590 research outputs found
THE EFFECTS OF REDUCTION OPERATION WITH GENITAL LYMPHEDEMA ON THE FREQUENCY OF ERYSIPELAS AND THE QUALITY OF LIFE
No full textGenital lymphedema represents a severe disability for patients particularly when complicated by erysipelas, the most frequent complication. The objectives of this study were: to investigate the frequency of erysipelas in patients with genital lymphedema and genital lymphatic cysts who underwent evaluation for surgical treatment, to observe the influence of resection operations on the frequency of erysipelas, and to measure changes in the quality of life due to the resection. A total of 93 patients with genital lymphedema were studied. All patients underwent integrated care treatment in the Foldi Clinic, Hinterzarten and the Department of Plastic and Hand Surgery of the University Hospital Freiburg during the period between 1997 and 2007. 44 of these patients underwent surgical treatment of genital lymphedema. The results indicate that lymphatic cysts were the most important risk-aggravating factor for recurrent erysipelas with lymphorrhea in the genital region (p<0.001). Following the resection operation, however, the number of erysipelas incidents significantly decreased (p<0.001). In addition, the antibiotic dose could be reduced after surgery (p=0.039) and an improved quality of life was achieved (p<0.001)
THE EFFECTS OF REDUCTION OPERATION WITH GENITAL LYMPHEDEMA ON THE FREQUENCY OF ERYSIPELAS AND THE QUALITY OF LIFE
No full textGenital lymphedema represents a severe disability for patients particularly when complicated by erysipelas, the most frequent complication. The objectives of this study were: to investigate the frequency of erysipelas in patients with genital lymphedema and genital lymphatic cysts who underwent evaluation for surgical treatment, to observe the influence of resection operations on the frequency of erysipelas, and to measure changes in the quality of life due to the resection. A total of 93 patients with genital lymphedema were studied. All patients underwent integrated care treatment in the Foldi Clinic, Hinterzarten and the Department of Plastic and Hand Surgery of the University Hospital Freiburg during the period between 1997 and 2007. 44 of these patients underwent surgical treatment of genital lymphedema. The results indicate that lymphatic cysts were the most important risk-aggravating factor for recurrent erysipelas with lymphorrhea in the genital region (p<0.001). Following the resection operation, however, the number of erysipelas incidents significantly decreased (p<0.001). In addition, the antibiotic dose could be reduced after surgery (p=0.039) and an improved quality of life was achieved (p<0.001)
Treatment of various secondary lymphedemas by microsurgical lymph vessel transplantation
No full textDonor defects after lymph vessel transplantation and free vascularized lymph node transfer: A comparison and evaluation of complications
No full textIntegrated concept of treatment for reduction of morbidity after resection of panniculus morbidus associated with lymphoedema
No full textTwo propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
No full textOpen-Access-Publikationsfonds 202
Funktionsprotektiver Verschluss einer urethrokutanen Fistel der prostatischen Harnröhre über einen perinealen Zugang mit Gracilis-Flap
No full textZusammenfassung Es wird von einem 36-jährigen Patienten berichtet, der beim Miktionieren Urin perianal aus einem kutanen Porus verliert. Nach entsprechender Diagnostik wird die Diagnose einer urethrokutanen Fistel aus der prostatischen Harnröhre unklarer Ätiologie gestellt. Aufgrund des jungen Alters und der sexuellen Aktivität, stellt die chirurgische Therapie eine Herausforderung dar. Über einen perinealen Zugang wird die Fistel isoliert und prostatanah ligiert, ohne die Gefäßnervenbündel zu gefährden. Um einen sicheren Fistelverschluss zu erzielen, wird anschließend ein Gracilis-Flap als Zwischenschicht zwischen Prostatahinterfläche und perkutanem Fistelausgang gelegt. Bis dato ist kein Fall einer erfolgreichen chirurgischen Therapie einer prostatokutanen Urinfistel beschrieben, die funktionserhaltend durchgeführt werden konnte
Tissue Healing in Hemicraniectomy
No full textIntroduction Decompressive hemicraniectomy (DHC) is a last-resort treatment for refractory intracranial hypertension. Perioperative morbidity is associated with high risks of wound healing disturbances (WHD). Recently, a retromastoidal frontoparietooccipital (RMF) incision type was performed to avoid healing disturbance due to enhanced tissue flap perfusion compared to the classical reverse “question mark” (“Dandy flap”) incision. The goal of this study was to analyze the details of tissue healing problems in DHC. Materials and methods A total of 60 patients who underwent DHC were retrospectively analyzed. In 30 patients the “Dandy flap” incision (group A) and in 30 patients the RMF incision (group B) was made. Since no evidence-based data for the incision type that favors better wound healing exists, the form of incision was left at the surgeon´s discretion. Documentation of the patients was screened for the incidence of WHD: wound necrosis, dehiscence, and cerebrospinal fluid (CSF) leakage. Patient age, the time interval from surgery until the appearance of WHD, the length of surgeries in minutes, and the indications of the DHC were analyzed. A Chi-square test of independence was performed to examine the relationship between the incision type and the appearance of WHD with the statistical significance level set at p<0.05. The mean age of the patients, the mean time interval from surgery until the occurrence of WHD, and the mean length of the surgery between the two groups were compared using an independent sample t-test with the statistical significance level set at p<0.05. Results The most common indication for DHC in both groups was malignant MCA infarction (n=20, 66.6% for group A and n=16, 53.3% for group B). CSF leakage was 20% of the most frequent WHD in each group. Wound necrosis was observed only in group A. Although group B showed 13.3% fewer WHD than group A, this difference was not statistically significant. There was no statistically significant difference in the time range between surgery and the occurrence of WHD between the two groups. The length of surgery in group B was significantly shorter than in group A (120.2 mins vs. 103.7 mins). Conclusion A noticeable trend for reduced WHD was observed in the patient group using the RMF incision type although the difference was not statistically significant. We praise that the RMF incision allows an optimized skin-flap vascularization and, thereby, facilitates better wound healing. We were able to show a statistically shorter length of surgery with the RMF incision in contrast to the classic “Dandy flap” incision. Larger multicenter studies should be implemented to analyze and address the major advantages and pitfalls of the routinely applied incision techniques
The New Jersey African American history curriculum guide, grades 9 to 12. by Larry A. Greene, Lenworth Gunther.
No full textThe New Jersey African American history curriculum guide is a resource for New Jersey high school teachers who wish to incorporate African American experiences into their teaching of U.S. history. The guide provides narratives, keywords, suggested activites, and bibliographies.CONTENTS:
Foreword -- About the Authors -- Preface -- How to Use This Guide -- Acknowledgments -- Unit 1 African Beginnings -- Unit 2 Africa, Europe, and the Rise of Afro-America, 1441-1619 -- Unit 3 African American Slavery in the Colonial Era, 1619-1775 -- Unit 4 Blacks in the Revolutionary Era, 1776-1789 -- Unit 5 Slavery and Abolition in Post-Revolutionary and Antebellum America, 1790-1860 -- Unit 6 African Americans and the Civil War, 1861-1865 -- Unit 7 The Reconstruction Era, 1865-1877 -- Unit 8 The Rise of Jim Crow and The Nadir, 1878-1915 -- Unit 9 World War I and the Great Migration, 1915-1920 -- Unit 10 The Decade of the Twenties: From the Great Migration to the Great Depression -- Unit 11 The 1930s: The Great Depression -- Unit 12 World War II: The Struggle for Democracy at Home and Abroad, 1940-1945 -- Unit 13 The Immediate Postwar Years, 1945-1953 -- Unit 14 The Civil Rights and Black Power Era: Gains and Losses, 1954-1970 -- Unit 15 Beyond Civil Rights, 1970-1994
Topically Confined Enhancement of Cutaneous Microcirculation by Cold Plasma
No full textINTRODUCTION: We aim to explore potentials and modalities of cold atmospheric pressure plasma (CAP) for the subsequent development of therapies targeting an increased perfusion of the lower leg skin tissue. In this study, we addressed the question whether the microcirculation enhancement is restricted to the tissue in direct contact with plasma or if adjacent tissue might also benefit. METHODS: A dielectric barrier discharge (DBD)-generated CAP device exhibiting an electrode area of 27.5 cm2 was used to treat the anterior lower leg of ten healthy subjects for 4.5 min. Subsequently, hyperspectral imaging was performed to measure the tempospatially resolved characteristics of microcirculation parameters in superficial (up to 1 mm) and deeper (up to 5 mm) skin layers. RESULTS: In the tissue area covered by the plasma electrode, DBD-CAP treatment enhances most of the perfusion parameters. The maximum oxygen saturation increase reached 8%, the near-infrared perfusion index (NIR) increased by a maximum of 4%, and the maximum tissue hemoglobin increase equaled 14%. Tissue water index (TWI) was lower in both the control and the plasma groups, thus not affected by the DBD-CAP treatment. Yet, our study reveals that adjacent tissue is hardly affected by the enhancements in the electrode area, and the effects are locally confined. CONCLUSION: Application of DBD-CAP to the lower leg resulted in enhancement of cutaneous microcirculation that extended 1 h beyond the treatment period with localization to the tissue area in direct contact with the cold plasma. This suggests the possibility of tailoring application schemes for topically confined enhancement of skin microcirculation, e.g., in the treatment of chronic wounds
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