Inhalation injury is a major contributor to mortality following burn injury. Despite recognised clinical criteria to guide the intubation of burn patients, concerns remain regarding overutilisation of intubation. Complications can arise as a result of intubation, including ventilator-associated pneumonia (VAP).
View Article and Find Full Text PDFThe aim of this study was to investigate the role of a completely synthetic dermal matrix (Biodegradable Temporizing Matrix [BTM]) for staged reconstruction of complex wounds. The authors defined complex wounds as wounds not amenable to reconstruction with skin grafting alone due to an inherent avascularity such as the presence of bare bone, tendinous, or neural structures. A retrospective review of a prospectively maintained database of complex wounds as defined above was carried out.
View Article and Find Full Text PDFThis case report details our experience using a two-stage Biodegradable Temporizing Matrix (NovoSorb® PolyNovo Ltd) and autograft for acute reconstruction of a complex perineal burn wound in an elderly comorbid patient. A 77-year-old man sustained 42% full-thickness burns extending circumferentially from bilateral thighs and buttocks, across the entire perineal and genital regions up to his mid-trunk, following self-immolation using an accelerant. Early total burn wound excision was carried out with acute application of Biodegradable Temporizing Matrix to all affected sites.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
April 2019
Presented is the case of an obese, 72 year-old diabetic man with a dorsal foot de-gloving injury. Whilst the tendons of extensor hallucis longus, extensor digitorum longus to all digits, and extensor digitorum brevis to hallux and second toe were intact after surgical debridement, none had any covering paratenon. The joint between the medial cuneiform and first metatarsal was open.
View Article and Find Full Text PDFEpithelial to mesenchymal transition (EMT) is a process whereby epithelial cells undergo transition to a mesenchymal phenotype and contribute directly to fibrotic disease. Recent studies support a role for EMT in cutaneous fibrotic diseases including scleroderma and hypertrophic scarring, although there is limited data on the cytokines and signalling mechanisms regulating cutaneous EMT. We investigated the ability of TGF-β and TNF-α, both overexpressed in cutaneous scleroderma and central mediators of EMT in other epithelial cell types, to induce EMT in primary keratinocytes and studied the signalling mechanisms regulating this process.
View Article and Find Full Text PDFAbdominoplasty is often requested by patients following massive weight loss or multi-gravida. We report the cases of three patients who had incidental asymptomatic hernias diagnosed intra-operatively during abdominoplasty. All patients had previously undergone laparoscopic procedures and two had subsequent massive weight loss.
View Article and Find Full Text PDFHand injuries account for 2000 referrals to the Northern Ireland plastic surgery trauma service each year. Emergency nurse practitioners are increasingly utilised to assess and manage minor injuries and independently refer patients to the hand trauma service. This paper uses a newly developed scoring system to assess the impact of varying grades of referring practitioner on the quality and appropriateness of referral.
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