Background/purpose: Purpura fulminans (PF) is a serious, often life-threatening disease. As more children are surviving their disease, surgeons are presented with increasing numbers of multiple and complicated wounds as sequelae of PF. The purpose of this paper is to review the management of nine cases of PF, and present the reconstruction method in treating bilateral exposed elbow and knee joints.
Methods: All cases of pediatric patients with PF and treated by the division of plastic and reconstructive surgery between 1986 and 1998 were reviewed.
Results: Seven children (78%) had meningococcal PF, and one (11%) had PF after Haemophilus influenza septicemia. PF developed in one (11%) but with no growth in either blood or cerebrospinal fluid cultures. Five children (56%) required amputation procedures. Two children (22%) required knee disarticulation. Two patients (22%) had free myocutaneous flap transfers for bone coverage. One (11%) had PF involving the face.
Conclusions: Meningococcal PF is a rare, often life-threatening disease generally of childhood. More children are surviving their diseases but with devastating sequelae. Successful reconstructive treatment outcome of these children requires a multidisciplinary team approach involving multiple specialties. The goal is to preserve function, maintain maximal length, and salvage limbs when possible. Flexibility and innovation are necessary in treating these multiple and complicated wounds.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/s0022-3468(99)90082-9 | DOI Listing |
JMIR Res Protoc
January 2025
Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
Background: An aging population in combination with more gentle and less stressful surgical procedures leads to an increased number of operations on older patients. This collectively raises novel challenges due to higher age heavily impacting treatment. A major problem, emerging in up to 50% of cases, is perioperative delirium.
View Article and Find Full Text PDFUrogynecology (Phila)
January 2025
From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Importance: Patients with urgency urinary incontinence are often recommended to avoid bladder irritants, but there is a lack of evidence for this.
Objective: The aim of the study was to compare consumption of purported bladder irritants between women with and without urgency urinary incontinence.
Study Design: We performed a case-control study of nonpregnant females aged ≥20 years using the National Health and Nutrition Examination Survey, 2007-2020.
Endocr Pathol
January 2025
Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
Merkel cell carcinoma (MCC) is diagnosed through histopathological and immunohistochemical examination of biopsies from skin or other organs. Its distinguishing features include perinuclear dot-like staining with Cytokeratin 20 (CK20) and detection of Merkel cell polyomavirus (MCPyV) using various methods. However, CK20 and MCPyV negative MCC cases have been reported at varying rates.
View Article and Find Full Text PDFLasers Med Sci
January 2025
Department of Clinical Sciences, Sapienza University of Rome, Rome, Italy.
Backgrounds And Aims: Submental skin laxity (SSL), manifesting as sagging skin and double chin, can significantly affect patients' self-perception and social interactions. While surgical treatments exist, non-invasive methods are increasingly sought for their minimal recovery time. This study assesses the safety and effectiveness of a novel microwave-based device for treating SSL, aiming to provide long-term improvements in skin tightness and appearance.
View Article and Find Full Text PDFACS Appl Mater Interfaces
January 2025
Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill 27599, United States.
Architecturally hindered crystallization of bottlebrush graft copolymers offers a reaction- and solvent-free pathway for creating injectable elastomers with tissue-mimetic softness. Currently, injectable materials involve solvents and chemical reactions, leading to uncontrolled swelling, leaching of unreacted moieties, and side reactions with tissue. To address this issue, bottlebrush copolymers with a poly(ethylene glycol) (PEG) amorphous block and crystallizable poly(lactic acid) (PLA) grafted chains (A--B) were synthesized, with grafted chains of controlled length arranged along the backbone at controlled spacing.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!