Composite Graft Replacement of Digital Tips

1997 ◽  
Vol 22 (3) ◽  
pp. 346-352 ◽  
Author(s):  
N. S. MOIEMEN ◽  
D. ELLIOT
Keyword(s):  
Delay Time ◽  
Composite Graft ◽  
Graft Replacement ◽  
Mean Delay ◽  
Successful Group ◽  
The Mean

This study investigated the outcome of composite graft replacement of 50 amputated digital tips in 50 children over a period of 3 years and 6 months. Eleven of 18 tips (61%) which were replaced within 5 hours survived completely while none of 32 digital tips replaced after 5 hours survived completely. This difference was highly significant. The mean delay time between amputation and replacement in the successful group was 3.9 hours and in the others was 7.2 hours. This difference was also statistically significant. The implications of the findings of this series to the use of this treatment are discussed.

scholarly journals Constraints on SN Ia Progenitors and ICM Enrichment from Field and Cluster SN Rates

2005 ◽  
Vol 192 ◽  
pp. 561-565
Author(s):  
D. Maoz ◽  
A. Gal-Yam
Keyword(s):  
Star Formation ◽  
Delay Time ◽  
High Redshift ◽  
Core Collapse ◽  
Short Delay ◽  
Cluster Galaxies ◽  
Mean Delay ◽  
Short Delay Time ◽  
Type Ia ◽  
The Mean

SummaryThe iron mass in galaxy clusters is about 6 times larger than could have been produced by core-collapse SNe, assuming the stars in cluster galaxies formed with a standard IMF. Type-Ia SNe have been proposed as the alternative dominant iron source. We use our HST measurements of the cluster SN-Ia rate at high redshift to study the cluster iron enrichment scenario. The measurements can constrain the star-formation epoch and the SN-Ia progenitor models via the mean delay time between the formation of a stellar population and the explosion of some of its members as SNe-Ia. The low observed rate of cluster SNe-Ia at z ~ 1 pushes back the star-formation epoch in clusters to z > 2, and implies a short delay time. We also show a related analysis for high-z field SNe which implies, under some conditions, a long SN-Ia delay time. Thus, cluster enrichment by core-collapse SNe from a top-heavy IMF may remain the only viable option.

Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON
Keyword(s):  
Emergency Department ◽  
Complete Resolution ◽  
Wound Care ◽  
Duration Of Treatment ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
The Mean ◽  
Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

scholarly journals Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 39-47
Author(s):  
Connor Zale ◽  
Joshua Hansen ◽  
Paul Ryan
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Healthcare System ◽  
Pain Syndrome ◽  
Occupational Outcomes ◽  
Mean Delay ◽  
Significant Difference ◽  
The Mean ◽  
Over Time

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.

Functional dystonia in the foot and ankle

2021 ◽  
Vol 103-B (6) ◽  
pp. 1127-1132
Author(s):  
Julia Gray ◽  
Matthew Welck ◽  
Nicholas P. Cullen ◽  
Dishan Singh
Keyword(s):  
Age Of Onset ◽  
Pain Syndrome ◽  
Rapid Onset ◽  
Response To Treatment ◽  
Foot And Ankle ◽  
Mean Delay ◽  
Chronic Regional Pain Syndrome ◽  
Injury Event ◽  
The Mean ◽  
A Minor

Aims To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle. Methods We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia. Results A total of 29 patients were seen. A majority were female (n = 25) and the mean age of onset of symptoms was 35.3 years (13 to 71). The mean delay between onset and diagnosis was 7.1 years (0.5 to 25.0). Onset was acute in 25 patients and insidious in four. Of the 29 patients, 26 had a fixed dystonia and three had a spasmodic dystonia. Pain was a major symptom in all patients, with a coexisting diagnosis of chronic regional pain syndrome (CRPS) made in nine patients. Of 20 patients treated with Botox, only one had a good response. None of the 12 patients who underwent a surgical intervention at our unit or elsewhere reported a subjective overall improvement. After a mean follow-up of 3.2 years (1 to 12), four patients had improved, 17 had remained the same, and eight reported a deterioration in their condition. Conclusion Patients with functional dystonia typically presented with a rapid onset of fixed deformity after a minor injury/event and pain out of proportion to the deformity. Referral to a neurologist to rule out neurological pathology is advocated, and further management should be carried out in a movement disorder clinic. Response to treatment (including Botulinum toxin (Botox) injections) is generally poor. Surgery in this group of patients is not recommended and may worsen the condition. The overall prognosis remains poor. Cite this article: Bone Joint J 2021;103-B(6):1127–1132.

Composite Graft Replacement of the Aortic Root: Long-term Results, Incidence of Reoperations

1999 ◽  
Vol 47 (05) ◽  
pp. 317-321 ◽  
Author(s):  
U. Niederhäuser ◽  
A. Künzli ◽  
M. Genoni ◽  
P. Vogt ◽  
M. Lachat ◽  
...  
Keyword(s):  
Aortic Root ◽  
Composite Graft ◽  
Long Term Results ◽  
Graft Replacement

scholarly journals Results of composite graft replacement for aortic root aneurysms

1980 ◽  
Vol 80 (5) ◽  
pp. 754-759 ◽  
Author(s):  
Hovald K. Helseth ◽  
John J. Haglin ◽  
Bjorn K. Monson ◽  
Per H. Wickstrom
Keyword(s):  
Aortic Root ◽  
Composite Graft ◽  
Graft Replacement

scholarly journals Outcome of Myringoplasty with Temporalis Fascia and Perichondrial-Cartilage Composite Graft in High Risk Perforations

2019 ◽  
Vol 21 (1) ◽  
pp. 60-64
Author(s):  
Anup Dhungana ◽  
RR Joshi ◽  
AS Rijal ◽  
KK Shrestha ◽  
S Maharjan
Keyword(s):  
High Risk ◽  
Tympanic Membrane ◽  
Uptake Rate ◽  
Pure Tone Audiometry ◽  
Composite Graft ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Significant Difference ◽  
The Mean ◽  
And Cartilage

 The objective of this study was to compare the graft uptake results and postoperative hearing of myringoplasty with temporalis fascia and cartilage-perichondrial composite graft in high risk perforations. Patients of age 13 years and above with diagnosis of chronic otitis media – mucosal type with high risk perforation that is >50% perforation of tympanic membrane, revision cases, absent/ eroded handle of malleus, oedematous/unhealthy middle ear mucosa and marginal involvement cases were included for myringoplasty. Pure Tone Audiometry was done within 1 week before surgery. 80 cases were included for myringoplasty which were randomly allocated by lottery method with 40 cases each in temporalis fascia group and cartilage perichondrial composite graft group. Graft uptake results were assessed after 6 weeks and postoperative hearing was evaluated and compared within and between the groups. Graft uptake rate in temporalis fascia group and cartilage perichondrial composite graft group was 90% and 92.5%, respectively with no significance difference in the graft uptake rate (p = 0.692) between the groups. The mean pre and post-operative air bone gap in temporalis fascia group and cartilage perichondrial composite group were 30.69dB±10.19,16.36±8.37dB and 33.73±8.07dB, 20.76±9.47dB, respectively with highly significant difference in both groups (p < 0.001) showing improvement in the hearing after surgery in both groups. The mean air bone gain were 14.33dB and 12.97dB in temporalis fascia and cartilage perichondrial composite group respectively with no significant difference between the groups (p=0.469). The graft uptake rate and hearing results after cartilage perichondrial composite graft are comparable to those of temporalis fascia graft. Furthermore, the cartilage perichondrial composite graft is more rigid and thick so it is more resistant than fascia to anatomic deformation and necrosis. Therefore, we recommend the use of cartilage perichondrial composite graft for tympanic membrane reconstruction in high risk perforation without concern about affecting audiometric results.

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