Plastic and reconstructive surgery
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Malignant hyperthermia is a seemingly rare genetic myopathy. Hypermetabolic crisis accompanied by a rise in body temperature to as high as 44 degrees C is its hallmark. Malignant hyperthermia is usually triggered by potent inhalated anesthetics and/or depolarizing muscle relaxants. ⋯ The contracture study was positive in all patients studied. No anesthetic or surgical complications were encountered. This study demonstrates that patients at risk of developing malignant hyperthermia crisis can have plastic surgical procedures performed safely while undergoing appropriately selected general anesthesia.
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Plast. Reconstr. Surg. · Aug 1988
Case Reports Historical ArticleMaqua (therapeutic burn) as an indicator of underlying disease.
The origin and nature of the maqua (the Arabic therapeutic burn) is presented together with our clinical experience of patients previously treated by this traditional method. Maquas are small deep burns inflicted in areas either in proximity to a diseased organ or in points related traditionally to the original basic problem. ⋯ Maquas alone only rarely present a threat to the patient, but in many cases they may serve as an indicator of the original underlying disease. This and other folklore treatment modalities, together with the healers themselves, should be acknowledged by us, as markers for health problems or maybe for potential healing methods and doctor-patient relationships.
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Plast. Reconstr. Surg. · Jul 1988
Case ReportsClinical application of autologous cultured epithelia for the treatment of burn wounds and burn scars.
This report presents our experience with autologous cultured human epithelia grafting on burn wounds, burn scars, and skin-graft donor sites in seven patients. Dispersed epidermal cells were cultured with 3T3 cells treated with mitomycin C. After 2 to 3 weeks, cultured epithelia (total 350 to 2250 cm2) were grafted to the wound. ⋯ A rete ridge and the adnexal structures were absent in the specimens that adhered to the burn wounds. However, in the specimens that took on abraded wounds, a gently sloping rete ridge and elastic fibers were seen. The histologic findings showed structures resembling normal skin.
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Plast. Reconstr. Surg. · May 1988
Randomized Controlled Trial Comparative Study Clinical TrialComparison of midazolam and diazepam for sedation during plastic surgery.
A randomized double-blind study was designed to compare midazolam, a rapid-acting water-soluble benzodiazepine, with diazepam for sedation when administered as an adjuvant to ketamine during local anesthesia. In the preliminary dose-ranging study, midazolam (0.05 to 0.15 mg/kg IV) was found to produce a spectrum of central nervous system activity (e.g., sedation, amnesia) that was similar to diazepam (0.1 to 0.3 mg/kg IV). However, the slope of midazolam's dose-response curve for sedation appeared to be steeper (i.e., a narrower therapeutic dosage range). ⋯ Midazolam was associated with significantly less pain on injection and a lower incidence of postoperative venoirritation. Overall patient acceptance was higher with midazolam compared to diazepam. Finally, recovery characteristics were similar for the two benzodiazepines in our outpatient setting.