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Introduction Curettage and dermabrasion are effective in the treatment of giant congenital melanocytic nevi (GCMN); however, local infection and hypertrophic scar formation are major issues. Thus, we applied cultured epithelial autografts (CEA) on skin defects after curettage or abrasion of GCMN and assessed the postoperative outcomes. Methods Seven nevi lesions of five patients (aged 3 months to 24 years) were treated with CEA after curettage or abrasion with a dermatome or a surgical bar, respectively. We assessed the postoperative outcomes, including CEA take ratio, erosion and/or ulcer formation in the acute phase, hospitalization days, Vancouver scar scale, and color improvement one year after the operation. In addition, a histological evaluation of a skin biopsy was performed over one year after the operation. Results The CEAs took well on the wound, and the wound surface was mostly epithelized by postoperative day 7 in all cases. While hypertrophic scar formation and slight pigmentation were observed in some lesions, the color was improved in all of the treated lesions. Histopathological examination revealed that the regenerated epidermis had stratified keratinocytes with rete ridges, and the dermal layer without nevus cells regenerated above the remaining dermis layer. Conclusions In this study, we found that early epithelialization and regeneration of the dermal layer was achieved after the application of CEA, suggesting that CEA could be an effective option after curettage or abrasion of GCMN., Highlights • Cultured epithelial autograft (CEA) application is effective in the treatment of giant congenital melanocytic nevi. • The grafted CEA takes well on skin defects post curettage and abrasion. • CEAs can achieve rapid epithelization. • Normal dermal tissue regenerates after CEA application.

This study aimed to assess the validity and efficacy of blue dye in colposcopic assessment of genital injury in pre- and postmenopausal women with and without history of consensual sexual intercourse. Two hundred women were prospectively enrolled and examined colposcopically with and without toluidine blue dye in order to detect and categorize genital lesions (laceration, bruise and abrasion). Examination of genital trauma was accomplished in a standardized way and findings were photo documented. A wide range of influencing factors with a potential impact on prevalence and nature of genital injury was recorded beforehand using a questionnaire. The frequency of diagnostic injury differed substantially depending on the examination technique, ranging from 9% using colposcopic magnification only to 28% with the additional use of toluidine blue dye. A vertical laceration affecting the posterior fourchette was the most frequent lesion detected (17%, n = 32). Menopausal status seems to have significant impact on genital injury prevalence (p = 0.0165), as 42% (16/ 38) of postmenopausal compared to 24% (36/ 151) of premenopausal women had at least one genital lesion. Furthermore, vaginal medication (p = 0.0369), vaginal dryness (p = 0.0228), dyspareunia (p = 0.0234) and low frequency of sexual intercourse (p = 0.0022) were found to significantly correlate with the presence of genital lesions. According to our findings, standardized colposcopy in combination with toluidine blue dye facilitates accurate assessment of genital lesions. Genital trauma situated at another site than the posterior part of the vaginal introitus seems to be uncommon after consensual intercourse.

Extensive glenoid labral tears, whether the result of repetitive instability or first-time dislocation, compromise the mechanical stability of the glenohumeral joint due to disruption of the anterior, inferior, posterior, and/or superior portions of the labrum. These lesions often result in recurrent multiplanar instability and pain that is nonresponsive to conservative management and difficult to diagnose due to variability in clinical presentation and advanced imaging findings. Arthroscopic repair techniques to address symptomatic shoulder instability have showed positive patient-reported outcomes, low failure rates, and high return-to-sport rates. The evolution of knotless suture anchors offers a fixation method that has proven to be functionally equivalent to knotted suture anchors while avoiding the risks of knotted anchors (knot loosening, knot migration, articular abrasion) and allowing easier placement and decreased operative time. The purpose of this technique is to describe our preferred method to treat a 270° labral tear through arthroscopic knotless anchor repair and demonstrate the expanded application of this technique for extensive glenoid labral pathology., Technique Video Video 1 For the treatment of a 270° labral tear in this left shoulder, the patient is placed in the lateral decubitus position and the standard diagnostic arthroscopy is performed using a posterior portal, anterior superior portal, and mid glenoid portal. Initial evaluation includes confirmation of the labral tear extending from 2 o’clock anteriorly to 11 o’clock posteriorly. Then attention is turned to the glenoid rim and torn labrum in preparation for repair. An arthroscopic shaver is used to debride the damaged labral tissue and create a bleeding surface on the glenoid rim to allow for better suture fixation and facilitate healing of the repaired labrum. A curved elevator is used to lyse capsulolabral adhesions and mobilize the labrum to allow for it to fall at the level of the glenoid articular surface. Suture repair is then performed using a ReelPass SutureLasso (Arthrex) to pass the repair suture through the capsule and grasp a several-millimeter (approximately 2-3 mm) portion of the labrum to integrate it into the repair. To address the anterior portion of the 270° labral tear, three 2.9 mm knotless PEEK PushLock Anchors (Arthrex) are fixed 5-7 mm apart from the 6 o’clock to 4 o’clock position. An accessory 7 o’clock portal is established for better accessibility to the posterior portion of the labral tear. A 3 mm knotless SutureTak Anchor (Arthrex) is placed at the 7 o’clock position followed by three additional 2.9 mm knotless PushLock Anchors 2-3 mm apart to the 11 o’clock position. A total of seven anchors are required to fully complete the capsulolabral repair and provide restoration of the labrum contour anterior, inferiorly, and posteriorly. Inspection with an arthroscopic probe is performed to check the integrity of the repair. The portal sites are then closed with no. 3-0 Monocryl suture, Dermabond, and Steri-Strips. A sterile dressing is placed, and then the shoulder is placed into a padded abduction sling.

Background Rodeo is an extreme sport involving powerful forces created by large animals. Objective The objective of this study was to characterize rodeo-related injuries among adolescents treated at United States emergency departments (EDs). Methods Cases were rodeo-related injuries among patients ages 13–19 years reported to the National Electronic Injury Surveillance System during 2000–2019. The distribution of the national injury estimates was determined for selected variables. Results A total of 408 adolescent rodeo-related injuries were identified, resulting in a national estimate of 17,363 injuries. Bulls were involved in 58.4% of the injuries and horses in 28.8%. The patients were 84.7% male and 15.3% female. The most frequently reported mechanisms of injury were: fell or thrown from an animal (41.4%), stepped on by an animal (22.4%), other contact with an animal (7.4%), contact with infrastructure (6.6%), and kicked by an animal (5.9%). The most common diagnoses were contusion or abrasion (29.5%), fracture (22.8%), strain or sprain (15.0%), laceration (8.1%), and concussion (8.0%). The affected body part was 26.9% head and neck, 25.9% upper extremity, 24.6% lower extremity, and 21.6% trunk. Conclusion Most of the injuries involved bulls. The majority of patients were male. Most of the injuries resulted from falling or being thrown by an animal or stepped on by an animal. The most frequently reported injuries were contusion or abrasion, fracture, strain or sprain, laceration, and concussion. The injuries most often affected the head and neck followed by the upper extremity and lower extremity.

A hammer is a popular tool among the “do it yourself” (DIY) population who pursue home-improvement projects. While we are aware that hammers have health hazards, no study has yet to explore the craniomaxillofacial injuries that could arise from the use of hammers. The purpose of this study is to describe the characteristics of craniomaxillofacial injuries from hammers. This is a 20-year cross-sectional study conducted using the National Electronic Injury Surveillance System (NEISS). Injuries from hammers were included in this study if they involved the head, face, eyeball, mouth, or ear. The study predictor was the mechanism of injury. The study outcome was the admission rate from the emergency department (ED) and anatomical site injured. Patient and injury characteristics were compared using chi-squared and independent sample tests. Our final sample had a total of 2967 hammer-induced injuries. Most of the sample consisted of white (55.3%) males (80.2%). Summer was the most injury-congested season (30.1%). The majority of the patients were over the age of 18 (65.6%). Laceration (47.3%) was the most common primary diagnosis, followed by contusion/abrasion (21.9%). The head (42.9%) was the most commonly injured craniomaxillofacial region followed by the face (29.0%). Craniomaxillofacial injury most frequently transpired at the patient’s home (63.6%). Concerning the mechanism of injury, accidentally self-induced injuries with a hammer were the most common (32.4%). Patients who were injured from the debris were more likely (P

Posterior fractures of the acetabulum are the most frequent pattern of acetabular fractures. Based on the works of Judet and Letournel, accurate reduction and stable osteosynthesis with early mobilization have become the gold standard for the treatment of posterior acetabular fractures. Recently, a less invasive approach has been described to decrease Kocher-Langenbeck (K-L) approach complications. The clinical case describes a patient affected by two-column fractures of the acetabulum with skin abrasions of the gluteus. The clinical evaluation was based on Merle d’Aubigne and Postel scoring, which Matta has modified. The approach used is a modified, less invasive K-L: a straight skin incision from the midpoint between the posterior superior iliac spine and the posterior tip of the greater trochanter. We observed the essential advantages using this approach were a lesser split of the gluteus maximus and no risk of damage for the superior gluteal nerve. In the early postoperative rehabilitation, we examined the strength of the gluteus maximus, which was better than in patients treated with the typical Kocher–Langenbeck approach. The patient resumed after fifteen years after surgery; hip mobility is complete and painless.

Hyperpigmentation is a condition where melanin is present in excess quantity which can cause significant esthetic problems. Pigmentation of gingiva is considered to be unaesthetic by patients, and it may have a psychological impact on them. This impact is aggravated in patients with “gummy smile” or excessive gingival display while smiling (high smile line). Variety of treatment modalities have been promulgated for depigmentation of gingival such as scraping, bur abrasion, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, techniques such as scalpel and diode laser have been tried for treatment of hyperpigmentation, which are simple, effective, and yielded good results, along with good patient satisfaction.

Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is crucial to maintain lubrication and proper health of the eye. In lagophthalmus, there is inability to close the eyelid and loss of blinking mechanism, thereby resulting in corneal dryness, ulceration, abrasion and infection. It may occur due to facial nerve damage secondary to trauma, iatrogenic due to surgery, tumour or Bell’s palsy. Initial symptomatic management is directed towards ocular surface lubrication. Viscous artificial tears are used or thin polyethylene film may be applied over the eyes to reduce evaporative drying. Temporary or permanent tarsorrhaphy may be required in some cases. Changing the position of either the top or bottom eyelid can help relieve the symptoms of lagopthalmus. A prosthetic procedure involves implanting gold weights into the upper eyelid, which allows the eyes to close by gravity. A case report of management of Lagophthalmus is presented here. Keywords: Lagophthalmus, Gold implant, Prosthetics.

Systemic buprenorphine and topical antiseptics such as chlorhexidine are frequently used in research animals to aid in pain control and to reduce infection, respectively. These therapeutics are controversial, especially when used in wound healing studies, due to conflicting data suggesting that they delay wound healing. Low-level laser therapy (LLLT) has been used to aid in wound healing without exerting the systemic effects of therapies such as buprenorphine. We conducted 2 studies to investigate the effects of these common treatment modalities on the rate of wound healing in mice. The first study used models of punch biopsy and dermal abrasion to assess whether buprenorphine HCl or 0.12% chlorhexidine delayed wound healing. The second study investigated the effects of sustained-released buprenorphine, 0.05% chlorhexidine, and LLLT on excisional wound healing. The rate of wound healing was assessed by obtaining photographs on days 0, 2, 4, 7, and 9 for the punch biopsy model in study 1, days 0, 1, 2, 4, 6, 8, 11, and 13 for the dermal abrasion model in study 1, and days 0, 3, 6, and 10 for the mice in study 2. Image J software was used to analyze the photographed wounds to determine the wound area. When comparing the wound area on the above days to the original wound area, no significant differences in healing were observed for any of the treatment groups at any time period for either study. Given the results of these studies, we believe that systemic buprenorphine, topical chlorhexidine, and LLLT can be used without impairing or delaying wound healing in mice.

Objectives Several studies have reported negative effects of open wedge high tibial osteotomy (OWHTO) on patellofemoral joints with cartilage degeneration and recommended performing other procedures. However, if chondral resurfacing surgery could promote improvement of cartilage degeneration in the patellofemoral joint, OWHTO would be an acceptable option. The purposes of this study were to arthroscopically evaluate the femoral trochlear articular cartilage after abrasion arthroplasty combined with OWHTO and to investigate the factors promoting improvement of that cartilage. Methods The present study cohort comprised 18 knees of 18 patients with varus osteoarthritis of the knee who had (1) International Cartilage Repair Society (ICRS) grade 4 femoral trochlear chondral lesions at the time of OWHTO; (2) undergone abrasion arthroplasty of the femoral trochlear cartilage in combination with OWHTO; (3) undergone second-look arthroscopy; and (4) been followed up for more than 2 years. Cartilage status was arthroscopically graded at the time of OWHTO and second-look arthroscopy. Patients were allocated to two groups according to the status of the femoral trochlear cartilage at the time of second-look arthroscopy: the improved group comprised patients with an ICRS grade of less than 3, and the not improved group comprised those with an ICRS grade of 4. Clinical outcomes, expressed as Knee Injury and Osteoarthritis Outcome Score (symptoms, pain, activities of daily living, function in sports/recreation and quality of life) and selected radiographic variables were compared between the two groups. Results There were 11 (61%) knees in the improved group and 7 (39%) in the not improved group. A comparison of radiographic variables between the two groups revealed that neither limb alignment nor patellar height affected cartilage changes. The two groups had similar results on the symptoms, pain, sports/recreation and activities of daily living subscales of the Knee Injury and Osteoarthritis Outcome Score. However, the quality of life subscale significantly differed between the two groups (p=0.025). Conclusion Degenerated femoral trochlear cartilage can improve after combined abrasion arthroplasty and OWHTO. A comparison of clinical outcomes between the improved and not improved groups revealed that neither radiographic variables nor clinical symptoms, including pain, affected cartilage changes at short-term follow-up. Level of evidence Case series, level V.

Necrotizing fasciitis is a surgically diagnosed infection of the deep soft tissues that results in high mortality. It is usually caused by aerobic and anaerobic bacteria and group A Streptococcus. Metallosis is characterized by the deposition of metal debris in the blood that causes metal poisoning and tissue damage. The abrasion of metal components that occurs after joint replacements causes metallosis, which may lead to severe complications. We report a rare case of metallosis-induced necrotizing fasciitis of the right thigh. Metallosis should be considered as a cause of necrotizing fasciitis if the patient has had a joint replacement surgery.

Keratoconus leads to a progressive protrusion and thinning of the cornea. In order to stop this, corneal crosslinking can be performed if the progression of the disease is proven. Crosslinking according to the "Dresden protocol" includes abrasion of the corneal epithelium, application of riboflavin eye drops and irradiation with UV-A light of an intensity of 3 mW/cm² for 30 minutes. The efficacy has been shown in several prospective randomized studies. One of the more recent developments is accelerated crosslinking, which allows a shorter irradiation time. On the other hand, the possibility of transepithelial crosslinking was presented, which does not require an abrasion of the cornea. This should reduce the occurrence of postoperative pain. The range of indications has also been expanded. Corneal crosslinking is used for post-LASIK keratectasia as well. It is also being considered for use in infectious keratitis. Topographically controlled crosslinking can likewise be used to try to positively influence the refractive power of the cornea. The risks of crosslinking include the occurrence of pain, haze or scarring, endothelial cell damage and, rarely, the occurrence of keratitis.Ein Keratokonus führt zu einer progressiven Vorwölbung und Verdünnung der Hornhaut. Um dies aufzuhalten, kann ein Crosslinking durchgeführt werden. Dabei ist eine Behandlung nach dem „Dresdener Protokoll“ eine effektive und sichere Behandlungsmöglichkeit, aber auch zahlreiche neue Anwendungsprotokolle (akzeleriertes Crosslinking, transepitheliales Crosslinking) und sogar weitere Indikationen (refraktive Eingriffe, infektiöse Keratitis) wurden in den letzten Jahren veröffentlicht.

The problem of studying the mechanisms of the occurrence of traumatic brain injury remains a very urgent issue for forensic medicine. The high incidence and high mortality rate of head injuries underlines its importance to experts. The article presents a case from the practice of a forensic medical examination of a traumatic brain injury. This case is indicative, since it clearly demonstrates the difficulties that forensic doctors face when examining craniocerebral injuries, when determining the mechanism of damage and the severity of bodily injuries. In this case, there is damage to the head and a concussion. The cited several conclusions of the experts of the bureau of forensic medical examination and the commission examination of the Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine regarding the forensic medical assessment in the case of traumatic brain injury with damage to the head. When conducting an investigative experiment, it was determined that the simultaneous occurrence of an abrasion and a concussion of the brain with one traumatic effect in the glabellar region is unlikely. After all, a concussion of the brain and abrasions in the glabellar area were formed by different mechanisms. The results of this assessment of the characteristics of traumatic brain injury can be useful for preventing difficulties in establishing the mechanism of damage in further expert practice.

The purpose of this study was to determine the pattern of penis ring-related injuries in the US. During 2000-2019, 162 penis ring-related injuries (for a national estimate of 6,344 such injuries) were treated at US emergency departments (EDs). Of the estimated injuries, 32.3% occurred during 2000-2011 and 67.7% during 2012-2015. The patients were 49.8% age 30-49 years. The most common types of injuries were ring stuck on the penis or scrotum (75.3%), edema (29.9%), pain (18.7%), and contusion or abrasion (7.6%). In 81.9% of the estimated injuries, the patient was treated or examined at the ED and then released.

Introduction Dentofacial esthetics demands have increased tremendously in the past decade. Psychological impact of unsatisfactory esthetic appearance can manifest in decreased sense of self-esteem and can negatively affect social and professional interactions. Esthetic awareness of dental patients has extended to include requests of gingival color modification. Gingival pigmentation can be physiological due to ethnic pigmentation or can be a result of various pathological processes. Different surgical modalities, tools and materials have been used in management of gingival pigmentation. This case report is introducing a simple, cost effective, minimally invasive technique of gingival sculpting for the purpose of significantly reducing gingival pigmentation. Case presentation A healthy 32-year-old male patient presented with a chief complaint of gingival pigmentation that is causing him distress and low self-esteem. Gingival sculpting technique was used. This simple technique uses a combination of two methods, bur abrasion and scalpel blade with copious irrigation. The procedure resulted in minimal intra and postoperative complications and excellent esthetic results achieved instantly and maintained at 3 months postoperatively. High patient esthetic satisfaction was achieved. Conclusion Gingival sculpting is minimally invasive procedure that can be performed at any dental office. It renders excellent esthetic results using minimal chair time and down time for the patient. It is well tolerated by the patient with minimal bleeding, postoperative pain, and rapid healing time. Long-term follow-up is needed to ensure stability and lack of recurrence.

Wear-induced complications after cervical disc replacement (CDR) are rare. A literature review on this topic found only a few case reports. We present a case of late complications after implantation of two cervical disc replacements, which resulted in infectious/abrasion-induced mixed-type inflammation with extensive osteolysis. The diagnostic workup, surgical therapy and outcome are presented and discussed with a review of the recent literature.Abriebinduzierte Komplikationen nach zervikalem Bandscheibenprothesenersatz (C-BSE) sind selten. Hierzu finden sich der Literatur nur vereinzelte Berichte. Wir präsentieren den Fall einer Spätkomplikation nach Implantation von 2 zervikalen Bandscheibenendoprothesen, bei denen es im Verlauf zu ausgedehnten Osteolysen aufgrund eines entzündlichen Geschehens vom infektiösen/abriebinduzierten Mischtyp kam. Die Vorgehensweise und die erzielten Ergebnisse werden gezeigt und auf Grundlage der aktuell verfügbaren Literatur diskutiert.

Introduction: Necrotizing fasciitis is a rare disease of soft tissue infection with a high mortality. It is characterized by rapidly spreading inflammation and necrosis of fascial planes. It usually follows an injury, though the cause may be a small abrasion or an insect bite or surgical incisions. It is commonly caused by bacteria such as Group A streptococcus. It may be accompanied by septic shock. It causes rapid death unless it is diagnosed quickly and managed aggressively. Prompt surgical debridement must be done to reduce mortality. Rapid diagnosis, antibiotic therapy, fluid resuscitation, and surgical debridement of the infection are all needed in the management of this fatal disease. However, when necrotizing fasciitis is associated with an underlying fracture the treatment becomes even challenging and limb-threatening. Case Report: A 48-year-male patient of South Asian descent came to Emergency Room with history of road traffic accident and sustained injury to the right (RT) leg. He was admitted with pain, swelling and blisters of the RT leg and suspected to have necrotizing fasciitis with proximal tibia fracture of the RT leg. He was treated with thorough surgical debridement, broad-spectrum antibiotics, free flap, and Masquelet’s technique with limb reconstruction system (LRS). At 18 months of follow-up the fracture healed, LRS was removed, pin tracts healed and patient was able to walk without any support. Conclusion: Necrotizing fasciitis is rare, rapidly progressive disease with a high mortality rate which requires prompt diagnosis, early surgical debridement, broad-spectrum antibiotics, careful fluid, and electrolyte management. These patients require a combined multidisciplinary approach for their management. Keywords: Necrotizing fasciitis, proximal tibia fracture, surgical debridement.

Introduction: Onychomycosis is a frequent complaint in dermatological practice and corresponds to the most common nail disease. The treatment of onychomycosis remains a challenge, as several factors end up compromising and making treatment difficult. Nail abrasion is considered a useful method in many cases. However, there is controversy about this approach, as there is an aerosol formation that could contaminate the environment and cause fungal changes or hypersensitivity reactions by the disseminated dust. We conducted a pilot study to investigate the fungal viability of nail particles from nails with onychomycosis after abrasion procedure. Methods: In this study, nail dust from the gloves and mask, used in the procedure, was collected from 9 patients with clinical and dermoscopic diagnoses of onychomycosis. Results: Hyaline septate hyphae were found in 12 materials (gloves and/or masks) from 7 patients. However, these hyphae were morphologically deformed or mutilated in all exams. In Mycosel® agar, there was no growth of any fungus. Discussion/Conclusion: The absence of dermatophyte isolation in all fungal cultures may demonstrate that the deformed fungal structures shown are not viable and would not present risks of contamination after nail abrasion.

Firearm injuries were well known for their atypical findings and appearances in routine so a retrospective study from 2013 to 2018 was performed to evaluate the morphology of firearm injuries and the damaged caused by it. Data of 65 cases was collected from post mortem notes of the deceased. It was observed that the age group of 21–40 years was most commonly affected with 63 cases (96.9%) and a male: female ratio 31.5: 1. Individuals of the Hinduism religion (50 cases, 76.9%) were most commonly affected and most of the victims were brought dead or were dead on the spot (34 cases, 52.3%). Rifled firearm weapon most commonly used (63 cases, 96.9%) while shotgun was used in 02 cases (3.1%). Single entry (43 cases, 66.2%) and exit wounds 37 cases (56.9%) were most commonly observed. In 41 cases (63.1%) no bullet was recovered while single bullet was recovered in 16 cases (24.6%) during post mortem examination. Entry wounds were most commonly found on head, face and neck region of body in 29 cases (44.6%) followed by chest region in 26 cases (40.0%), while right lower limb region with one case (1.5%) was least commonly found. Exit wounds were most commonly found on head, face and neck region (22 cases, 33.8%) followed by back region (15 cases, 23.1%). Lungs (22 cases, 33.8%) and brain (21 cases, 32.3%) were most commonly damaged organs in firearm injuries while kidneys and spleen (2 cases, 3.1%) each were least commonly involved organs. Skull and facial bones (23 cases, 35.4%) were most commonly fractured bones by firearm weapons followed by ribs and clavicle (17 cases, 26.2%). Abrasion collar was the most common entry wound artefact (53 cases, 81.5%) followed by smudging/blackening/stippling (20 cases, 30.8%). Homicidal was the most common manner of death with 44 cases (67.7%), followed by Suicidal with 15 cases (23.1%). Shock and Haemorrhage was the most common cause of death with 30 cases (46.2%).

Context: Melanin pigmentation of the gingiva is a physiological process that occurs in all ethnicities. Many treatment modalities are available to treat gingival hyperpigmentation. These are based on the principle of complete removal of the epithelial layer along with a part of subepithelial connective tissue which is then permitted to heal by secondary intention. Aim: This study aims to compare the treatment outcome of laser and its effectiveness in the management of gingival hyperpigmentation over scalpel. Design: A split-mouth study. Methods: Twenty young patients, between the ages of 18–35 with no systemic comorbidities with concerns regarding of dark-colored gums were selected for the study. A split-mouth study involving treatment of melanin pigmentation using scalpel abrasion on one side (left side upper and lower jaws) and Diode laser (980 nm) on other side (right side upper and lower jaws) was carried out. Observations regarding time taken, amount of bleeding during procedure, postoperative pain, healing of wound, and recurrence were made. Statistical Analysis: Data were analyzed using SPSS version 21.0 for Microsoft Windows. Results: Pain and healing were comparable in both the groups, though intraoperative time consumed and bleeding was significantly lower for laser group. Recurrence also was significantly lower on the laser group. Conclusion: Diode lasers can give better results in the management of gingival pigmentation compared to conventional scalpel abrasion technique.

Following civil unrest during 2020, physicians began to notice a variety of injuries resulting from crowd control weapons. While prior research emphasized ocular trauma, genitourinary complications of injuries have yet to be investigated. A previously healthy 27-year-old male presented to the emergency department due to sudden onset of severe left testicular pain following rubber bullet trauma. Physical exam showed extreme tenderness, abrasion, contusion, and edema of the left testicle with normal right testicle. Doppler ultrasound showed minimal blood flow to the superior pole with irregularity of the tunica albuginea. Surgery confirmed testicular rupture with a large tunical violation and extruded spermatic tubules. The testicle was thoroughly irrigated, non-viable tubules were debrided, and intraoperative ultrasound confirmed restoration of blood flow. Patient was discharged and instructed to follow-up should he face any fertility concerns in the future. Current crowd control guidelines state projectiles should be aimed at the lower abdomen or extremities; however, projectiles can cause testicular trauma which may lead to hypogonadism, infection, and psychological impact. Until there are changes to methods of crowd control, attendees should consider the use of athletic cups.

Musculoskeletal disorders are common conditions involving joints, muscles. Nerves, ligaments and tendons found in the community. These disorders affect the normal activities and causes discomfort. These discomforts are managed by different types of interventions including exercise, acupuncture, soft tissue release and manual therapy as conservative mode of management. Soft tissue release including active release technique, Fascial abrasion, and myofascial release are considered effective for musculoskeletal functions improvement. The advancements and technology improved and Instrument assisted techniques are being used. These different types of instruments including Graston, Ergon, Gua Sha, Hawk Grips, Rock Tapes, FAKTR. These instruments are sensitive in localization, specification and facilitation of the target area with the help of mechanical pressure applied on tissue with movement of specific muscle. Prognosis varies with good outcomes using fewer sessions than others.But it needs proper localization of muscle involved and special training. The advantage considered is that musculoskeletal disorders Continuous...

Introduction: Cosmetic expectations have increased with time and pigmentation of gingiva is a negative factor in an otherwise acceptable “smile window”. Amongst the various treatment modalities for depigmentation like scalpel technique, cryosurgery, laser, abrasion etc, there seems to be a need to compare efficacy of cryosurgery with TFE and Diode laser. Objective: The objective was to compare the efficacy of cryosurgery with 1,1,1,2 tetrafluroethane and Diode Laser for the treatment of gingival pigmentation. Materials and Methods: A randomized controlled split mouth study was conducted for 10 patients with gingival pigmentation, wherein one quadrant was treated with the TFE cooled swab( Group A) and the other quadrant was treated using diode laser (980nm at 1W) (Group B). Pre and post treatment photographs, VAS pain scores, were evaluated by the clinician at 4 days, 1 week, 1month and also number of analgesics required to be taken by the patient following treatment with both the techniques. Results: Clinically significant results were seen in both the groups. Mild erythema was seen immediately after the application of cryogen following which a whitish slough could be separated from the underlying connective tissue at fourth day. In group B, a white fibrin slough was seen 24hrs after the procedure. The healing was uneventful and complete epithelialization takes place in 3-4 weeks in both the groups. Though, the patient acceptance was good for both the procedures, mild pain and discomfort was experienced by the patient in group B. Conclusion: Depigmentation of gingival melanin hyperpigmentation by cryosurgery using TFE and diode laser were found to be an effective procedures, however the patient compliance and acceptance was greater in Tetrafluoroethane cryosurgery when compared to the Diode laser. Keywords: Cryosurgery, Laser, Depigmentation, Tetrafluroethane.

Aims and Objectives: The aim was to compare the effectiveness between patching and non-patching in the treatment of non-infected, non-contact lens related traumatic corneal abrasions, as well as of abrasions following foreign body removal. Materials and Methods: A prospective, controlled, randomized study on 100 patients over 1 year who presented with ocular pain, with a history of trauma or foreign body removal & had corneal abrasion on fluorescein stain. Patients were randomized into two groups: with patch group (receiving an eye patch with topical antibiotics) and no patch group (topical antibiotics with no eye patch) and patients were followed up. Results: Patients with corneal abrasions healed significantly faster and relieved symptomatically in the no patch group. Conclusion: We conclude that routine use of eye patching is not effective in the healing of simple corneal abrasion. Keywords: Corneal abrasion, Corneal foreign body removal, Fingernail injury, Patching.

Estimation of an injury in living as well in dead is of paramount importance in any criminal investigation. Determination of the age of injuries is crucial in clinical forensic medicine work because it is related to the time of occurrence of the crime. Doctor is required to ascertain the date of injuries while preparing an injury report. Present study illustrates the sequential changes in abrasive injuries and to compare the findings with available standard data. All the medico-legal cases brought to the emergency/ OPD/IPD /cases or for post mortem examination were selected over a period of 18 months who were having abrasions on their body. On comparing with standard data, 100% individual showed bright red abrasion for first 12hrs. Scab formation was completed within 12 to 48hrs in 7% individuals and within 24-48 hrs in 93% individuals. Healing reached another stage of scab turning dark brown on 3rd and 4th day in 41% individuals while it was seen completed on day 5 in 18% individual. Observations of this study was similar at times but not regularly often with the sequential colour changes mentioned in the available literature. Keywords: Age, Estimation, Abrasion, Colour.

Background: Marrow stimulation (MST) surgery, which includes microfracture, subchondral drilling, and abrasion arthroplasty, and autologous chondrocyte implantation (ACI) are 2 surgical options to treat articular cartilage lesions in the knee joint. Recent studies have suggested worse outcomes when ACI is used after failed MST. Purpose: To investigate the failure rates and clinical outcomes of primary knee ACI versus ACI after failed MST surgery (secondary ACI). Study Design: Systematic review. Methods: A systematic review was performed by searching the PubMed, Embase, and Cochrane Library databases to identify studies evaluating clinical outcomes of patients undergoing primary versus secondary ACI of the knee joint. The search terms used were as follows: “knee” AND (“autologous chondrocyte implantation” OR “osteochondral allograft”) AND (microfracture OR “marrow stimulation”). Patients undergoing primary ACI (group A) were compared with those undergoing secondary ACI (group B) based on treatment failure rates and patient-reported outcomes (PROs). Results: Seven studies (2 level 2 studies, 5 level 3 studies) were identified and met inclusion criteria, including a total of 1335 patients (group A: n = 838; group B: n = 497). The average patient age in all studies was 34.2 years, and the average lesion size was 5.43 cm2. Treatment failure occurred in 14.0% of patients in group A and 27.6% of patients in group B ( P < .00001). Four studies reported PROs. One study found significantly better Subjective International Knee Documentation Committee scores ( P = .011), visual analog scale (VAS) pain scores ( P = .028), and VAS function scores ( P = .005) in group A. Another study found significantly better Knee injury and Osteoarthritis Outcome Score (KOOS) Pain scores ( P = .034), KOOS Activities of Daily Living scores ( P = .024), VAS pain scores ( P = .014), and VAS function scores ( P = .032) in group A. Two studies found no significant difference in PROs between groups A and B ( P < .05). Conclusion: Patient-reported improvement can be expected in patients undergoing primary or secondary ACI of the knee joint. Patients undergoing secondary ACI have a significantly higher risk of treatment failure and may have worse subjective outcomes compared with patients undergoing primary ACI.

Gingival hyperpigmentation is produced by excessive melanin deposit, generating a dark gum coloring. Although it does not constitute a health issue, in some cases it usually represents an aesthetic problem that can affect psychologically, for which there are currently several treatment alternatives such as: surgery with scalpel, laser therapy, abrasion, cryosurgery, electrosurgery, among others. The aim of this literature review was to analyze the available information about gingival melanosis and the therapeutics that can be applied to improve the appearance of patients with this condition. Articles in English and Spanish, published during the period 2000-2020 in the PubMed, Medline, Scielo, Cochrane and Lilacs databases, were reviewed. It was concluded that the selection of the technique will depend on each particular case, however, the laser is the most relevant. La hiperpigmentación gingival se produce por el depósito excesivo de melanina, generando una coloración oscura de la encía. Aunque no constituye un inconveniente para la salud, en algunos casos suele representar un problema estético que puede afectar psicológicamente, por lo cual, en la actualidad existen diversas alternativas de tratamiento como: cirugía con bisturí, terapia láser, abrasión, criocirugía, electrocirugía, entre otros. El objetivo de esta revisión de la literatura fue analizar la información disponible acerca de la melanosis gingival y la terapéutica que puede ser aplicada para mejorar el aspecto de los pacientes con esta condición. Se revisaron artículos en inglés y español, publicados durante el período 2000-2020 en las bases de datos PubMed, Medline, Scielo, Cochrane y Lilacs. Se concluyó que la elección de la técnica dependerá de cada caso en particular, sin embargo, el láser es el más destacado.

There is a high prevalence of intra-abdominal adhesions following bowel resection, which can result in chronic pain, bowel obstruction, and morbidity. Although commercial adhesion barriers have been widely utilized for colonic resections, these barriers do not prevent anastomotic leakage resulting from reduced healing of the anastomosis, which can result in long-term health problems. To address this limitation, we have developed an adhesive bilayer wrap with selective bioactivity to simultaneously prevent intra-abdominal adhesion formation and promote anastomotic healing. Reactive electrospinning was used to generate a crosslinked gelatin mesh to serve as a cell-instructive substrate to improve anastomotic healing. A coating of poly(ethylene glycol) (PEG) foam was applied to the bioactive mesh to generate an antifouling layer and prevent intra-abdominal adhesions. After in vitro confirmation of selective bioactivity, the composite wrap was compared after 2 weeks to a commercial product (InterceedⓇ) in an in vivo rat colonic abrasion model for prevention of intra-abdominal adhesions. The composite bilayer wrap was able to prevent intra-abdominal adhesions when clinical placement was maintained. The composite bilayer wrap was further modified to include tissue adhesive properties for improved efficacy. Preliminary studies indicated that the adhesive composite bilayer wrap maintained a maximum shear strength comparable to InterceedⓇ and greater than fibrin glue. Overall, this work resulted in an initial proof-of-concept device that was shown to effectively prevent intra-abdominal adhesion formation in vivo. The composite bilayer wrap studied here could lead to an improved technology for improved healing of intestinal anastomoses.

Anacardium occidentale nut shell liquid has been used for decades especially by natives of South America, Asia and Africa in the treatment of topical skin diseases, abrasion and cancerous ulcers amongst others. Chronic exposure to sunlight can lead to skin damages including erythema, edema, hyperplasia, formation of sunburn cells, photo-aging, suppression of the immune system and skin cancer. This study was aimed at evaluating the effect of methanol extract of A. occidentale nut shell liquid on UV radiation (UVR) induced skin damage and cancer initiation. Gas chromatography and mass spectroscopic (GC-MS) analysis was carried out on the extract. Skin damage was induced by exposing the hairless part of the experimental animals directly to UVR (180 mJ/cm2 daily) for 42 days alongside treatment with the extract. Percentage weight gain, relative organ weight, lipid peroxidation and histological studies were carried out. The methanol extract of CNS as determined by GC-MS analysis contains 1,2,3-Benzenetriol and benzofuran. A normal skin tissue and hepatocyte was observed in the normal control, severe wrinkling of skin epithelium with actinic keratosis of the dermal collagen and marked venous congestion in the liver of the negative control and complete recovery in the group treated with 300 mg/kg of the extract was observed. This study suggests that the administration of the extract exhibited a chemopreventive effect against skin damage which could lead to cancer initiation stage resulting from ultraviolet radiation by preventing its detrimental impact on the epidermis. Key words: Anacardium occidentale (Cashew), chemo-preventive effect, bioactive compounds, skin damage, ultra-violet radiation.

Topical hemostatic agents, used alone or in combination, have become common adjuncts to manage tissue and organ bleeding resulting from trauma and surgical procedures. Oxidized regenerated cellulose (ORC) is one of the most commonly used adjunctive hemostatic agents. The aim of the present study was to compare the hemostatic efficacy of a novel ORC-based product, SURGICEL® Powder Absorbable Hemostat (Surgicel-P) to that of HEMOBLAST™ Bellows (Hemoblast-B), a collagen-based combination powder.Using an established porcine liver abrasion model, we randomly tested Surgicel-P and Hemoblast-B in 60 experimental lesion sites (30 per product tested). Primary endpoints included hemostatic efficacy measured by absolute time to hemostasis (TTH) within 5 minutes. We also examined number of applications required to achieve hemostasis, and sustained hemostasis following saline irrigation of test sites that achieved hemostasis.Surgicel-P demonstrated significantly higher hemostatic efficacy and lower TTH (Surgicel-P provided more effective and sustained hemostasis and faster TTH than Hemoblast-B. Surgicel-P represents a novel clinical alternative to provide adjunctive control of diffuse mild and moderate bleeding. Surgicel-P combines an ORC powder formulation and a delivery system in a device that is particularly useful for application on large surfaces and difficult-to-access anatomical locations where application of other forms of topical hemostats may be impractical.

Objectives Planning, adequate preparation, and further prosthodontic management are the most important steps in the treatment of this population of patients with dental and mandibular anomalies. The purpose of the article is the improvement of safety and clinical effectiveness of prosthodontic rehabilitation of patients after full-mouth reconstruction. Materials and Methods A single-center open prospective nonrandomized study, examination, and treatment of 198 patients with partial or total absence of teeth were performed. Higher safety and clinical effectiveness of the treatment were found in the patients of the main group who showed a significant reduction in the rate of complications relative to the comparison group. In the main group, the number of aesthetic defects and cases of repeated prosthetics decreased in comparison with the corresponding occurrence rate of such cases in patient groups. Results It showed statistically significantly reduction in the rates of occurrence of the complications when using the proposed algorithm: the rate of inflammation of the marginal periodontium and peri-implant tissues in the main group was 2.9 times less frequent and loosening of the supporting implants was 3.9 times less frequent. The rate of polymer chipping or abrasion in the area of the incisal edge or masticatory surface was two times lower in the main group of patients, short crowns were found 1.9 times less often, sores in the area of the dental pontic in the main group were 1.8 times less frequent than in the comparison group, and no fractures of bridgework were found in the main group. The frequency of neuralgic facial pain in the patients of the main group was 5.2 times less than in the comparison group, complaints about pain in the temporomandibular joint area were 8.4 times less frequent, increased abrasion of antagonist teeth was 3.9 times less frequent, and phonetics disorders were 8.4 times less frequent.The effectiveness of the algorithm developed by us is also confirmed by the fact that the number of aesthetic defects and cases of the need for repeated prosthetic treatment was reduced in comparison with the corresponding frequency of such cases in groups of patients where standard approaches to prosthetics were applied. In particular, aesthetic defects found in the main group of patients were 2.5 times less frequent than in the comparison group, and repeated prosthetics was performed 2.7 times less frequently. Conclusion Application of the developed comprehensive approach to planning of prosthodontic rehabilitation provides for significant reduction in the frequency of complications and aesthetic defects, as well as cases of repeated need for prosthetics.

Characterized by the rupture of the corneal epithelium, corneal ulcers threaten ocular integrity, with multifactorial development, such as decreased protection and excessive abrasion applied to the corneal surface. Keratoplasty restores the corneal anatomy, removing the inflamed or infected tissues, in order to promote visual acuity. The technique of deep anterior lamellar keratoplasty (DALK) selectively removes the diseased layers of the cornea, keeping the Descemet membrane and endothelium healthy, reducing the risk of rejection, aimed at tissue recovery. In the present report, a canine, from the Shih Tzu breed, a female, that has not been castrated, 2 years and 6 months old, was treated, she had a history of ocular discomfort and mucous secretion in both eyes. In the ophthalmic examination, keratoconjunctivitis sicca was found in the left eye and ectopic cilia was found in both eyes. With the aid of a fluorescein test, the presence of a deep stromal ulcer affecting the right eye was confirmed. The patient underwent ectopic cilia removal using the wedge resection technique and an allogeneic corneal transplantation using DALK, with only the diseased epithelium and stroma being replaced, reducing the risk of rejection and failures related to surgery. 90 days after the procedure, there was no reaction to the graft, there was complete epithelial repair and maintenance of visual function with slight corneal opacity.

Background Dermabrasion is related with mechanical and surgical traumas on the skin; usually topical antiseptics and/or saline have been used for healing. Natural products for wound healing can also be used for abrasions, such as latex from Hevea brasiliensis. Objective This study aimed to evaluate the in vitro viability and migratory/proliferative effects of latex serum from H. brasiliensis and to compare with a commercially available standard antiseptic solution and saline in experimental dermabrasion on rats. Methods For in vitro evaluation, MTT and scratch assays were used. In vivo testing was performed in 72 rats submitted to dermabrasion, treated with saline, antiseptic, or latex serum. This study evaluated re-epithelialization, neutrophilic infiltration, and the quantification of crust and epidermis. Results Latex showed viability at 1% and 0.1% concentrations and migratory/proliferative activity at 0.01% concentrations. The re-epithelialization was highest in latex group on 7th day. The latex group displayed lower thickness of crusts and greater extent of epidermal layers. The latex and antiseptic groups showed increases of myeloperoxidase levels on the 2nd day and showed important reductions from the 7th day. Study limitations Acute superficial wound model in rats and non-use of gel-cream (medium) without latex. Conclusion In conclusion, non-toxic latex stimulated migration/proliferation of keratinocytes in vitro and significantly accelerated wound healing in animal excoriation models compared to chlorhexidine or saline.

Cosmetic desires have improved with time and current trends speak volumes about gingival esthetics and smile designing. Gingival hyperpigmentation plays a negative role in an otherwise acceptable 'smile window'. In the present world, people are concerned more about their esthetics. Several techniques have been employed such as scalpel, electrosurgery, cryosurgery, chemical agents, abrasion, and laser method for the removal of melanin hyperpigmentation. The present case series were aimed to assess the efficacy of gingival soft tissue ceramic trimmer in gingival hyperpigmentation. Pain index (VAS), healing index (Landry, Turnbull & Howley index) and pigmentation index (Takashi et al. 2005) were evaluated to assess its efficacy. The results showed that ceramic trimmer has a lower pain index and a better healing index and delayed re-pigmentation index than rest all other procedures. Thus, it can be concluded that ceramic trimmer might prove to be a boon in achieving aesthetic satisfaction and could be used for depigmentation as it is very cost-effective, readily available and acceptable to the patient.

Highlights • The incidence of closed infected fracture is rare. • Any patient can become infected even with closed fracture and despite being an immunocompetent host. • In this patient, the risk factors of closed infected tibial plateau fracture are subdural hematoma and multiple skin abrasions. • Any sign of surgical site infection with sepsis is an indication perform, the surgeon should operate to irrigation and debridement., Introduction Acute hematogenous osteomyelitis in a closed fracture usually occurs pediatric and/or immunocompromised patients and only rarely in an immunocompetent patient. Case presentation We report the case of a 44-year-old female patient who was diagnosed as acute hematogenous osteomyelitis in a tibial plateau fracture. Following a motorcycle accident she was diagnosed as having a subdural hematoma at the right parietal lobe and combined closed fracture of the left tibial plateau and avulsion of tibial tubercle. Intraoperatively a cloudy fluid was found at the fracture site of left tibial plateau that was cultured and grew Staphylococcus aureus. The risk factors for acute hematogenous osteomyelitis in a closed fracture of this patient were the subdural hematoma and multiple abrasion wounds around her left knee. Conclusion Not only open fractures have a risk of acute hematogenous osteomyelitis but closed fractures also have a chance of developing this infection. The surgeon should be concerned about this type of infection if the patient has risk factors such as evidence of head injury or multiple abrasion wounds.

Purpose. To assess the efficacy and safety of a simple, noninvasive, “flap-sliding” technique for managing flap striae following laser in situ keratomileusis (LASIK). Methods. This prospective, interventional study included eyes with post-LASIK flap striae. All eyes underwent flap sliding 1-2 days after surgery. Following flap edge epithelialisation, a cellulose sponge was used to gently slide the flap perpendicular to the striae direction. This technique allows for flap striae treatment without flap lifting, avoiding any associated lifting complications. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive error were monitored one day after the flap-sliding procedure. Results. Fifteen eyes (15 patients) with post-LASIK flap striae were managed using the flap-sliding technique. The procedure did not successfully relocate the flap striae in 1 eye, and flap elevation and floating (using a balanced salt solution) were required. Therefore, 14 eyes were included in post-flap-sliding analyses. The UDVA improved in all patients the first day after the flap-sliding procedure was performed, with 11 of 14 eyes (78.57%) reaching an UDVA of 20/25 or better. Complications following flap sliding occurred in 2 eyes (14.29%). One eye had intraoperative epithelial abrasion, and 1 eye had residual postoperative striae outside of the optical zone. Conclusion. The flap-sliding technique is a simple, noninvasive, efficient, and safe technique for managing post-LASIK flap striae that develop after epithelial healing in the early post-LASIK period. This trial is registered with NCT04055337.

Abrasion injuries such as graze abrasions occur due to dragging of the body over a rough surface along the line of force. Such dragging of a body usually occurs when a person is trapped/pinned underneath a moving object like an automobile. Most of such injuries are superficial in nature or are limited to the soft tissues only. However, when the body is dragged for a considerable distance with considerable force then there might be bony involvement causing abrasion injuries to bone, which may be termed as “bone abrasion”. The authors present 2 cases having a specific pattern of abrasion injuries due to dragging of the broad body surface area by a moving vehicle for a considerable distance with speed and force in a road traffic accident. With evolving science there is a need to acknowledge injuries which may have specific pattern. Abrasion of bone due to a dragging force comprises such an interesting pattern of injuries, which potentially have forensic significance.

Pneumothorax is defined as a collection of air that is located between the visceral and parietal pleura. Spontaneous pneumothorax occurs in the absence of any identified trauma. It is subdivided into primary and secondary types. The annual incidence of primary spontaneous pneumothorax (PSP) in the general population is estimated to be 5 to 10 per 100000. The peak incidence occurs between 16 and 24 years of age. We present the case of a sixteen-year-old boy who manifested on several occasions with right-sided spontaneous pneumothorax. The boy was actively involved in sports. Until spontaneous pneumothorax occurred, he had never been ill. He did not take medication. He had no allergies. A total of three times the right chest was drained. At each arrival, pneumothorax manifested with abrupt pain. The X-ray confirmed the diagnosis each time. After a third spontaneous pneumothorax, a CT of the chest was done. CT showed small apical blebs. The trachea was neatly positioned, neatly branching. The right main bronchus seemed wider than the left. The vascular structures were of a neat appearance. The heart was neatly positioned, with a morphologically neat appearance. Surgical treatment was initiated. After collapse of the right lung, an incision was made in the third intercostal space to the right in the anterior axillary line. An angle camera was installed. Upon placement of the camera, the trocar is placed in the seventh intercostal space in the median axillary line. After identifying the apical blebs changes with a linear endostapler, a resection is performed. A partial parietal pleurectomy is then performed. Negative pressure drainage is set. In prophylaxis, the boy received cefazolin. A one-year follow-up did not result in relapse. Surgery for pneumothorax consists of stapling ruptured blebs and resection of abnormal lung tissue. The approaches used include VATS (video-assisted thoracoscopic surgery), mini-thoracotomy and conventional thoracotomy. We usually use VATS, which provides adequate exposure for resection or stapling and an opportunity for pleurectomy, abrasion or chemical pleurodesis. The morbidity of VATS is less than with conventional or mini-thoracotomy, and recurrence rates are approximately 5%, although open thoracotomy and pleurectomy have the lowest recurrence rate. Given that in our previous cases, after repeated tube drainage, we did not have recurrences, we did not opt for VATS immediately after the first recurrence. Reading the literature, in the future we will be guided by the algorithm to initiate VATS after the first recurrence of pneumothorax.

Technical advancements in meniscal repairs have greatly contributed to the ability to repair a variety of meniscal tears that were once thought untreatable. The gold-standard treatment for arthroscopic meniscal body repair remains an inside-out technique. The advantages of this technique are innate to the low-profile nature of the suture-passing construct, which allows for perpendicular access to tears with the benefit of multiple fixation points, in contrast to often bulkier all-inside repair devices. This technique requires a posteromedial or posterolateral incision for safe suture passing and needle retrieval and necessitates a surgical team experienced in this method of repair. However, the newest generation of all-inside devices has allowed for more facile placement of a variety of suture types. The all-inside repair technique includes both capsular-based and meniscal-based fixation, is not limited by a need for additional experienced surgical personnel to pass and retrieve needles, and does not require additional incisions. Regardless of fixation type, meniscal repair has been shown to improve long-term functional scores when compared with meniscectomy. Additionally, biological adjuncts have been introduced into the repair algorithm to improve healing rates when performing isolated meniscal repairs. Preparing the healing site with abrasion or trephination creates vascular channels that can facilitate repair. Intercondylar-notch marrow venting attempts to replicate the environment created by anterior cruciate ligament drilling for which healing rates are notably higher than those with isolated meniscal repairs. The use of fibrin clots in inside-out meniscal repairs with suturing of the clot to the area of the tear has also shown promising early healing rates on both magnetic resonance imaging and second-look arthroscopy. Finally, biological adjuncts such as platelet-rich plasma and concentrated bone marrow aspirate have shown both early clinical and radiographic improvements in Level IV case series, but further research is needed to more definitively measure their utility in the setting of meniscal repair.

Clinical experience during COVID-19 pandemic has shown that there is an increase in the number of patients complaining of teeth hypersensitivity. Paying attention to the patients’ history has revealed some similar reasons. It seems that the stress caused by this pandemic has caused an obsession with oral hygiene, especially with the belief that oral health may be associated with coronavirus prevention. Restriction of dental services caused by the novel coronavirus outbreak and fear of not having access to them make this obsession worse and make the situation even more complicated. Therefore, there is a change in the brushing pattern in terms of increasing the number of times, hand pressure, and duration of each brushing which ultimately leads to gingival recession and destruction of tooth structure, especially in the cervical area (abrasion), which results in teeth hypersensitivity. As dental professionals we should be aware of this and recommend our patients the proper measures of brushing to prevent tooth abrasions and subsequent sensitivity.

(1) Background: Protruding ears are the most common auricular malformation affecting approximately 5% of the population. One common factor leading to auricular protrusion is a deficiency or total absence of the antihelix. A technique first described by Gottfried Lemperle in 2003 attempts cartilage thinning, folding, and fixation by non-absorbable mattress sutures after ventral skin incision along the ventral helical rim. (2) Methods: Retrospective analysis of patient records was performed for otoplasties according to this technique, performed between 1985 and 2014 at Agaplesion Markus Hospital in Frankfurt, Germany. All recorded complications were examined. (3) Results: A total of 912 single otoplasties were performed according to this technique from 1985 to 2014. Overall complications included 26% minor complications not requiring further surgery and 11% major complications leading to revision surgery. Within those requiring revision surgery, the most common reason was recurrence of auricular protrusion (5%), followed by suture granulomas (5%) and hematomas (2%). (4) Conclusions: Lemperle’s otoplasty technique addresses the open thinning and shaping of the antihelix through a ventral incision along the helix to prevent irregularities and possible ridges. Results show a low complication rate comparable to data found in published studies. This technique is easy to perform, safe, and avoids often seen contour irregularities of the antihelix compared to techniques with a posterior approach.

PURPOSE The purpose of this study was to report on the characteristics of head and neck injuries secondary to the sport of Handball in the United States. MATERIALS AND METHODS This is a 20-year cross-sectional study that was conducted using the National Electronic Injury Surveillance System. Handball injuries were included in the study if they involved the head, face, eyeball, mouth, ear, or neck. The primary study predictor was age group. The study outcome was the type of injury (diagnosis) and the location of injury. Chi-squared testing (χ2) was performed to compare categorical variables. RESULTS Males composed more than three-fourths of the sample of patients (76.2%). White patients (38.7%) composed the most common racial group. The most common anatomical location injured was the head (45.9%). The most common primary diagnoses were contusion/abrasion (22.5%). Children were most likely to injure their head (P

We report a case of a 56-year-old Brazilian woman, with relapsing lepromatous leprosy, and onychomycosis caused by a non-dermatophyte filamentous fungi. The pathogenic fungi was identified as Arthrinium arundinis and treated with chemical abrasion of the nail with 40% urea and application of terbinafine cream. Onychomycosis caused by Arthrinium species is rare, and this is the second reported case.

Cavernous hemangiomas of the uterine cervix are very rare benign tumors. They are usually more common around the third decade, but around the fifth decade, their frequency is even rarer. Sometimes, they can cause obstetric and gynecological complications, but most are asymptomatic and are detected by chance. Surgical treatment is usually the means of choice, which, in most cases, is performed in connection with other pathologies. We present a case of cervical hemangioma in a 58-year-old woman who was diagnosed accidentally. The reason for consulting a gynecologist was the weak postmenopausal bleeding for 6 months. Ultrasonographically, intramural leiomyoma of the uterine corpus was detected. Atrophic endometrium was found from the test abrasion. A total hysterectomy with salpingo-oophorectomy was performed. The histological examination confirmed the diagnosis: Cavernous hemangioma of the cervix. This case supports the fact that postmenopausal bleeding may also be due to cavernous hemangioma of the cervix.

The most common sources for metal ions after total hip arthroplasty (THA) are the bearing surface in metal-on-metal articulations and trunnion corrosion. Concomitant dual interface failure is an uncommon complication in metal-on-polyethylene THA. We report an unusual case of a 59-year-old woman with ceramic-on-ceramic THA in 2005, who underwent revision to metal-on-polyethylene THA 4 years later after femoral head fracture. Subsequently, she developed substantial adverse local tissue reaction and significant metal ion elevation and the failure was found to be due to both wear at the bearing surface and corrosion at the head neck junction requiring second revision. Findings included massive adverse local tissue reaction, abductor mechanism destruction, osteolysis, and corrosion damage of the trunnion. Abrasive damage of the trunnion was also noted, but prior abrasion from the original ceramic fracture could not be ruled out. Postoperative course at 14 months demonstrates 95% and 64% reduction in cobalt and chromium levels respectively, with symptom resolution. Keywords: Metallosis, Total hip arthroplasty, Metal ion toxicity

Syringoma is a benign eccrine sweat gland tumor that predominantly appears in females during puberty with multiple smooth papules measuring 1–2 mm in diameter. Common locations are on lower eyelids and cheeks. Vulvar syringoma is quite a rare, occurring condition with only a few cases reported. Here, we are reporting a case of 31-year-old female with vulvar syringoma associated with pruritus. The lesion was treated with carbon dioxide (CO2) laser ablation and 50% trichloroacetic acid (TCA) chemical peeling. Jaungo was used for wound care after laser abrasion. The combination treatment was effective for removing syringoma lesions. Post laser management with fusidic acid cream and jaungo cream was sufficient to prevent infection and promote wound healing.

Literature describes that a well-maintained moist wound healing environment leads to faster healing by preventing scabbing and drying of the wound. A moist wound speeds healing by allowing for unimpeded movement of newly dividing epidermal cells in the wound. Contrary to what is described in literature and practiced by clinicians, first-aid dressings used at home by consumers advertise breathability and absorptivity as benefits. This manuscript examines the effects of dressing breathability and highly absorptive pads on healing and wound appearance in a porcine dermatome wound model, designed to mimic an abrasion injury. Partial thickness wounds were covered with an experimental silicone-polymer film dressing and various over-the-counter bandages for time frames ranging from 4 to 11 days. The progression of healing was quantified by histology and wound-size reduction measurements. The thickness and persistence of a scab or serocellular crust (SCC) over the injury was measured using both pixel density and optical coherence tomography to supplement visual observations, demonstrating new tools for quantification of SCC over wounds. The results of the experiments illustrate the impact of dressing features on the rate of wound reepithelialization and the formation of SCC. Both a low moisture vapor transmission rate (MVTR) and the absence of an absorptive layer were important in speeding wound healing. Surprisingly, use of a dressing with a low MVTR and a highly absorptive pad healed significantly more slowly than a comparative dressing with a low MVTR and no absorptive pad, even though both dressings had very little scab formation over the wound. This study shows that breathability and absorbency of dressings play independent roles in providing an optimal healing environment, and that these properties can vary widely among commercially available dressings.

The article substantiates the need for the use of botulinum therapy in the management of bruxism as a movement disorder. We present the technique of injecting a new Russian botulinum neuroprotein Relatox into the masticatory muscles of patients with bruxism. We have the positive clinical effects of botulinum therapy, a decrease in the level of pain on the visual analogue scale, normalization of muscle activity according to the surface electromyography of masticatory muscles, a decrease in number of nocturnal bruxism according to abrasion on the foil surface on Brux Checker are shown.

Violation of the conditions of animals keeping and the lack of proper level of veterinary and sanitary culture on farms does not allow to achieve a balance between the organism of the cattle and the environment of its stay. The uneven distribution of body weight on the surface of the sole caused by keeping animals on a rough floor promotes the emergence of producing corns, stretching of the tendons and ligaments, slippery flooring leads to the fall of animals and the occurrence of various injuries, in particular, fractures of the limbs, tensile bond, capsule of the joint, excessively hard floor – to excessive erosion of the horn of the sole, etc. In such herds it is difficult to maintain animal health at the proper level and prevent the occurrence of, in particular, aseptic pododermatitis. The article deals with the results on the dissemination of aseptic pododermatitis in cows for the presence of animals on wooden and reinforced concrete slit floors during the winter and standstill period of containment. It has been established that aseptic pododermatitis in cows on reinforced concrete slit floor is registered in 71.6% of cases, while on wooden – only 28.4%. In the hoof horn of the thoracic and pelvic extremities of the cows, with aseptic pododermatitis, the amount of moisture decreased by 8.2 and 9.3% respectively, the concentration of SH-groups increases by 10.6 and 15.8%, with a possible decrease in the content of calcium, sulfur, cuprum and zinc; decreases the hoof horn density and resistance to abrasion of the epithelium of the hooves of the pelvic limbs by 1.6 and 18.0%, as well as the intensity of the abrasion sole hooves of the thoracic and pelvic limbs is increased by 7.5 and 20.0%, which helps to reduce the growth of the epidermis of the sole. Consequently, changes in certain biochemical and biophysical indices of hoof horns of cows suffering from aseptic pododermatitis, which were held on the reinforced concrete slit, indicate a deterioration in the quality of the epidermal hooves and excessive erosion of the sole, which is one of the causes of the occurrence and development of aseptic pododermatitis in cows.

Background:Hip arthroscopy is becoming more advanced and commonly performed. However, significant controversy exists regarding whether high-grade acetabular cartilage lesions should be treated with debridement/abrasion or microfracture. In addition, patients treated with microfracture are subject to extended protected weightbearing rehabilitation to mitigate risk of subchondral plate fracture and to protect fibrocartilage tissue formation.Purpose:To determine the midterm patient-reported outcomes and failure rate of patients with grade 3 and 4 acetabular labrum articular disruption (ALAD) lesions managed with debridement/abrasion or microfracture.Study Design:Cohort study; Level of evidence, 3.Methods:Primary arthroscopic labral repair cases at 2 centers from November 2008 to April 2016 were reviewed for patients aged Results:A total of 113 hips in 110 patients (66 males, 44 females; mean age, 34.5 ± 1.1 years) undergoing debridement/abrasion (n = 82) or microfracture (n = 31) were followed for a mean of 4.9 years (range, 2.0-8.5 years). Lesion size was not statistically different between the debridement/abrasion (1.3 ± 1.0 cm2) and microfracture cohorts (1.4 ± 1.0 cm2) ( P = .47). Patients undergoing debridement/abrasion achieved 3.6-point mean improvements in VAS ( P < .01), 21.2-point improvements in mHHS ( P < .01), and 25.4-point improvements in HOS-SSS ( P < .01), which were not significantly different from those observed in microfracture patients ( P≥ .20). The 5-year rate of survival free of revision surgery was 84.0% in the debridement/abrasion group and 85.6% in the microfracture group ( P = .78). The cartilage treatment technique was found not to be predictive of revision risk during both univariate (hazard ratio [HR], 1.01; P = .98) and multivariate (HR, 0.93; P = .90) analysis accounting for patient age, lesion grade, and acetabular coverage.Conclusion:Patients undergoing debridement/abrasion of high-grade unipolar acetabular cartilage lesions demonstrate similar outcome scores and revision rates compared with those of patients undergoing microfracture. These outcomes support the consideration of preferential debridement/abrasion at the discretion of the treating surgeon to optimize recovery while maintaining established positive outcomes after hip arthroscopy.