Annals of plastic surgery
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There are numerous methods cited in the literature on the treatment of painful neuroma. Nonsurgical methods range from injections with various materials into the nerve end to desensitization of nerve pain conduction pathways. Some surgical treatments aim to alter the environment of the amputated nerve end by transposing it into muscle or bone, others have designed various flaps to protect truncated nerve ends from scar tissue, and still others try to "cap" the nerve with silicon, a nerve graft, or epineurium to prevent nerve regeneration. ⋯ The authors review the common treatments for painful neuromas. In addition, they review the preliminary results of the extended autologous venous nerve conduit as a novel technique of treating painful neuromas. They also report recent investigations into the pathophysiology of injured nerves.
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Digital block anesthesia with epinephrine, ring technique, and digital tourniquet have been implicated in causing finger gangrene. An extensive review of the literature provided no case of finger gangrene attributed solely to the adjunctive use of epinephrine with lidocaine for digital block. By causing vasoconstriction, epinephrine complements the local analgesic by prolonging the duration of action and providing a temporary hemostatic effect. Epinephrine augmentation of digital block anesthesia was used in the treatment of 23 finger injuries without a complication.
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Annals of plastic surgery · Sep 1997
Review Historical ArticleA historical review of hemostasis, thrombosis, and antithrombotic therapy.
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Annals of plastic surgery · Sep 1992
Review Case ReportsAeromonas hydrophila infections following use of medicinal leeches in replantation and flap surgery.
Aeromonas hydrophila infections are a recognized complication of postoperative leech application, and can occur with measurable frequency in populations of patients treated with leeches. We review 11 previously reported leech-related Aeromonas infections and analyze seven unreported cases. These infections range from minor wound complications to extensive tissue loss and sepsis. ⋯ We also recommend that patients treated with leeches receive antibiotics effective against Aeromonas hydrophila before leech application. Patients treated with leeches and discharged with eschars or open wounds might benefit from oral antibiotic therapy until wound closure. These precautions may minimize or eliminate this complication of leech use.
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An overview of the various methods available for treatment of mandibular fractures is presented; these range from the application of arch bars and intermaxillary fixation alone to open reduction with compression plating. Whenever possible, particularly in young patients, mandibular fractures requiring open reduction are approached transorally.