RESUMO
Hand bites from domestic animals are extremely common. Though many may initially appear benign, it is important for treating physicians to be aware of the factors that place patients sustaining animal bites at additional risk for infection. As clinicians, we must be able to efficiently diagnose and treat these patients properly to avoid the morbidity that animal bites can provoke. The current paper reviews the evaluation and management of domestic animal bites to the hand.
Assuntos
Mordeduras e Picadas/cirurgia , Traumatismos da Mão/cirurgia , Mãos/cirurgia , Animais de Estimação , Infecção dos Ferimentos/cirurgia , Animais , Aves , Mordeduras e Picadas/diagnóstico , Mordeduras e Picadas/microbiologia , Mordeduras e Picadas/fisiopatologia , Gatos , Cães , Furões , Mãos/fisiopatologia , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/microbiologia , Traumatismos da Mão/fisiopatologia , Humanos , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/microbiologia , Mordeduras de Serpentes/fisiopatologia , Mordeduras de Serpentes/cirurgia , Serpentes , Resultado do Tratamento , Infecção dos Ferimentos/diagnóstico , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/fisiopatologiaRESUMO
The outcomes of 20 patients diagnosed with osteoarthritis or rheumatoid arthritis with body mass index less than 18.5 (considered underweight) who received total hip arthroplasty at a single institution were reviewed. Surgical complications in the first 30 days after surgery included 1 prolonged surgical site drainage and 3 posterior dislocations. Two patients experienced medical complications that included hematemesis, confusion, aspiration pneumonia, and death. Sixty-five percent of the patients received at least one blood transfusion. Harris hip scores improved from 35 to 81 (P < .05) at an average of 6.1 years (2-10.1 years) of follow-up. Total hip arthroplasty is effective in patients who are underweight; however, they appear to be at an increased risk of dislocation and blood transfusion.
Assuntos
Artrite Reumatoide/cirurgia , Artroplastia de Quadril/efeitos adversos , Osteoartrite do Quadril/cirurgia , Magreza , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Articulação do Quadril , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Among 25 patients of mean age 91.5 years (range, 90-96 years) who received a total hip or knee arthroplasty at the authors' institution, 8% experienced surgical complications, 56% experienced at least 1 medical complication, and 80% received perioperative blood transfusions. At a mean follow-up of 4.1 years, patients were experiencing pain reduction and somewhat higher functional capacity and had slightly better survival characteristics than age-matched controls. Total hip and knee arthroplasty patients in this cohort should be told that they have a higher likelihood of experiencing perioperative medical complications and of receiving a blood transfusion than younger individuals; at the same time, they can expect pain relief as well as equal or better survival than their age-matched peers.
