Dressing of the Axilla Using a Water-Filled Surgical Glove After Axilla Grafting
Usually, after grafting of the axilla, it is difficult to obtain a reliable dressing using traditional materials including tulls and fluffy gauzes. As an alternative to this traditional approach, a sterile surgical glove filled with saline can be used to obtain a bulky dressing.
Optimizing the Correction of Severe Postburn Hand Deformities by Using Aggressive Contracture Releases and Fasciocutaneous Free‐Tissue Transfers
&NA; Severe postburn hand deformities were classified into three major patterns: hyperextension deformity of the metacarpophalangeal joint of the fingers with dorsal contracture of the hand, adduction contracture of the thumb with hyperextension deformity of the interphalangeal joint, and flexion contracture of the palm. Over the past 6 years, 18 cases of severe postburn hand deformities were corrected with extensor tenotomy, joint capsulotomy, and release of volar plate and collateral ligament. The softtissue defects were reconstructed with various fasciocutaneous free flaps, including the arterialized venous flap (n = 4), dorsalis pedis flap (n = 3), posterior interosseous flap (n = 3), first web space free flap (n = 3), and radial forearm flap (n = 1). Early active physical therapy was applied. All flaps survived. Functional return of pinch and grip strength was possible in 16 cases. In 11 cases of reconstruction of the dorsum of the hand, the total active range of motion in all joints of the fingers averaged 140 degrees. The mean grip strength was 16.5 kg and key pinch was 3.5 kg. In palm reconstruction, the wider contact area facilitated the grasping of larger objects. In thumb reconstruction, key‐pinch increased to 5.5 kg and the angle of the first web space increased to 45 degrees. Jebsen's hand function test was not possible before surgery; postoperatively, it showed more functional recovery in gross motion and in the dominant hand. Aggressive contracture release of the bone, joints, tendons, and soft tissue is required for optimal results in the correction of severe postburn hand deformities. Various fasciocutaneous free flaps used to reconstruct the defect provide early motion, appropriate thinness, and excellent cosmesis of the hand. (Plast. Reconstr. Surg. 107: 1, 2001.)
Novel polymeric hydrogel composites: Synthesis, physicochemical, mechanical and biocompatible properties
In this research study, novel hydrogel composite films were constructed using different ratios of poly (vinyl alcohol) (PVA)/kappa-carrageenan (KC) (PVA90/KC10%, PVA80/KC20%, PVA70/KC30%, PVA60/KC40%) crosslinked with glutaraldehyde (0.025%) and investigated their physicochemical characteristics such as mechanical, thermal, morphological, swelling behaviour, and cell viability. SEM and FTIR revealed that surface morphology changed to heterogeneous and the presence of molecular interaction among the polymers. PVA90KC10 and PVA60KC40 exhibited smaller and larger pores on surface respectively. The change in the proportion of PVA and KC also triggered the tensile strength (Ts) of the film and the highest Ts observed were 21.60 MPa for PVA60KC40. Moreover, the thermal analysis showed three-phase degradation, and an increase in KC40 concentration results inversely proportional to a decrease in the rate of thermal degradation. Further, swelling and in-vitro biodegradation study confirmed the enhanced perseverance of water uptake for PVA60KC40 (286%) due to pores structure of the hydrogel film and PVA and KC alone degraded faster as compare to other films results suggested higher concentration of PVA90KC10 showed lower degradation rate and highest for PVA60KC40 about 6% and 22% respectively. Further, the cell viability was studied with MTT assay method by using NIH3T3 and HEK-293 cells for biocompatibility study revealed NIH3T3 cells were more biocompatible than HEK-293 and cell viability percent for PVA60KC40 showed the highest cell attachment about 99%. Overall corroborating data obtained from the study attested to the average swelling, appreciable mechanical characters, good interaction between molecules, and cell viability of the constructed PVA/KC hydrogel film, these all characters pave to be used as a potential template for biomedical applications such as tissue engineering and drug delivery.