Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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Children with burns inflicted by other children represent a small proportion of referrals to our paediatric burns unit. The aim of this paper is to investigate any differences between them. ⋯ Older male children sustained significant burns outside their homes. They reported them as being deliberate assaults, although on closer inspection of the circumstances it was difficult to support their account of the events.
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J Plast Reconstr Aesthet Surg · Jan 2008
Ear reconstruction following severe complications of otoplasty.
Correction of prominent ears is one of the most common operations performed in congenital deformity. Many appropriate corrective techniques have been described. While rare, severe complications destroying ear contours can occur and their correction should follow the established principles of ear reconstruction. ⋯ While more minor contour deformities are correctable with a contralateral conchal cartilage graft, when more than a quarter of the ear or more than two planes of its complex folds are deformed, costal cartilage is recommended for surgical repair. The principles of ear reconstruction should be well understood prior to attempting a repair of severe complications after otoplasty.
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J Plast Reconstr Aesthet Surg · Jan 2008
Continuous postoperative monitoring of cutaneous free flaps using near infrared spectroscopy.
Reliable detection of circulatory compromise threatening free-flap viability is essential for prompt surgical intervention and flap salvage. Numerous techniques have been developed to address the issue of postoperative flap monitoring but none have achieved universal acceptance. Near infrared spectroscopy (NIRS) is a noninvasive technique that allows continuous monitoring of tissue oxygenation and perfusion. It is increasingly recognised to be a reliable method for flap viability assessment. This study was designed to investigate the ability of NIRS to detect and identify microvascular thrombosis endangering flap survival. To our knowledge, this is the first clinical evaluation of NIRS used for continuous monitoring of free flaps. ⋯ Continuous NIRS monitoring can reliably detect and identify early stages of arterial and venous thrombosis, and is a credible method for noninvasive postoperative flap surveillance. Based on these findings, we advocate its use for monitoring of flaps with a cutaneous component.
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J Plast Reconstr Aesthet Surg · Jan 2008
A safe and simple technique using the distal pedicled reversed upper arm flap to cover large elbow defects.
The reconstruction of large soft-tissue defects at the elbow is hard to achieve by conventional techniques and is complicated by the difficulty of transferring sufficient tissue with adequate elasticity and sensate skin. Surgical treatment should permit early mobilisation to avoid permanent functional impairment. Clinical experience with the distal pedicled reversed upper arm flap in 10 patients suffering from large elbow defects is presented (seven male, three female; age 40-70 years). ⋯ Stable defect coverage led to long-term wound stability without any restriction of elbow movement. The lateral and medial upper arm flaps represent a safe and reliable surgical treatment option for large elbow defects. The surgical technique is comparatively simple and quick.
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J Plast Reconstr Aesthet Surg · Jan 2008
Biography Historical ArticleOnce upon a time ... how west discovered east.
One of the most critical advances in modern burns care stemmed from the realisation that morbidity and mortality were significantly reduced if the burn tissue was surgically removed and the resulting surgical wound was closed with autologous skin grafts. This observation derived from the pioneering work of Zora Janzekovic who introduced the burns world to the practice of tangential excision. ⋯ This paper is a personal account of this revolutionary era of burns care. It was presented by Zora Janzekovic herself at the 10th Workshop of the European Club for Paediatric Burns held in Graz, Austria, in the autumn of 2007.