Search

This article examines the treatment of facial wounds in early modern Britain through a close study of the casebook of St Bartholomew's Hospital surgeon Joseph Binns (d. 1664). It explores surgeons' and related practitioners' special attention to the care and infliction of facial wounds and scarring in their practice, including impairments to facial movement and expression, the use of specific suturing techniques and the reduced use of stitches, and the development of agglutinative medicaments. The face was recognised as a site of immense vulnerability and exposure, requiring particular care, and this vulnerability was mirrored in the capacity for facial scarring to detrimentally advertise a practitioner's skill. This essay reads Binns' unpublished notes against the cases and theoretical ideals set out in published texts from surgeons such as the Scottish Alexander Read, the East India Company surgeon John Woodall, and the London surgeon and physician Daniel Turner. I argue that both the textbooks and Binns' practice demonstrate awareness of the special role of the face in the early modern period, and that this guided the medical approach to disfiguring injuries and conditions. [ABSTRACT FROM AUTHOR]

A scar is a mark left in the skin by the healing of injured tissue. Outcome depends on the type of trauma causing the scar and how well it is repaired and managed initially. In most people, a scar heals to a fine line, hut in others, the scar may grow in all directions, is elevated and remains hyperaemic. Excessive scar tissue is classified either as hypertrophic or keloid. Unfortunately, it is not always easy to predict those patients who will develop problematic scars that require referral to specialist scar management clinics. This article describes the development of a new universal scar risk assessment and management pathway. The pathway was designed specifically to assist practitioners in identifying patients who are at risk of developing problem scars after surgery and to clearly set out evidence-based standards of care that will assist and guide the management for those patients at risk. INSET: KEY POINTS. [ABSTRACT FROM AUTHOR]

Actually the wounds cause by gun shots constitute a public health problem in the world. As an example we mention that wound by gun shots are the first cause of the dead in the group between one and 19 years of age in United States. In Mexico we know about an increase in the frequency of this diseases but we don't have a complete data about this problem. The concepts and medical therapy used in this patients, contrasts in the literature. In this research we report the incidence of wounds by gunshots in two years at Sharp Hospital in Mazatlan Sinaloa. We register all the information of every patient we admit, their general conditions, the procedures we performed, complications and their condition once they were discharged from the hospital. We have in this research 30 patients. We performed 97 surgical procedures. General surgery was the service with higher participation being follow by trauma and orthopedics. The results we obtained in this research are similar to the reports in the medical literature. Although we have a high mortality rate of 26%, fact we believe it's according the high velocity projectiles used. We conclude it's mandatory to have a solid hospital infrastructure and a high quality medical staff in order to offer the best attention to this patients. [ABSTRACT FROM AUTHOR]

Objective To report the design and benefits of a rigid polyethylene cover 'shell' for the protection of dorsal torso wounds and tube fixation in pigs. Methods Open C-shaped polyethylene shells were designed to protect wounds and dressings on the dorsum of pigs used in research into negative pressure dressing-assisted wound healing. The shells were designed to resist trauma and contamination, to be comfortable and expansible, and to facilitate tube fixation and management. Strap fixation was optimised during experimentation. Efficacy was assessed by direct observation of dressing and wound protection, tube integrity and by macroscopic and microscopic assessments of wound healing. Results The shells effectively protected the wounds against blunt and sharp trauma, were simple to remove and reapply, were well tolerated and allowed for growth of the pigs. Circumferential neck straps attached by lateral straps to the shells proved critical. There was no wound infection or inflammation underlying the shells. Porting tubing via mid-dorsal holes in the shells and affixing the tubing just cranial to these holes prevented tube damage and traction, permitted tube management from outside the cages and allowed the pigs to move freely without becoming entangled. Conclusion These shells effectively protected dorsal skin wounds and dressings, prevented tube damage and facilitated tube management in pigs. Similar systems may be useful for other production animals for wound management and for tube management with negative pressure wound healing, drain tubes or the delivery of nutrition, fluids or medications. [ABSTRACT FROM AUTHOR]

Background: The majority of patients with liver trauma can be managed conservatively. However, the unstable patient requires emergency laparotomy to control bleeding. Controversy exists regarding the primary surgical management of these injuries. This is of particular relevance for the isolated rural general surgeon. Methods: The literature was reviewed by searching MEDLINE databases from 1966 to the present time. The majority of the evidence presented is level 3, with interpretations and recommendations based on the experience of the senior authors. Results: In the majority of patients, conservative management remains the mainstay of treatment. However, haemodynamic ­instability requires urgent laparotomy. Perihepatic packing should be used to arrest bleeding. Primary anatomical resection is rarely indicated, especially in non-specialist centres. Conclusion: In the remote rural setting, severe liver trauma remains a daunting condition for the general surgeon to manage. Primary surgical treatment should be perihepatic packing, stabilization and urgent transfer; there is no place for primary anatomical resection outside specialist units. [ABSTRACT FROM AUTHOR]