RESUMO
Fire is a rare but potentially disastrous operating room misadventure. In this article, the authors describe the elements of operating room fires and present an illustrative case. The risk of fire can be minimized when the operating room team understands the interactions among the three sides of the classic fire triangle: oxidizers, fuels, and ignition sources. Lists of fire prevention techniques and steps to take in the event of an operating room fire are provided.
Assuntos
Incêndios , Salas Cirúrgicas , Adulto , Cateterismo , Calázio/cirurgia , Eletrocoagulação , Feminino , Incêndios/prevenção & controle , Incêndios/estatística & dados numéricos , Humanos , Terapia a Laser , Gestão da Segurança , Estados UnidosAssuntos
Mordeduras e Picadas/epidemiologia , Cães , Adulto , Animais , California/epidemiologia , Criança , Cães/classificação , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/etiologia , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/etiologia , Humanos , Incidência , Notificação de Abuso , Estações do Ano , Traumatismos do Punho/epidemiologia , Traumatismos do Punho/etiologiaRESUMO
A simplified approach to subperiosteal midface lifting with suspension is described, which has been performed on 75 patients since 1986. In comparison with standard facelifting, this technique results in long-lasting vertical resuspension of ptotic midfacial tissues. To date there has been a high rate of patient satisfaction with no cases of nerve injury or hematoma. There is a rare incidence of minor complications.
Assuntos
Blefaroplastia/métodos , Periósteo/cirurgia , Ritidoplastia/métodos , Adulto , Blefaroplastia/normas , Ossos Faciais/anatomia & histologia , Músculos Faciais/anatomia & histologia , Músculos Faciais/cirurgia , Nervo Facial/anatomia & histologia , Fáscia/anatomia & histologia , Fasciotomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Ritidoplastia/normas , Fatores de Tempo , Resultado do TratamentoAssuntos
Implantes de Mama , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/cirurgia , Mamoplastia/métodos , Mastectomia Subcutânea/métodos , Técnicas de Sutura , Adulto , Biópsia , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Estadiamento de Neoplasias , Dispositivos para Expansão de TecidosRESUMO
The anatomy of the cervical and marginal mandibular branches of the facial nerve is reviewed. In the senior author's practice, "pseudoparalysis of the marginal mandibular nerve" due to cervical branch injury occurred in 34 of 2002 superficial musculoaponeurotic system-platysma face lifts (1.7 percent) and was associated with a full recovery in 100 percent of cases within a time period ranging from 3 weeks to 6 months. Cervical branch injury can be distinguished from marginal mandibular nerve injury by the fact that the patient will be able to evert the lower lip because of a functioning mentalis muscle.
Assuntos
Traumatismos do Nervo Facial/epidemiologia , Paralisia Facial/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Ritidoplastia/efeitos adversos , Traumatismos do Nervo Trigêmeo , Adulto , Estudos Transversais , Traumatismos do Nervo Facial/etiologia , Paralisia Facial/etiologia , Feminino , Seguimentos , Humanos , Lábio/inervação , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Remissão Espontânea , Ritidoplastia/estatística & dados numéricos , Sorriso/fisiologiaRESUMO
Leg amputations are associated with marked morbidity and mortality in the atherosclerotic population. The survival in patients undergoing lower extremity amputations is 50% at 3 years and 30% at 5 years. Despite excellent reported results with pedal bypass, some patients are "nonbypassable" with traditional techniques because of very small, short target vessels in the pedal arch. The authors report six cases of microscope-assisted inframalleolar bypass using autogenous artery in 5 patients presenting with threatened limb loss, with 83% graft patency at 52 months average follow-up. They hypothesize that the success in these patients is the result of less surgical trauma and less compliance mismatch at the distal anastomosis, and perhaps the result of vasoactive substances secreted by the arterial grafts. Microscope-assisted pedal bypass with autogenous artery should be considered for "nonbypassable" patients with tissue necrosis or rest pain who do not appear to have sufficient inflow to heal a forefoot amputation.
