RESUMO
Raw area on the breast, especially when it is lactating, can lead to complications, including hyperprolactinemia and development of milk fistulae. A 25-year-old female presented with raw area over the left breast after 2 months of childbirth. She had history suggestive of necrotizing disease, which had primarily been managed elsewhere with debridement and dressings. We excised the raw area and applied split thickness skin grafts with minimal meshing. Bulky dressing prevented breastfeeding. On postoperative day 3, there were blebs containing milk underneath the graft. The blebs were drained and oral cabergoline was administered for 3 months. The skin graft healed well. If expression of breast milk is not possible then suppression of lactation should be considered before definitive cover of the raw area of breast.
Assuntos
Lactação , Transplante de Pele , Feminino , Humanos , Adulto , Leite Humano , Aleitamento Materno , BandagensRESUMO
Six hundred cases of tetanus were studied to find out incidence of respiratory complications and to evaluate factors predisposing such complications in tetanus. The incidence of complications was 41 per cent. Infants, patients of more than 40 years of age, smokers, cases with grossly contaminated injuries, short incubation period and short period of onset were more vulnerable. Patients with dysphagia, spasm, associated respiratory diseases and the patients in higher grades were also found to be more susceptible to respiratory complications.
Assuntos
Transtornos Respiratórios/etiologia , Tétano/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Transtornos de Deglutição/complicações , Humanos , Lactente , Pessoa de Meia-Idade , Espasticidade Muscular/complicações , Transtornos Respiratórios/complicações , FumarRESUMO
Fifty cases of puerperal tetanus were studied. It constituted 6.66% of total cases of tetanus with overall mortality of 52% which was higher in cases with incubation period of 14 days or less, period of onset 48 hours or less, higher grades, cases with temperature more than 37.7 degrees C and patients with respiratory complications. Significantly higher mortality rate after 48 hours signifies the need of effective local control of infection to improve prognosis. Prevention, early detection and prompt treatment of respiratory complications which is the main cause of death may further reduce mortality rate in these patients.