngocutaneous fistula in the left side of the neck. Clinical examination and X-rays were unremarkable. Conservative treatment led to healing of the fistula and he was discharged. Two weeks later he was readmitted with an abscess in the right supraclavicular region. Exploration under general anaesthesia revealed a 7 cm long wooden fragment of a spear in the abscess cavity. The fragment was removed. After several days' antibiotic treatment, he recovered fully and was discharged.

Abscess↗
PubMed2003

Small female head and neck interaction with a deploying side airbag.

OBJECTIVE: This paper presents dummy and cadaver experiments designed to investigate the injury potential of an out-of-position small female head and neck from a deploying side airbag. METHODS: Seat-mounted, thoracic-type, side airbags were selected for this study to represent those currently available on selected luxury automobiles. A computer simulation program was used to identify the worst case loading position for the small female head and neck. Once the initial position was identified, experiments were performed with the Hybrid III 5th percentile dummy and three small female cadavers, using three different inflators. RESULTS: Peak head center of gravity (CG) accelerations for the dummy ranged from 71x g to 154 x g, and were greater than cadaver values, which ranged from 68 x g to 103 x g. Peak neck tension as measured at the upper load cell of the dummy increased with inflator aggressivity from 992 to 1670N. A conservative modification of the US National Highway Traffic Safety Administration's (NHTSA's) N(ij) proposed neck injury criteria, which combines neck tension and bending, was used. All values were well below the 1.0 injury threshold for the dummy and suggested a very low possibility of neck injury. In agreement with this prediction, no injuries were observed. CONCLUSIONS: Even in a worst case position, small females are at low risk of head or neck injuries under loading from these thoracic-type airbags; however, injury risk increases with increasing inflator aggressivity.

Acceleration↗
PubMed1996

Angiography and transcatheter arterial embolization of vascular injuries of the face and neck.

The condition of patients sustaining penetrating neck trauma often appears deceptively stable, even when major structures have been injured. The clinician must identify patients who require treatment and limit invasive procedures in those without significant injuries. Angiography is often used to search for vascular damage following penetration of the neck and face. The charts of 401 hemodynamically stable patients with penetrating cervicofacial wounds who were evaluated by angiography followed, when necessary by either transcatheter arterial embolization and observation or surgery were reviewed. One hundred twelve patients (27.9%) had 131 vascular injuries identified by angiography; 77 (68.8%) of these patients sustained injuries to zone III of the neck or the face. The most commonly injured vessels were the internal carotid artery (ICA), the vertebral artery, and the external carotid artery (ECA) system. Multiple vessel injuries were seen in 17 (15.2%) of 112 patients and were more likely in patients with wounds in zone III or above than in those wounded in zone II or below (20.8% vs. 2.9%, respectively; P < .025). Injuries to the internal maxillary artery (IMA) (60%), ECA (53.3%), and the ICA (30.8%) were also significantly more likely to be accompanied by additional vascular injuries (P < .005). No clinically significant venous injuries were missed. Complications were noted in only 4 patients, and no deaths occurred as a result of angiography. Angiography is a safe, effective modality in the head and neck trauma setting. Particular scrutiny should be given to patients with zone III or facial wounds, particularly those with documented ICA, IMA, and ECA injuries, since these patients have a higher incidence of multiple vascular injuries.

Blood Vessels↗