Śródoperacyjne jatrogenne oparzenie termiczne twarzy

70-letnia pacjentka została przeniesiona do Zachodniopomorskiego Centrum Leczenia Ciężkich Oparzeń w Gryficach z Kliniki Chirurgii Onkologicznej. Powodem przekazania było oparzenie termiczne twarzy, głównie III stopnia, powstałe w wyniku zapłonu tlenowej kaniuli donosowej i obłożenia chirurgicznego podczas zabiegu chirurgicznego Mohsa. W trakcie hospitalizacji pacjentka była leczona zachowawczo w celu uniknięcia okaleczającego zabiegu nekrektomii. Uzyskano pozytywny efekt gojenia rany oparzeniowej bez interwencji chirurgicznej. Rany oparzeniowe w obrębie twarzy wykazują duży potencjał samoistnego gojenia. Z tego względu kwalifikacja do zabiegu nekrektomii w tym obszarze powinna być szczególnie ostrożna.

Zastosowanie tlenoterapii hiperbarycznej w COVID-19

Pandemia COVID-19 stanowi poważne obciążenie dla sektorów ochrony zdrowia na świecie. Znaczna część objawów, potencjalnych powikłań oraz zgonów wynika z zajęcia układu oddechowego. Ograniczona liczba metod terapeutycznych o potwierdzonej naukowo skuteczności warunkuje konieczność poszukiwania nowych sposobów zwalczania zakażenia oraz podejmowania prób zastosowania klasycznych metod terapii, takich jak tlenoterapia hiperbaryczna. W niniejszym artykule omówiono patofizjologię COVID-19, ze wskazaniem potencjalnych elementów mogących świadczyć o skuteczności terapii hiperbarycznej. Opisano wpływ tlenoterapii pod zwiększonym ciśnieniem na procesy fizjologiczne, a także podsumowano zakończone i trwające prace badawcze nad wpływem tlenoterapii hiperbarycznej na przebieg choroby COVID-19.

Antyseptyki. Różnice i podobieństwa

Prawidłowo stosowane antyseptyki są w stanie zapobiec konieczność wdrożenia antybiotyków w leczeniu ran niegojących się. Szybko rozwijający się biofilm bardzo skutecznie blokuje penetrację rany przez antybiotyki, leczenie okazuje się nieefektywne i powoduje rozwój oporności drobnoustrojów. Prawidłowo dobrane antyseptyki są zupełnie wystarczające w leczeniu każdej rany niegojącej się.

Two-point flap blood glucose measurement for monitoring propeller flap perfusion – a case report

Monitoring flap perfusion is a helpful method of postoperative care allowing for proper early intervention in and salvage of a flap. The basic means of blood supply monitoring include the assessment of color, warmth, skin tension, and a pin-prick examination. Along with advances in microvascular surgery, methods of flap blood circulation assessment have been also developed. This paper presents the case of a peroneal artery propeller perforator flap for the treatment of a secondary wound resulting from an orthopedic complication of ankle arthrodesis. Blood glucose level (BGL) was used to monitor flap perfusion as an early indicator of possible venous congestion. It is well known that in case of vascular compromise, whether arterial or venous, the flap salvage rate depends on how fast the vascular problem is resolved. Arterial insufficiency is easily detectable, and the arterial flow may be also monitored with minidoppler, however venous insufficiency causes symptoms less dynamically. This fact emphasized the importance of early prediction of venous insufficiency before clinical symptoms appear. It is crucial that the time between pedicle impairment and clinical signs is as short as possible.

Zastosowanie opatrunków srebrowych w leczeniu oparzeń i odmrożeń, zespołu Lyella oraz ran przewlekłych

The skin is the largest organ of the human body and is composed of several layers each having different properties and physiological functions. The loss of skin integrity due to injury or disease can lead to acute physiological and immune disorders which may even result in death. The following properties are taken into consideration when choosing an appropriate dressing for the burn wound: the ability to support epithelialization and granulation, reduction of pain, patient discomfort, and costs. The aim of this study is to evaluate the usefulness of silver dressings in treatment of burns, frostbites, Lyell’s syndrome and chronic wounds. The use of silver dressings in thermal injuries, Lyell’s syndrome and chronic wounds had a significant effect on treatment progress. Silver dressings can be a temporary substitute for the epidermis in burns, frostbites, Lyell’s syndrome and chronic wounds.

Pomoc przedszpitalna u oparzonych

Advancements in burn treatment, in the last decades, resulted in a reduction of mortality among burn victims. Increased funding and the creation of regional burn treatment facilities focused on comprehensive therapy of severe burns resulted in improvement of treatment outcomes. Effective functioning and usage of resources in burn centers depends on the organization of prehospital care, proper segregation of patients, triage and prompt transfer to a place where highly specialized care is available. Initial care of a burn injury patient includes actions taken by witnesses of the event and by the emergency medical team during transfer to the emergency department. After evaluating and stabilizing the patient, a decision is made whether or not he should be treated at a specialized burn treatment center to which he may be transferred by land or by air. This paper presents burn patient treatment protocols at each of the following stages: at the burn scene, during transportation, initial hospital treatment and criteria for referring the patient to a burn treatment center.

Rzadka izolowana wrodzona szczelina powieki górnej z tłuszczakiem powieki – opis przypadku

Congenital eyelid defects mainly include unilateral or bilateral ptosis of epicanthic folds or atresia of the tear ducts. Eyelid defects can also be associated with cleft facial defects as described by Tessier. These defects are rare especially if they are isolated. The eyelid fissure, depending on its size, may cause a functional problem related to incomplete protection of the eye against drying out, or an aesthetic problem, which is particularly important in the psychological development of a child. The reconstruction of the upper eyelid with restoration of its full continuity is a prerequisite for improving the appearance and comfort of life of the growing child.

Częstość występowania i różnorodność patologicznych zmian w jamie ustnej u pacjentów leczonych w Zakładzie Chirurgii Stomatologicznej WUM w latach 2012–2017. Badanie retrospektywne

Introduction A large number of lesions of various etiopathogenesis may be found in the oral cavity. They range from benign inflammatory-hyperplastic changes to malignant tumors. The following study aims to statistically show the frequency and type of changes depending on the age and sex of patients treated in the Department of Dental Surgery of the Medical University of Warsaw. Material and methods 612 results of histopathological examinations of sections or entire lesions of the oral cavity collected from patients in the years 2012–2017 were analyzed. The results were analyzed in terms of gender, age and the site of tissue collection. Neoplasms and 8 other groups of lesions of the mucosa were distinguished. Results The most common lesion was fibroma (35%), followed by a chronic inflammatory process (15.4%), and salivary gland cysts (11.9%). Papillomas (HPV) accounted for 10.5%, epilemomas 9.64%, tumors 6.54%, cysts and ulcers 4.74% and 4.25%, respectively. Pre-neoplastic lesions were found in 70 cases. These included ulcerations, leukoplakia, changes with metaplasia, dysplasia and pseudo-neoplastic hyperplasia. The most common localization of pathological changes in the oral cavity was related to the gums. Conclusions Many lesions of various etiology may present with a similar clinical manifestation. Therefore, in order to correctly diagnose pathological changes in the oral cavity, it is necessary to conduct a thorough medical history and physical examination, and identify the factors that may have caused the lesion. A particular group of pathological changes of the oral mucosa are ulcers which, despite a conservative approach, do not respond to treatment. In such cases a neoplasm should be suspected and a section of the lesion be obtained for histopathological evaluation which is the only reliable method that allows a final diagnosis.

Historia leczenia rozszczepów wargi

The cleft lip and palate require a multidisciplinary and multi-step approach. The accounts of these defects can be found in texts from ancient times, which confirms their presence from the beginning of mankind. The nomenclature and methods of comprehensive treatment of cleft defects have changed over the centuries. This paper describes the evolution of the surgical approach towards these extremely complex cases. The main part of this work is based on a timeless and unprecedented in other fields of plastic surgery monograph of one of the greatest authorities in the field – Ralph Millard. In three large volumes, he describes the history of cleft lip treatment from the earliest to his contemporary times with important details crucial for understanding the subject. Other authors quoted in this paper help to objectify the medical and historical approach to the difficult topic of cleft defects.