RESUMEN
The treatment of the patient with an exposed vascular implant should usually be in the hands of an expert vascular surgeon. In certain instances, such as when the exposed area is not close to a suture line and no fistulous tracts connect the exposed area to either suture line, plastic surgery can solve the problem. We present a case of an exposed aortic prosthesis which was successfully treated by removing devitalized tissue, turning a pectoralis major muscle flap over the implant, and closing the skin and subcutaneous tissue over the muscle flap.
Asunto(s)
Aorta Torácica/cirugía , Prótesis Vascular/efectos adversos , Infecciones/etiología , Complicaciones Posoperatorias/cirugía , Anciano , Procedimientos Quirúrgicos Dermatologicos , Humanos , Masculino , Métodos , Músculos/cirugía , Tereftalatos PolietilenosRESUMEN
After elective surgery, 28 patients with 40 wounds were enrolled in a controlled clinical study to assess the effects of two different dressings on incisional healing. Patients served as their own control with one-half of each incision covered with an impregnated gauze (Xeroform) and the other half of the incision covered with a thin occlusive hydrocolloid dressing (DuoDerm Extra Thin CGF). All wounds were evaluated 2 to 3 days, 7 to 10 days, 4 weeks, and 7 months postoperatively. None of the incisions segments showed any evidence of infection. At the time of suture removal, the hydrocolloid dressing's ability to contain exudate, protect the wound, and facilitate mobility and personal hygiene were rated higher compared with the gauze-type dressing (p < 0.001, for all variables). At the 4-week visit, both the patient and the surgeon rated the scar segments covered with the hydrocolloid dressing better with respect to color, evenness, and suppleness (p < or = 0.04, for all variables). These differences were no longer apparent 7 months after surgery.
Asunto(s)
Vendajes , Coloides , Cirugía Plástica , Cicatrización de Heridas/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Vendas Hidrocoloidales , Cicatriz/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Infección de la Herida Quirúrgica/etiología , SuturasRESUMEN
A review of the anatomy of the course of the ulnar nerve at the wrist, in the pisohamate tunnel. The exit from this tunnel is the most likely place for compression of the ulnar nerve at the wrist.