Articles: surgery.
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Comparative Study
A comparison of optical and electromagnetic computer-assisted navigation systems for fluoroscopic targeting.
Freehand targeting using fluoroscopic guidance is routine for placement of interlocking screws associated with intramedullary nailing and for insertion of screws for reconstruction of pelvic and acetabular injuries. New technologies that use fluoroscopy with the assistance of computer guidance have the potential to improve accuracy and reduce radiation exposure to patient and surgeon. We sought to compare 2 fluoroscopic navigation tracking technologies, optical and electromagnetic versus standard freehand fluoroscopic targeting in a standardized model. ⋯ Both optical and electromagnetic computer-assisted guidance systems have the potential to improve accuracy and reduce radiation use for freehand fluoroscopic targeting in orthopaedic surgery.
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Clinical Trial
The new generation polestar n20 for conventional neurosurgical operating rooms: a preliminary report.
The objective of this work is to present the preliminary clinical experience we acquired in using the new PoleStar generation, N20 (Medtronic Navigation, Louisville, CO), in a modified conventional operating room. ⋯ The acquisition of the PoleStar N20 opened new horizons in the treatment of our patients. This novel, compact, intraoperative magnetic resonance imaging scanner can be installed in a standard operating room without major modifications. Standard surgical instruments can be used. Intraoperative magnetic resonance imaging provided valuable information that allowed intraoperative modification of the surgical strategy.
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Effective treatment of perioperative acute pain requires that information about the patient's goals for pain relief, previous history with analgesics, and type of surgical procedure is used to guide decisions about analgesic regimens. Analgesics are selected based on the location of surgery, degree of anticipated pain, and patient characteristics (such as comorbidities), and routes of administration and dosing schedules are determined to maximize the effectiveness and safety of analgesia while minimizing the potential for adverse events. ⋯ To accomplish this, nurses must have a thorough understanding of the pharmacology of analgesics. This article provides useful information for commonly used analgesics, primarily nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and local anesthetics for control of acute postoperative pain.
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Annals of plastic surgery · Mar 2008
ReviewA critical evaluation of the use of Biobrane as a biologic skin substitute: a versatile tool for the plastic and reconstructive surgeon.
Biobrane and Biobrane-L are becoming increasingly popular in the management of superficial and moderate-depth partial-thickness burns, particularly in pediatric patients. When used appropriately, they have been shown to reduce pain levels, healing time, inpatient stay, and nursing requirements when compared with traditional dressings. In this manuscript, we provide a critical evaluation of the evidence base for the varied uses of Biobrane within the field of plastic and reconstructive surgery. ⋯ Biobrane is a versatile biosynthetic wound dressing. There is good evidence (Grade A) to support the use of Biobrane in the management of burns, particularly in partial-thickness burns in children. Biobrane also has many potential uses as a dressing outside the burns unit of which we feel reconstructive surgeons should be aware. Conditions resulting in disruption of the epidermis such as toxic epidermal necrolysis (TEN) and paraneoplastic pemphigus have been managed successfully using Biobrane (Grade B). Biobrane has also been successfully used following dermabrasion, skin-graft harvesting, and laser resurfacing (Grades B to C). Temporary coverage with Biobrane has been successfully used in individuals with chronic wounds such as open sternotomy sites and venous ulcers (Grades B to C). Biobrane has a wealth of potential uses outside its traditional remit; however, further prospective clinical trials are warranted if these new applications are to become more widely accepted.