The Parkland 12-Minute Checklist Tracheotomy.

Purpose: To validate the surgical time and propose a new checklist or algorithm to execute a tracheotomy within 12 minutes with optimal outcomes.

Materials And Methods: The authors designed and implemented a checklist method for tracheotomy based on 6 consecutive patients with respiratory failure and prolonged intubation in a medical intensive care unit. The primary outcome variable was surgical time for a tracheotomy performed by a fifth- or sixth-year resident under the supervision of the senior author (M.

Delayed ear reconstruction: case report of reconstruction of an avulsed ear 2 days after injury.

Auricular reattachment and reconstruction following traumatic ear avulsion is a challenging surgical problem. Suggested reconstruction methods include direct reattachment, composite grafting, pocket methods, coverage with periauricular flaps, and microsurgical repair. A published alternative is reattachment and burial of the amputated part under a postauricular flap.

The 7-hole angle plate for mandibular angle fractures.

Purpose: To evaluate the 7-hole angle plate for open reduction, internal fixation of mandibular angle fractures when the Champy technique is inadequate and more rigid or semirigid fixation is beneficial and to provide rational indications for the choice of the 7-hole angle plate.

Patients And Methods: Retrospective evaluation of 10 patients selected at Parkland Memorial Hospital over a 2-year period when the 7-hole angle plate stabilized their angle fracture. Patients were evaluated for postoperative complications including pain, malocclusion, and infection.

Actinic keratosis: from the skin to the lip.

Purpose: Actinic keratoses are commonly the result of intense sun damage to the skin and lips of susceptible patients. The purposes of this 2-section article are to familiarize the surgeon with options for care and to suggest methods of incorporation into practice as a true benefit to patients.

Patients And Methods: The first section discusses the options chosen for patients who were referred to the Facial Lesion Clinic in a county hospital for precancerous or cancerous facial lesions; the second section reviews ramifications for precancerous sun-damaged lips with clinical leukoplakia.

Cutaneous cysts of the head and neck.

Purpose: This article reviews the types of cutaneous cysts in patients referred to the Facial Lesion Clinic at John Peter Smith Hospital in Fort Worth, TX, and proposes effective treatment modalities based on lesion and patient variables. Cyst variables included proper identification, size of the lesion, and acute or chronic processes. Patient considerations included age, skin type, and location.

Reconstruction of skin cancer defects of the auricle.

Purpose: This article reviews the results of reconstruction of surface defects of the auricle after removal of skin cancer, and discusses the results of the delayed reconstruction method of care and modalities of treatment.

Patients And Methods: Fifty-four patients with 62 defects involving various locations on the auricle were treated. Management included direct closure, secondary epithelization, full thickness skin grafts, local flaps using direct advancement, and rotational advancement flaps using one or more stages.

Pivot point and secondary defect problems with rotation flaps.

Purpose: Our goal was to evaluate 2 design properties, pivot point and secondary defect, that affect the results of rotation flaps used to treat skin cancer defects of the head and neck.

Materials And Methods: We conducted a retrospective review of the last 50 patients who underwent rotation flaps for closure of skin cancer defects on the head and neck with regard to postoperative complications.

Results: Four patients experienced complications, all of which were managed to an acceptable conclusion.

Fibula microvascular free tissue reconstruction of the severely comminuted atrophic mandible fracture--case report.

Severely atrophic comminuted fractures of the mandible often have inadequate bone stock available to allow for adequate rigid fixation and subsequent progression to union. Grafting with rib, iliac crest or a variety of allograft materials is required in order to increase the success rate of the repair in this patient population. In this article, we report our favourable experience in using a fibula microvascular free tissue transfer for the treatment of a particularly challenging patient with a fractured atrophic mandible.