J Trauma
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Comparative Study
Comparison of blood serum iodine levels with use of Iodoplex and povidone iodine ointment.
Concentrations of iodine were assayed in burn patients, who were covered with Iodoplex ointment up to 30% of their body surface. The iodine levels in the serum were found to be in linear proportion to the area treated with an increase of 30 micrograms iodine per 100 ml of serum for 1% of TBSA. The maximal levels were reached within 24 hours of applying the Iodoplex ointment and decreased quickly following its discontinuation. Concentrations of the iodine were much lower than those found after treatment with povidone iodine, a fact which indicates that using Iodoplex in second-degree burns and donor sites entails fewer possible complications due to high levels of iodine in the serum than with povidone iodine.
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Cutaneous injury caused by exposure to gasoline and other hydrocarbons is a clinical entity with potentially life-threatening effects. We report four cases of such injury. One patient developed full-thickness skin loss following gasoline immersion, and another developed severe systemic complications following contact with a carburetor cleaning solvent. ⋯ In most cases this includes debridement, topical antimicrobial agents, and dressing changes. Severe pulmonary, cardiovascular, neurologic, renal, and hepatic complications may accompany hydrocarbon absorption, particularly in cases involving gasolines containing lead additives. Therefore immediate surgical debridement should be considered if there is suspicion of continued absorption of toxic compounds from the wound.
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Case Reports
Aortic gunshot injury and paraplegia: preoperative definition with arteriography and computerized axial tomography.
Computerized axial tomography provided the diagnosis for an evolving paraplegia in a patient with a gunshot wound of the descending thoracic aorta. Successful surgical management of the aortic injury and considerations regarding the paraplegia are presented. We do not advocate arteriography and computed tomography routinely in major vascular injuries; however, in clinically stable patients with a high suspicion of associated injuries, use of both can be useful.
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Data on venous injury in blunt extremity trauma are scarce. The nature of injury and results of therapy in 22 patients presenting with blunt venous extremity injury at MIEMSS and KUMC in a 10-year period are presented. Comparisons of the outcome with venous ligation and repair, the use of anticoagulants, and the use of fasciotomy, led to the development of guidelines for the therapy of blunt venous injury in both upper and lower extremity trauma.