Tramadol as a local anaesthetic in tendon repair surgery of the hand.

This double-blind pilot study compared the local anaesthetic effects of tramadol plus adrenaline with lidocaine plus adrenaline during surgery to repair hand tendons. Twenty patients were randomly allocated to receive either 5% tramadol plus adrenaline (n = 10) or 2% lidocaine plus adrenaline (n = 10). Injection site pain and local skin reactions were recorded. At 1-min intervals after injection of the anaesthetic agent, the degree of sensory blockade was assessed by the patient reporting the extent to which they felt a pinprick, light touch and a cold sensation. Pain felt during surgical incision was also recorded. There was no difference in the quality of sensory blockade or the incidence of side effects between the two groups. Only patients treated with tramadol did not require additional post-operative analgesia. A combination of tramadol plus adrenaline provided a local anaesthetic effect similar to that of lidocaine plus adrenaline.

The effects of onion extract on hypertrophic and keloid scars.

OBJECTIVE: To evaluate the therapeutic activity of topical onion extract in gel form on hypertrophic and keloid scars, focusing on problems such as elevation, redness, hardness, itching and pain. METHOD: This comparative prospective study assigned 60 patients to three groups. Group I was treated with onion extract alone, group 2 with silicon gel sheet alone and 3 group with a combination of onion extract and silicon gel sheet. RESULTS: In the group comparisons, a significant difference was observed at the end of six months in the colour parameter between group I and group 2 and in the height parameter between group I and group 3 (ANOVA post-hoc Tukey's test, p<0.01 and p<0.05 respectively). The onion extract was more effective in relation to scar colour, while the silicon gel sheet was superior in decreasing the height of scar (paired sample t-test, p<0.001). In addition, the most effective therapeutic results were obtained when the silicon gel sheet treatment was combined with onion extract in group 3. CONCLUSION: Onion extract improved hypertrophic and keloids scars via multiple mechanisms. However, it was statistically ineffective in improving scar height and itching. For this reason, onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a satisfying decrease in scar height.

Cross-sectional internal diameters of radial, thoracodorsal, and dorsalis pedis arteries in children: relationship to subject sex, age, and body size.

The purpose of this study was to determine the average diameter of the radial, thoracodorsal, and dorsalis pedis arteries in a pediatric population and to evaluate the relationship of these measurements to the subject's age, sex, height, weight, and body mass index (BMI). The internal diameters of the radial, thoracodorsal, and dorsalis pedis arteries were non-invasively studied in 45 normotensive, presumed normal children of various ages (4 to 14 years) with the use of a Doppler system. The average diameters of the radial, thoracodorsal, and dorsalis pedis arteries in females and males were as follows: radial artery 1.39 (SD +/- 0.18) mm and 1.57 (SD +/- 0.18) mm; thoracodorsal artery 1.27 (SD +/- 0.11) mm and 1.36 (SD +/- 0.2) mm; and dorsalis pedis artery 1.22 (SD +/- 0.08) mm and 1.34 (SD +/- 0.12) mm. These were correlated with the age, height, weight, and BMI. Gender had a strong influence on the diameter of these arteries. In a linear regression model, weight was found to be statistically the best independent variable for predicting radial and dorsalis pedis diameters, whereas age was the best predictor for the diameter of the thoracodorsal artery. The diameters of these three arteries in an age group of 4 to 14 years ranged between 1 to 2 mm. The age and weight of the children predicted the diameters of the peripheral arteries.

Spotting the signs: a case of late diagnosed painful calciphylaxis.

Although the number of cases of calciphylaxis is increasing, it is often not diagnosed until a late stage, increasing the risk of mortality. A characteristic is purple, mottled and painful lesions, which have a tendency to become necrotic.

Caffeic acid phenethyl ester improves oxidative organ damage in rat model of thermal trauma.

Severe burn injuries cause functional impairment in distant internal organs. Although this mechanism is not clear, it is possible that free radical toxicity plays an important role. Research in animals and clinical studies have shown that there is a close relationship between a lipid peroxidative reaction and secondary pathological changes following thermal injury. It has been demonstrated that antioxidant treatment prevents oxidative tissue damage associated with thermal trauma. This study was designed to determine the possible protective effect of caffeic acid phenethyl ester (CAPE) treatment against oxidative damage in the kidney and lung induced by thermal injury. Rats were decapitated either 1, 3 or 7 days after burn injury. CAPE was administered intraperitoneally immediately after thermal injury. Kidney and lung tissues were taken for the determination of malondialdehyde (MDA) level, myeloperoxidase (MPO), catalase (CAT), superoxide dismutase (SOD) and xanthine oxidase (XO) activities. Severe skin thermal injury caused a significant decrease in SOD and CAT activities, as well as significant increases in MDA level, XO and MPO activities in tissues during the postburn period. Treatment of rats with CAPE (10 micromol/kg) significantly elevated the decreased SOD and CAT activities, while it decreased MDA levels and MPO as well as XO activity.

Ear lobe reconstruction with a posterior ear flap. Case reports.

We describe a technique for reconstruction of the ear lobe. Although there are many procedures that aim to reconstruct the ear lobe naturally, the aesthetic results of using a posterior ear flap are better because the scar tissue that remains behind the ear is invisible.

Hyperphosphatemic tumoral calcinosis.

Tumoral calcinosis is a rare syndrome characterized by progressively growing and painless masses of calcium phosphate deposits within periarticular areas. Biochemical findings are normal except for an association with hyperphosphatemia. This report describes hyperphosphatemic tumoral calcinosis in a 22-year-old man who had been operated on five times in 5 years because of painless extremity swellings.

Reconstruction of defects of the dorsum of the nose with bilateral transposition flaps. Case report.

Transposition flaps are old but are the method of choice in reconstruction of defects of the dorsum of the nose. Eleven consecutive patients with such defects were treated with 22 transposition flaps. The nasal defects resulted from tumour (n = 9), trauma (n = 1), and keratoacanthoma (n = 1). The dissection is rapid, easy and the complication rate is low.

Use of reverse triangular V-Y flaps to create a web space in syndactyly.

The authors describe a new technique for division in syndactyly. The web space is reconstructed using two reverse V-Y island triangular flaps. The flaps are raised both on the dorsal and the palmar aspect of the hand. This technique does not require the use of a skin graft. Fourteen syndactylies in 9 children-three incomplete (two congenital and one secondary to burn) and six complete-were treated using this technique. The results after a maximum 4-month follow-up and the advantages of the technique are discussed.