Primary Repair of Ear Avulsion with Adjuvant Hyperbaric Therapy and Nitroglycerin Ointment.

Traumatic auricular avulsion is a rare and deforming injury. Classically, repair has required microvascular anastomosis. In this publication, we report two separate cases of pediatric auricular avulsion from dog bites. In both cases, the ear was cleaned and surgically reattached. Adjunctive therapies included hyperbaric oxygen and nitroglycerin ointment. There was complete graft take for one patient and 90% graft take for the second, both achieving satisfactory aesthetic outcome. These unique cases highlight the benefits of surgical reattachment of the avulsed portion of the ear followed by hyperbaric oxygen therapy and nitroglycerin ointment.

Respiratory effect of prolonged electrical weapon application on human volunteers.

BACKGROUND: Conducted electrical weapons (CEWs) are used by law enforcement to subdue combative subjects. Occasionally, subjects will die after a CEW has been used on them. It is theorized that CEWs may contribute to these deaths by impairing respiration. OBJECTIVES: To examine the respiratory effects of CEWs. METHODS: Human volunteers received a 15-second application of electrical current from a CEW while wearing a respiratory measurement device. Common respiratory parameters were collected before, during, and after exposure. Health histories and demographic information were also collected. RESULTS: Fifty-two subjects were analyzed. Thirty-four underwent a 15-second continuous exposure, and 18 underwent three 5-second burst exposures. In the continuous application group, the baseline mean tidal volume of 1.1 L increased to 1.8 L during application, the baseline end-tidal CO2 level went from 40.5 mm Hg to 37.3 mm Hg after exposure, the baseline end-tidal oxygen level went from 118.7 mm Hg to 121.3 mm Hg after exposure, and the baseline respiratory rate went from 15.9 breaths/min to 16.4 breaths/min after exposure. In the 5-second burst group, the baseline mean tidal volume increased to 1.85 L during application, the baseline end-tidal CO2 level went from 40.9 mm Hg to 39.1 mm Hg after exposure, the baseline end-tidal oxygen level went from 123.1 mm Hg to 127.0 mm Hg after exposure, and the baseline respiratory rate went from 13.8 breaths/min to 14.6 breaths/min after exposure. CONCLUSIONS: Prolonged CEW application did not impair respiratory parameters in this population of volunteers. Further study is recommended to validate these findings in other populations.