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Instruments and Implants in Hand Surgery
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Anil K Bhat, Ashwath M Acharya, Mithun Pai G
Bone curettes of varying sizes: These are available in various sizes and are used to curette out the marrow or hematoma. They are also used as part of the debridement to clear out the dirt and slough from bone and soft tissues (Figure 15.8).
Aetiology and Laboratory Diagnosis
Published in Raimo E Suhonen, Rodney P R Dawber, David H Ellis, Fungal Infections of the Skin, Hair and Nails, 2020
Raimo E Suhonen, Rodney P R Dawber, David H Ellis
In patients with suspected dermatophytosis of the skin (tinea or ringworm), any ointments or other local applications present should first be removed with an Alcowipe. Using a blunt scalpel, tweezers or a curette, firmly scrape the lesion, particularly at the advancing border. A curette is safe and useful for collecting specimens from babies, young children and awkward sites, such as interdigital spaces. If multiple lesions are present choose the most recent for scrapings, as old loose scale is often unsatisfactory. Any small vellus hairs when present within the lesions should be epilated. The roof of any fresh vesicles should be removed as the fungus is often plentiful in this site, especially in cases of vesicular tinea pedis.
Surgical management of postpartum hemorrhage
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Men-Jean Lee, Renata A. Sawyer, Charles J. Lockwood
Uterine atony is the number one cause of primary postpartum hemorrhage, defined as vaginal bleeding occurring within 24 hours of delivery. Bimanual massage is the first intervention in addition to uterotonics and a thorough exploration of the uterine cavity for retained placenta. Curettage, preferably utilizing a large curette, e.g., a Banjo curette, is useful to minimize uterine perforation. In cases of a vaginal birth, ultrasound guidance is helpful. A uterine tamponade balloon may be used (Figure 36.1). When the above measures and uterotonics fail to control the bleeding, laparotomy should be performed promptly, via a vertical midline or large transverse incision to optimize exposure. However, in centers with immediately available IR, this may be a faster and preferred option. An open abdomen allows for the introduction of ancillary tamponade methods such as the placement of uterine compression sutures. The most recognized technique is the B-Lynch uterine compression suture. Several modifications have been described, e.g. Pereira, Hayman, Cho, and multiple square suturing. B-Lynch compression suture was first performed in 1989 by Christopher B-Lynch in a patient with PPH who refused hysterectomy (B-Lynch et al. 1997).
Comparison of laparoscopic adnexal mass extraction via the transumbilical and transvaginal routes
Published in Journal of Obstetrics and Gynaecology, 2022
Kemal Güngördük, Varol Gülseren, İsa Aykut Özdemir
A curette was placed into the uterine cavity and stabilised with a tenaculum for manipulation of the uterus. After separation of the adnexal mass ligaments, the manipulator was removed to perform TV retrieval. A vaginal retractor was inserted into the vagina to view the cervix and allow removal of the mass via the TV route. The posterior lip of the cervix was grasped with an Allis forceps and then pulled superiorly to expose the posterior vaginal dome. The sampler was inserted into the vagina and pushed gently against the vaginal wall to define the posterior fornix between the uterosacral ligaments. A 1–2-cm transverse TV posterior colpotomy was performed under LS control using a 3-mm monopolar hook. The sample was pulled into the vagina by holding the bag mouth from the colpotomy with ring forceps. The bag mouth was opened in the vaginal canal and the sample was transferred from the vagina.
The effect of hysteroscopy and conventional curretage versus no hysteroscopy on live birth rates in recurrent in vitro fertilisation failure: a retrospective cohort study from a single referral centre experience
Published in Journal of Obstetrics and Gynaecology, 2022
Ferruh Acet, Gulnaz Sahin, Ege Nazan Tavmergen Goker, Erol Tavmergen
Similarly, another meta-analysis also suggested improved pregnancy outcomes in women with unexplained RIF with local endometrial injury in the preceding cycle of controlled ovarian stimulation (Potdar et al. 2012). Unlike these studies Hoogenhuijze et al. did not find any significant difference between live birth rates in patients with recurrent implantation failure in their meta-analysis of four studies (RR 1.28 (95%CI 0.67–2.45) (Van Hoogenhuijze et al. 2019). However, in the studies included in this meta-analysis, hysteroscopy was not performed prior to endometrial biopsy. In our study ES was performed by simple curette, after visualisation the uterine cavity and for any possible intrauterine pathology as a contributing factor to infertility in the intervention group. Although cavity evaluation was not performed by hysteroscopy in the control group, all cases were evaluated in terms of endometrial pathology with HSG or saline infusion sonography. However, bias due to undiagnosed intrauterine pathology in the control group seems unlikely because literature showed that the results of saline infusion sonography and hysteroscopy did not differ significantly (Widrich et al. 1996).
An update on local and systemic therapies for nonmelanoma skin cancer
Published in Expert Review of Anticancer Therapy, 2022
Kelly M Elleson, Danielle K DePalo, Jonathan S Zager
Electrodessication and curettage (ED&C) is the most common method used by dermatologists to treat nodular BCC and superficial BCC tumors <1.5 cm as it is a quick and simple procedure; however, the one drawback is that with ED&C, complete tumor excision is not able to be confirmed histologically [16,17]. After the tumor is scraped with a curette, the area is treated with electrosurgery to control bleeding and eliminate cancer cells around the wound margin. Typically, 2–3 cycles are recommended. Recurrence was higher in nasal, paranasal, and forehead areas. Another study of 2,314 primary BCC tumors treated with ED&C also showed significantly higher recurrence rates for tumors in the mask area of the face and for tumors ≥6 mm in diameter located on the cheek, forehead, scalp, and neck [17]. A key disadvantage to ED&C is risk for scarring since there is no primary closure of the defect.