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At least 1,621 records · Page 90Linked to original sources

[Damage to the lateral cutaneous femoral nerve after transfemoral angiography].

We report on two patients with lesions of the lateral cutaneous nerve of the thigh after transfemoral angiography. Symptoms were hypesthesia, dysesthesia and hypalgesia of the right lateral thigh. One patient had no hematoma, the other a hematoma of the medial thigh which did not enlarge thigh circumference. Both patients had had a tight pressure bandage applied for 24 hours. There were no signs of a femoral nerve lesion. Both patients were severely distressed by paresthesia. The numbness subsided after three weeks in one patient, but pain persisted. The other patient had symptoms for over six months. The lateral cutaneous nerve of the thigh is located distinctly lateral to the puncture site in transfemoral angiography. Hence we suggest that the nerve lesion was caused neither by the puncture itself nor by a hemorrhage, but by the tight bandage.

Aged↗

Six hour ambulation after elective coronary angioplasty and stenting with 7F guiding catheters ald low dose heparin.

BACKGROUND: Early ambulation after coronary angioplasty may reduce in-hospital stay and add to the patient's comfort. This approach, however, may increase the risk of insertion site related complications, such as arterial bleeding, haematoma, pseudoaneurysm, and the need for surgical repair. AIM: To evaluate the feasibility and safety of ambulation of patients six hours after elective coronary angioplasty or stenting, or both. METHODS: Coronary angioplasty and stenting were performed using 7F guiding catheters via the femoral or brachial approach. The first dose of heparin 5000 IU was given immediately after insertion of the arterial sheath and the second dose heparin 2500 IU was given 90 minutes later. There were no angiographic exclusion criteria. The arterial sheath was removed immediately after the procedure. Haemostasis was achieved by manual compression and maintained with a compression bandage. Early ambulation was attempted after six hours of supine bed rest following removal of the bandage. The incidence of bleeding at ambulation requiring compression and additional bed rest, and insertion site complications documented 48 hours after the procedure, were analysed. RESULTS: 326 patients (290 femoral, 36 brachial route) were included. Stent implantation was performed in 267 patients (82%). The mean+/-SD time to haemostasis was 14+/-4 minutes. Bleeding at ambulation occurred in 7 (2.14%) patients, and major haematomas were seen in 8 (2.45%) patients during 48-hour follow up. All were seen in patients in whom the femoral route was used and who were treated conservatively. There were no late bleeding or vascular complications. CONCLUSIONS: Ambulation six hours after elective balloon angioplasty or stent implantation with 7F guiding catheters using femoral or brachial route and low dose heparin is feasible and safe, with a low incidence of insertion site complications. This early ambulation protocol shortens hospital stay.

Adult↗

Otoplasty for prominent ears in children. The technique adopted in the Portmann Institute.

The Otoplasty technique adopted in the Portmann Institute is a simple rapid technique that maintains the natural contours of the auricle with minimal risk of infection. The technique involves excision of a large ellipse of skin from the mastoid surface of the auricle and reflection of remaining skin to the edge of the helix. The subcutaneous and muscular tissues on the mastoid bone are excised and the mastoid surface of the auricular cartilage scored with monopolar diathermy. After haemostasis, the wound is closed using continuous long-term absorbable sutures. A dressing and bandage are applied and the child is monitored for 10 days. A head bandage is applied at night for one month with use of a sun-screen cream on the scar at daytime.

Academic Medical Centers↗

Anhidrotic ectodermal dysplasia with spontaneous corneal perforation and keratoconus.

A patient with anhidrotic ectodermal dysplasia and severe dry eyes was admitted with spontaneous corneal perforation in his right eye. The corneal perforation was sealed with cyanoacrylate glue and bandage contact lens placement. Three weeks later, the patient underwent penetrating keratoplasty. On follow-up examination, he had corneal graft abscess that was treated successfully with topical antibiotics and corneal erosion that was treated with a bandage contact lens. Corneal topography performed as a routine examination showed inferior corneal steepening typical of keratoconus in the left eye. This accidental discovery of keratoconus in the patient's left eye may suggest a possible association between anhidrotic ectodermal dysplasia and keratoconus.

Corneal Diseases↗

[The onset of physiological activity in the stomach in the postoperative period. A comparative study with a prokinetic preparation, Ganaton].

UNLABELLED: Postoperative gastroparesis decreases patient's postoperative comfort. The aim of this prospective study was to assess efficacy of the peroperatively administered prokinetic preparation Ganaton (Itopridi hydrochloridum, Abbott) on the postoperative gastroparesis. METHODOLOGY: This prospective study was conducted in the Ist Surgical Clinic of the 1st Medical Faculty in Prague in 2001-2001. The total of 64 patients took part in this study. The patients underwent either a non-adjustable bandaging of the stomach via laparoscopy for a severe obesity, or a laparoscopic cholecystectomy. In the postoperative period, a subjective status of each patient, as well as objective examinations (auscultaion, gas excretion, stool excretion) and a percutaneous electrographic record were recorded. RESULTS: The patients after both the gastric bandaging and the laparoscopic cholecystectomy, demonstrated faster restoration of the physiological stomach contractions frequency in the group with itopride, compared with the placebo group. CONCLUSION: The prokinetic preparation was well tolerated and the authors did not record any undesirable side-effects. The preparation significantly speeded up restoration of the physiological stomach contractions frequency compared with the placebo group. Based on our results, its administration is a suitable part of the prophylaxis and treatment of the postoperative gastroparesis.

Adult↗

[The principles and techniques of cast application].

In this chapter, the chemical properties of the plaster cast and synthetic cast, the techniques of the plaster bandage, and its complications are discussed. The plaster cast is one of the useful materials in the treatment of the orthopedic surgery. Orthopedic surgeon must improve the skill of plaster bandage.

English Abstract↗

[Preliminary study on the improvement of wound microcirculation and retrospection on several methods of the management of deep partial thickness burn wound].

OBJECTIVE: To analyze several methods of wound repair for deep partial thickness burn wounds retrospectively, so as to evaluate the significance of improvement of wound microcirculation on wound healing. METHODS: (1) 2,976 burn patients admitted to our department were enrolled in the study, among them 614 undertook tangential excision, 32, eschar abrasion, 86 allo-skin coverage after debridement, 1836 tropical application of silver sulfadiazine and 408 with traditional Chinese medicine (Jing Wan Hong ointment) with gauze bandage. The results of the management with different methods were compared. (2) Rat model with deep partial thickness burn was reproduced and topical application of silver sulfadiazine was given. The rats were randomly divided into control (n = 10, with normal saline injected via caudal vein within 5 minutes postburn), and treatment (n = 10, with batroxobin injected via caudal vein within 5 minutes postburn) groups. The blood flow perfusion unit in the wound skin was measured before burn and at 0.5 to 72 postburn hours by Laser Doppler. The wound healing rate, contraction rate and wound healing time in each group were calculated on 14 and 18 postburn days (PBDs). The number of hair follicles after wound healing was observed by histological method. RESULTS: (1) The burn wound treated by tangential excision healed within 2 to 3 post operation weeks (POWs), with the healing rate of 94.8% in patients with burn covering 50% - 70% TBSA and 93.4% in those with burn of 80% approximately 98% TBSA. The healing time of patients with allo-grafts coverage after eschar abrasion was 13.8 +/- 2.1 days without scar formation. The wound healing time was 18.0 +/- 2.3 day in 82 patients with allo-graft coverage after debridement, and it was 26.0 +/- 3.2 days with subeschar healing in 1658 patients with topical application of silver sulfadiazine. Infection in burn wound was encountered in most patients undergoing traditional Chinese medicine bandage treatment with wound healing time of 26.0 +/- 2.8 days in the lower extremities. (2) The blood flow perfusion unit of the rats in the treatment group was significantly higher than that in the control group (P < 0.01). The wound healing rate in treatment group on 14 and 18 PBD was obviously higher than that in the control group (P < 0.01). But the wound contraction rate in the two groups was similar (P > 0.05). The wound healing time in treatment group was much shorter than that in control group (P < 0.01). A few hair follicles remained in the dermis of the rats in the control group on 30 PBD, and the number was evidently smaller than that in the treatment group (P < 0.01). CONCLUSION: Early tangential excision and eschar abrasion remained better methods in the management of deep partial thickness burn wounds, as they could ameliorate burn wound infection, shorten treatment period, raise wound healing rate and quality. Application of batroxobin could accelerate wound healing rate by improving wound microcirculation in deep partial thickness burn wound.

Adult↗

Evaluation of a flexible new liquid polymer wound dressing.

Occlusive dressings are the foundation of wound care and have been shown to speed epithelialization and healing of surgical sites. Many different dressings have been introduced over the years including antibacterial ointments with gauze and adhesive, hydrocolloid bandages, and liquid adhesives. All of these have their limitations and advantages. We introduce our experience with a new organic polymer in solvent which when applied to a wound forms a flexible occlusive bandage. The material has been shown to have antimicrobial properties and be well-tolerated by patients.

Aged↗

[The therapy of acute radiogenic epitheliolysis with a dressing of hydrocolloids and polymers (Biofilm). A report on clinical experience].

Acute skin lesions following radiotherapy are uncomfortable and unacceptable side effects. They are observed predominantly after high surface doses as in conventional roentgen or electron beam therapy. To accelerate the wound healing we tested a bandage consisting of hydrocolloids and polymers, which is permeable for gas and water. Handling, compatibility and effectiveness of this plaster were tested in this study. According to the RTOG scoring system 19 irradiated fields with grade II to IV lesions were treated. Densitometric measurements of verification films with and without Biofilm showed no energy absorption. The bandage was comfortable for the patients and easy to handle.

Acute Disease↗

Tight lens syndrome associated with a 24-hour disposable collagen lens: a case report.

Tight lens syndrome occurred 8 hours after a 24-hour Bio-Cor bandage collagen lens (Bausch & Lomb, Inc.) was placed on the eye of a 19 year old female patient with a history of Stevens-Johnson syndrome and recurrent corneal abrasions. Because collagen bandage contact lenses share some physical and fitting properties with hydrophilic lenses, they should be used with caution in patients at high risk for a tight lens.

Adult↗

[Treatment of uncomplicated closed fractures of the metatarsal bones by the functional method].

Functional method has been used in the treatment of 110 patients with noncomplicated closed fractures of metatarsal bones. Theoretical rationale of the method is presented. Positive effect of early exercise on the injured limb is demonstrated. A plaster bandage permitting talocrural movements is described. A plaster bandage permitting talocrural movements is described. Immobilization periods, shorter than the common ones, are validated. Employment of this method resulted in a stable reduction of invalidity periods.

Adolescent↗

[Mercury pressotherapy in the treatment of lymphedema].

Increasingly growing pressure gradients impressed upon a limb maintained vertically positioned in mercury (metal) have been used as an individually-adjusted compressive, evacuating and atraumatic mould in lymphatic or venolymphatic disease of the limbs. We studied this new so-called mercury pressure-therapy applied to 100 cases of lymphedema of the upper extremity, 100 cases of lymphedema of the lower extremity, 150 cases of inflammatory hypodermitis of the leg and 50 refractory venous ulcers. During the first trials, the patients were treated with a prototype, then with a model of the latest version of the Gradient-1000 device (fig. 1), allowing for mercury displacement along the limb controllable by 6 parameters. During experimentation, we used the following methodology: 1) Each patient's treatment consisted in 3 to 4 compression sessions at 3 to 8 day intervals. Later, the patient was followed up for 3 to 6 months and received 1 to 2 additional pressure treatments, as deemed necessary. 2) Each session comprised 30 minutes of actual compression by several rising mercury waves falling back to the zero level each time, using the following criteria: slow velocities (1 to 2 cm/second), progressively higher rising levels (45 to 70, even 80 cm), each level upheld for 3 to 5 minutes, few repeated up and down phases (6 to 10, depending upon the duration of each phase). 3) In between the compression sessions, the patient wore a compressive elastic bandage permanently. 4) The first 3 to 4 compression sessions constituted the initial treatment; the patient was then fit with a removable elastic bandage to be worn 12/24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗

Pulsed ultrasound does not improve healing of venous ulcers.

A controlled study of the effects of pulsed ultrasound was carried out in conjunction with a standard treatment for healing chronic leg ulcers on 44 patients divided randomly into two groups. All patients received standard treatment (paste impregnated bandage and a self-adhesive elastic bandage) plus placebo-ultrasound or pulsed ultrasound (1:9, 0.5 watt/cm2 at 1 MHz, for 10 min) 3 days a week for 4 weeks, thereafter twice weekly for 4 weeks and once weekly for the following 4 weeks. Percentage healed ulcer area and comparison of percentage healed ulcers were examined after 4, 8 and 12 weeks. There were no significant differences in the proportion of healed ulcers or ulcer area in the pulsed ultrasound group as compared with the placebo group.

Aged↗

Evaluation of a new cutaneous topical anesthesia preparation.

Topical anesthetic agents are usually not effective on intact skin because of poor penetration. EMLA is a new topical anesthetic formulation consisting of a eutectic mixture of the local anesthetics lidocaine 5% and prilocaine 5%. We evaluated the ability of this preparation to prevent or ameliorate the pain associated with the percutaneous placement of large IV catheters. Under double-blind randomized conditions, either EMLA or placebo was applied to the dorsum of both hands and an occlusive bandage then placed over each application site. The creams were placed 30, 45 or 60 minutes prior to IV cannulation. A 16-gauge catheter was inserted through each application area. Patients were asked to evaluate the relative degree of pain at each venous puncture site. The EMLA site was preferred when the formulation was applied for 45 to 60 minutes prior to cannula placement (p less than 0.01, confidence limits for the binomial distribution). Cusum analysis confirmed this minimal effective application time. The results indicate that EMLA is an effective cutaneous anesthetic formulation when applied with an occlusive bandage for a minimal time period of 45 minutes.

Anesthetics, Local↗

Observations and proposed mechanism of N,N',N''-triethylenethiophosphoramide (thiotepa)-induced hyperpigmentation.

After receiving N,N',N''-triethylenethiophosphoramide (thiotepa) and cyclophosphamide intravenously, five women with metastatic adenocarcinoma of the breast developed a patterned hyperpigmentation confined to skin occluded by adhesive-containing materials. Determinations of thiotepa concentrations in occluded and nonoccluded skin, plasma, bandage with adhesive, and gauze containing sweat were performed. The results suggest that this alkylating agent is excreted onto the skin surface in sweat, accumulates beneath adhesive-containing bandages and electrocardiogram pads, and exerts a local toxic effect resulting in hyperpigmentation.

Adult↗

[Biomechanical studies on various methods of osteosynthesis on a photoelastic model of the mandible].

Biomechanical studies on a model of the mandible served to verify the stability of a fracture treated with the techniques of pressure-plate osteosynthesis, traction-bandage osteosynthesis and percutaneous compression osteosynthesis, respectively. Stress distribution in the model were determined photoelastically. In this way, it has been possible to obtain informations about stresses caused by different loads (biting-off, stress on the left or right lateral region). Of the methods of osteosynthesis under investigation, plate osteosynthesis yielded the most stable union of the fragments. Satisfactory values were also achieved by means of traction-bandage osteosynthesis and percutaneous compression osteosynthesis. Consequently, these methods may be regarded as function-stable. Conclusions as to the optimal location of the osteosynthesis material can be drawn from an exact analysis of the stress curves. Maximum stress on the mandible, especially in the anterior region, should be avoided for a least 3 weeks.

Biomechanical Phenomena↗

[Rotatory atlanto-axial luxation in children].

Two cases of atlanto-axial rotatory dislocation following ear and head surgery are presented. Reduction was followed by Halo bandage in one, and by wedge C1-2 arthrodesis and Halo bandage in the other. The importance of early recognition by diagnostic CT-scan is emphasized.

Atlanto-Axial Joint↗

[Leg ulcer--ambulatory treatment and results].

The results of ambulatory treatment in 85 patients with leg ulcers are presented. 59 were females (mean age 66 years) and 26 males (mean age 58 years). 50% were recurrent ulcers, of which 40% had been treated previously. Under local application of zinc ointment for the ulcer, cortisone ointment for the surrounding eczema, compression bandages and injection sclerotherapy for ulcer supporting varices. 78% of all ulcers healed and 14% were improved or nearly healed. We can therefore assume a healing rate of 92%. The majority of ulcers healed within 2 months of starting continuous treatment and 12% required more than 3 months. In 5 patients (6%) the ulcers did not heal and deteriorated under ambulatory treatment, while 2 (2.5%) remained unchanged. Among these 7 patients 4 had concomitant arterial occlusive diseases and 3 were very elderly patients with an extensive postphlebitic state who could not be treated on an ambulatory basis because of lack of mobility. 96% of the 75 venous ulcers healed completely under ambulatory treatment. We concluded that ambulatory care of leg ulcer, including compression bandages and injection sclerotherapy, is effective in the great majority of cases. Concomitant arterial occlusive disease and immobility of elderly patients may prevent successful local therapy.

Aged↗