scholarly journals Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. I. Surgical Never Events: 3. Urological Electrosurgical Never Events

2018 ◽  
Vol 12 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Rabea A. Gadelkareem
Keyword(s):  
Plastic Surgery ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Tertiary Level ◽  
Skin Burn ◽  
Penile Shaft ◽  
Hospital Records ◽  
Major Complications ◽  
Never Events ◽  
Multiple Bone Fractures

Introduction: Surgical fires are unique topics that belong to surgical never events and deserve urological attention. Materials and Methods: A retrospective search of our hospital records was done for the states of electrosurgical never events in the period from July 2001 to June 2016. The included events were classified according to the site of occurrence in relation to the patient's body and possibilities of human involvement. The events were studied for the type, extent, damages, personnel involvements, complications, and management. Results: Of more than 82,000 urological interventions, 18 cases (0.022%) of electrosurgical never events were detected. Four subcategories were differentiated: electrosurgical theater fires (33.3%), electrosurgical contact skin burns (38.9%), electrosurgical internal injuries (16.7%), and electrocutions (11.1%). Electrosurgical theater fires included 3 ignition fires with fire skin burns and 3 device explosions. Fires only occurred with the use of alcoholic skin disinfectants. Contact skin burns resulted from inadvertent direct electrosurgical contacts, with 2 burns on the back, 3 burns on the lower limbs, 1 burn at the penile shaft, and 1 burn at the suprapubic region. Only 1 case of contact skin burn required plastic surgery. Electrosurgical internal in-juries involved the intestine, spleen, and urethra and were followed by major complications. Electrocutions involved a doctor and a patient with multiple bone fractures in the former. Conclusion: Urological electrosurgical never events are very rare incidents and were differentiated into 4 clinical subcategories. Human involvements varied from absence to major devastating complications. Reduction of these events depends on the adjusted use of electricity-based armamentarium.

scholarly journals Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

2021 ◽  
Vol 18 (8) ◽  
pp. 4219
Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Heterotopic Ossification ◽  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
University Hospital ◽  
Pain Sensation ◽  
Vein Thrombosis ◽  
Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

scholarly journals PROFILE OF PLASTIC SURGERY TRAUMA PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

2019 ◽  
pp. 1-4
Author(s):  
Darwin Firmansyah Siregar ◽  
Frank Bietra Buchari ◽  
Utama Abdi Tarigan ◽  
Aznan Lelo
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Bone Fractures ◽  
Soft Tissue Injuries ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Adult Age ◽  
Common Etiology ◽  
Tissue Injuries ◽  
Age Range

Introduction: According to data from Perhimpunan Dokter Bedah Plastik Rekonstruksi dan Estetik Indonesia (PERAPI), there are only 193 plastic surgeons throughout Indonesia. There is no sufcient data that described pattern of incidence, workload, and role of Plastic Surgery in trauma cases at Indonesian Referral Center Hospital, especially in the Province of North Sumatra. Methods: This research is a descriptive study with a retrospective approach. Sample of this study was medical records of trauma patients who required Plastic Surgery who came to the H. Adam Malik General Hospital Medan Emergency Room (1 January 2016-31 December 2018). This study used total sampling method. Results: This study involved 536 patients and 40.85% included in the adult age range. Men vs women ratio is 3:1 (405 vs 131). Based on type of injury, the most common injury is facial trauma, followed by burns and soft tissue injuries (291, 178 and 66). The most common etiology is trafc accidents (90 cases). Most of facial bone fractures located at mandibular bone (segmental fracture). Inhalation trauma due to burns only occurred in 6 cases (3.24%). Most of soft tissue injuries occurred at lower extremities (upper limbs). Conclusion: Trafc accidents are the most common etiology for trauma in Plastic Surgery. Most of the patients are men and included in the adult age range. Facial trauma is the most common injury in Plastic Surgery. Most facial bone fractures located at mandible (symphysis and parasymphysis). Most of burns injury are re burns. Most soft tissue injuries are located at lower extremities (upper limbs).

Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Bone Fractures ◽  
Infectious Complications ◽  
Lower Limbs ◽  
Oncologic Patients

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

scholarly journals Recurrent infections and multiple bone fractures in a 4-year-old child.

1998 ◽  
Vol 74 (874) ◽  
pp. 497-498 ◽  
Author(s):  
A. Vaghjimal ◽  
J. Shliozberg ◽  
A. Rubinstein
Keyword(s):  
Bone Fractures ◽  
Recurrent Infections ◽  
Multiple Bone Fractures

scholarly journals Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Early Assessment ◽  
Group I ◽  
Group Ii ◽  
Degloving Injuries

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

scholarly journals Complex Neuro-Muscular favorable rehabilitation program of a patient with politrauma including spinal cord injury and multiple bone fractures

2018 ◽  
Vol 9 (3) ◽  
pp. 260-263 ◽  
Author(s):  
Cristina Octaviana Daia ◽  
◽  
Sabina Solcan ◽  
Andra Cristina Mihai ◽  
Diana Elena Nita ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bone Fractures ◽  
Rehabilitation Program ◽  
Cord Injury ◽  
Multiple Bone Fractures

scholarly journals Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

2017 ◽  
Vol 3 (3) ◽  
pp. 557 ◽  
Author(s):  
Hrishikesh Pande ◽  
Chander Mohan Singh ◽  
Anjan Prabhakara ◽  
Vivek Mathew Philip ◽  
Mohd Shezan Iqbal ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Ilizarov Technique ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Long Bone Fractures ◽  
Ilizarov Ring Fixator

<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>

Repeated never events in plastic surgery: Can human factors help us understand why we fail?

2020 ◽  
Vol 73 (1) ◽  
pp. 184-199 ◽  
Author(s):  
Juan Enrique Berner ◽  
Vimal Gokani ◽  
Jessica Savage ◽  
Adam Blackburn
Keyword(s):  
Human Factors ◽  
Plastic Surgery ◽  
Never Events
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