Nerve compression syndromes may cause postburn morbidity that can often be difficult to recognize and manage. This study reviewed patients in the authors' institution who needed nerve decompression secondary to thermal or electrical burns. The objective was to evaluate the timing of nerve decompression in the burn population. A 4-year review of the authors' institution's database found 22 patients who underwent peripheral neuroplasty. This patient population included both thermal and electrical burn patients. Two patients were excluded from the study because they underwent rapid forearm amputation, and a third patient who had his initial burn care done in Europe was also excluded. The authors reviewed the mechanism of burn: percentage of body surface area burned, which nerves underwent decompression, and time from burn to decompression. Nerve compression syndromes were diagnosed and treated in this group of patients from day 46 to 1530 post-burn. Carpal tunnel was the most common site of compression accounting for 46% of the nerve decompressions. Sixteen of the 19 (84%) patients required that synchronous nerves be decompressed. The average body surface area burn in the thermal group was 43 and 5% in the electrical burn group. Nerve compression syndromes secondary to burns can be a challenging problem to diagnose and treat. Multiple studies have shown the importance of treating nerve compressions in the acute setting; however, this study shows the importance of long-term surveillance, secondary to the late presentation of nerve compression syndromes. Late nerve compression neuropathies were present in both the electrical and thermal burn patients. The authors also found that presentation of a single nerve compression should raise the suspicion of a synchronous nerve compression. Patients with thermal burns greater than 20% body surface area and electrical burns should be routinely questioned and examined for the peripheral nerve compression syndromes during long-term follow-up.
Heparin is commonly included in the irrigation solution used during microvascular surgery. Evidence has accumulated to indicate a beneficial effect of heparin on anastomotic patency, implying that its topical use is critical to success even in routine microvascular repairs. This investigation compared heparin and urokinase as additives to the irrigation solution (Ringer's lactate) used during rat groin free flap replantation. A newly trained microsurgeon performed all surgical procedures to lower the possible success rate through microsurgical inexperience and, thus, to create a stronger challenge for the topical irrigant. Solutions were administered on a blinded, randomized basis. Vessel patency and flap survival were followed for 7 days. No statistically significant differences were found between any of the treatment groups: patency and survival rates of 67% for heparin, 57% for urokinase, and 73% for controls (vehicle only). The flap failures that occurred may have been attributable to undetected technical errors due to the microsurgical inexperience of the surgeon. In a separate series, an experienced microsurgeon achieved 93% success using vehicle without additives for irrigation. These results suggest that topical heparin or urokinase is not essential for achieving high levels of success during microvascular surgery.
Liposuction has been recognized as a useful adjunct to breast reduction surgery for fine contouring of adjacent areas to achieve aesthetic balance and preservation of nipple sensation. In particular, the liposuction technique has provided an acceptable way of treating the "fat roll" of the lateral portion of the breast, which extends to the axilla and lateral chest. The purpose of this study was to review the authors' approach to adjunctive lipoplasty with breast reduction surgery and to review their experience. Examination of their own results in 70 consecutive women who underwent reduction mammaplasty in 1998 by the senior surgeon did not reveal any substantial difference in the complication rate of those women who had adjunctive liposuction with their breast reduction surgery vs. those who did not. All complications such as fat necrosis, cellulitis, and seromas were confined to the breast and were not related to the liposuction. Furthermore, there was no additional morbidity associated with ultrasonic liposuction compared with traditional suction-assisted lipectomy. Their experience indicates that patients undergoing reduction mammaplasty may benefit aesthetically from adjunct lateral chest wall liposuction without additional morbidity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.