scholarly journals Degloving injury of the distal aspect of the limb in a horse and preventing bone sequestrum formation using multiple, partial depth cortical fenestration

2021 ◽  
Vol 90 (1) ◽  
pp. 57-61
Author(s):  
Filip Koľvek ◽  
Zdeněk Žert
Keyword(s):  
Granulation Tissue ◽  
Clinical Report ◽  
Common Complication ◽  
Outer Cortex ◽  
Good Cosmetic Outcome ◽  
Degloving Injury ◽  
Exposed Bone ◽  
Good Cosmetic ◽  
Distal Aspect ◽  
The Right

Exposed or denuded bone is a common complication of wounds of the distal aspect of the limb. This clinical report describes the treatment of an extensive laceration of the right hindlimb of a 12-year-old Hungarian Warmblood Horse gelding, which was managed initially by application of hydrogel dressings to enhance autolytic debridement, subsequently, by cortical fenestration of the denuded cortical bone and by stimulating the production of granulation tissue to cover the exposed bone. An early radiographic sign of sequestrum formation (discrete changes in the outer cortex) was not seen after the injury. Six weeks later, the wound was completely covered with vascularized, healthy-appearing bed of granulation tissue, which was prepared for grafting using the punch technique. A reinforced bandage was applied for the following 7 weeks; the grafts were accepted by granulation tissue. The horse was discharged 20 weeks after admission and the owners were advised to maintain stall rest with hand walking for two weeks. Four years later the owner reported that the wound had completely healed with a good cosmetic outcome and the horse was being used in a carriage.

scholarly journals A simple novel technique [PUIT] for closure of urethrocutaneous fistula after hypospadias repair: Preliminary results

2005 ◽  
Vol 38 (02) ◽  
pp. 114-118
Author(s):  
M S Awad
Keyword(s):  
Common Complication ◽  
Hypospadias Repair ◽  
Fistula Repair ◽  
Urethrocutaneous Fistula ◽  
Good Opportunity ◽  
Good Cosmetic Outcome ◽  
Novel Technique ◽  
Good Cosmetic ◽  
The Mean ◽  
Incision Technique

ABSTRACTUrethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied, the closure of the fistula is a challenging problem. We present a simple surgical procedure, posterior urethral incision technique [PUIT] to close the fistula in our department.Between February 2001 and December 2004 we prospectively evaluated 32 patients, 26 patients with initial hypospadias fistulas and 6 with recurrent fistulas who underwent closure of urethrocutaneous fistula after hypospadias repair. The mean age of patients was 5 years, the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and 2 mm below the fistula opening then re-approximation of the urethral edges using 6/0 vicryl sutures with loop magnification.The timing of fistula repair was between 6 and 13 months after it was formed, all of these were effectively closed except three cases with stricture and fistula. Of these, two were completely relieved after repeated urethral dilatation, three times a week for 2 weeks. The third failed case will need another sitting after 6 months.The posterior midline urethral incision gives a good opportunity for repair without tension with a good cosmetic outcome. This may be done under local anesthesia in adults. The procedure is considered simple rapid and easy to be done for variable fistulas types whatever of its site and the age.

Morphometric analysis of the actions of angiotensin II on renal arterioles and glomeruli

1992 ◽  
Vol 262 (3) ◽  
pp. F367-F372 ◽  
Author(s):  
K. M. Denton ◽  
P. A. Fennessy ◽  
D. Alcorn ◽  
W. P. Anderson
Keyword(s):  
Electron Microscopy ◽  
Angiotensin Ii ◽  
Vascular Resistance ◽  
Morphometric Analysis ◽  
Unit Length ◽  
Average Difference ◽  
Outer Cortex ◽  
Efferent Arteriole ◽  
Transmission Electron ◽  
The Right

To study the effects of angiotensin II on afferent and efferent arteriole diameters and on intraglomerular dimensions, angiotensin II (20 ng.kg-1.min-1) or saline vehicle was infused intravenously for 20 min into anesthetized rabbits pretreated with enalapril. Both kidneys were perfusion fixed (glutaraldehyde), and vascular casts were made of the right kidneys using methacrylate. Morphometric analysis of the left kidneys using transmission electron microscopy revealed no significant effects of angiotensin II within the glomerulus, including the degree of mesangial contraction. The diameters of the afferent and efferent arteriole casts from the right kidneys were measured at 20, 50, and 75 microns from the glomerulus by scanning electron microscopy. In the outer cortex the mean diameters of the afferent and efferent arterioles were 14.1 +/- 0.8 and 9.7 +/- 0.5 microns, respectively, in the angiotensin II-infused rabbits, significantly less than in the control (vehicle) rabbits, 17.0 +/- 0.7 microns (P less than 0.001) and 10.7 +/- 0.4 microns (P less than 0.005), respectively. Calculation of the relative changes in vascular resistance, however, indicated that the effects of angiotensin II on efferent arteriole resistance (average difference 2.4 +/- 1.2 units/microns) were significantly greater per unit length than the effects on afferent arteriole resistance (average difference 0.9 +/- 0.3 units/microns). Thus infused angiotensin II caused greater reduction in afferent arteriolar diameter than in efferent, but the calculated increase in vascular resistance per micron was greater in efferent vessels due to their smaller resting diameter.

scholarly journals Ruptured aneurysm of right sinus of valsalva - a case report

2016 ◽  
Vol 44 (3) ◽  
pp. 175-177
Author(s):  
Md Nazmul Hasan ◽  
Md Nazmul Hasan ◽  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Md Rasul Amin ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Annulus Fibrosus ◽  
Common Complication ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Aortic Media ◽  
Surgical Options ◽  
Potential Risks ◽  
The Right

The sinus of valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. It may be either acquired or congenital. The right coronary sinus is most frequently affected, with the most common complication being rupture of the sinus. Cardiac failure and sudden auscultation changes suggest the possibility of SVA rupture. Echocardiography is sufficient to diagnose SVA, its complications, repercussions and to determine surgical options. SVA, even if asymptomatic, has potential risks of expansion, rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction which has a low mortality rate in both the short and long-term.Bangladesh Med J. 2015 Sep; 44 (3): 175-177

scholarly journals Initial Experience with Simple Oncoplastic Breast Conserving Surgery in Nepal: A Case Report

2020 ◽  
Vol 42 (2) ◽  
pp. 97-99
Author(s):  
Yogendra P Singh ◽  
Suman Khanal
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Outer Quadrant ◽  
Good Cosmetic Outcome ◽  
Node Biopsy ◽  
Areola Complex ◽  
Good Cosmetic

Oncoplastic breast conserving surgery is increasingly used in the management of early breast cancer. Though its use in Nepal is increasing, it is still under-utilized. We present a case of upper outer quadrant early breast cancer located away from nipple-areola complex managed with radial ellipse segmentectomy 10 years back and under regular follow up. We recommend its usage in upper outer quadrant lesions because of its simplicity, access for sentinel lymph node biopsy and good cosmetic outcome.

scholarly journals Multidisciplinary approach in the treatment of ossifying fibroma: Case report

2020 ◽  
Vol 9 (10) ◽  
pp. e3779108833
Author(s):  
Luara Teixeira Colombo ◽  
Laís Kawamata de Jesus ◽  
Ana Flávia Piquera Santos ◽  
Henrique Hadad ◽  
Everton Pontes Martins ◽  
...  
Keyword(s):  
Bone Lesion ◽  
Facial Asymmetry ◽  
Postoperative Recovery ◽  
Ossifying Fibroma ◽  
Clinical Report ◽  
Total Excision ◽  
Stomatognathic System ◽  
Slow Evolution ◽  
The Right ◽  
And Function

Ossifying fibroma is a type of fibro-bone lesion characterized by asymptomatic volumetric increase, of slow evolution, which can reach large dimensions resulting in facial asymmetry, causing tooth displacement and functional impairment of the stomatognathic system structures. The purpose of this article was to the clinical report a case of a female patient, seen at the University Clinic, with a complaint of a volumetric increase in the right mandibular region with an evolution of approximately 1 (one) year. Before the total excision of the lesion, an incisional biopsy was performed with the diagnosis of ossifying fibroma. Due to the proportions of the lesion, the patient presented dysphagia, which resulted in an anemic condition, requiring normalization of the condition prior to the total excision of the lesion. After 6 months of follow-up, the patient showed significant improvement in the shape and function of the operated region, in addition to the nutritional deficiency. The assessment of the patient's nutritional status is extremely important, should not be neglected, since malnutrition is directly linked to the evolution of the disease, and interferes with postoperative recovery.

A Modified Lateral Orbitotomy Approach to the Superior Orbital Fissure: A Video Case Report and Review of Anatomy

2018 ◽  
Vol 16 (6) ◽  
pp. 685-691 ◽  
Author(s):  
Gmaan A Alzhrani ◽  
Yair M Gozal ◽  
Brandon A Sherrod ◽  
William T Couldwell
Keyword(s):  
Patient Experiences ◽  
Total Resection ◽  
Superior Orbital Fissure ◽  
Good Cosmetic Outcome ◽  
Lateral Orbitotomy ◽  
Orbital Wall ◽  
Good Cosmetic ◽  
Histopathologic Analysis ◽  
Video Case Report ◽  
Orbital Rim

Abstract BACKGROUND The lateral orbitotomy approach (LOA) is often used for accessing the orbital contents and middle skull base; however, most prior descriptions of the LOA involve complete drilling of the lateral orbital wall. This practice requires retraction of the orbital contents and produces postoperative diplopia that the patient experiences for a limited time. OBJECTIVE To describe a modified LOA with partial sparing of the lateral orbital wall for accessing lesions of the superior orbital fissure (SOF). METHODS One patient with a progressively enlarging SOF lesion and visual loss underwent a modified LOA for resection. The orbital rim lateral to the SOF was removed as a bone flap, and the greater wing of the sphenoid inferior to the SOF was drilled to expose the lesion. The lateral orbital wall was thinned but was not completely removed. The orbital rim was resecured with miniplates and screws. RESULTS Gross total resection of the SOF mass was achieved without unnecessary exposure or retraction of the orbital contents. Histopathologic analysis of the resected mass was consistent with a cavernous hemangioma. The patient had a good cosmetic outcome without complication. CONCLUSION Modified LOA with partial sparing of the lateral orbital wall is a feasible approach for lesions of the SOF.

scholarly journals Dorsal subscapularis approach for the surgical drainage of subscapularis intramuscular abscess: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ryogo Furuhata ◽  
Doji Inoue ◽  
Yasuhiro Kiyota ◽  
Hideo Morioka ◽  
Hiroshi Arino
Keyword(s):  
Shoulder Pain ◽  
Granulation Tissue ◽  
Glenohumeral Joint ◽  
Ct Imaging ◽  
Antibiotic Administration ◽  
Surgical Drainage ◽  
Subscapularis Muscle ◽  
Limited Range Of Motion ◽  
Contrast Enhanced ◽  
The Right

Abstract Background Abscess formation in the subscapularis muscle is a rare clinical condition. Few reports are available regarding the treatment methods and surgical approaches for subscapularis intramuscular abscesses. Here, we describe a case of subscapularis intramuscular abscess that was treated successfully via surgical drainage using a new approach, the “dorsal subscapularis approach”. Case presentation A 67-year-old woman presented to our hospital with complaints of fever and disturbance of consciousness. Two days prior to visiting our hospital, right shoulder pain and limited range of motion in the shoulder were noted. Cerebrospinal fluid examination and contrast-enhanced computed tomography (CT) imaging on admission revealed a right subscapularis intramuscular abscess with concomitant bacterial meningitis. The patient’s clinical symptoms improved after antibiotic administration for 3 weeks, but the right shoulder pain persisted. Contrast-enhanced CT imaging performed after antibiotic administration revealed an abscess in the right shoulder joint space, in addition to a capsule of the abscess in the right subscapularis muscle. We performed open surgical drainage for the abscess, which had spread from the subscapularis muscle to the glenohumeral joint. Using the deltoid-pectoral approach, we detected exudate and infected granulation tissue in the joint cavity. Furthermore, we separated the dorsal side of the subscapularis muscle from the scapula using a raspatory and detected infected granulation tissue in the subscapularis muscle belly. We performed curettage and washed as much as possible. After surgery, antibiotic administration continued for 2 weeks. The patient’s right shoulder pain subsided and CT performed 2 months after surgery revealed no recurrence of infection. Conclusions The present case indicated that a subscapularis intramuscular abscess could lead to severe concomitant infections of other organs via the hematogenous route. Thus, early detection and treatment are necessary. Moreover, in this case, surgical drainage using a dorsal subscapularis approach was beneficial to treating the abscess, which had spread from the subscapularis muscle to the glenohumeral joint.

Experience with use of improvised negative pressure wound therapy in the management of wounds with exposed bone

2020 ◽  
pp. 004947552096274
Author(s):  
Uwakwe C Mba ◽  
Wilfred O Okenwa
Keyword(s):  
Teaching Hospital ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Significant Challenge ◽  
Exposed Bone

Wounds with exposed bone pose a significant challenge in healing. Negative pressure wound therapy has simplified reconstructive options. In economically constrained regions, this has been modified with materials that are affordable. Its effect on such wounds has not been well studied and so case summaries of 15 patients with 17 wounds who were managed with modified negative pressure wound therapy at Ntasiobi Specialist Hospital and ESUT Teaching Hospital between 2015 and 2019 were obtained. The procedure progressed satisfactorily in 88% of patients with granulation tissue covering the bones while the procedure was discontinued in 12%. The modified negative pressure wound therapy achieves similar results as the patented version and is recommended where resources are limited.

scholarly journals Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Alqasem Fuad H. Al Mosa ◽  
Mohammed Ishaq ◽  
Mohamed Hussein Mohamed Ahmed
Keyword(s):  
Chest Tube ◽  
Complete Resolution ◽  
Pleural Cavity ◽  
Tube Thoracostomy ◽  
Thoracic Cavity ◽  
Common Complication ◽  
Thoracostomy Tube ◽  
Chest Computed Tomography ◽  
Initial Improvement ◽  
The Right

Chest tube malpositioning is reported to be the most common complication associated with tube thoracostomy. Intraparenchymal and intrafissural malpositions are the most commonly reported tube sites. We present a case about a 21-year-old patient with cystic fibrosis who was admitted due to bronchiectasis exacerbation and developed a right-sided pneumothorax for which a chest tube was inserted. Partial initial improvement in the pneumothorax was noted on the chest radiograph, after which the chest tube stopped functioning and the pneumothorax remained for 19 days. Chest computed tomography was done and revealed a malpositioned chest tube in the right side located inside the thoracic cavity but outside the pleural cavity (intrathoracic, extrapleural). The removed chest tube was patent with no obstructing materials in its lumen. A new thoracostomy tube was inserted and complete resolution of the pneumothorax followed.

Hydrocolloid Dressings Promote Granulation Tissue on Exposed Bone

2013 ◽  
Vol 39 (1pt1) ◽  
pp. 123-125 ◽  
Author(s):  
Cuong V. Nguyen ◽  
Carl V. Washington ◽  
Seaver L. Soon
Keyword(s):  
Granulation Tissue ◽  
Exposed Bone
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