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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In a 39-year-old man who was previously shown to be allergic to neomycin and bacitracin, systemic contact dermatitis developed from a root canal paste filling containing both antibiotics. Symptoms included generalized itching, erythema and edema of the face, inflammation of the oral mucosa with difficulty in swallowing and breathing, and aggravation of previously existing eczema on the amputation stump of a leg (where he had become sensitized to neomycin and bacitracin). Oral treatment with bacitracin had considerably aggravated the dermatitis and oral provocation with neomycin resulted in itching of the skin in the popliteal folds, follicular eczema at those locations and edema of the face (138). This case of systemic contact dermatitis was caused by resorption of neomycin and bacitracin from the dental root canal paste.
Principles of lower limb prosthetics and rehabilitation
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Rajiv S Hanspal, John Sullivan
The characteristics of the amputation stump have a significant influence on the ability to tolerate and control a prosthesis (Figure 21.1). The stump is a mechanical lever and a short stump reduces the mechanical advantage. A correlation exists between the length of stump and quality of gait. A short transfemoral stump and the associated loss of adductor mass magnify the Trendelenburg effect, a common characteristic of transfemoral gait (6).
Principles of Operative Treatment
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
Applying an amputation stump bandage requires skill and experience. It involves figure-of-eight bandaging in a manner that provides firm pressure over the stump end (and thus aids haemostasis) without circumferential compression that may risk impeding venous return.
Endovascular therapy and free flap transfer in chronic limb-threatening ischemia
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Shoichi Ishikawa, Kiyohito Arai, Takeshi Kurihara, Tomoya Sato, Shigeru Ichioka
The arterial anastomosis location was determined In consultation with the endovascular physician based on the preoperative angiogram. Although the site of ballooning of the artery should be avoided due to the possibility of intimal damage, most cases were ballooned over a wide area and anastomosis was performed in that area. In most cases, side-to-end arterial anastomosis was performed by creating a hole in the recipient artery. If an artery near the midfoot amputation stump was available, an end-to-end arterial anastomosis was performed because there was no need to preserve the peripheral blood flow beyond the anastomosis. Arterial anastomoses were performed using 8-0 or 7-0 nonabsorbable monofilaments to penetrate calcified lesions, and double needles were used to avoid intimal dissection.
Comparative analysis of clinical outcome and quality of life between amputations and combined bone and flap reconstructions at the lower leg
Published in Disability and Rehabilitation, 2022
Björn Behr, Sebastian Lotzien, Marcel Flecke, Christoph Wallner, J. Maximillian Wagner, Mehran Dadras, Adrien Daigeler, Thomas A. Schildhauer, Marcus Lehnhardt, Jan Geßmann
Post-surgery rehabilitation was performed according to standard protocols and included a comprehensive hospital-based rehabilitation followed by an ambulant based physiotherapist assisted rehabilitation therapy. For amputees, after completion of the initial wound healing phase, an individual liner was manufactured for the amputation stump. Ambulation was encouraged with forearm crutches for approximately five weeks, until the liner and a testing lower leg prosthesis was administered by an orthopedic technician. Upon receipt of the permanent prosthesis, an in-patient rehabilitation program including physiotherapy, sports (including swimming) and counseling regarding car-conversions, etc. were administered. Upon request, psychological support as well as a peer support mentoring program were available.
Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report
Published in Paediatrics and International Child Health, 2021
Priyanka S. Amonkar, Jeetendra B. Gavhane, Suhas N. Kharche, Sameer S. Kadam, Dattatray B. Bhusare
As the gangrene of the right limb progressed, embolectomy was undertaken on Day 12 of hospitalisation. A 1-cm clot was retrieved from the distal aorta and a small clot was removed from the right common iliac artery. Post-embolectomy Doppler demonstrated flow in the common femoral, deep femoral and popliteal arteries bilaterally, and the aorta showed no evidence of thrombus. Unfortunately, on Day 16, amputation of the right limb below the knee was required, and low molecular weight heparin and aspirin were commenced. Oral corticosteroids were continued, and inflammatory markers showed serial return to normal by Day 21 (Day 31 of life) (Table 1). The neonate was discharged on Day 28 with aspirin for 6 weeks and a plan to taper corticosteroids over the following 4 weeks. At 1-month follow-up, he was doing well with adequate weight gain and good healing of the wound, and there were no amputation stump-related complications.