Urgent Care Centers and What You Need to Know.

Interpretation of and adaption to the health care environment have become a daily activity in the practice of medicine. Patients need health care that is affordable, convenient, and timely. The evolution of urgent care centers has been based on their ability to adapt in the face of changes and respond to patient needs to become a viable entry point into the health care system.

Necrotizing fasciitis: Diagnosis and management of an occult infective focus.

Necrotizing fasciitis is a life-threatening, fulminant disease that is a diagnostic and therapeutic challenge. Presenting with a triad of findings including progressive erythema, severe dermatological edema and severe pain disproportionate to the physical findings, this disease is a surgical emergency. Delayed diagnosis and surgical debridement lead to higher mortality.

Intraoperative acute tissue expansion revisited: a valuable tool for challenging skin defects.

Background: The efficacy of acute tissue expansion (ATE) in achieving skin closure has been strongly debated. Proponents maintain that ATE is efficacious, whereas critics have argued for lack of supporting scientific data and that ATE is no more effective than skin undermining in closure of surface defects.

Objective: To compare and actually quantify gain in skin length after extensive undermining of skin edges alone or in combination with ATE in skin defects.

Management of iatrogenic injury to the spinal accessory nerve.

Spinal accessory nerve injury results in a debilitating shoulder dysfunction. The trapezius is a major suspensory muscle of the shoulder girdle, and paralysis results in chronic pain and debility from disruption of synchronous scapulohumeral rhythm. This injury usually follows a simple posterior triangle lymph node biopsy and is treatable if appropriate measures are taken in a timely fashion.