9 research outputs found
Nerve compression due to benign tumors or ganglion cysts in the upper limb – case series
Tumor nerve compressions in the upper limb are relatively rare, usually involving ganglion cysts and benign tumors. We present a case series of five patients with peripheral nerve compression in the upper limb due to tumor or cystic masses- ulnar nerve compression in the Guyon’s tunnel due to a ganglion cyst, large median nerve schwannoma compressing anterior interosseous nerve and median nerve, voluminous lipoma compressing median nerve in the proximal forearm, superficial branch of radial nerve compression by a synovial cyst and elbow region lipoma compressing radial nerve. In the beginning, those benign lesions are asymptomatic but, as they continue to grow adjacent to a peripheral nerve clinical manifestations appear progressively as compressive neuropathies. After a preoperative imagistic analysis, tumor resection with careful dissection, in order to preserve the neurovascular structures, is the elective surgical procedure in order to obtain an optimal functional recovery
Candida Infections in Severely Burned Patients: 1 Year Retrospective Study
Infections represent the most common complication occurring during the evolution of the severely burned patient, hence requiring closer study and targeted result analysis. The fungal infections are one of the most aggressive types of existing infections, their opportunistic character enabling them to cause invasive infections, ultimately leading to a higher morbidity and a higher rate of mortality. The present study focuses on the presence of Candida spp. in 19 out of a total of 70 patients admitted to the Critical Care Burn Unit in the Clinical Emergency Hospital Bucharest, between 01.01.2019-31.12.2019. No other fungal species, besides Candida spp., were identified in this patient lot. The aim of this study was to analyze the risk factors and the dynamics of the biological parameters of the patients presenting Candida spp. infections, in order to determine how these contribute to the prognostic and final outcome of these patients. We can conclude that a precise diagnostic and prompt treatment can make a significant difference in the outcome of severely burnt patients presenting with a fungal infection
CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT
Introduction. The field of composite tissue allotransplatation became a clinical reality since first hand
transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications in a selected
group of patients under institutional protocols.
Aim. This paper is an attempt to review the outcomes of VCA to date.
Method. Analysis of relevant publications of composite tissue allotransplantation was performed, including the International Registry on Hand and Composite Tissue Transplantation (IRHCTT).
Results and discussion. To date, there are more than 200 composite tissue allograft transplants performed worldwide, including upper limb, face, larynx, trachea, abdominal wall, lower limb, penis, and
uterus. The technical aspects of VCA are no longer the factors limiting the widespread application of this
treatment modality in the clinical setting. The feasibility of the procedure has been established, and the functional outcomes have been very good so far. The major challenge is at the immunologic level, long-term goal
being to promote donor-specific tolerance and to avoid the toxicity of immunosuppression.
Conclusions. Vascularized composite allografts transplatation is a viable treatment option well on the
way of becoming a standard of care for those who have lost extremities and suffered large tissue defects. The
initial ethical dilemmas and concerns of safety and feasibility have been overcome recently and with further
standardized surgical and immunological protocols the field is likely to grow significantly in the future
Abstract 11.25 EXPERIMENTAL MODELS FOR IMMUNOLOGICAL STUDIES IN VASCULARIZED COMPOSITE ALLOTRANSPLANTATION
Abstract 16.05 VASCULARIZED COMPOSITE ALLOTRANSPLATATION AS THERAPEUTIC STRATEGY FOR BURNED PATIENTS
SESSION V: BASIC RESEARCH AND PLASTIC SURGERY: Step By Step Free Flap Training Based on Inferior Superficial Epigastric Vessels in Rats
SESSION III: EXPERIMENTAL AND TRANSLATIONAL RESEARCH: Preclinical Studies in Vascularized Composite Allotransplantation
Venous Thromboembolism in Burn Patients: A 5-Year Retrospective Study
Background and Objectives: Burn patients manifest all components of Virchow’s triad, amplifying the concern for venous thromboembolism (VTE). Routine prophylaxis for VTE remains a subject of debate, with the central concern being the occurrence of associated adverse events. Materials and Methods: We conducted a five-year retrospective study on burn patients admitted to our burn center. Demographic data, comorbidities, burn lesions characteristics, surgical interventions, anticoagulant medication, the need for transfusions, the presence of a central venous catheter, length of stay, complications, and mortality were recorded. Results: Of the overall number of patients (494), 2.63% (13 patients) developed venous thromboembolic complications documented through paraclinical investigations. In 70% of cases, thrombosis occurred in a limb with central venous catether (CVC). Every patient with VTE had a Caprini score above 8, with a mean score of 12 points in our study group. Conclusions: Considering each patient’s particularities and burn injury characteristics, individualized approaches may be necessary to optimize thromboprophylaxis effectiveness. We suggest routinely using the Caprini Risk Assessment Model in burn patients. We recommend the administration of pharmacologic thromboprophylaxis in all patients and careful monitoring of patients with Caprini scores above 8, due to the increased risk of VTE. Additionally, ongoing research in this field may provide insights into new strategies for managing thrombotic risk in burn patients
Therapeutic principles in upper limb trauma
Upper limb trauma cases vary from simple to high energy impactful injuries, with different etiologies; situations which frequently require unique, demanding and challenging endeavors in order to obtain the most favorable outcome. Experience, good decision-making and knowledge of functional goals are mandatory in order to elaborate a therapeutic plan and execute it accordingly. Although cases differ in nature and prognosis, respecting a set of therapeutic principles whilst dealing with either simple or complex cases, will enhance patient outcome and give the surgeon the confidence to tackle any kind of upper limb trauma. After clearing out vital threat, the emergency surgery represents the first threshold in achieving and restoring normal function and biomechanics, mostly in young and labor active patients, with the mindset to salvage as much tissue as possible, with a thorough debridement and step-by-step approach to different types of tissues. Secondary surgery and reconstructive surgery can be planned timely, with prior discussion with both the therapist and the patient in order to enhance patient’s upper limb function and aesthetic and ensure social reintegration