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Site Complications (site + complications)
Selected AbstractsSmallpox vaccination site complicationsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Kirk H. Waibel MD The typical resolution of the smallpox vaccination site is a smooth scar, a sequela that is discussed during prevaccination counseling. In addition, other types of lesion may develop at the scar site, including short- or long-term benign and malignant changes, as reviewed below. Although current recommendations do not discuss potential scar complications or scar surveillance, healthcare providers would benefit from an awareness of these potential complications, and should consider periodic scar surveillance as part of a general physical examination. [source] The Radial Approach: Is This the Route to Take?JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2008M.R.C.P., SUDHIR RATHORE M.D. The benefits of the transradial approach have clearly been demonstrated over the years in various studies. The reduced incidence of access site complications and early mobilization are some of the benefits making this technique popular with interventional cardiologists worldwide. With increasing experience and availability of dedicated equipment this technique is now been increasingly used for complex catheter interventions. However, there still remain some potential problems and complications with the transradial approach and it needs further research. The main purpose of this review is to highlight the benefits, complications, and potential problems with the transradial approach. [source] Percutaneous Left and Right Heart Catheterization in Fully Anticoagulated Patients Utilizing the Radial Artery and Forearm Vein: A Two-Center ExperienceJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2006TED S. N. LO M.R.C.P. Background: Stopping oral anticoagulants prior to cardiac catheterization is associated with an increased risk of thromboembolism. Performing the procedures via the femoral artery and vein without interruption of anticoagulation is associated with a high rate of major access site complications. The transradial technique for left heart catheterization is safe in fully anticoagulated patients but few data are available on the percutaneous right and left heart catheterization utilizing a combination of the radial artery and antecubital vein in this group of patients. Methods: We report our experience in 28 consecutive patients that underwent left and right heart catheterizations via this percutaneous arm approach without interruption of anticoagulation. These were compared to 31 consecutive non-anticoagulated patients that underwent the procedure via a conventional femoral artery and vein approach. Results: Arterial and venous accesses were achieved and complete angiographic and hemodynamic data obtained in all patients. There were no access site complications in the anticoagulated patients despite an International normalized ratio (INR) of 2.5 ± 0.5. Procedural duration was longer in the anticoagulated group of patients, but fluoroscopy time and patient radiation dose were similar in both groups. Conclusion: Our experience suggests that left and right heart catheterization can be safely performed in most fully anticoagulated patients using this technique with a low bleeding and thromboembolic risk and no increase in radiation exposure. [source] Reconstruction of the Through-and-Through Anterior Mandibulectomy Defect: Indications and Limitations of the Double-Skin Paddle Fibular Free Flap,THE LARYNGOSCOPE, Issue 8 2008Frederic W.-B. Abstract Objectives/Hypothesis: The purpose of this report is to describe our recent experience using a double-skin paddle fibular free flap (DSPFFF) for reconstruction of the through-and-through anterior mandibulectomy defect and to present a reconstructive algorithm based on the extent of lip and mental skin resection. Study Design: Retrospective review of 10 consecutive patients with through-and-through anterior mandibulectomy defects. Methods: Outcomes that were examined included methods of reconstruction based on the cutaneous defect, flap complications, fistula rate, and donor site complications. Results: Seven patients were reconstructed with a DSPFFF. For lip reconstruction, two patients were also concomitantly reconstructed with Karapandzic or lip advancement flaps. Three patients were reconstructed with both a fibular free flap and a second free flap (1 radial forearm fasciocutaneous flap and 2 anterolateral thigh flaps). The transverse dimensions of the DSPFFFs were as great as 15 cm. None of the patients developed a fistula. All free tissue transfers were successful. One patient developed partial loss of the fibular skin paddle used for submental skin replacement. Conclusions: DSPFFF is a safe and reliable way to reconstruct an anterior through-and-through mandibular defect. Indications for using a DSPFFF are 1) a cutaneous defect that lies at or below the plane of the reconstructed mandible, 2) a transverse width of the oral mucosa and cutaneous defect that does not exceed 15 cm (the approximate distance from the mid-calf to the anterior midline), and 3) a lip defect that, if present, can be reconstructed with local flaps. [source] Radial Forearm Osteocutaneous Free Flap in Maxillofacial and Oromandibular ReconstructionsTHE LARYNGOSCOPE, Issue 9 2005J H. Kim MD Abstract Objectives/Hypothesis: The radial forearm osteocutaneous free flap is an excellent reconstructive modality for oromandibular and maxillofacial reconstruction in certain well-defined circumstances. The initial concern over donor site morbidity and the ability of the bone to reconstruct mandibular defects have led to only a few published series. Study Design: Retrospective study of the experience of two tertiary medical centers with radial forearm osteocutaneous free flap. Methods: Retrospectively, 52 patients were studied who underwent radial forearm osteocutaneous free flap reconstruction for cancer (49 cases) and trauma (3 cases). Bone length and skin paddle harvested, general morbidity (hematoma, wound infection, and dehiscence), recipient site morbidity (nonunion of neomandible, flap failure, and bone or plate exposure), and donor site morbidity (radius bone fracture, plate exposure, and skin graft failure) were reviewed. Results: The average skin paddle size was 55.1 cm2 (range, 15,112 cm2). The average radius bone harvest length was 6.3 cm (range, 2.5,11 cm). Donor site complications included tendon exposure (3 cases), radius bone fracture (1 case), and exposure of the plate (0). Recipient site complications included nonunion of the mandible (4), exposed mandible (1), exposed mandibular plates (2), exposed maxillary plates or bone (0), venous compromise (1), and flap failure (1). Two patients had perioperative deaths. Conclusion: Radial forearm osteocutaneous free flap is a valuable and viable option for oromandibular and maxillofacial reconstruction. [source] |