- Use of a vascularized dorsal sensory branch of an ulnar nerve flap for repairing a proper digital nerve with coverage of a volar soft tissue defect: Report of two cases. [Case Reports]
- MMicrosurgery 2019 Jul 17
- To repair a short nerve gap, autograft, allograft, autogenous, or synthetic conduits are selected, but a vascularized nerve autograft is preferred to obtain a reliable postoperative outcome in the ca…
To repair a short nerve gap, autograft, allograft, autogenous, or synthetic conduits are selected, but a vascularized nerve autograft is preferred to obtain a reliable postoperative outcome in the case of an unfavorable wound bed. The purpose of this report is to describe and evaluate two cases of repair of a proper digital nerve and volar soft tissue defect with a vascularized dorsal sensory branch of an ulnar nerve flap. The cases of two men, 40 and 20 years old, who suffered index finger defects due to crush lacerations that required a flap and a nerve graft, are presented. A 4.0 cm × 2.0 cm and a 3.2 cm × 1.6 cm flap, which were nourished by the perforators from the ulnar proper digital artery of the little finger, were elevated from the ulnar side of fifth metacarpal bone head and transferred for coverage of the soft tissue defect. A 4.6-cm and a 3.0-cm vascularized nerve graft was interposed in the nerve gap. The patients' postoperative courses were uneventful, and both patients had no complaints related to the donor site. Static and moving two-point discrimination were 8 and 6 mm, respectively, at 6 months after surgery in the first case and 5 and 3 mm, respectively, at 9 months after surgery in the second case. This flap, which could be elevated in the same operative field with a nerve having similar diameter to that of the proper digital nerve, was useful for repair of a finger volar tissue defect.
- The Bridge Occlusion Balloon for Venous Angioplasty in Superior Vena Cava Occlusion. [Case Reports]
- BJBraz J Cardiovasc Surg 2019 Jun 01; 34(3):368-371
- The Bridge Occlusion Balloon is a compliant balloon, specifically designed for temporary Superior vena cava occlusion in case of Superior Vena Cava laceration during lead extraction procedures. We he…
The Bridge Occlusion Balloon is a compliant balloon, specifically designed for temporary Superior vena cava occlusion in case of Superior Vena Cava laceration during lead extraction procedures. We here report the first case, using Bridge Occlusion Ballon for a venous angioplasty in a patient with dysfunctional pacemaker leads and symptomatic Superior Vena Cava occlusion. After successful lead extraction, venography was showing a narrow venous canal. Therefore, venous angioplasty using the Bridge balloon was performed. Especially for high-risk lead extraction cases in patients with Superior Vena Cava stenosis, the Bridge Occlusion Ballon might be used as a combination of a safety-net in case of Superior Vena Cava perforation and for Superior Vena Cava angioplasty.
- Assessment of tear meniscus by optical coherence tomography in patients with canalicular laceration repair. [Journal Article]
- IOInt Ophthalmol 2019 Jul 15
- CONCLUSIONS: Tear meniscus measurement with OCT is a rapid, quantitative and objective tool for evaluation of canalicular patency in patients with canalicular laceration repair.
- Hand injuries associated with reaching into a snow blower to clear clogged snow. [Journal Article]
- AJAm J Emerg Med 2019 Jul 03
- CONCLUSIONS: Hand injuries remain the main threat of injury among snow blower operators. While trends are declining, given the seriousness of the injuries involved, further public health education campaigns and design modifications are warranted.
- Bringing the end-of-the-bed assessment to the multidisciplinary team in outpatient pre-tibial laceration management. [Letter]
- JPJ Plast Reconstr Aesthet Surg 2019 Jun 27
- Comparison of ultrasound and physical examination with computerized tomography in patients with blunt abdominal trauma. [Journal Article]
- UTUlus Travma Acil Cerrahi Derg 2019; 25(4):369-377
- CONCLUSIONS: Even though US is a reliable method for the determination of the intraabdominal fluid, US and physical examination are not reliable in the determination of the organ injuries as compared to CT.
- Steel rod impalement injuries involving the spine: A case report and literature review. [Case Reports]
- UTUlus Travma Acil Cerrahi Derg 2019; 25(4):417-423
- Steel rod impalements, mostly experienced by construction workers due to falls from heights, are known entities, but only some individuals unfortunately suffer spinal cord injury. The management of t…
Steel rod impalements, mostly experienced by construction workers due to falls from heights, are known entities, but only some individuals unfortunately suffer spinal cord injury. The management of the spine involved injuries is challenging due to the lack of guidelines, various clinical presentations resulting from different trajectories, and high risk of infection. We report a case of steel rod impalement involving the spinal canal and review the literature to enhance the management strategies and to identify the risk factors for possible complications, particularly infection. A 37-year-old male construction worker presented to our emergency department due to falling onto a concrete reinforcing steel rod that penetrated through his perineum to the L4 vertebra. Examination revealed paralysis and sensory loss of the left foot. The rod was removed in the operating room (closed removal) under general anesthesia, followed by laparotomy. Rectal laceration was primarily repaired, and colostomy was performed. In a separate session, laminectomy was performed. At 3 months post-discharge, the patient was ambulatory with armrest based on the same motor examination performed on presentation This case is a good example of careful preoperative planning, multidisciplinary involvement, and appropriately sequenced interventions resulting in an acceptable outcome for an injury with high morbidity and mortality and demonstrates the feasibility and potential benefits of closed removal of the rod in an operating room just before laparotomy. The presence of an intestinal perforation increases the infection risk, but infections can still be prevented in this setting. Shorter time intervals between the incidence and surgery may reduce the infection rate.
- Spontaneous transvaginal small bowel evisceration following hysterectomy: a case report. [Case Reports]
- UTUlus Travma Acil Cerrahi Derg 2019; 25(4):424-426
- Transvaginal small bowel evisceration is a rare, life-threatening condition, requiring urgent surgical intervention. In our case, ischemia developed in the intestinal segment with evisceration, with …
Transvaginal small bowel evisceration is a rare, life-threatening condition, requiring urgent surgical intervention. In our case, ischemia developed in the intestinal segment with evisceration, with a laceration in the small intestine of the mesentery, and finally, a small bowel resection was required. An 89-year-old woman was brought to the hospital with a sudden onset of abdominal pain, which lasted for 4 hours. Upon the examination, it was found that approximately 50 cm of the small intestine was eviscerated from the vagina, with its mesentery. The intestines were edematous, and also there were signs of ischemia on the mesentery. The patient was urgently transferred to surgery. Functional end-to-end anastomosis was performed, following a 70 cm small bowel resection. The vaginal defect was repaired transvaginally. Transvaginal small bowel evisceration is rarely described in the literature. It is most commonly seen in postmenopausal, elderly women who underwent vaginal surgery before and who have enterocele. The treatment is an emergent surgical approach. Surgical treatment should be based on individual patient. Various surgical techniques have been described for the repair of transvaginal small bowel evisceration, such as vaginal, abdominal, laparoscopic, and combined approaches. Transvaginal small bowel evisceration should be considered in the differential diagnosis of patients with a sudden onset abdominal pain. Patients with an increased risk for transvaginal small bowel evisceration are postmenopausal women and patients who underwent vaginal surgery before. After the accurate diagnosis, patients should be operated as soon as possible, and necessary surgery should be done.
- Innovative cost-effective method to repair lacrimal cannaliculi laceration - finding proximal end and stent. [Case Reports]
- GOGMS Ophthalmol Cases 2019; 9:Doc20
- CONCLUSIONS: The reported surgical technique is a very cost-effective option for lacrimal canalicular laceration repair.
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- Safety and complications of medical thoracoscopy in the management of pleural diseases. [Journal Article]
- BPBMC Pulm Med 2019 Jul 10; 19(1):125
- CONCLUSIONS: Medical thoracoscopy is generally a safe and effective method, not only in the diagnosis of undiagnosed pleural effusions, but also in the management of pleural diseases. Mastering medical thoracoscopy well, improving patient management after the procedure and attempts to reduce the occurrence of post-procedural complications are the targets that physicians are supposed to achieve in the future.