Exploration and characterization of grafting productions by experimental methods are often cumbersome or sometimes impossible.Therefore,quantum chemistry calculations were performed to characterize the graft sites of ...Exploration and characterization of grafting productions by experimental methods are often cumbersome or sometimes impossible.Therefore,quantum chemistry calculations were performed to characterize the graft sites of epoxy resin.According to the Gibbs free energy criterion of the second law of thermodynamic,the reported graft sites were confirmed,and more important,some unreported graft sites were found.In addition,method of increasing the number of graft sites was studied in this article.展开更多
Full thickness skin grafts and composite grafts are a workhorse in reconstructive surgery of nose and ear defects whether they are originated from trauma, cancer surgery or burns. The reliability of these grafts has b...Full thickness skin grafts and composite grafts are a workhorse in reconstructive surgery of nose and ear defects whether they are originated from trauma, cancer surgery or burns. The reliability of these grafts has been proved with an established clinical use and morbidity to the donor site is minimal if harvesting and donor site selection if appropriate. Use of double or multiple grafts to reconstruct a complex defect of the nose has not been described and our report is meaningful for the fact that it describes a further use of the surgical concept of grafting.展开更多
Background: Dressing of split-thickness skin graft donor sites can be traumatic for the patient. The most advanced and expensive dressings have been compared to the most basic of dressings, with little or no consensus...Background: Dressing of split-thickness skin graft donor sites can be traumatic for the patient. The most advanced and expensive dressings have been compared to the most basic of dressings, with little or no consensus and an unpersuasive level of evidence. We aimed to determine the efficacy of the locally manufactured non-adherent, hydroconductive Drawtex? dressing and compare it to our current standard-of-care dressing, a thin transparent polyurethane film, in the healing of split-thickness donor sites. Methods: This prospective, within-patient controlled study included 27 adult participants, each with two split-thickness skin donor sites. The 54 donor site wounds were compared with regard to time to re-epithelialisation, perceived pain and healed wound quality. Results: By day 5, complete healing of donor site wounds, defined as >90% of epithelialized surface, was significantly higher in the hydroconductive dressing group compared to the polyurethane film group (22.2% and 3.7%, respectively;p < 0.0001). The hydroconductive dressing-treated donor site wounds were significantly less painful at 24-hours, 48-hours and 7-days post-operatively, and had fewer complications and superior wound healing quality. Conclusion: We have demonstrated that the relatively cheap and readily available dressing made locally in South Africa, Drawtex? is at least as safe, and potentially superior in wound healing, when compared to our current standard-of-care dressing.展开更多
BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of t...BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of the knee after an ACL reconstruction,and discuss the importance of accurate diagnosis and appropriate management,including the issue of graft preservation versus removal.CASE SUMMARY A 33-year-old gentleman underwent ACL reconstruction using a hamstring tendon autograft with suspensory Endobutton fixation to the distal femur and an interference screw fixation to the proximal tibia.Four years after ACL reconstruction,he developed an abscess over the proximal tibia and underwent incision and drainage.Remnant suture material was found at the base of the abscess and was removed.Five years later,he re-presented with a lateral distal thigh abscess that encroached the femoral tunnel.He underwent incision and drainage of the abscess which was later complicated by a chronic discharging sinus.Repeated magnetic resonance imaging revealed a fistulous communication between the lateral thigh wound extending toward the femoral tunnel with suggestion of osteomyelitis.Decision was made for a second surgery and the patient was counselled about the need for graft removal should there be intraarticular involvement.Knee arthroscopy revealed the graft to be intact with no evidence of intra-articular involvement.As such,the decision was made to retain the ACL graft.Re-debridement,excision of the sinus tract and removal of Endobutton was also performed in the same setting.Joint fluid cultures did not grow bacteria.However,tissue cultures from the femoral tunnel abscess grew Enterobacter cloacae complex,similar to what grew in tissue cultures from the tibial abscess five years earlier.In view of the recurrent and indolent nature of the infection,antibiotic therapy was escalated from Clindamycin to Ertapenem.He completed a six-week course of intravenous antibiotics and has been well for six months since surgery,with excellent knee function and no evidence of any further infection.CONCLUSION Prompt and accurate diagnosis of surgical site infection following ACL reconstruction,including the exclusion of intra-articular involvement,is important for timely and appropriate treatment.Arthroscopic debridement and removal of implant with graft preservation,together with a course of antibiotics,is a suitable treatment option for extra-articular knee infections following ACL reconstruction.展开更多
Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft a...Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft allows a large dimension sheet of good quality skin with low donor-site morbidity. Also it provides similar skin quality to the recipient areas with much less cosmetic difference. Methods: Four men and eight women underwent neck contracture release and reconstruction from December of 2015 to August of 2016. Mean patient age was 29 years (range from 12 to 46 years). Burn scar contracture releases were performed and cervicoplasty was added for optimal neck appearance. Uniformly full thickness skin grafts were applied. Both lateral ends of these grafts (release incisions) were designed with a fishtail shape for sufficient release and to minimize linear scar band formation in the most lateral region of the neck. Results: Full thickness skin grafts as large as 24 ± 12 cm (in length) and 10 - 15 cm (in width) were used. All grafts were taken without significant complications. Range of neck motion increased, and the cervico-mental angle was regained in all patients. A highly natural neck contour was universally obtained without a secondary debulking procedure. Conclusions: Full thickness skin grafts for treatment of post burn neck contraction give good functional and cosmetic results. They give similar color match and good skin quality, also help in regaining of cervico-mental angle.展开更多
Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be...Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be enough to solve the puzzle and histology remains the mainstay of diagnosis. Aim: Our aim is to highlight the unusual long interval between initial surgery and presentation of foreign body granuloma. Case Presentation: A 65-year-old man who presented 48 years after initial surgery with progressive painless fascia lata donor site soft tissue swelling. The management and histology findings were highlighted. Conclusion: The occurrence of foreign body granuloma remains an important differential following a history of past surgical procedure regardless of the time interval between the surgical procedure and the clinical presentation.展开更多
目的探讨后路PLIF/TLIF手术患者手术部位感染(surgical site infection,SSI)的发病率及病原菌季节变化。方法选择2016年1月~2020年12月在本院接受PLIF/TLIF手术的462例患者作为研究对象,观察SSI发生率。收集患者手术方式(PLIF或TLIF)、...目的探讨后路PLIF/TLIF手术患者手术部位感染(surgical site infection,SSI)的发病率及病原菌季节变化。方法选择2016年1月~2020年12月在本院接受PLIF/TLIF手术的462例患者作为研究对象,观察SSI发生率。收集患者手术方式(PLIF或TLIF)、手术医师、手术季节、手术时间、平均估算失血量、年龄、性别、体质量指数(body mass index,BMI)、美国麻醉医师协会(American Association of anesthesiologists,ASA)分级、医学共病、融合节段等资料,采用卡方检验和多因素Logistic回归分析观察季节因素对SSI的影响。结果462例患者发生SSI 29例,发生率6.28%。不同季节间,夏季SSI发生率高于非夏季手术患者(P<0.05);此外,夏季SSI患者的耐甲氧西林金黄色葡萄球菌检出率显著高于非夏季SSI患者(P<0.05)。多因素Logistic回归分析显示,剔除混杂因素后,夏季是PLIF/TLIF术后发生SSI的独立风险因素(P<0.05);影响SSI发生的其他因素包括糖尿病、融合节段≥2个节段(P<0.05)。结论夏季PLIF/TLIF术后的SSI发生率明显高于其他季节,金黄色葡萄球菌/耐甲氧西林金黄色葡萄球菌感染为常见病原菌。展开更多
基金supported by the Program of Introducing Talents of Discipline to Universities(No.B08003).
文摘Exploration and characterization of grafting productions by experimental methods are often cumbersome or sometimes impossible.Therefore,quantum chemistry calculations were performed to characterize the graft sites of epoxy resin.According to the Gibbs free energy criterion of the second law of thermodynamic,the reported graft sites were confirmed,and more important,some unreported graft sites were found.In addition,method of increasing the number of graft sites was studied in this article.
文摘Full thickness skin grafts and composite grafts are a workhorse in reconstructive surgery of nose and ear defects whether they are originated from trauma, cancer surgery or burns. The reliability of these grafts has been proved with an established clinical use and morbidity to the donor site is minimal if harvesting and donor site selection if appropriate. Use of double or multiple grafts to reconstruct a complex defect of the nose has not been described and our report is meaningful for the fact that it describes a further use of the surgical concept of grafting.
文摘Background: Dressing of split-thickness skin graft donor sites can be traumatic for the patient. The most advanced and expensive dressings have been compared to the most basic of dressings, with little or no consensus and an unpersuasive level of evidence. We aimed to determine the efficacy of the locally manufactured non-adherent, hydroconductive Drawtex? dressing and compare it to our current standard-of-care dressing, a thin transparent polyurethane film, in the healing of split-thickness donor sites. Methods: This prospective, within-patient controlled study included 27 adult participants, each with two split-thickness skin donor sites. The 54 donor site wounds were compared with regard to time to re-epithelialisation, perceived pain and healed wound quality. Results: By day 5, complete healing of donor site wounds, defined as >90% of epithelialized surface, was significantly higher in the hydroconductive dressing group compared to the polyurethane film group (22.2% and 3.7%, respectively;p < 0.0001). The hydroconductive dressing-treated donor site wounds were significantly less painful at 24-hours, 48-hours and 7-days post-operatively, and had fewer complications and superior wound healing quality. Conclusion: We have demonstrated that the relatively cheap and readily available dressing made locally in South Africa, Drawtex? is at least as safe, and potentially superior in wound healing, when compared to our current standard-of-care dressing.
文摘BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of the knee after an ACL reconstruction,and discuss the importance of accurate diagnosis and appropriate management,including the issue of graft preservation versus removal.CASE SUMMARY A 33-year-old gentleman underwent ACL reconstruction using a hamstring tendon autograft with suspensory Endobutton fixation to the distal femur and an interference screw fixation to the proximal tibia.Four years after ACL reconstruction,he developed an abscess over the proximal tibia and underwent incision and drainage.Remnant suture material was found at the base of the abscess and was removed.Five years later,he re-presented with a lateral distal thigh abscess that encroached the femoral tunnel.He underwent incision and drainage of the abscess which was later complicated by a chronic discharging sinus.Repeated magnetic resonance imaging revealed a fistulous communication between the lateral thigh wound extending toward the femoral tunnel with suggestion of osteomyelitis.Decision was made for a second surgery and the patient was counselled about the need for graft removal should there be intraarticular involvement.Knee arthroscopy revealed the graft to be intact with no evidence of intra-articular involvement.As such,the decision was made to retain the ACL graft.Re-debridement,excision of the sinus tract and removal of Endobutton was also performed in the same setting.Joint fluid cultures did not grow bacteria.However,tissue cultures from the femoral tunnel abscess grew Enterobacter cloacae complex,similar to what grew in tissue cultures from the tibial abscess five years earlier.In view of the recurrent and indolent nature of the infection,antibiotic therapy was escalated from Clindamycin to Ertapenem.He completed a six-week course of intravenous antibiotics and has been well for six months since surgery,with excellent knee function and no evidence of any further infection.CONCLUSION Prompt and accurate diagnosis of surgical site infection following ACL reconstruction,including the exclusion of intra-articular involvement,is important for timely and appropriate treatment.Arthroscopic debridement and removal of implant with graft preservation,together with a course of antibiotics,is a suitable treatment option for extra-articular knee infections following ACL reconstruction.
文摘Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft allows a large dimension sheet of good quality skin with low donor-site morbidity. Also it provides similar skin quality to the recipient areas with much less cosmetic difference. Methods: Four men and eight women underwent neck contracture release and reconstruction from December of 2015 to August of 2016. Mean patient age was 29 years (range from 12 to 46 years). Burn scar contracture releases were performed and cervicoplasty was added for optimal neck appearance. Uniformly full thickness skin grafts were applied. Both lateral ends of these grafts (release incisions) were designed with a fishtail shape for sufficient release and to minimize linear scar band formation in the most lateral region of the neck. Results: Full thickness skin grafts as large as 24 ± 12 cm (in length) and 10 - 15 cm (in width) were used. All grafts were taken without significant complications. Range of neck motion increased, and the cervico-mental angle was regained in all patients. A highly natural neck contour was universally obtained without a secondary debulking procedure. Conclusions: Full thickness skin grafts for treatment of post burn neck contraction give good functional and cosmetic results. They give similar color match and good skin quality, also help in regaining of cervico-mental angle.
文摘Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be enough to solve the puzzle and histology remains the mainstay of diagnosis. Aim: Our aim is to highlight the unusual long interval between initial surgery and presentation of foreign body granuloma. Case Presentation: A 65-year-old man who presented 48 years after initial surgery with progressive painless fascia lata donor site soft tissue swelling. The management and histology findings were highlighted. Conclusion: The occurrence of foreign body granuloma remains an important differential following a history of past surgical procedure regardless of the time interval between the surgical procedure and the clinical presentation.
文摘目的探讨后路PLIF/TLIF手术患者手术部位感染(surgical site infection,SSI)的发病率及病原菌季节变化。方法选择2016年1月~2020年12月在本院接受PLIF/TLIF手术的462例患者作为研究对象,观察SSI发生率。收集患者手术方式(PLIF或TLIF)、手术医师、手术季节、手术时间、平均估算失血量、年龄、性别、体质量指数(body mass index,BMI)、美国麻醉医师协会(American Association of anesthesiologists,ASA)分级、医学共病、融合节段等资料,采用卡方检验和多因素Logistic回归分析观察季节因素对SSI的影响。结果462例患者发生SSI 29例,发生率6.28%。不同季节间,夏季SSI发生率高于非夏季手术患者(P<0.05);此外,夏季SSI患者的耐甲氧西林金黄色葡萄球菌检出率显著高于非夏季SSI患者(P<0.05)。多因素Logistic回归分析显示,剔除混杂因素后,夏季是PLIF/TLIF术后发生SSI的独立风险因素(P<0.05);影响SSI发生的其他因素包括糖尿病、融合节段≥2个节段(P<0.05)。结论夏季PLIF/TLIF术后的SSI发生率明显高于其他季节,金黄色葡萄球菌/耐甲氧西林金黄色葡萄球菌感染为常见病原菌。
