Multiple Reconstructive Procedures Research Articles

Accidental Formaldehyde Injection in Cosmetic Blepharoplasty

Formaldehyde was accidentally injected into the eyelids of a woman undergoing blepharoplasty, causing severe lid damage that required multiple reconstructive surgical procedures. Report of a Case. —A 59-year-old woman underwent cosmetic blepharoplasty at a surgical center. A nurse in the operating room mistakenly filled the syringes with formaldehyde from a pathologic specimen bottle that was on the operating table. The surgeon, believing that the solution was lidocaine hydrochloride, injected it subcutaneously into all four eyelids. Apparently, he realized the mistake immediately after-ward but proceeded with the blepharoplasty. I first examined the patient in October 1985, 5 weeks postoperatively. Her eyelids and medial and lateral canthi were extremely swollen, erythematous, excoriated, and necrotic (Fig 1). She had difficulty in opening her eyelids. Palpebral fissure widths were 0 mm OD and 2 mm OS. Her visual acuity was 20/40 OU. I continued treatment with the topical and systemic antibiotics she was using

Accidental Farm Injuries in Children

Eighty-seven children with 88 farm injuries presented to our emergency room in Rochester, Minn, from November 1974 to July 1985. Seventy-four accidents (84.1%) occurred in boys, and 14 (15.9%) in girls. Ages ranged from 1 to 16 years. Farm machines involved included corn augers in 37 accidents (42.0%); tractors, 22 (25.0%); power takeoffs, ten (11.4%); conveyor belts, five (5.7%); and miscellaneous, 14 (15.9%). Fractures and lacerations were the most common injuries, occurring in 55 (62.5%) and 30 (34.1%), respectively. Significant long-term disability occurred in 36 (40.9%). Eleven children required multiple reconstructive surgical procedures; two died. Preventive measures that can be employed by physicians, family members, educators, and legislators are discussed.

工作機械によるきょう部全層欠損 Ｄ‐Ｐ皮弁，前頭島状皮弁による再建の１例

Nowadays, facial trauma is getting much more complicated and severed along with the social factors.Progress in surgical, anesthetical and medical ambulatory care has made it possible to save severely injured patients. Such life-threatening forces also cause severe facial trauma and cases needing more complex treatment plans arc increasing.In this paper, a case of a 44 year old male treated with multiple reconstructive procedures is presented.The patient was caught in to an iron-work machine by his left forearm and had an abulsed right malar area. After first aid for life was given, he was transfered to our department. The extent of injury was confirmed to be a rt. cheek full-thichness defect, partial loss and fractures of maxilla and mandible, multiple facial lacerations and burns through the first operation included wound debridement and primary maxillary and mandiblar reduction and fixation.One month later, the facial defect settled to 6 × 9 cm and segmental loss of rt. mandible was evident. D-P flap and forehead island flap reconstruction for cheek defect, mandibular repair with Vitallium® cast splint and iliac bone graft, transposition of parotid duct to oropharynx were performed.Through 4 separate operations over 20 hours, good functional and cosmetic reconstruction was aquired.

Modified bilobular (“gemini”) pectoralis major myocutaneous flap

The bilobular or gemini type of pectoralis major myocutaneous flap evolved from a desire to simplify the closure of large surgical defects of both mucosa and skin that could not be satisfactorily closed primarily. Previously, such defects often required combined or multiple reconstructive procedures such as myocutaneous and deltopectoral flap operations. The mucosal and skin defects are closed by two skin paddles supported by a single muscular vascular pedicle. The skin paddles are fashioned side by side and separated from each other as the muscle is folded between them parallel to the vascular axis. All of the defects were successfully closed and the major portion of all grafts survived. This operation permits single-stage reconstruction after ablation of tumors or treatment of complications which produce large through-and-through mucocutaneous defects of the head and neck area.

Combined wrist arthrodesis and metacarpophalangeal joint arthroplasty in rheumatoid arthritis.

This paper describes a surgical procedure which combines wrist arthrodesis and metacarpophalangeal joint arthroplasty into one operation. Its basic indication is the severely crippled rheumatoid patient who is faced with multiple reconstructive surgical procedures. In addition to the combined wrist fusion and metacarpophalangeal joint arthroplasty, other surgical procedures can sometimes be performed into same hand, thereby completing the entire reconstruction in one operation. Of the 19 patients who have undergone the combined procedure, only one failed to obtain a solid clinical arthrodesis. There were no infections, skin sluffs or other complications. Combining the two procedures did not jeopardize either wrist fusion or metacarpophalangeal joint arthroplasty. Specific contraindications for the procedure are fixed wrist flexion contracture or a complete dislocation requiring extensive exposure in order to align or reduce the radiocarpal joint.

Thrombocytopenia and its management in the surgical patient needing multiple reconstructive procedures

Thrombocytopenia and its management in the surgical patient needing multiple reconstructive procedures

Thrombocytopenia and its management in the surgical patient needing multiple reconstructive procedures

Thrombocytopenic patients with surgically correctable lesions such as radial clubhands are too often repeatedly transfused with randomly pooled platelets. This is followed by a clinical rejection of the foreign protein and rapid destruction of the platelets. There may be excessive bleeding episodes. Tissue typing technics now available can provide antigenically compatible platelet concentrates which elicit few of these reactions. Therefore, multiple reconstructive procedures can be achieved with a greater safety margin than previously possible.

Restoration of Hand Function by the Use of Partial or Total Prosthetic Replacement

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