RESUMO
Alcohol use is a risk factor for head and neck cancer. One of the primary therapeutic modalities is surgical tumor ablation followed by immediate reconstruction. Such therapy places patients in a controlled environment, without alcohol, creating the risk of alcohol withdrawal syndrome. The authors attempted to identify the incidence of alcohol withdrawal among patients undergoing free-flap reconstruction for head and neck cancer and were interested in the effect of alcohol withdrawal on the postoperative course of affected patients. In this retrospective review of 51 patients, six experienced alcohol withdrawal or delirium tremens. No difference in the rate of overall complications was seen between the patients who experienced withdrawal and those who did not, although patients who experienced withdrawal did have a statistically significant ratio of non-flap-related to flap-related complications. A review of the current management for alcohol withdrawal is included and places an emphasis on preoperative screening, close observation, rapid diagnosis, and immediate medical care.
Assuntos
Delirium por Abstinência Alcoólica/complicações , Delirium por Abstinência Alcoólica/terapia , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Sobrevivência de Enxerto , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Prognóstico , Procedimentos de Cirurgia Plástica/efeitos adversos , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Resultado do TratamentoAssuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Úlceras Orais/etiologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Metástase Linfática , Mandíbula/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/cirurgia , Invasividade Neoplásica , Prognóstico , Radioterapia Adjuvante , Cirurgia Plástica , Tomografia Computadorizada por Raios XAssuntos
Mandíbula/transplante , Transplante Autólogo/métodos , Transplante Homólogo/métodos , Anastomose Cirúrgica , Animais , Cães , Músculos Faciais/transplante , Sobrevivência de Enxerto , Veias Jugulares/cirurgia , Mandíbula/irrigação sanguínea , Complicações Pós-Operatórias , Transplante Autólogo/fisiologia , Transplante Homólogo/fisiologiaRESUMO
Penetration of antibiotic preparations (gentamicin, neomycin, silver sulfadiazine, mupirocin) through Omiderm, a synthetic wound covering, was tested in vitro and in 5 patients with full-thickness burns who had undergone tangential excision and split-thickness skin grafting. All antibiotic preparations tested penetrated both meshed and unmeshed Omiderm. Omiderm did not affect the zones of inhibition of antimicrobial activity as compared with controls.
