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Health care in terms of palliative care for neoplastic wounds is characterized by a comprehensive assessment, determining coverage, measuring the wound, minimizing suffering and pain, in addition to supporting the family, working with the other health professionals. The challenges faced by these professionals are great, as knowledge is still lacking, and there is a need for qualification and continuous permanent education. Thus, the objective was to reflect on palliative care with regard to neoplastic wounds. It was possible to conclude that it is possible to observe that the patient with the presence of neoplastic wounds still represents a challenge? for the healthcare team that provides direct assistance in managing the signs and symptoms that the wound imposes, in addition to caring for the injuries. It is evident that the lack of knowledge about how to manage and manipulate neoplastic wounds is a reality present in health institutions and among team members, which hinders the quality of patient treatment. It was realized that continuing education is the key for care to be properly carried out, aiming to improve the health team's assistance in a comprehensive manner. The research highlighted this result, reflecting and debating on the topic with professional diversity in mind. [ABSTRACT FROM AUTHOR]

This paper presents a new, digital, and interactive list of wounds, deaths, and other acts of aggression in the Iliad. After an introduction, it discusses the state of the art in quantitative approaches to the subject. The following section presents the methodology for compiling the data, briefly establishing the criteria for the distribution of instances in each category. In the discussion, I compare the results with previous similar projects and mention a few examples of the potentiality of the new list – to be published online, not included in the paper –, showing the advantages of the digital format.

ABSTRACT Objective: Cervical trauma is an important cause of morbidity and mortality, affecting 2% of patients admitted to emergency units. Therefore, this study aims to compare the use of two clinical cervical spine evaluation algorithms, the Canadian C-Spine Rule (CCR) and the National Emergency X-radiography Utilization Study (NEXUS). Methods: A descriptive study of the use of the two algorithms by medical residents in the initial assessment of severely traumatized patients admitted to the regional emergency unit was conducted. The evaluation of the indication for imaging tests and the positive predictive value of the algorithms were the parameters analyzed. Finally, the residents answered a questionnaire evaluating the applicability, degree of confidence and advantages of both flowcharts. Results: There was no significant difference between the number of indications for imaging or their predictive values. In the analysis of the questionnaires, the CCR proved to be more reliable and the NEXUS more applicable, and the positive and negative points of applying each of them were highlighted. Conclusion: It is concluded that the two methods are similar in detecting injuries and optimizing the use of imaging exams, being equally indicated to evaluate cervical trauma. However, the technical specifics of each must be taken into account when deciding which to use. Level of evidence IV; Descriptive Study.

Winners of the "DR. Walter Soares Pinto" E-poster award at the SGAWCM 2021 – SOBRATAFE Global Advanced Wound Care Meeting 2021

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The study aimed to observe the technical and scientific knowledge of nurses in a Community Health Foundation of Sinop / MT, related to wound care. For it belongs to the nurse assessment and differential with the development and implementation of a plan of care, evaluation and reevaluation of treatment used for each patient diagnosis. Check autonomy and the scientific expertise of the nurse related to the procedure in curative practices; Assess the knowledge of nurses regarding the guidance given their nursing staff on the implementation of curative and delegation practices. It is a field research with an applied nature, quantitative and qualitative approach with exploratory and descriptive characteristic. Data collection was conducted through a questionnaire consisting of 28 objective and subjective questions. The selection criterion was the 21 nurses working in the following clinics: Medical, Surgical Clinic, Maternity Clinic, Pediatrics, Adult ICU, Private Practice Private Practice I and II. Inclusion criteria are: nurses who work in the area of health care that perform related care and wound care practices. Were excluded from the research nurse who does not exercise direct activities of health care nurses respectively of CCIH and CME. The sample was characterized for female nurses, with over two years of training, more time in the job (50%) has

It's visible that, on the violence rates, most situations involve firearms. It's use is extremely explored to commit homicides, according to the statistics. The firearms are responsible for causing several injuries that can lead to sequels, which can be reversible or not, and compromise the social, professional and psychological life of the victim. Some studies show that there is a preference for the maxillofacial region, due to the capacity of disfigure a visible area that has a huge importance for the individual coexistence. Besides that, this region is considered unprotected and exposed. The most common sequels caused on this region are neurological, phonoaudiological, ophthalmological and orthopedic. The trauma can, basically, rush any anatomical area of the head: soft tissues, dent alveolar tissue, and cranioencephalic region. Besides the physical traumas suffered by the victims, the psychological traumas are also important, since the researches show that the quality of life post injury is a quite considerable factor. On cases that involve drilling by firearm, the approaches are the most complex, requiring emergency care and demanding multidisciplinary action. Thus, the knowledge about the topic and the principles of treatment are extremely important, so satisfactory results can be obtained on the patient's life. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Complex wounds pose a challenge to the plastic surgeon. In these cases, the most common solution is skin grafting or the use of flaps; however, depending on the affected structure, the results may not be satisfactory. Matrices were initially developed for the treatment of burn sequelae. Since then, different varieties of matrices have been developed for application in the treatment of several diseases, including complex wounds. Only a few heterologous acellular dermal matrices (HADMs) are available in Brazil, and they are still very expensive. The objective of this study was to report the experience with the use of HADMs for the treatment of patients with a need for reconstructive plastic surgery. METHOD: From February 2011 to July 2014, five different HADMs were used in the treatment of 24 lesions of different etiologies, including three etiologies not previously described in the literature: rhinophyma, hidradenitis suppurativa, and Lyell's syndrome (toxic epidermal necrolysis). RESULTS: Twenty patients with lesions of different etiologies and who received treatment with HADM grafts in different anatomical regions, associated or not with autologous skin grafting, attained adequate aesthetic and functional results. CONCLUSION: The use of HADMs can be considered an alternative in the treatment of several difficult-to-treat cases, and has its place in modern plastic surgery; however, its indication should be carefully evaluated owing to the high cost of the materials.

ABSTRACT Background Obtaining effective hemostasis either in the traumatic or surgical lesions of parenchymal viscera, especially the liver, has always been a challenge. Aim: Comparative study between the use of different hemostatic sponges in hepatic wound and their capacity of integration to cells in a short period. Methods: Fifteen Wistar rats were divided into three groups. Through laparotomy a standardized wound in hepatic right lobe was made. The animals were treated with three sponges, being gelatin in group I, equine collagen in group II, and oxidized cellulose in group III. The hemostatic capacity was analysed. On the 7º day after surgery samples for histology analysis (H&E and picrosirius) were collected for inflammatory evaluation and collagen quantification (types I and III) with polarized microscopy. Results: All materials used had similar haemostatic effects, with no significant difference in hemostasis time. In the assessment of tissue repair and adhesions provoked, as well as analysis of the inflammatory process, the gelatin sponge presented greater inflammation and adhesions to the contiguous structures to the procedure in relation to the other groups. Conclusion: Animals which had their wounds treated with collagen and regenerated cellulose sponges presented better results in relationship to the ones treated with gelatin sponge.

Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate clinical and histopathological aspects of topical application of pure and ozonized andiroba oil (Carapa guianensis Aublet.) on the healing process of wounds of healthy horses. Eight 6.25-cm2 wounds were surgically produced on each horse, cranial to the sacrum, being four wounds on each side of the lumbar region. In three animals, left side was used for macroscopic observations and area measurement and right side was used for histopathological analysis. For the other two animals, evaluations were inverted. Beginning of the topical treatment occurred 12 hours after surgical induction of the injuries and was maintained daily until complete healing of the wounds, using sequentially and bilaterally in the craniocaudal direction saline solution (GC), ozonized saline solution (GO), pure andiroba oil (GAP) and ozonized andiroba oil (GAO). Randomly, sequence of the treatments was modified. Macroscopic and histopathological analyses were performed at 3, 7, 14, and 21 days after surgery. Completed healing time for all wounds were recorded. A wound contraction of 67.75% for GC, 65.26% for GO, 67.91% for GAP, and 69.84% for GAO were recorded. Histopathologic evaluation revealed that wounds from the GAO and GAP had an advanced epithelialization, fibroblast proliferation and collagen deposition, moderate vascular proliferation, and presence of PMN infiltrate and discrete viewing of MN. It was possible to conclude that all treatments had benefits when comparing to control group and both pure and ozonized andiroba oil can be good options for wound treatment in horses.

INTRODUCCIÓN: Objetivos: Determinar la prevalencia, mortalidad y evolución clínica de los pacientes con heridas por arma de fuego en columna vertebral y determinar si la extracción del proyectil mejora el estado neurológico de los pacientes. MÉTODO: Se realizó un estudio de serie de casos, donde se analizaron los registros de todos los pacientes con heridas por arma de fuego en la columna vertebral ingresados en la UMAE, Hospital de Especialidades del CMNO del IMSS, de septiembre del 2010 a septiembre del 2011, que eran compatibles con los criterios de inclusión, exclusión y de no inclusión. Se midió el grado de discapacidad de los pacientes mediante la escala de Oswestry. RESULTADOS: El grupo se formo por 13 (86,7%), pacientes del sexo masculino y 2 (13,3%) del sexo femenino, con edad media de 42 años y desviación estándar de 14 años. Las regiones más afectadas fueron torácica 7 (46,7%), cervical 5 (33,3%) y por último, lumbar con 3 (20%) pacientes; la estancia intrahospitalaria observada con mayor frecuencia fue 7 (13,3%) y 10 (13.3%) días, con 2 casos cada una; la estancia hospitalaria mínima fue de 3 días, con tan solo un (6,7%) caso y la mayor fue de 94 días, en 1 (6,7%) paciente. La estancia superior a 10 días ocurrió en 11 (73,3%) pacientes y la inferior a 10 días, en 4 (26,7%) pacientes. El tratamiento quirúrgico se realizó en 4 (26,7%) pacientes y 11 (73,3%) pacientes solo recibieron tratamiento clínico; la extracción del proyectil se efectúo en 3 (20%) pacientes, de los cuales 2 tuvieron infección. Se observaron complicaciones en 14 (93,3%) pacientes y tan solo en 1 (6,7%) no hubo complicaciones. En 6 (40%) pacientes ocurrió infección en comparación con 9 (60%) en quienes no la presentaron. El estatus neurológico mediante la escala de ASIA inicial predominante fue "A" en 7 (46,7%) y el ASIA final predominante fue "B" en 6 (40%) casos. Fallecieron 3 (20%) pacientes y 12 (80%) pacientes sobrevivían durante el periodo del estudio. El grado de discapacidad medido mediante la escala de Oswestry inicial mínimo fue de 18 puntos, el máximo de 94, con media de 62 y desviación estándar de 22.2. El Oswestry final tuvo una media de 58 puntos con desviación estándar de 23.5. CONCLUSIONES: En nuestro estudio podemos concluir que las heridas por arma de fuego en la columna, ocasionan un alto grado de discapacidad y evolucionan con alta morbilidad. A esto hay que añadir que tanto el tratamiento clínico cuanto el quirúrgico, no proporcionan mejoría sustancial en el estado neurológico y funcional del paciente. Tan solo se limitan a medidas de soporte para disminuir en lo posible las complicaciones, que a final de cuenta, son las que influenciarán en la calidad y sobrevida de los afectados. La extracción del proyectil y el tiempo transcurrido desde la cirugía no alteran el estado funcional final del paciente.OBJETIVOS: Determinar prevalência, mortalidade e evolução clínica dos pacientes com ferimentos por arma de fogo na coluna vertebral e determinar se a extração do projétil melhora o estado neurológico dos pacientes. MÉTODO: Realizou-se um estudo de série de casos por meio da análise dos prontuários médicos de todos os pacientes com ferimentos por arma de fogo na coluna vertebral, internados na UMAE, Hospital de Especialidades do CMNO do IMSS, de setembro de 2010 a setembro de 2011, que eram compatíveis com os critérios de inclusão, exclusão e não-inclusão. O grau de incapacidade dos pacientes foi medido pelo índice de Oswestry. RESULTADOS: O grupo foi formado por 13 (86,7%) pacientes do sexo masculino e 2 (13,3%) do sexo feminino, com média de idade de 42 anos e desvio padrão de 14 anos. As regiões mais afetadas foram torácica 7 (46,7%), cervical 5 (33,3%) e, por último, lombar, co 3 (20%) pacientes; a permanência no hospital observada com mais frequência foi 7 (13,3%) e 10 (13,3%) dias com 2 casos cada uma; a permanência hospitalar mínima foi de 3 dias, com apenas um (6,7%) caso e a maior foi de 94 dias, em um (6,7%) paciente. A estadia superior a 10 dias ocorreu em 11 (73,3%) pacientes e a inferior a 10 dias, em 4 (26,7%). O tratamento cirúrgico foi realizado em 4 (26.7%) pacientes e 11 (73,3%) pacientes receberam apenas tratamento clínico; a extração do projétil foi executada em 3 (20%) pacientes, dos quais, dois tiveram infecção. Foram constatadas complicações em 14 (93.3%) pacientes e apenas um (6,7%) não as apresentou. Em 6 (40%) pacientes verificou-se infecção, em comparação com 9 (60%) que não tiveram. O estado neurológico pela escala ASIA inicial foi predominante "A" em 7 (46,7%) e a escala ASIA final foi predominante "B" em 6 (40%) casos. Três (20%) pacientes foram a óbito e 12 (80%) estavam vivos durante o período do estudo. O grau de incapacidade medido pelo índice de Oswestry inicial mínimo foi 18 pontos e o máximo foi 94, com média de 62 e desvio padrão de 22,2. O índice de Oswestry final teve média de 58 pontos, com desvio padrão de 23,5. CONCLUSÕES: Em nosso estudo, podemos concluir que os ferimentos por arma de fogo na coluna vertebral, ocasionam alto grau de incapacidade e evoluem com alta morbidade. É preciso acrescentar que tanto o tratamento clínico quanto o cirúrgico, não proporcionam melhora substancial do estado neurológico e funcional do paciente. Ambos limitam-se a medidas de apoio para reduzir o máximo possível de complicações, que por fim, são o que influenciarão a qualidade e a sobrevida dos afetados. A extração do projétil e o tempo transcorrido desde a cirurgia não alteram o estado funcional final do paciente.OBJECTIVES: To determine prevalence, mortality and clinical course of patients with gunshot wounds of the spine and determine if the extraction of the bullet improves their neurological status. METHODS: We conducted a case series study by analyzing the medical records of all patients with gunshot wounds in the spine, hospitalized in UMAE, Specialties Hospital of the CMNO, IMSS, from September 2010 to September 2011, which were compatible with the inclusion, exclusion, and not-inclusion criteria. The degree of disability of patients was measured by the Oswestry index. RESULTS: The group consisted of 13 (86.7%) males and 2 (13.3%) females, with a mean age of 42 years and standard deviation of 14 years. The regions most affected were thoracic with 7 (46.7%), cervical with 5 (33.3%) and, finally, lumbar, with 3 (20%) patients; the most frequent hospital stays were 7 (13, 3%) and 10 (13.3%) days with 2 cases each; minimum hospital stay was 3 days, with only one (6.7%) case and the largest was 94 days in one (6.7 %) patient. A stay exceeding 10 days occurred in 11 (73.3%) patients and less than 10 days in 4 (26.7%). Surgical treatment was performed in 4 (26.7%) patients and 11 (73.3%) patients received only medical therapy; the extraction of the bullet was performed in 3 (20%) patients, of whom two had infection. Complications were observed in 14 (93.3%) patients and one (6.7%) did not. Six (40%) patients had infection in comparison with nine (60%) who had not. The neurological status by the initial ASIA scale was predominantly "A" in 7 (46.7%) and the final ASIA scale was predominantly "B" in 6 (40%) cases. Three (20%) patients died and 12 (80%) were alive during the study period. The degree of disability measured by the initial Oswestry index was 18 points minimum and maximum was 94, with a mean of 62 and a standard deviation of 22.2. The final Oswestry index averaged 58 points, with a standard deviation of 23.5. CONCLUSIONS: In our study, we conclude that the injury by firearm in the spine causes a high degree of disability and evolve with high morbidity. It should be added that both the medical and the surgical treatment do not provide substantial improvement in neurological and functional status of the patient. Both are limited to support actions to reduce the possible complications, which ultimately is what will influence the quality and survival of those affected. The extraction of the bullet and the time elapsed since surgery does not change the final functional status of the patient.

INTRODUÇÃO: Escalpelamento é trauma causado por avulsão parcial ou total do couro cabeludo, decorrente, principalmente, de contato acidental dos cabelos longos com motor de eixo rotativo. A alta rotação desses motores gera uma força que suga os cabelos da vítima, tracionando e arrancando o couro cabeludo de forma abrupta. MÉTODO: Foi realizado um estudo observacional transversal, retrospectivo, descritivo, incluindo 62 pacientes vítimas de escalpelamento tratados na Fundação Santa Casa de Misericórdia do Pará. RESULTADOS: Os pacientes mais acometidos foram crianças de 7 anos a 16 anos (56,4%), do gênero feminino (93,5%), sendo 59,7% estudantes e que, predominantemente, praticavam a religião católica (43,5%). CONCLUSÕES: Campanhas profiláticas sobre os riscos de se viajar e manter uma embarcação sem proteção no eixo do motor são fundamentais, uma vez que a tragédia do escalpelamento é causada principalmente pelos cabelos que se enrolam no eixo do motor.BACKGROUND: Scalping is a trauma caused by partial or total avulsion of the scalp. It is primarily due to accidental contact of long hair with the rotary shaft of a motor. Rotary shafts suck in the victim's hair, causing traction and abruptly pulling the scalp off. METHODS: A longitudinal, observational, retrospective, and descriptive study of 62 scalping victim-patients treated at Fundação Santa Casa de Misericórdia do Pará was conducted. RESULTS: The most commonly affected patients were children between 7 and 16 years of age (56.4%) and women (93.5%); 59.7% were students and 43.5% were Catholics. CONCLUSIONS: Prophylactic campaigns about the risks of traveling in and maintaining a vessel without motor shaft protection are essential because scalping is primarily caused by hair twisting around the motor shaft.

Contexto: Na prática clínica o tratamento de feridas constitui, inevitavelmente, um importante foco de atenção da Enfermagem enquanto disciplina e ciência, bem como, do enfermeiro interessado em cuidar a pessoa com ferida. Com o aparecimento das novas abordagens e novos materiais cresce a necessidade/obrigatoriedade do enfermeiro acompanhar esta evolução. Assim, este artigo surge na sequência da utilização de um produto inovador - a polihexanida. Objetivo: Descrever a evidência científica disponível acerca da eficácia da polihexanida no tratamento de feridas colonizadas/infetadas. Métodos: Foram seguidos os princípios propostos pelo Cochrane Handbook, tendo sido realizada pesquisa manual e eletrónica em várias bases de dados que conduziram a sete artigos que cumpriam critérios previamente definidos. Resultados: Os estudos indicam que a polihexanida é eficaz no tratamento de feridas colonizadas/infetadas, verificando-se redução significativa do tempo de cicatrização, sinais inflamatórios, infeção/colonização e dor, quando esta é utilizada. Conclusão: Estas evidências permitem-nos concluir que a utilização da poliexamida é uma prática segura no tratamento de feridas colonizadas/infetadas.Contexto: En la práctica clínica el tratamiento de heridas constituye inevitablemente un importante foco de atención de Enfermería en cuanto disciplina y ciencia, así como del enfermero interesado en cuidar a la persona herida. Con el aparecimiento de nuevos enfoques y nuevos materiales ha aumentado la necesidad/ obligatoriedad por parte del enfermero en acompañar esta evolución. Así, este artículo surge en la secuencia de la utilización de un producto innovador - la polihexanida. Objectivo: Describir la evidencia científica disponible acerca de la eficacia de la polihexanida en el tratamiento de heridas colonizadas/infetadas. Métodos: Se siguieron los principios propuestos por el Cochrane Handbook, no sin haber antes realizado una búsqueda manual y electrónica en varias bases de datos que condujeron a siete artículos que cumplían con los criterios previamente definidos. Resultados: Los estudios indican que la polihexanida es eficaz en el tratamiento de heridas colonizadas/infetadas, al comprobarse la reducción significativa del tiempo de cicatrización, señales inflamatorias, infección/colonización y dolor, cuando esta es utilizada. Conclusión: Estas evidencias nos permiten concluir que la utilización de la poliexamida es una práctica segura en el tratamiento de heridas colonizadas/infetadas.Context: In clinical practice wound treatment is inevitably a nursing focus in terms of discipline and science, as well as nurses’ interest in caring for wounds. With the emergence of new approaches and new materials, the need/requirement increases for nurses to monitor these developments. Thus,this article considers the use of an innovative product - polyhexanide. Objective: To gather and synthesize the available scientific evidence about the efficiency of polyhexanide in the treatment of colonized or infected wounds. Methods: We followed the Cochrane Handbook principles and carried out manual and electronic searches in databases and and identified seven articles that followed previously defined criteria. Results: After analyzing the included studies, it can be said that polyhexanide is effective in the treatment of colonized/infected wounds, and there is a significant reduction in healing time, signs of inflammation, infection/colonization and pain.

TEMA: ferimentos causados por projéteis de arma de fogo apresentam alta incidência na região da cabeça e face. A articulação temporomandibular pode estar envolvida, além de estruturas anatômicas importantes como o nervo facial, necessitando de equipe multidisciplinar para efetuar tratamento adequado. PROCEDIMENTOS: apresentação de caso clínico de fratura condilar cominutiva causada por projétil de arma de fogo tratado de forma não-cirúrgica associado à terapia miofuncional orofacial. Paciente encaminhado para avaliação e procedimentos fonoaudiológicos após conduta da equipe de cirurgia bucomaxilofacial, sem remoção do projétil, alojado superficialmente, próximo da origem do músculo esternocleidomastóideo à direita, com fratura condilar cominutiva e lesão do nervo facial. Foram aspectos observados em avaliação: mordida aberta anterior, importante redução da amplitude dos movimentos mandibulares com desvios para o lado acometido, ausência de lateralidade contralateral, dor muscular, paralisia e parestesia em terço médio e superior da hemiface direita. Realizadas sessões de terapia miofuncional seguindo protocolo específico para traumas de face constando de: drenagem de edema; manipulações na musculatura levantadora da mandíbula ipsilateral; ampliação e correção dos movimentos mandibulares; procedimentos específicos referentes à paralisia facial e reorganização funcional direcionada. RESULTADOS: após oito semanas de terapia os resultados obtidos mostram restabelecimento de amplitude e da simetria dos movimentos mandibulares, reorganização da mastigação, adequação da deglutição e fala, remissão da sintomatologia dolorosa e remissão da paralisia do terço médio. CONCLUSÃO: o tratamento conservador da fratura por meio da terapia miofuncional orofacial resultou na reabilitação funcional da mandíbula e face dirigindo os movimentos e estimulando a adequação das funções estomatognáticas.BACKGROUND: firearm wounds are relatively frequent and show high incidence at the head and face area. Temporomandibular joint may be involved, and also some important anatomic structures as the facial nerve directing the need for an interdisciplinary team in order to promote an efficient treatment. PROCEDURES: a case report related to a comminuted condyle fracture caused by firearms with a nonsurgical treatment associated to myofunctional therapy. The patient was referred to Speech and Language Pathologist after the conduct of oral and maxillofacial surgery team, without removing the bullet, lodged superficially near the origin of the sternocleidomastoid muscle on the right side; with comminuted condyle fracture and facial nerve damage. Myofunctional evaluation found an important reduction in the mandibular movement amplitude with severe deviations as for the affected side, no contralateral laterality, muscle pain; paralysis and paresthesia on the right side of the face. Myofunctional therapy followed a specific protocol for facial trauma including: drainage of edemas, specific ipsilateral manipulations on jaw muscles; correction and enlargement of the mandibular movements, specific procedures related to facial paralysis and directed functional reorganization. RESULTS: after eight therapy sessions we obtained: mandibular movements with adequate amplitude and symmetry, chewing reorganization, adequacy of swallowing and speech, remission of painful symptoms and remission of paralysis in the medium third of the face. CONCLUSION: the conservative treatment for comminuted condyle fracture through myofunctional therapy resulted in functional rehabilitation of the jaw and face, directing the movements and stimulating the adequacy of the sthomatognatic functions.

Objective: To analyze thoracic trauma assisted by the EmergencyService of Hospital da Irmandade da Santa Casa de Misericórdia deSão Paulo. Methods: One hundred patients with thoracic trauma wereassisted throughout six months in 2006. Data from their records werecollected and a protocol of thoracic trauma was fulfilled. The RevisedTrauma Score was used to evaluate gravity of injury and to calculatethe survival index. Results: Prevalence of trauma injury in male from20 to 29 years old was observed. Out of all patients, 44 had blunttrauma and 56 penetrating trauma (78.6% presented stab woundsand 21.4% gun shots). Up to the settings of injuries, 23% were in thethoracoabdominal transition, 7% in the precordium and 70% in theremainder thoracic area. In those with the thoracoabdominal transitioninjury, 22.7% were hemodynamically unstable and 77.3% stable.Thoracoabdominal injury patients presented 40.9% of diaphragmwound and all were stable. Of those with precordium wound, 37.5%presented cardiac injury. In cardiac onset, 66.7% presented stableand 33.3% unstable. Thoracic drainage was the most accomplishedsurgical procedure (71%). Conclusions: The thoracic trauma patientis most prevalently young male with stab wound penetrating injury,without associated injuries, hemodynamically stable, presentinghemothorax, with high probability of survival.

INTRODUÇÃO: Várias são as causas responsáveis pelo atraso no diagnóstico da fratura toracolombar explosão, entretanto poucos trabalhos discutem a respeito do tratamento das fraturas operadas após algumas semanas do trauma. OBJETIVO: O objetivo deste estudo retrospectivo foi verificar o resultado do tratamento dos pacientes operados entre três a cinco semanas do trauma mediante artrodese e instrumentação metálica posterior. PACIENTES E MÉTODOS: De 1980 a 2004, excluindo as seqüelas ou fraturas recentes, 15 apresentaram um seguimento mínino de um ano. De acordo com a escala de Frankel, três dos cinco pacientes com alteração do quadro neurológico melhoraram (60%). RESULTADOS: Do ponto de vista clínico, 10 pacientes estão assintomáticos. Um apresentou infecção superficial e uma disfunção esfincteriana. Do ponto de vista radiográfico, a principal complicação encontrada foi a cifose no local da fratura, ocorrendo em cinco pacientes (33%). Houve piora média de 3 graus em relação ao valor da radiografia inicial. CONCLUSÃO: Acreditamos que, do ponto de vista da cifose no pós-operatório, a fratura toracolombar explosão subaguda deve ser tratada de forma distinta.INTRODUCTION: Several factors are responsible for the late diagnosis of thoracolumbar burst fractures; however, few papers have been published concerning the treatment of these fractures weeks after the original trauma. OBJECTIVE: This is a retrospective study aimed to verify treatment outcomes of patients submitted to arthrodesis and posterior instrumentation three to five weeks after thoracolumbar burst fractures. PATIENTS AND METHOD: From 1980 to 2004, excluding patients with sequelae or recent fractures, 15 cases were identified with a minimum follow-up period of one year. RESULTS: From the clinical viewpoint, 10 patients were asymptomatic and according to the Frankel scale, three of the five patients that presented neurological changes showed improvement (60%). One patient presented superficial infection and sphincter dysfunction. X-ray studies demonstrated kyphosis on fracture site to be the main complication, affecting five patients (33%). There was a mean 3 degree worsening of the kyphosis compared to the values found on early X-ray images. CONCLUSION: We believe, based on a postoperative kyphosis perspective, that subacute thoracolumbar burst fractures should be treated in a specific manner.

As lesões da valva tricúspide decorrentes de trauma torácico penetrante são raras e frequentemente subdiagnosticadas. O objetivo deste relato é descrever um caso de insuficiência tricúspide grave secundária a acidente por arma branca com evolução insidiosa, diagnosticada 19 anos após o ocorrido. O caso enfatiza a importância do acompanhamento adequado dos pacientes vítimas de trauma torácico penetrante por longo período após a injúria, para detecção de possíveis complicações tardias do trauma.Las lesiones de la válvula tricúspide resultantes de trauma torácico penetrante son raras y frecuentemente subdiagnosticadas. El objetivo de este relato es describir un caso de insuficiencia tricúspide severa secundaria a accidente por arma blanca con evolución insidiosa, diagnosticada 19 años tras lo sucedido. El caso enfatiza la importancia del seguimiento adecuado de los pacientes víctimas de trauma torácico penetrante por largo período tras la injuria, para detección de posibles complicaciones tardías del trauma.Tricuspid valve lesions caused by penetrating chest trauma are rare and often underdiagnosed. The objective of this report is to describe a case of severe tricuspid insufficiency secondary to a knifing incident with an insidious evolution, diagnosed 19 years after the incident. The case emphasizes the importance of adequate follow-up of patients that are victims of penetrating chest trauma for a long period after the injury, to detect possible late complications of the trauma.

This article describes the case of a work accident victim with a penetrating wound to the right inguinal region caused by a metal spiral. The patient developed an arteriovenous fistula between the deep femoral artery and deep femoral vein, combined with a pseudoaneurysm surrounding these structures and the common femoral vein. Arteriovenous fistulas frequently occur after traumas, but the combination of fistula and pseudoaneurysm is rare. It is recommended that they be treated immediately after diagnosis. Duplex ultrasound is the most widely used method for initial assessment and arteriography is the gold standard for diagnosis of arteriovenous fistulas. Endovascular surgery has recently been used successfully in such cases. However, this patient was treated conventionally using a direct surgical approach, arterial suture and venous ligatures, and the limb was saved. The patient developed no complications and was discharged to outpatients follow-up. [ABSTRACT FROM AUTHOR]

Neste estudo experimental, avaliou-se o uso de membrana amniótica eqüina preservada em glicerina 98%, à temperatura ambiente, em feridas com cura por segunda intenção, nos membros locomotores de eqüinos. Foram provocadas cirurgicamente feridas de 9,6cm² na face lateral da articulação metacarpo-falangeana, face medial do terço proximal do metacarpo e face lateral do terço médio do metatarso de ambos os membros locomotores de cinco eqüinos adultos, perfazendo total de trinta feridas. Foram constituídos dois grupos experimentais com quinze feridas cada, sendo um destes grupos tratado com membrana amniótica, e o outro, grupo controle, tendo recebido apenas gaze umidecida em solução fisiológica. Os curativos foram trocados a cada 48horas, tendo sido a membrana amniótica e a gaze umidecida substituídas. Em todas as feridas foram mensurados a área, o grau de secreção, a formação de tecido de granulação exuberante e o tempo para a epitelização se completar. Realizou-se também exame bacteriológico e histopatológico em um grupo de feridas, tratadas e controle. Na membrana amniótica, fez-se determinação bioquímica de proteínas e identificação de fator de crescimento de fibroblasto. Em todas as feridas tratadas, observou-se: menor tempo para cicatrização, menor formação de tecido de granulação exuberante, menor incidência de bactérias patológicas e menor aumento na área total.In the present experimental study, the use of the equine amniotic membrane preserved in glvcerol 98%, at room temperature, in wounds with secound intention healing of equine limbs were evaluated. Surgical wounds of the size of 9.6cm² were made on the fetiock joint, medial aspect of the proximal third of the metacarpus and lateral aspect of the medium third of the metatarsus ofboth limbs offive adult horses, making a total of thirty wounds. Two experimental groups were made with fifteen wounds in each group, where one of these groups was treated with amniotic membrane, and the other, the control group, treated only with a damp gauze changed every 48 hours. In all the wounds the procedure was to evaluate the measurement of the área, degree of secretion, development of exuberant granulation tissue and the complete time of epitheliazation. Bacteriologic and histopatologic exams were made in a sample of the treated and contrai groups. The biochemical determination of proteins and the identification of fibroblastic growth factor were realized in the amnionic membrane. In all the treated wounds were observed shorter healing time, less formation of exuberant granulation tissue, smaller incidence of pathogenic bacterias and a smaller increase of the wound area.

The plant Carapa guianensis is used empirically for the treatment of dermatological diseases against inflammatory processes. The present study aimed at evaluating the healing of open skin lesions in Wistar rats treated with the C. guianensis oil. Two incisions were made on the back of the animals and the wounds were treated with the C. guianensis oil at 50% (A50) and 20% (A20). The control group (CG) received a treatment with vaseline. The wounds were treated daily and clinical, morphological and histological evaluations were performed on the fourth, seventh, 14th and 21st days of treatment and the tensiometric study on the 21st day. The biochemical profile of the animals was also assessed after 21 days of treatment. It was observed that the use of C. guianensis showed similar results to the ones of the control group in the evaluations, but in the tensiometry, the concentration A20 group presented lower tension when compared to the other groups. Regarding the biochemical parameters, the AST enzyme of the A50 group showed higher values in relation to the control group. It was possible to conclude that the C. guianensis oil shows similar results to the vaseline in wound healing, especially at a concentration of 50%. This study also showed a possible biological interference of the C. guianensis oil on the AST enzyme. [ABSTRACT FROM AUTHOR]

Oncological wounds are caused by the infiltration of malignant cells in the epithelial tissue and a flaw in its integrity. These lesions occur in 5 to 10% of patients suffering from cancer. They may develop at the onset of the disease, as in skin cancer, or at the end, through metastases. Oncological lesions are a bad prognostic since they do not heal, require palliative care to lessen their symptoms, reduce complications and improve the life quality by prevention and a relief from the patient's and family's suffering. The health team, especially nurses, should be aware that specific care should be provided to people with tumor wounds and the need of products, materials and medicine for treatment. Current review of literature underscores the lack of scientific works on the subject matter and its contribution towards knowledge for better planning of activities for people with tumor lesions. Strategies should be implemented for professional qualification, improvement of care by the establishment of new practices and a higher satisfaction to patients and their families through the attendance of their needs. [ABSTRACT FROM AUTHOR]

Background: firearm wounds are relatively frequent and show high incidence at the head and face area. Temporomandibular joint may be involved, and also some important anatomic structures as the facial nerve directing the need for an interdisciplinary team in order to promote an efficient treatment. Procedures: a case report related to a comminuted condyle fracture caused by firearms with a nonsurgical treatment associated to myofunctional therapy. The patient was referred to Speech and Language Pathologist after the conduct of oral and maxillofacial surgery team, without removing the bullet, lodged superficially near the origin of the sternocleidomastoid muscle on the right side; with comminuted condyle fracture and facial nerve damage. Myofunctional evaluation found an important reduction in the mandibular movement amplitude with severe deviations as for the affected side, no contralateral laterality, muscle pain; paralysis and paresthesia on the right side of the face. Myofunctional therapy followed a specific protocol for facial trauma including: drainage of edemas, specific ipsilateral manipulations on jaw muscles; correction and enlargement of the mandibular movements, specific procedures related to facial paralysis and directed functional reorganization. Results: after eight therapy sessions we obtained: mandibular movements with adequate amplitude and symmetry, chewing reorganization, adequacy of swallowing and speech, remission of painful symptoms and remission of paralysis in the medium third of the face. Conclusion: the conservative treatment for comminuted condyle fracture through myofunctional therapy resulted in functional rehabilitation of the jaw and face, directing the movements and stimulating the adequacy of the sthomatognatic functions. [ABSTRACT FROM AUTHOR]

In order to know the effects of application of honey to wounds (that is, in their healing process), the following question was formulated: "How does the application of honey to wounds contribute to their treatment?". To carry out the work, the seven steps in the Cochrane Handbook were followed. Using this process, it was possible to assemble a set of studies that followed the previously-defined criteria for inclusion and exclusion. The analysis showed that honey can be beneficial in the healing of wounds; however, no definitive conclusions are possible. This review opens doors for further research to be undertaken in this area. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the effectiveness of Cissus quandrangularis and Phyllanthus reticulatus poir in healing at induced wound in guinea pigs skin. Were used 12 guinea pigs, male, Abyssinian, with 6 months old and weighing 550 to 850g. Three groups of four animals were created. Once anesthetized, three surgical wounds were performed on each animal. The F1 was treated with Cissus quandrangularis; F2 was group control (saline solution) and F3 with Pyllanthus reticulatus poir. Group I was euthanized on the seventh day after surgery; Group II on the fourteenth day and the Group III on the twenty-first day after surgery and the lesions submitted to histological examination. Were used SPSS®, with analysis of variance (ANOVA) followed by Tukey test at 5% of significance. The lesions treated with Cissus quandrangularis healed faster and higher than Phyllanthus reticulatus poir. [ABSTRACT FROM AUTHOR]