ABSTRACT
Ninety-two retrospective cases of human bite injury referred to a Plastic Surgery department are presented. Particular emphasis is placed on the relationship of alcohol intake to these injuries, their distribution and subsequent management. A review of the literature is conducted. The human bite is a leisure time injury of the young single male in the North East. It has been shown that there is a clear link to alcohol and in particular weekend drinking. Prompt operative intervention and wounds located at the head and neck have been shown to be associated with a decreased risk of subsequent infection, which reflects findings in the earlier literature. Fifteen cases were infected. One was the result of a postoperative complication. The remainder were infected on admission. The majority of infected cases were upper limb bites and were associated with a delayed presentation.
Subject(s)
Alcohol Drinking/epidemiology , Bites, Human/epidemiology , Violence/statistics & numerical data , Adult , Anti-Bacterial Agents/therapeutic use , Debridement , England/epidemiology , Facial Injuries/epidemiology , Female , Humans , Male , Plastic Surgery Procedures , Retrospective Studies , Time Factors , Upper Extremity/injuries , Wound Infection/drug therapy , Wound Infection/epidemiologyABSTRACT
There are reports of patients having normal full term pregnancies following pedicled transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. These are individual cases and there is only limited published evidence to support the safety of pregnancy following surgery of this nature. Little is known about the effects of pregnancy after free tissue transfer, therefore it has been difficult to advise patients, in this situation, what the recommended course of action should be. A report of pregnancy following free TRAM flap breast reconstruction is presented with a review of relevant literature in an attempt to clarify this issue and improve the consent process. We conclude that TRAM flap breast reconstruction is not an obstacle to normal pregnancy and delivery. Patients need to be guided through the potential risks to their health if they should become pregnant, before reconstruction takes place. Obstetric and Oncological Specialists, as part of the multi-disciplinary setting, need to be involved early in pregnancy to further inform and counsel these patients.
