Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Oct 2015
Parallel pocket incision: Less invasive surgical intervention for the treatment of intractable pressure ulcer with wound edge undermining.
The treatment of deep pressure ulcer with a wide wound edge undermining (pocket) is challenging, especially when conservative treatments are ineffective. As most patients with a pressure ulcer suffer from systemic comorbidities, invasive surgery cannot be performed on all patients, and less invasive treatment is required. ⋯ PPI is a simple, technically easy, and less invasive surgical intervention to an intractable pressure ulcer with a pocket, which can be safely performed under local infiltration anesthesia even on a patient with severe systemic comorbidities.
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J Plast Reconstr Aesthet Surg · Sep 2015
Perfusion dynamics in lower limb reconstruction: Investigating postoperative recovery and training using combined white light photospectroscopy and laser Doppler (O2C(®)).
Postoperative regimes designed to acclimatise lower limb free flaps to the changing flow dynamics of standing (flap training exercises) are widely employed despite a paucity of evidence for their use. This study utilises non-invasive monitoring of perfusion parameters to investigate flap training at the microcirculatory level. ⋯ Prior to flap training, lower limb dependency causes reduced oxygenation, increased venous pooling and decreased flow consistent with venous congestion. Following a three day training regime, flap perfusion begins to accommodate for these changes. These findings provide a rationale for flap training, although further work is required to explain the mechanisms.
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J Plast Reconstr Aesthet Surg · Sep 2015
Soft tissue reconstruction after compound tibial fracture: 235 cases over 12 years.
Outcomes in management of compound tibial fractures are measured by the rate of infection and non-union. These are a function of many variables that interact in complex ways. Our aims are to describe changes in these injuries over the past decade, to determine which variables predict a poor outcome and to compare reconstructive options controlling for these variables. ⋯ Therapeutic III.