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Biobrane^(TM) for burns of the pubic region: minimizing dressing changes

Military Medical Research 2019年第1期6卷 89-92页

作者： Jia-Jun Feng Jia Le See Abby Choke Adrian Ooi Si Jack Chong Department of Plastic Reconstructive and Aesthetic Surgery Singapore General Hospital University of Auckland Faculty of Medical and Health Sciences

Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time *** presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and *** were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without *** epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic ***: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.

关键词： pubic Thermal burns Perineum Dressing BiobraneTM

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Severe pubic Symphysis Diastasis Managed Conservatively: A Case Report and Review

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Case Reports in Clinical Medicine 2017年第4期6卷 120-126页

作者： Vijay Palvia Susan Kim Holli Warholic James Anasti Department of Obstetrics and Gynecology St. Luke’s University Health Network Bethlehem Pennsylvania USA Temple School of Medicine Bethlehem Pennsylvania USA

Background: pubic symphysis diastasis (PSD) is an uncommon complication of labor and delivery. Common risk factors of PSD include precipitous labor, rapid second stage of labor, intense uterine contractions, prior pelvic pathology, multiparity and macrosomia. Diagnosis is made clinically and confirmed by imaging. Management of PSD depends on the severity of symptoms and degree of symphysis separation. Standard therapy is conservative, but surgery may be needed in severe cases. Case Report: A 25-year-old female at term pregnancy presented in active labor and had a rapid second stage of labor without intravenous oxytocin or an epidural. She was subsequently diagnosed with severe PSD with a 5.5 cm separation. Her management included a pelvic binder, pain management, physical therapy, and serial imaging to monitor improvement. Discussion: In severe cases, surgery can be avoided in favor of conservative measures for the management of PSD. Multidisciplinary involvement with orthopedic surgery, radiology, physical therapy, and anesthesiology can play a vital role in optimal management. PSD may recur in future deliveries, but this does not preclude vaginal birth.

关键词： pubic Symphysis Diastasis

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Effects of Curved Periacetabular Osteotomy on the Stress Fields of the pubic Rami and Ischium: A Finite Element Model Analysis

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Open Journal of Orthopedics 2013年第4期3卷 199-203页

作者： Norio Imai Yoichiro Dohmae Ken Suda Dai Miyasaka Tomoyuki Ito Naoto Endo Department of Orthopedic Surgery Nii- gata University Medical and Dental Hospital Niigata Japan. Department of Orthopedic Surgery Niigata Prefectural Shibata Hospital Niigata Japan Department of Orthopedic Surgery Niigata Prefectural Shibata Hospital Niigata Japan

Background: Postoperative pubic or ischial stress fracture may be a complication after curved periacetabular osteotomy (CPO). The discontinuity of the superior pubic rami is a risk factor for this complication. We investigated the stress field differences in standing and sitting positions after CPO. Methods: We used finite element analysis to assess the effects of inferior pubic rami and ischial fractures with or without discontinuity of superior pubic rami. We used the “union model”, obtained from a bony union at the osteotomy site of the superior pubic rami from 38-year-old woman who had undergone CPO for left hip dysplasia. We deleted the bony union region and created a discontinuity in the superior pubic rami equal to the non-union, creating the “discontinuity model”. We compared the stress field and stress value in the simulated standing and half weight-bearing positions on the operative side, one-legged standing position on the non-operative side, and the sitting position. Findings: In 4 cases, the inferior rami experienced the highest stress. Stress values in the discontinuity model were higher than those in the union model: 1.7 times in the case of one-legged standing on the operative side, 2.4 times in the case of half weight-bearing on the operative side, 3.8 times in the case of one-legged standing on the non-operative side, and 2.0 times in the sitting position, respectively. Interpretation: We recommend patients delay weight bearing on the operative side, avoid the sitting position as long as possible, and sit down slowly to prevent inferior pubic rami and ischial fractures after CPO.

关键词： Curved Periacetabular Osteotomy Ischial Fracture Inferior pubic Ramifracture Stress Field Finite Element Analysis

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Bareback Equestrian Trauma: pubic Symphysiolysis and Abdominal Arterial Hemorrhage

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Surgical Science 2011年第10期2卷 493-495页

作者： David Spelt Herman Frima Lijckle van der Laan 不详

pubic symphysiolysis and retroperitoneal arterial vessel rupture after bareback horse riding is a rare traumatic combination. We report a case of a 59-year-old man who experienced severe pubic, abdominal and lower back pain due to a bounce after a asynchronous rhythm of horseback riding without a saddle. The patient was referred to our Emergency Department because of a suspected ruptured abdominal aortic aneurysm. Computer tomography demonstrated diastasis of the pubic symphysis, active bleeding of a branch of the left internal iliac artery and a massive retroperitoneal haematoma. The arterial bleeding was directly coiled in the emergency setting, the stable pubic symphysiolysis was treated conservatively and the haematoma was surgically drained after three days. Bareback horse riding can lead to a pelvic fracture and severe bleeding leading to haemodynamical instability and life threatening situations. Using proper protective equipment including a saddle to prevent equestrian injury should be emphasized.

关键词： Equestrian pubic Symphysiolysis Hemorrhage Trauma

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