Contraction rates of meshed, nonexpanded split-thickness skin grafts versus split-thickness sheet grafts.

Contraction rates of wounds covered by meshed, nonexpanded split-thickness skin grafts were compared with split-thickness sheet-grafted wounds in a porcine model. No significant difference was found in wound contraction. When compared with previous studies, this study shows that differences in contraction previously observed were not a result of meshing and suggests that expansion may be the cause of the difference previously observed.

Comparative accuracy of diagnostic peritoneal lavage, liver-spleen scintigraphy, and visceral angiography in blunt abdominal trauma.

Diagnostic peritoneal lavage (DPL), liver-spleen scintigraphy (LSS), and visceral angiography (VA) have been cited as useful in the evaluation of patients sustaining blunt abdominal trauma to determine the existence of injuries requiring operative intervention. We have reviewed the clinical courses of 44 patients who sustained blunt abdominal trauma and had various combinations of DPL, LSS, and VA employed in their diagnostic evaluation. The predictive value and efficiency of these tests have been compared in this group of patients. DPL is sensitive and specific for the presence of intraperitoneal blood. LSS is sensitive and specific for parenchymal irregularity in the liver and spleen. VA is sensitive and specific for vascular abnormality, severe hemorrhage, and arteriovenous shunting. None of these tests are completely sensitive and specific for the spectrum of surgically significant injuries produced by blunt abdominal trauma. In this group of patients who had multiple studies because of diagnostic uncertainty, DPL had the highest predictive value and the highest efficiency. LSS results did not by themselves dictate a change in management for any patient. In some patients VA was helpful in determining operative or nonoperative management.