[Socioeconomic adjustment in young cleft lip-palate patients]. / Intégration socioéconomique des jeunes adultes opérés de fentes labiomaxillopalatines.

INTRODUCTION: The aim of our study was to evaluate socioeconomic adjustment of young adults after treatment for cleft lip and palate. MATERIALS AND METHODS: A retrospective study was made including patients born from 1975 to 1986 and followed-up in our department. The investigation was based on response to a questionnaire that partly replicated a national survey of social and economic life in the population (standard of living survey Burgundy, Insee France 1999). The control group was constituted by individuals taken from a regional probability sample of households. This report covered education, employment, and marriage. RESULTS: 41 patients were enrolled in this retrospective study and compared to 972 young adults. There was a significant delay in the independence process, regarding housing and marriage. Patients remained in normal limits concerning employment. However the patients' education history showed a significant delay, and a higher rate of vocational courses. DISCUSSION: The independence process showed a significant delay in cleft lip-palate patients, as well as education history. Nevertheless the final socioeconomic adjustment was similar to that of the general population.

[Enteral feeding by nasogastric tube in mandibular fracture osteosynthesis]. / Alimentation entérale par sonde naso-gastrique: intérêt après ostéosynthèse des fractures mandibulaires.

INTRODUCTION: Mandibular fractures are among the most common fractures of the face; their treatment consists in a reduction by intermaxillary blocking then miniplate osteosynthesis. In our unit we systematically insert a nasogastric tube for enteral feeding to improve nutrition and to protect healing. Since the beginning of 2002, a series of patients operated for simple mandibular fractures were fed immediately after the operation by a semiliquid food. The purpose of this work is to verify the real advantage of enteral feeding by nasogastric tube in patients operated for simple fractures of the mandible. MATERIAL AND METHOD: This retrospective study includes all the patients operated for closed fractures of the toothed portion of the mandible from January 1999 to October 2003. There were two series, a first series of patients operated between 1999 and 2002 fed by nasogastric tube until mouth healing and the second series of patients operated between 2002 and 2003 fed by mixed oral-enteral nutrition from the first postoperative day. We analyzed demographic features, time between trauma and operation, type of fracture, feeding modalities, duration of use of the nasogastric tube, duration of hospital stay and postoperative complications. RESULTS: A total of 111 patients were included in the study. The first group of 81 patients fed by nasogastric tubes included 19 women and 62 men with an average age of 29.7 years (from 15 to 81 years). The average time from trauma to operation was 2.3 days (0 to 5 days), the feeding by nasogastric tubes was maintained 5.9 days after the operation (4 to 12 days), the average hospital stay was 7.2 days (5 to 13 days). Eleven immediate complications were observed (13.6%). The second group of 30 patients fed orally the day after the intervention included 7 women and 23 men. The average time from trauma to operation was 2.2 days (0 to 7 days), the average hospital stay was 2.5 days (2 to 3 days). One complication was observed (3.3%). DISCUSSION: Immediate oral feeding the day after the operation for simple closed mandibular fractures provides certain comfort for the patient by avoiding the inconveniences of nasogastric feeding tubes without increasing the rate of postoperative complications such as disunion, delayed healing or infection. The hospital stay is significant shortened, enabling a real cost savings.

How to deal with abdominoplasty in an abdomen with a scar.

Abdominoplasty is a common procedure in plastic surgery. Reviewing 150 patients who underwent abdominoplasty, it has been observed that 72% of the patients already had an abdominal scar. How to deal with abdominoplasty in an abdomen with a previous scar is discussed in this article.

Hand rejuvenescence by fat filling.

The advantages of fat filling for hand rejuvenescence are discussed. Seventy-two patients treated by this method are presented, including their follow-up, complication rate, and details of combined operations. Preference is given to local anesthesia when no other major surgeries are associated with the method. A highly satisfactory rate was obtained (98.62%) with a low complication rate (4.15%).

Umbilical technical maneuvers to facilitate abdominoplasty with limited incisions.

Eighty six cases of abdominoplasty with limited incisions are discussed and the advantages of severing the umbilical stump are stressed.

Emprego de debrisan no tratamento de feridas infectadas. / Use of debrisan in the treatment of infected wounds

Os autores apresentam os resultados de estudo de 20 pacientes portadores de feridas infectadas, de etiologias variadas, submetidos a tratamento topico com debrisan.Metodo simples de tratamento, diminui rapidamente a reacao inflamatoria, a secrecao, e a dor local, acelerando a formacao de tecido de granulacao, permitindo a cicatrizacao espontanea da ferida, e condicoes para sutura ou enxertia da lesao, diminuindo significativamente o tempo de permanencia hospitalar