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Peri-operative care
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Wound healing by primary/first intention: describes mechanical closure with direct apposition of the skin edges (e.g. with staples, sutures, glue). This should which ideally be performed <6 hours from time of injury and is the preferred method of wound healing in clean wounds where there is minimal soft tissue loss and healthy tissue. Advantages: results in better cosmesis and healing time compared to healing by secondary intention.
Mathematical Modeling and Analysis of Soft Tissue Viscoelasticity and Dielectric Relaxation
Published in A. Bakiya, K. Kamalanand, R. L. J. De Britto, Mechano-Electric Correlations in the Human Physiological System, 2021
A. Bakiya, K. Kamalanand, R. L. J. De Britto
The tissues in the human body can be classified into soft and hard tissues. The soft tissues play a significant role in the proper structural and functional characteristics of the physiological system. The various soft tissues in the human physiological system include the tendons, muscles, ligaments, fascia, skin, nerves, fibrous tissues, fat and blood vessels. Soft tissues is are classified into connective and non-connective tissue (Figure 1.3).
Calcaneal fractures
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Devendra Mahadevan, Adam Sykes
Soft tissue complications can occur acutely at the time of injury or later as a result of the further insult of surgery. The soft tissue envelope should be assessed at the time of injury, as any impending problems should be addressed urgently. Ice, elevation and careful monitoring should be implemented to ensure that swelling and subsequent tissue hypoxia is kept to a minimum.
Rehabilitation of a patient with bilateral rectus abdominis full thickness tear sustained in recreational strength training: a case report
Published in Physiotherapy Theory and Practice, 2022
Omer B. Gozubuyuk, Ceylan Koksal, Esin N. Tasdemir
There is no clear definition of the rehabilitation program for the abdominal wall injuries documented in the literature (Balius et al., 2011). Treatment usually consists of correcting the soft tissue dysfunction and strengthening the injured muscles. The restoration of the lumbopelvic stability and eccentric control of trunk muscles need particular emphasis (Brukner and Khan, 2012). Balius et al. (2011) followed their protocol in their abdominal wall injury series of 5 cases, consisting of relative rest in the first 72 hours and pain medications and ice. Although our patient presented to our clinic more than 1 month after the injury, we initially used physical modalities as a first-line treatment for pain control due to his severe pain. Balius et al. (2011) continued with TA activation exercises on day 4; however, we could only initiate this in the second week. Our case’s major distinct features were; our patient was a sedentary male and his injury was a full-thickness and bilateral tear of the TA muscle.
Lisfranc injury: Prevalence and maintaining a high index of suspicion for optimal evaluation
Published in The Physician and Sportsmedicine, 2022
Michael C. Meyers, James C. Sterling
Stable anatomical alignment is considered the best predictor for outcome [88,89]. Conservative non-surgical care is reserved for those injuries that are truly stable and non-displaced such as Stage I defined by Nunley and Vertullo [4]. While the isolated soft tissue injuries can be managed without surgery [90], surgical intervention is needed for the more complex unstable injuries such as Stage II and Stage III. However, Stage I with greater than 2 mm displacement, with or without fractures needs surgery as well as Stage II and III [62]. The athlete with a stable Lisfranc injury should not be allowed to compete for the remainder of the season. Operative treatment is required for optimal outcomes [91,92]. Surgical considerations are supported by these clinical findings: presence of the “fleck sign”, proximal metatarsal fracture (any number), widening of the first and second metatarsal base and MRI/CT scan with abnormal findings [93].
The four category systematic approach for selecting patients for face transplantation
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Matias Sipilä, Emma-Lotta Kiukas, Andrew Lindford, Tuija Ylä-Kotola, Jouni Lauronen, Harri Sintonen, Patrik Lassus
Patients with a severe facial deformity often have panfacial injuries or large areas of their face injured. Soft-tissues with or without bony injuries may be involved. There may be additional iatrogenic facial injuries that occur during attempts at conventional reconstruction. The Boston group have previously reported an inclusion criteria for FT consisting of a defect comprising over 25% of the face and/or loss of one of the major facial features, such as the nose, lip(s), or eyelid(s) [1]. There has also been some debate regarding whether or not patients should be subjected to a full or partial FT. The Boston group has advocated preserving all of the patient’s functional tissue and only removing and restoring what is non-functional [18]. From the perspective of the aesthetic outcome, a partial FT is often more discernible and might not succeed in restoring a near to normal appearance. Moreover, if the aesthetic outcome is considered to be one parameter of success it would then be advisable to perform a full FT in a patient with a large portion of their face injured [19]. The flip side is that the latter would increase the stakes in view of possible early or late graft failure. Our approach has been to preserve all functioning tissue in view of this being a high-risk procedure. In addition, a back-up plan should be in place in the event of acute or early graft loss [20].