Influence of methotrexate on the frequency of postoperative infectious complications in patients with rheumatoid arthritis.

Objective: To evaluate the influence of methotrexate (MTX) on the frequency of postoperative complications in patients with rheumatoid arthritis (RA).

Methods: We conducted a randomized unblinded prospective study in 64 patients with RA treated with MTX and who underwent orthopedic surgery. Two groups of patients were constituted: in Group A (32 patients), MTX was interrupted 7 days before the surgery; in Group B (32 patients), MTX was not discontinued.

[Esthetic reconstruction of the face in burnt patients].

All reconstruction should be aesthetic but in burned patient, everything combines to make a cosmetically satisfactory result more difficult to achieve. However the burns patients, deformed and disfigured has to confront the gaze of others in daily life. Three points are discussed by authors: skin quality can be improved or replaced by a full thickness pressure graft; surgical modification of the underlying structures; repair of peri-orificial areas and free edges.

Primary pressure grafts in early reconstruction of deep facial burns.

The face is an area of great cosmetic importance where the repair of deep burns is particularly delicate, as both appearance and function must be taken into account. In order to improve the aesthetic prognosis of full skin thickness facial burns, a primary pressure graft technique was used in eight patients. Early excision was carried out during postburn day 3 and after good-quality granulation tissue was obtained around day 10, a full skin thickness graft was applied.

Severe electric injuries of the hand and forearm.

Electrical injuries of the upper limb produce major destruction of tissue mainly affecting the forearm, since the hand is usually the site of entry of current. Limb salvage, if it is to be successful, requires the rapid institution of a number of surgical procedures. Vein grafting to restore blood supply is frequently required and just as frequently requires skin flap cover following adequate debridement.