scholarly journals Surgical management of Encapsulating Peritoneal Sclerosis (EPS) in children: international case series and literature review

2021 ◽  
Author(s):  
Videha Sharma ◽  
Zia Moinuddin ◽  
Angela Summers ◽  
Mohan Shenoy ◽  
Nicholas Plant ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Management ◽  
Supplementary Information ◽  
Operative Morbidity ◽  
Post Surgery ◽  
Paediatric Patients ◽  
Stoma Formation ◽  
Gut Function ◽  
Health And Development ◽  
Secondary Closure

Abstract Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / − stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient’s stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

Transorbital approach to infratemporal fossa: novel technique

2011 ◽  
Vol 125 (6) ◽  
pp. 638-642 ◽  
Author(s):  
A Mishra
Keyword(s):  
Infratemporal Fossa ◽  
Case Series ◽  
Cerebrospinal Fluid Leakage ◽  
Malignant Tumours ◽  
Operative Morbidity ◽  
Diagnostic Uncertainty ◽  
Medical College ◽  
Case Series Report ◽  
Cranial Nerve Injury ◽  
Considerable Morbidity

AbstractObjective:To present a conservative surgical approach, via the transorbital route, for selected cases of infratemporal fossa involvement or inferolateral orbital tumours extending to the infratemporal fossa.Design:Case series report.Setting:Department of ENT, CSM Medical University (King George Medical College), Lucknow, India.Participants:One patient.Main outcome measures:Operative feasibility, intra-operative access, post-operative morbidity and cosmesis.Results:This novel and relatively conservative technique provides excellent exposure in selected cases of infratemporal fossa involvement and has minimal post-operative morbidity. Cosmesis is excellent, as osteotomy is not required and scarring is minimal. There is no risk of trismus, Vth or VIIth cranial nerve injury, or cerebrospinal fluid leakage, and haemostasis is easily achieved.Conclusion:Classical, open approaches to the infratemporal fossa involve considerable morbidity, while conservative approaches have their limitations. Diagnostic uncertainty over a small infratemporal fossa mass (perhaps an extension from an inferolateral orbital tumour) is an uncommon clinical challenge. The transorbital approach described is suited to benign and early malignant tumours, and has excellent results when combined with orbital exenteration (if needed). This paper discusses this approach's technical details and feasibility in different clinical situations, and compares it with other infratemporal fossa approaches.

Open wound management following pull‐through resection for oral cancer: A case series of 14 patients

2021 ◽  
Author(s):  
Atsushi Taguchi ◽  
Tsuyoshi Kojima ◽  
Yusuke Okanoue ◽  
Hiroki Kagoshima ◽  
Koki Hasebe ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Case Series ◽  
Wound Management ◽  
Open Wound ◽  
Pull Through

Post-traumatic arteriovenous fistulae of the extremities: a case series

2021 ◽  
Author(s):  
Zia Ur Rehman ◽  
Suleman Yousaf
Keyword(s):  
Case Series ◽  
Limb Ischemia ◽  
Venous Ulcer ◽  
University Hospital ◽  
Arterial Reconstruction ◽  
Penetrating Injuries ◽  
Operative Morbidity ◽  
Endovascular Interventions ◽  
Post Traumatic ◽  
Salvage Rate

Post-traumatic AVF can lead to congestive heart failure, and limb ischemia. The objective of the study is to determine presentations, interventions and outcomes (morbidity and mortality) of the patients treated with traumatic AVF at a university hospital between Jan 1995 to December 2018. Nine patients (M: F 8:1) with median age of 30 [IQR 24.5] years were included in the study. They presented as ‘missed injuries’ with median delay of 4 [IQR 55.25] months. Most had penetrating injuries and presented with painful limb swelling, pain and venous ulcer. Superficial femoral (33.3%) and popliteal (22.2%) vessels were the most involved vessels. Seven (77.7%) patients had surgery while two (22.2%) had endovascular interventions. Arterial reconstruction with interposition vein (44.4%) or with prosthetic (11.1%) grafts was done. There was no peri-operative morbidity or 30-day mortality. All patients had smooth recovery with 100% limb salvage rate. Continuous..

The treatment of paediatric burns with concentrated surfactant gel technology: a case series

2020 ◽  
Vol 29 (Sup6) ◽  
pp. S12-S17
Author(s):  
Timothy P Pittinger ◽  
Danielle Curran ◽  
Michel HE Hermans
Keyword(s):  
Antimicrobial Agent ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Ease Of Use ◽  
Anatomical Location ◽  
Paediatric Patients ◽  
Number Of Patients ◽  
Paediatric Burns ◽  
Different Types ◽  
Topical Antimicrobial

Objective: To assess the safety and efficacy of a surfactant-based technology for the management of burns. Method: In a retrospective review, paediatric patients with different types of burns were treated with the gel technology. In some patients, the treatment was combined with a topical antimicrobial agent. Primary objectives of the review were the assessment of healing, healing times and ease of use of the material. Results: The wounds of 15 paediatric patients with different types of burns, particularly with regard to depth and anatomical location, were evaluated using a retrospective chart review. It was found that the surfactant gel technology, with or without the topical antimicrobial agent, assisted in autolytic debridement, and that time to re-epithelialisation was short and within the range of those obtained with other established treatments. Conclusion: The number of patients and wounds in this evaluation is small but the study indicates that the gel technology provides a safe and effective way to treat smaller burns in paediatric patients.

scholarly journals Effectiveness of surgical fixation for lateral compression type one (LC-1) fragility fractures of the pelvis: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024737
Author(s):  
Alison Booth ◽  
Helen Margaret Ann Ingoe ◽  
Matthew Northgraves ◽  
Elizabeth Coleman ◽  
Melissa Harden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Case Series ◽  
Fragility Fractures ◽  
Hospital Length Of Stay ◽  
Cochrane Central Register ◽  
Lateral Compression ◽  
Post Surgery ◽  
Surgical Fixation ◽  
And Function

ObjectivesTo undertake a systematic review of the evidence base for the effectiveness of surgical fixation of lateral compression (LC-1) fragility fractures of the pelvis compared with non-surgical approaches.SearchesMEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and two international trials registers were searched up to January 2017 (MEDLINE to February 2019) for studies of internal or external fixation of fragility fractures of the pelvis.ParticipantsPatients with lateral compression pelvic fractures, sustained as the result of a low-energy mechanism, defined as a fall from standing height or less.InterventionsSurgery using either external or internal fixation devices. Conservative non-surgical treatment was the defined comparator.Outcome measuresOutcomes of interest were patient mobility and function, pain, quality of life, fracture union, mortality, hospital length of stay and complications (additional operative procedures, number and type of adverse events and serious adverse events).Quality assessment and synthesisThe Joanna Briggs Institute Checklist for Case Series was used to assess the included studies. Results were presented in a narrative synthesis.ResultsOf 3421 records identified, four retrospective case series met the inclusion criteria. Fixation types were not consistent between studies or within studies and most patients had more than one type of pelvic fixation. Where reported, mobility and function improved post-surgery, and a reduction in pain was recorded. Length of hospital stay ranged from 4 days to 54 days for surgical fixation of any type. Reported complications and adverse outcomes included: infections, implant loosening, pneumonia and thrombosis. Use of analgesia was not reported.ConclusionsThere is insufficient evidence to support guidance on the most effective treatment for patients who fail to mobilise after sustaining an LC-1 fragility fracture.Trial registration numberCRD42017055872.

Common Things are Common: A Case Series of Oral Foreign Bodies in Paediatric Patients

Dental Update ◽  
2009 ◽  
Vol 36 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Sarah Gale ◽  
Emily Hall ◽  
Nabina Bhujel ◽  
Sarah McKaig
Keyword(s):  
Foreign Bodies ◽  
Case Series ◽  
Paediatric Patients

scholarly journals Plastic Surgery at War: A Scoping Review of Current Conflicts

2020 ◽  
Author(s):  
Justin P Fox ◽  
Nickolay P Markov ◽  
Alexandra M Markov ◽  
Eamon O’Reilly ◽  
Kerry P Latham
Keyword(s):  
Plastic Surgery ◽  
Scoping Review ◽  
Wound Care ◽  
Critical Role ◽  
Case Series ◽  
The United States ◽  
Lessons Learned ◽  
Plastic Surgeon ◽  
Wound Management ◽  
Search Criterion

Abstract Introduction The scope of military plastic surgery and location where care is provided has evolved with each major conflict. To help inform plastic surgeon utilization in future conflicts, we conducted a review of military plastic surgery-related studies to characterize plastic surgeon contributions during recent military operations. Materials and Methods Using a scoping review design, we searched electronic databases to identify articles published since September 1, 2001 related to military plastic surgery according to a defined search criterion. Next, we screened all abstracts for appropriateness based on pre-established inclusion/exclusion criteria. Finally, we reviewed the remaining full-text articles to describe the nature of care provided and the operational level at which care was delivered. Results The final sample included 55 studies with most originating in the United States (54.5%) between 2005 and 2019 and were either retrospective cohort studies (81.8%) or case series (10.9%). The breadth of care included management of significant upper/lower extremity injuries (40%), general reconstructive and wound care (36.4%), and craniofacial surgery (16.4%). Microsurgical reconstruction was a primary focus in 40.0% of published articles. When specified, most care was described at Role 3 (25.5%) or Roles 4/5 facilities (62.8%) with temporizing measures more common at Role 3 and definite reconstruction at Roles 4/5. Several lessons learned were identified that held commonality across plastic surgery domain. Conclusions Plastic surgeons continue to play a critical role in the management of wounded service members, particularly for complex extremity reconstruction, craniofacial trauma, and general expertise on wound management. Future efforts should evaluate mechanisms to maintain these skill sets among military plastic surgeons.

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