ABSTRACT
We present a case of severe intractable epistaxis after midfacial trauma in which the bleeding was identified as coming from the descending palatine artery, a branch of the maxillary artery. It could not be controlled by simple packing, and was stopped by inserting a balloon into the maxillary sinus, tamponading the injured vessel in the sphenopalatine fossa (pterigopalatine fossa). We describe an easy and practical emergency manoeuvre to control bleeding from inaccessible branches of the maxillary artery and to prevent rebleeding after embolisation.
Subject(s)
Catheterization/methods , Embolization, Therapeutic/methods , Epistaxis/therapy , Maxillary Artery/injuries , Maxillary Sinus , Adult , Epistaxis/etiology , Facial Injuries/complications , Humans , MaleABSTRACT
Infection of prosthetic vascular grafts, although infrequent, is a dreadful complication in vascular surgery. It is a challenge for the surgeon and is life- and limb-threatening to the patient. Conventionally, infection involving a foreign body is eradicated by removing the foreign body. Despite its theoretical appeal, this solution is fraught with danger--a high mortality rate that ranges between 10% and 30%, a high rate of protracted postoperative morbidity, and a limb amputation rate as high as 70%. The salvage of infected prosthetic vascular grafts by prompt soft-tissue coverage with transposition muscle flaps in 3 consecutive patients treated during a period of 12 years is the subject of this report.
Subject(s)
Blood Vessel Prosthesis/adverse effects , Prosthesis-Related Infections/surgery , Surgical Flaps , Surgical Wound Infection/surgery , Aged , Humans , Male , Middle Aged , Salvage Therapy , Treatment OutcomeABSTRACT
A one-stage surgical correction of tuberous and tubular breast deformities is described. An intraareolar donut of pigmented skin is deepithelialized to correct the associated mega areola, allowing, at the same time, a port of entry for insertion of a retroglandular breast implant. The exposed areolar dermis is then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction, thus pushing the breast tissue against the implant and the chest wall and correcting the deformity. The round-block technique is then utilized to approximate the skin edges, resulting in a minimal scar, totally inconspicuous, confined to the immediate perinipple area.
