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  1 / 13986 MEDLINE  
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[PMID]:29211672
[Au] Autor:Stevens DL; Bryant AE
[Ad] Endereço:From the Veterans Affairs Medical Center, Boise, ID; and the University of Washington School of Medicine, Seattle.
[Ti] Título:Necrotizing Soft-Tissue Infections.
[So] Source:N Engl J Med;377(23):2253-2265, 2017 Dec 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Desbridamento
Fasciite Necrosante
[Mh] Termos MeSH secundário: Anti-Inflamatórios não Esteroides/efeitos adversos
Biomarcadores/sangue
Biópsia
Proteína C-Reativa/análise
Estado Terminal
Fasciite Necrosante/diagnóstico
Fasciite Necrosante/etiologia
Fasciite Necrosante/patologia
Fasciite Necrosante/terapia
Gangrena Gasosa
Seres Humanos
Oxigenação Hiperbárica
Imunoglobulinas Intravenosas/uso terapêutico
Infecções dos Tecidos Moles
Infecções Estreptocócicas/induzido quimicamente
Streptococcus pyogenes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Biomarkers); 0 (Immunoglobulins, Intravenous); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMra1600673


  2 / 13986 MEDLINE  
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[PMID]:29169601
[Au] Autor:Warrender WJ; Lucasti CJ; Chapman TR; Ilyas AM
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
[Ti] Título:Antibiotic Management and Operative Debridement in Open Fractures of the Hand and Upper Extremity: A Systematic Review.
[So] Source:Hand Clin;34(1):9-16, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open fractures of the hand are thought to be less susceptible to infection than other open fractures because of the increased blood supply to the area. Current evidence for all open fractures shows that antibiotic use and the extent of contamination are predictive of infection risk, but time to debridement is not. We reviewed in a systematic review the available literature on open fractures of the hand and upper extremity to determine infection rates based on the timing of debridement and antibiotic administration. We continue to recommend prompt debridement and treatment of most open fractures of the upper extremity.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Desbridamento
Fraturas Expostas/cirurgia
Traumatismos da Mão/cirurgia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Fixação Interna de Fraturas
Seres Humanos
Tempo para o Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  3 / 13986 MEDLINE  
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[PMID]:29169598
[Au] Autor:Bashir MM; Sohail M; Shami HB
[Ad] Endereço:Department of Plastic, Reconstructive Surgery and Burn Unit, King Edward Medical University, Mayo Hospital, House No 327-block-H DHA, Phase 5, Lahore, Pakistan.
[Ti] Título:Traumatic Wounds of the Upper Extremity: Coverage Strategies.
[So] Source:Hand Clin;34(1):61-74, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Soft tissue coverage of traumatic wounds of the upper extremity is often required to restore adequate function and form. An optimal coverage should be stable, durable, and able to withstand heavy demands of work, should allow free joint mobility, and should have an aesthetically acceptable appearance. Reconstructive options for coverage include autologous tissue and dermal skin substitutes. Multiple factors, including wound characteristics and complexity, general condition of the patient, and surgeon comfort and expertise, help in selection of the reconstructive technique. This article summarizes commonly used soft tissue reconstructive options for traumatic wounds of the upper extremity.
[Mh] Termos MeSH primário: Lesões dos Tecidos Moles/cirurgia
Extremidade Superior/lesões
Extremidade Superior/cirurgia
[Mh] Termos MeSH secundário: Algoritmos
Desbridamento
Seres Humanos
Tratamento de Ferimentos com Pressão Negativa
Pele Artificial
Retalhos Cirúrgicos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  4 / 13986 MEDLINE  
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[PMID]:29169595
[Au] Autor:Iorio ML; Harper CM; Rozental TD
[Ad] Endereço:Department of Orthopaedics, Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA. Electronic address: mattiorio@gmail.com.
[Ti] Título:Open Distal Radius Fractures: Timing and Strategies for Surgical Management.
[So] Source:Hand Clin;34(1):33-40, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open distal radius fractures are rare injuries with few studies to guide treatment. Degree of soft tissue injury and contamination may be a primary consideration to dictate timing and operative intervention. Antibiotics should be started as early as possible and include a first-generation cephalosporin. Surgical fixation remains a matter of surgeon preference: although studies support the use of definitive internal fixation, many surgeons address contaminated injuries with external fixation. Although postoperative outcomes are similar to closed injuries for low-grade open distal radius fractures, high-grade injuries with more complex fracture patterns carry a high risk of complications, poor outcomes, and repeat surgical procedures.
[Mh] Termos MeSH primário: Fraturas Expostas/cirurgia
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Fixação Interna de Fraturas
Fraturas Expostas/classificação
Seres Humanos
Lesões dos Tecidos Moles/cirurgia
Irrigação Terapêutica
Tempo para o Tratamento
Infecção dos Ferimentos/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  5 / 13986 MEDLINE  
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[PMID]:29169590
[Au] Autor:Tulipan JE; Ilyas AM
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA. Electronic address: jacob.tulipan@gmail.com.
[Ti] Título:Open Fractures of the Hand: Review of Pathogenesis and Introduction of a New Classification System.
[So] Source:Hand Clin;34(1):1-7, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open fractures of the hand are a common and varied group of injuries. Although at increased risk for infection, open fractures of the hand are more resistant to infection than other open fractures. Numerous unique factors in the hand may play a role in the altered risk of postinjury infection. Current systems for the classification of open fractures fail to address the unique qualities of the hand. This article proposes a novel classification system for open fractures of the hand, taking into account the factors unique to the hand that affect its risk for developing infection after an open fracture.
[Mh] Termos MeSH primário: Fraturas Expostas/classificação
Fraturas Expostas/cirurgia
Traumatismos da Mão/cirurgia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Fixação de Fratura
Seres Humanos
Infecção da Ferida Cirúrgica/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  6 / 13986 MEDLINE  
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[PMID]:29428033
[Au] Autor:Lauerman M; Kolesnik O; Park H; Buchanan LS; Chiu W; Tesoriero RB; Stein D; Scalea T; Henry S
[Ti] Título:Definitive Wound Closure Techniques in Fournier's Gangrene.
[So] Source:Am Surg;84(1):86-92, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Necrotizing soft tissue infection of the perineum, or Fournier's gangrene (FG), is a morbid and mortal diagnosis. Despite the severity of FG, the optimal definitive wound closure strategy is unknown, as are long-term wound outcomes. A retrospective review was performed over a 3-year period at a single trauma center. Patients were managed according to our institutional approach focusing on primary wound closure and secondary intention healing in residual wounds. Overall 168 patients were included. Complete primary wound closure was accomplished in 39.9 per cent of patients. Patients undergoing primary wound closure were primarily male (89.6 vs 64.4%, P < 0.001), had lower mean sequential organ failure assessment (SOFA) scores (1.70 ± 2.30 vs 2.98 ± 3.36, P = 0.004), more often had perineum-limited FG (67.2 vs 42.6%, P = 0.003), and required fewer debridements (2.40 vs 2.79, P = 0.02). On logistic regression, predictors of primary closure included gender (odds ratio 4.643, 95% confidence interval 1.885-11.437, P = 0.001) and SOFA score (odds ratio 0.834, 95% confidence interval 0.727-0.957, P = 0.01). Wound healing rates increased over time, to an 82.1 per cent wound healing rate without further intervention at greater than six months of follow-up. Wounds healed with secondary intention ranged from 70 to 9520 cm3 and primary closure ranged from 126 to 6912 cm3, whereas wounds requiring skin grafts ranged from 405 to 16,170 cm3. Complete primary wound closure is often achievable in FG patients. Using this standardized approach to FG wound management, even large wounds and wounds undergoing secondary intention healing will often close with long-term wound care and do not require flap creation or early skin grafting.
[Mh] Termos MeSH primário: Gangrena de Fournier/cirurgia
Técnicas de Fechamento de Ferimentos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Desbridamento/métodos
Feminino
Seguimentos
Gangrena de Fournier/mortalidade
Seres Humanos
Masculino
Meia-Idade
Orquiectomia/métodos
Orquidopexia/métodos
Estudos Retrospectivos
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


  7 / 13986 MEDLINE  
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[PMID]:29390269
[Au] Autor:Wang J; Wang D; Du J; Lin Z
[Ti] Título:A new strategy to reconstruct type III acetabular bone defect associated with inflammatory pseudotumor: combined medial and lateral acetabular bone grafting: A case report.
[So] Source:Medicine (Baltimore);96(50):e8777, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Inflammatory pseudotumor has been commonly reported in patients undergoing total hip arthroplasty (THA). PATIENT CONCERNS: We reported a patient who had a massive intra-pelvic pseudotumour and acetabular bone defect underwent two-stage revision THA. DIAGNOSES: A new surgical strategy for pseudotumor after THA is performed. INTERVENTIONS: Thorough debridement intra-pelvic pseudotumour via Smith-Petersen approach, bone grafting on iliac medial surface and plate-screw internal fixation were performed in the first stage, followed by revision of the loosened prosthesis to a cementless primary prosthesis in the second stage. OUTCOMES: A follow-up for 5 years showed satisfactory recovery of function. LESSONS: This surgical revision is less invasive than conventional methods, resulting in a stable and well-functioning hip joint after mid-term follow-up for 5 years.
[Mh] Termos MeSH primário: Acetábulo/transplante
Artroplastia de Quadril/efeitos adversos
Doenças Ósseas/cirurgia
Granuloma de Células Plasmáticas/cirurgia
Ossos Pélvicos/cirurgia
[Mh] Termos MeSH secundário: Adulto
Desbridamento
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008777


  8 / 13986 MEDLINE  
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[PMID]:27778039
[Au] Autor:Kamal A; Kanakeshwar RB; Shyam A; Jayaramaraju D; Agraharam D; Perumal R; Rajasekaran S
[Ad] Endereço:Department of spine surgery, Ganga Hospital, 313, Mettupalayam road, Coimbatore, India.
[Ti] Título:Variation in practice preferences in management of open injuries of extremities-an international survey by SICOT research academy.
[So] Source:Int Orthop;41(1):3-11, 2017 Jan.
[Is] ISSN:1432-5195
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Open fractures are challenging injuries and there is a lot of variation in practice preferences which may reflect the wide variations in outcome in different units across the world. A survey was done amongst the international community of SICOT membership to document the practice preferences and variations. METHODS: An online questionnaire containing 23 questions which were sub-divided into three sections covering the various aspects of open injury management was sent by email to orthopaedic trauma surgeons across the world. A total of 358 responses were evaluated and presented in this manuscript. RESULTS: The SICOT study confirmed wide variation in practice protocols. About 94.7 % of orthopaedic surgeons around the world use the Gustillo Anderson scoring system for assessment of open injury and 50.6 % of surgeons prefer lavage in operation theatre. For lavage, 84.6 % of surgeons preferred normal saline and for antibiotic prophylaxis, 48.3 % used a combination of second generation cephalosporin, metronidazole and an aminoglycoside for a minimum of three to five days. In 88 % of patients, orthopaedic surgeons performed the initial debridement and 69.2 % surgeons aimed for debridement within six hours. Regarding wound management, 43.9 % units preferred and were capable of soft tissue cover within 72 hours and about 26.3 % surgeons combined definitive fixation along with plastic procedure. CONCLUSION: Our study documented wide variations in practice preferences across the world and showed that information and awareness about current guidelines and practices will help many to update themselves in terms of basic questions about open fracture care.
[Mh] Termos MeSH primário: Fraturas Expostas/terapia
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Antibioticoprofilaxia/estatística & dados numéricos
Desbridamento/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Inquéritos e Questionários
Irrigação Terapêutica/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00264-016-3311-3


  9 / 13986 MEDLINE  
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[PMID]:29381958
[Au] Autor:Baez-Pravia OV; Díaz-Cámara M; De La Sen O; Pey C; Ontañón Martín M; Jimenez Hiscock L; Morató Bellido B; Córdoba Sánchez ÁL
[Ad] Endereço:Intensive Care Unit.
[Ti] Título:Should we consider IgG hypogammaglobulinemia a risk factor for severe complications of Ludwig angina?: A case report and review of the literature.
[So] Source:Medicine (Baltimore);96(47):e8708, 2017 11.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) are rare forms of complication of Ludwig angina. These potentially lethal infections are difficult to recognize in early stages and are often associated with predisposing factors like diabetes and immunocompromised states. Moreover, IgG hypogammaglobulinemia (hypo-IgG) is considered to be a risk factor of mortality in patients with septic shock; however, it is not routinely quantified in patients with extremely serious infections, particularly in cases with no history or evidence of immunocompromising disorders. PATIENT CONCERNS: We present a case of a 58-year-old woman who survived Ludwig angina, complicated by CNF and DNM. Despite a rapid diagnosis, aggressive surgical debridement and broad-spectrum antibiotics, the infection and necrosis advanced, requiring multiple surgical interventions and long intensive care unit (ICU) support. CONCLUSION: We hypothesize that detecting a low level of endogenous IgG and treating with adjuvant passive immunotherapy was key in determining a favorable outcome.
[Mh] Termos MeSH primário: Agamaglobulinemia/complicações
Fasciite Necrosante/etiologia
Imunoglobulina G
Angina de Ludwig/complicações
Mediastinite/etiologia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Implantes Dentários/efeitos adversos
Fasciite Necrosante/terapia
Seres Humanos
Angina de Ludwig/etiologia
Mediastinite/terapia
Meia-Idade
Pescoço
Fatores de Risco
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Dental Implants); 0 (Immunoglobulin G)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008708


  10 / 13986 MEDLINE  
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[PMID]:29298017
[Au] Autor:Zaitseva EL; Tokmakova AY; Shestakova MV; Galstyan GR; Doronina LP
[Ti] Título:The Study of Influence of Different Methods of Local Treatment on Wound Healing in Patients with Diabetic Foot Ulcers.
[So] Source:Vestn Ross Akad Med Nauk;71(6):466-71, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Aim: To evaluate the influence of different methods of local treatment on tissue repair in patients with diabetic foot ulcers. Materials and Methods: We evaluated such clinical characteristics as wound size and local perfusion after using negative pressure wound therapy (NPWT), local collagen, and standard care in patients with diabetic foot ulcers. We observed 63 patients with neuropathic and neuroischemic forms of diabetic foot (without critical ischemia) after surgical debridement. After that 21 patients received NPWT, 21 local collagen treatment and 21 ­ standard care. Results: After using NPWT wound area and depth decreased in 19,8% and 42,8% (p<0.05), in group of collagen dressings in 26,4 and 30,4% (p<0.05). In control group those parameters were 17,0 и 16.6% respectively (p<0.05). There was found the significant increase of local perfusion according to oxygen monitoring in group of NPWT (p<0.05). Conclusion: The received data showed that the intensity of lower limb tissue repair processes increases more significant after using NPWT and collagen dressings in comparison to standard care which is found according to wound size and tissue perfusion alterations.
[Mh] Termos MeSH primário: Colágeno/uso terapêutico
Desbridamento/métodos
Pé Diabético
Tratamento de Ferimentos com Pressão Negativa/métodos
[Mh] Termos MeSH secundário: Idoso
Curativos Biológicos
Pé Diabético/diagnóstico
Pé Diabético/fisiopatologia
Pé Diabético/terapia
Feminino
Seres Humanos
Masculino
Meia-Idade
Imagem de Perfusão/métodos
Fluxo Sanguíneo Regional
Resultado do Tratamento
Cicatrização/efeitos dos fármacos
Cicatrização/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
9007-34-5 (Collagen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn735



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