ABSTRACT
Facial injuries are cause of consultation in emergency departments. The maxillofacial region contains several structures that are vital for life. Hence, an early assessment and management of facial injuries is important to avoid their consequential complications and eventual mortality. This article is a review of the literature about the emergency clinical assessment and management of traumatic facial injuries by non-specialists.
Subject(s)
Humans , Patient Care Management/methods , Emergency Service, Hospital , Facial Injuries/therapy , Facial Injuries/diagnostic imaging , Injury Severity Score , Facial Injuries/physiopathologyABSTRACT
OBJECTIVE: After burn injuries, scarred skin lacks elasticity, especially in hypertrophic scars. Topical treatment with tretinoin can improve the appearance and quality of the skin (i.e., texture, distensibility, color, and hydration). The objective of this prospective study was to examine the effects of treatment with 0.05 percent tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring. Setting: Tertiary, Institutional. METHOD: Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected. Skin biopsies were obtained initially and after one year of treatment. The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system. The density of collagen fibers, elastic fibers, and versican were determined using immunohistochemical analysis. RESULTS: Tretinoin treatment significantly lowered skin resistance and elastance, which is a result that indicates higher distensibility of the skin. However, tretinoin treatment did not significantly affect the density of collagen fibers, elastic fibers, or versican. CONCLUSION: Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients.
Subject(s)
Adolescent , Adult , Female , Humans , Young Adult , Burns/complications , Cicatrix, Hypertrophic/drug therapy , Elasticity/drug effects , Facial Injuries/drug therapy , Keratolytic Agents/therapeutic use , Tretinoin/therapeutic use , Administration, Topical , Biomechanical Phenomena/drug effects , Cicatrix, Hypertrophic/pathology , Cicatrix, Hypertrophic/physiopathology , Facial Injuries/pathology , Facial Injuries/physiopathology , Prospective Studies , Skin/drug effects , Skin/pathology , Skin/physiopathology , Treatment OutcomeABSTRACT
Los nuevos programas en tomografía computada moderna ("slip-ring") permiten obtener rápidamente imágenes de alta resolución y lograr reconstrucciones multiplanares, volumétricas y tridimensionales. Estas propiedades pueden usarse en el estudio de pacientes con traumatismos o anomalías faciales. Hemos analizado la información obtenida con imágenes reconstruidas en tercera dimensión por tomografía computada (TC-3D) en pacientes con traumatismos faciales y la comparamos con la obtenida con imágenes de cortes en los planos coronal y axial
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Edema/diagnosis , Face/physiopathology , Facial Bones , Facial Injuries/physiopathology , Image Processing, Computer-Assisted , Surgical Procedures, Operative , Tomography, Emission-Computed/methodsABSTRACT
Nuevos logros en la fisiopatología traumática en los niños hasta los 18 años de edad han modificado la concepción terapéutica de los traumatismos craneoencefalicos. Los nuevos conceptos corresponden a congestión cerebral como respuesta inicial al trauna; la clara diferencia de trauma primario y trauma secundario; la ubicación del trauma del tallo cerebral dentro de los traumas secundarios y la derivación de una terapéutica más agresiva de acuerdo a estas nuevas concepciones y al monitoreo de la hipertensión endocraneana, cuando ella está indicada, según la escala de Glasgow