RESUMO
Despite modern surgical techniques and advanced antimicrobial therapy, osteomyelitis remains a difficult and challenging problem. A 10 year audit study from 1990 to 2000 was carried out to assess the outcome of treatment of chronic osteomyelitis. A total of 41 patients with chronic osteomyelitis (26 male, 15 female with an age range of 10-76 years, mean 45.3 years) underwent extirpation and reconstruction with muscle interposition. The duration of osteomyelitis ranged from 1 to 69 years (mean 16.6 years) and many patients had undergone multiple attempted procedures prior to definitive treatment. Thirty-seven patients underwent free microvascular muscle transfer and four patients underwent local transposition muscle flaps. Two of the 41 patients developed recurrent sepsis at 12 months (4.4% recurrence rate). These were treated successfully with elevation of the flap and curettage of the remaining infection and debris and re-insetting of the flap. Only one patient in the series required a below knee amputation and this was as a result of persistent intractable bone pain rather than recurrence of the osteomyelitis.
Assuntos
Osteomielite/cirurgia , Adolescente , Adulto , Idoso , Amputação Cirúrgica , Criança , Doença Crônica , Clavícula/cirurgia , Feminino , Fêmur/cirurgia , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Músculo Esquelético/transplante , Osteomielite/etiologia , Recidiva , Reoperação , Retalhos Cirúrgicos , Tíbia/cirurgia , Resultado do TratamentoAssuntos
Queimaduras/terapia , Varicela/complicações , Materiais Revestidos Biocompatíveis , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Superinfecção/etiologia , Queimaduras/complicações , Pré-Escolar , Contraindicações , Feminino , Humanos , Masculino , Resistência a MeticilinaRESUMO
Digital tourniquets are commonly used to provide a bloodless field for surgery to the finger. Such tourniquets, however, are potentially harmful and disastrous consequences occur if they are accidentally left in place. We propose a modification of the rubber glove tourniquet technique that will provide a safe and reliable tourniquet.