Wound closure represents a primary goal in the treatment of very deep and/or large wounds, for which the mortality rate is particularly high. However, the spontaneous healing of adult skin eventually results in the formation of epithelialized scar and scar contracture (repair), which might distort the tissues and cause lifelong deformities and disabilities. This clinical evidence suggests that ...

Between June 1999 and May 2003 we undertook direct primary closure of the skin wounds of 173 patients with Gustilo and Anderson grade-IIIA and grade-IIIB open fractures. These patients were selected from a consecutive group of 557 with type-III injuries presenting during this time. Strict criteria for inclusion in the study included debridement within 12 hours of injury, no sewage or organic co...

Introduction: The most common type of velopharyngeal valve (VPV) closure is a matter of controversy.The aim of this study was to estimate the most common type of VPV closure, including identification of the type and grade of VPV closure among Egyptian children.  Materials and Methods: This study included patients who were candidates for adenotonsillectomy. In these cases, video-nasoendoscopy an...

BACKGROUND Damage-control laparotomy (DCL) has revolutionized the surgery of injury. However, this has led to the dilemma of the nonclosable abdomen. Subsequently, there exists a subgroup of patients who after resuscitation and diuresis, remain nonclosable. Before the adoption of our open abdomen protocol (OAP) and use of transabdominal wall traction (TAWT), these patients required skin graftin...

Background: Laboratory and clinical data have shown that small (0.5-1.0 cm) bites of a running suture closely spaced (0.5 cm) and only through midline fascia results in the lowest incidence of incisional hernia. Methods: Laboratory and clinical manuscripts were used to formulate a goal for optimal closure of a long midline abdominal incision. Using these conclusions as a starting point, surgica...

BACKGROUND AND OBJECTIVE Continuous epidural administration of a local anesthetic drug for postoperative pain treatment of patients, who undergo a fusion operation of lumbar vertebrae is limited by the suction of wound drainage. The effect of the single epidural administration of levobupivacaine 0.25% 10 mL 20 minutes before finishing of skin closure was examined on the postoperative demand for...

Objectives: Large cutaneous defects of the cheek and external ear present a reconstructive challenge. While free tissue transfer has been increasingly used for such defects, many patients with these malignancies are poor candidates for lengthy reconstructive surgery. The cervicofacial and cervicothoracic advancement flaps have been previously described as a simple method for reconstructing defe...

The incidence of postoperative SSI (surgical site infection) after hepatic resection has decreased gradually with the refinement of surgical techniques and perioperative management. However, postoperative SSI still develops in a few patients after hepatic resection, leading to increased medical costs, longer hospitalization and a reduced quality of life in the postoperative course. The purpose ...

A 54-year-old man had considerable visceral swelling after laparotomy for intraabdominal infection, and primary closure could not be achieved. We provided temporary abdominal closure with a presterilized 3-L cystoscopy fluid bag (Fig. 1). The following day we inserted a Wittmann Patch using a cellophane sheet to prevent adhesions between the intestine and the abdominal wall and wound. We suture...

Cesarean delivery (CD) is one of the most common major surgeries performed in the United States and worldwide. Surgical techniques evaluated in well-designed randomized controlled trials (RCTs) that demonstrate maternal benefit should be incorporated into practice. The objective of this review is to provide a summary of surgical techniques of the procedure and review the evidence basis for them...