Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Head traumas frequently occur in polytrauma patients but are also found as isolated injuries. In our hospital trauma center without a neurosurgical department, in a 21-month period, 489 patients with head/brain trauma were treated. This represents 6.5% of all patients treated in the trauma and reconstructive surgery clinic. ⋯ In patients with intracerebral bleeding, bleeding in the dorsal fossa, injury of brain nerves, carotid artery or sinus cavernosus injuries, frontobasal injuries with liquor fistula or pneumonencephalon, transfer of the patients to specialized neurosurgical centers is indicated. With this selection, we obtained the same results in a trauma center without a neurosurgical department as reported in the literature. This avoids overloading neurosurgical centers with head/brain injury patients.
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We report on a 24-year-old female patient with a chronic secretion from an umbilical fistula. We describe the laparoscopic removal of the fistula using two 5-mm and two 10-mm ports.
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Mentosternal contractures still represent a surgical challenge due to their exposed location. They require early operative treatment for both functional as well as aesthetic reasons. ⋯ Between 1987 and 1994, 21 patients with cervical, mentosternal and mentothoracic contractures underwent operative procedures at our clinic. Eight patients underwent a surgical reconstruction with local flaps and 13 patients received a free microvascularized flap.