December 21st, 2011 by RamonaBatesMD in Research
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There is an interesting article in the current edition of the Plastic & Reconstructive Surgery Journal (December 2011). The focus of the article is a small subset of renal patients who need kidney transplants but whose abdominal panniculus excludes them due. A significant panniculus creates an infrapannicular area prone to increased moisture, skin maceration, and elevated bacterial counts, predisposing the patient to postoperative wound infections, necrosis, and dehiscence. Not good for anyone, but really not for someone on immunosuppression.
The article discusses the use of abdominal panniculectomy in these patients in preparation for the transplant. Nine patients, 3 men and 6 women, with a mean age of 54.5 years and a mean BMI 28.3 are the focus of the article. The focus is not Read more »
*This blog post was originally published at Suture for a Living*
November 23rd, 2011 by John Di Saia, M.D. in Health Tips
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About ten years ago plastic surgery had a nice little advance- the advent of the disposable pain pump. Breakthroughs in medicine are far fewer than advertising copy would have you believe, but this one is real. Unfortunately some practices use them like a marketing ploy in all cases and really don’t spend the time to make them work well or minimize their risk. Others don’t see the benefit and don’t use them at all.
Pain pumps are quite useful in some cases when used correctly. Plastic surgery is a technical specialty and some surgeons are more adept at making things work than others. There are risks with them and cases in which the benefit is harder to measure.
How Does a Pain Pump Work? Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
September 21st, 2011 by Paul Auerbach, M.D. in Research
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Once of the major recent advances in trauma care has been the evolution of topical substances that can be applied to wounds in order to limit or stop hemorrhage (bleeding). This is very important in wilderness medicine, because uncontrolled bleeding is a leading cause of death from injuries. When the bleeding site can be approached in such a manner as to stop the bleeding, then something very valuable may possibly be done for the patient.
In article entitled “Comparison of Celox-A, ChitoFlex, WoundStat, and Combat Gauze Hemostatic Agents Versus Standard Gauze Dressing in Control of Hemorrhage in a Swine Model of Penetrating Trauma,” Lanny Littlejohn, MD and colleagues used an animal model of a complex groin injury with a small penetrating wound, followed by completely cutting the femoral artery and vein, to determine whether there was any benefit to one or another hemostatic (stops bleeding) agent in comparison to each other and to standard gauze dressing. To cut to the chase (no pun intended), the results showed that no difference was found among the agents with respect to initial cessation of bleeding, rebleeding, and survival. In this study, WoundStat was inferior with respect to initial cessation of bleeding and survival when compared to Celox-A.
The authors point out how important it is to Read more »
This post, Article Compares Hemostatic Agents: Are There Any Differences?, was originally published on
Healthine.com by Paul Auerbach, M.D..
August 14th, 2011 by John Di Saia, M.D. in Health Tips, Opinion
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I have a wide scar on my leg that I got years ago. I have tried creams and stuff. When is surgery a good idea to improve a scar? Can a cream or a laser make it thinner?
Scar improvement has several phases and the condition of your body and how the wound occurred have parts to play. Early on after wounding there is the question of whether or not to have surgery to repair the wound. If the edges are clean and close together, then surgery is not always beneficial. If they are apart or the wound is dirty a proper medical evaluation and/or surgery can make things better down the line. When in doubt, get that evaluation.
Once the wound has started healing, Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
November 4th, 2009 by Paul Auerbach, M.D. in Better Health Network, Health Tips
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This is the third post based upon my presentation given at the Wilderness Medical Society Annual Meeting held in Snowmass, Colorado from July 24-29, 2009. The presentation was entitled “Just When You Thought It Was Safe to Go Back in the Water.”” The topic was an overview of hazardous marine animals and it was delivered by me. In the previous post, there was information about stingrays and scorpionfishes. In this post, there is information about injuries from sea urchins incurred in the marine environment.
Sea urchins are free-living echinoderms with egg-shaped, globular or flattened bodies. They are covered by tightly arranged spines and/or triple-jawed pedicellariae, which are seizing and envenoming organs. The spines can be brittle, hollow, sharp and venom-bearing or blunt and non venom-bearing (such as with Hawaiian pencil urchins). Most persons are envenomed when they step upon or brush against an urchin. Read more »
This post, What To Do If You Step On A Sea Urchin, was originally published on
Healthine.com by Paul Auerbach, M.D..
