Pulmonary embolism: even your patient is at risk.

The American Society of Plastic Surgeons' Clinical Guidelines specifically focuses on reducing complications from deep vein thrombosis and pulmonary embolism (PE). The incidence of these problems in plastic surgery is low. A 1998 survey of plastic surgeons found the incidence of deep vein thrombosis and PE in facelift patients to be 0.39% and 0.16% respectively (McDevitt, 1999). Despite the low occurrence of these complications in plastic surgical patients, PE is the third leading cause of death in the United States. PE is evasive and often deadly and therefore requires respect and understanding by all members of the health care team.

Repair and care of chest wall defects.

The formidable challenge of chest wall repair calls upon a multidisciplinary health care approach. The vital organs housed within the chest must be protected and the vascularity of available tissues used for repair must be maintained. Once chest wall reconstruction is complete, the patient must be closely monitored for stability and tissues must be protected from internal and external assaults. The following discussion will review the options for repair and the care of the patient undergoing chest wall defect reconstruction.

BOTOX: a review.

The history of medicine has many amazing stories of odd anecdotes for the treatment of a variety of ailments. Who would have thought that common mold would revolutionize the treatment of infection, or slimy leaches could assist in the resolution of venous congestion? When retching from the effects of food poisoning, or even worse, developing severe paralysis acquired from food contaminated with the anaerobic bacterium Clostridium Botulinum (Botulism), who could have guessed that toxins produced by this bacteria could be used as an effective cosmetic treatment for frown lines and wrinkles? Such is the story of medicine: always inventive and surprising, and sometimes downright odd.

Surgical alternatives for wounds.

Surgical alternatives in wound care are a primary consideration for the treatment of nonhealing and traumatic wounds. Using the Reconstructive Ladder as an outline, this article provides an overview of preoperative wound care and the indications for surgical options in wound care. An overview of nursing care is highlighted as each option is reviewed to include perioperative care of the patient.

Use of hyperbaric oxygen and negative pressure therapy in the multidisciplinary care of a patient with nonhealing wounds.

The case of a 55-year-old woman with nonhealing wounds located on the sternum, abdomen, and lower left extremities is described. The wounds were related to surgical incisions from coronary artery bypass grafting and were complicated by respiratory insufficiency, diabetes mellitus, and infection. This article presents a brief overview of the collaborative care provided in this case and a pictorial review of this patient's wounds during a 4-month period.

A glimpse at the specialty of wound care.

Many lessons have been learned over the course of the history of wound care. The answers to many questions still lie in the future. With this glimpse of where wound care has been and where it is headed in the future, certain trends were found. These trends are, in and of themselves, lessons that will be incorporated into this article as an act of reflection.

Negative pressure wound therapy.

Negative Pressure Wound Therapy, also known as Vacuum Assisted Closure (V.A.C.), is a new treatment in which controlled negative pressure is used to provide evacuation of wound fluid, stimulation of granulation tissue, and a decrease in bacterial colonization. A brief discussion of the physiology of wound healing is accompanied by an explanation of vacuum assisted wound closure. Indications and contraindications for V.A.C. are discussed. The authors present several case studies of patients with nonhealing wounds who benefitted from V.A.C.