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The Natchez Democrat - Vidalia man charged with juvenile molestation
Wounds or lacerations must be explored and thoroughly cleaned prior to closure. Suture materials vary in their composition and thickness, and the choice of the appropriate material depends upon the nature and location of the wound. ...
Articles-Updated.Com » Plastic surgery at affordable bargaining ...
Reconstructive Plastic Surgery is performed to correct functional impairments caused by burns, traumatic injuries, such as facial bone fractures, congenital abnormalities, such as cleft lip, or cleft palate, developmental abnormalities, infection or ... Tissue flaps of skin, muscle, bone, fat or a combination, may be removed from the body, moved to another site on the body and reconnected to a blood supply by suturing arteries and veins as small as 1-2 mm in diameter. ...
High Desert Veterinary Tales: Wednesday, Feb 10, 2010 Face Lacerations
The one anatomical exception to the "golden period" rule applies to facial lacerations, where wounds often heal uneventfully when sutured 24 hours or more after they occur. Even large wounds filled with debris that involve skin flaps ...
Facial Lacerations
33 FACIAL LACERATIONS
Lawrence L. Ketch M.D.
1. What distinguishes facial from other lacerations?
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Appearance is clearly of primary importance. Quality of the final result depends on strict adherence to basic principles of wound management and painstaking technique. Copious irrigation, judicious debridement, gentle tissue handling, meticulous hemostasis, and minimization of sutures combined with early stitch removal are critical to an optimal result. Fine suture and sharp instruments should be used; eversion of the wound margin with layered closure, obliteration of dead space, and lack of tension are mandatory.
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CONTROVERSIES
14. What controversies exist regarding the care and repair of facial lacerations?
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facial laceration and langers lines,Queries 3
Trauma To The Colon & Rectum. Colon Trauma
28 TRAUMA TO THE COLON AND RECTUM
W. Andrew Lawrence M.D., Jon M. Burch M.D.
COLON TRAUMA
1. How do most colon injuries occur?
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Nearly all (> 95%) colon injuries are caused by penetrating trauma from gunshot, stab, iatrogenic, or sexual injury. Blunt colonic trauma is rare and usually results from seat belts during motor vehicle accidents.
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colonic injury grade, iatrogenic colon injury, trauma dos colons, trauma of the colon,Queries 2
Hepatic & Biliary Trauma. Operative Management Of Liver Injury
OPERATIVE MANAGEMENT OF LIVER INJURY
11. How are acute liver injuries classified?
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Liver wounds are generally graded on a scale of I to VI according the depth of parenchymal laceration and involvement of the hepatic veins or retrohepatic portion of the inferior vena cava. Optimal methods of obtaining hemostasis vary with the severity of the injury.
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34 BASIC CARE OF HAND INJURIES
Michael J.V. Gordon M.D., Lawrence L. Ketch M.D.
1. What are the goals of hand repair?
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Functional considerations override cosmesis in the treatment of hand trauma. There are no minor hand injuries. Initial diagnosis and management determine the final result; expert secondary repair cannot overcome primary errors in diagnosis or decision making.
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Parotid Tumors
65 PAROTID TUMORS
Joyesh K. Raj M.D., William R. Nelson M.D.
1. What is the differential diagnosis of a mass located in front of the ear in a patient of any age?
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If the mass is painless, discrete, nontender, and located just anterior or just beneath the ear lobe, a parotid tumor is the first choice. The differential diagnosis for other isolated masses include parotitis, primary salivary neoplasm, upper jugular chain node enlargement, tumor of the tail of the submandibular gland, enlarged preauricular or parotid lymph node, branchial cleft cyst, epithelial inclusion cyst, or any mesenchymal neoplasm. Diffuse unilateral enlargement of the parotid gland indicates parotid duct obstruction that can either be persistent or intermittent because of calculi in the main duct. Bilateral diffuse enlargement may be caused by systemic conditions such as mumps, starch-eaters disease, and fatty infiltration.
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Can Health Care Be Reformed?
100 CAN HEALTH CARE BE REFORMED?
Alden H. Harken M.D.
1. Is health care reform an oxymoron?
Show answer
Yes.
2. What is fee for service?
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The doctor establishes the price, and the patient agrees to pay it. This traditional system of exchange has great merit if both parties understand the value of the service provided. If either party (usually the patient) cannot estimate the service value, it is possible (even likely) that the doctor will honestly escalate the service value in a fashion unchecked by the patient’s perceptions. Thus, in a fee-for-service system, medical prices tend to increase.
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how can managed care be reformed?,Splenic Trauma
26 SPLENIC TRAUMA
David J. Ciesla M.D., Ernest E. Moore M.D.
1. What is the physiologic role of the spleen?
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In fetal development, the spleen serves as a major site for hematopoiesis. In early childhood the spleen produces immunoglobulin M (IgM) and tuftsin. The spleen also functions as a filter, allowing resident macrophages to remove abnormal red blood cells (RBCs), cellular debris, and encapsulated and poorly opsonized bacteria.
Gastroesophageal Reflux Disease. Controversies
CONTROVERSIES
15. Is GERD better treated in the long term by PPI therapy or Nissen fundoplication?
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PPIs really work in resolving esophagitis and eliminating symptoms of GERD, but the long-term side effects are not fully known. Fundoplication potentially frees the patient from daily medicine (this has been challenged recently) and may cause morbidity in ≤ 10% of patients.
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CAROTID DISEASE
70 CAROTID DISEASE
Rao Gutta M.D., B. Timothy Baxter M.D.
1. What diseases affect the carotid arteries?
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Atherosclerosis is by far the most common (accounting for 90% of lesions in the Western world). The carotid also can be affected by fibromuscular dysplasia, inflammatory arteriopathies (e.g., Takayasu’s arteritis), extrinsic compression (e.g., neoplasm), and trauma.
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Pancreatic & Duodenal Injury
27 PANCREATIC AND DUODENAL INJURY
Caesar M. Ursic M.D.
1. How common are pancreatic injuries?
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The pancreas is not commonly injured because of its protected retroperitoneal position, and thus accounts for only 8% of all penetrating and 2% of all blunt visceral injuries.
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Upper Urinary Tract Injuries
30 UPPER URINARY TRACT INJURIES
Fernando J. Kim M.D., Siam Oottamasathien M.D.
1. What is the most common type of renal trauma in the United States, blunt or penetrating?
Show answer
Blunt, by far.
2. Do most kidney injuries require surgery?
Show answer
No. Fewer than 2% of blunt injuries require surgery, and many penetrating injuries can also be treated nonoperatively.
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Small Bowel Obstruction
46 SMALL BOWEL OBSTRUCTION
Joyce A. Majure M.D.
1. Name three mechanisms of bowel obstruction, and give examples and incidence of each type.
Show answer
1. Extrinsic compression: adhesions (60%), malignancy (20%), hernias (10%), volvulus, and others (5%)
2. Internal blockage of the lumen by abnormal materials (obturation): bezoars, gallstone, worms, or foreign body (usually obstructs at the ileocecal valve)
3. Mural disease encroaching on the lumen (inflammatory bowel disease [5%]), fibrous stricture secondary to trauma, ischemia, or radiation, intussusception)
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
