Prevention of SSIs requires a multipronged approach with particular emphasis on optimising preoperative issues, adhering religiously to strict protocols during the intraoperative period and addressing and optimising metabolic and nutritional status in postoperative period.
Oxandrolone, a testosterone analog, is used to counteract the catabolic effects of burn injury. Recent animal studies suggest a possible hormonal association with heterotopic ossification (HO) development postburn. This work examines oxandrolone administration and HO development by exploring historical clinical data bridging the introduction of oxandrolone into clinical practice. Additionally, we examine associations between oxandrolone administration and HO in a standardized mouse model of burn/trauma-related HO. Acutely burned adults admitted between 2000 and 2014, survived through discharge, and had a HO risk factor of 7 or higher were selected for analysis from a single burn center. Oxandrolone administration, clinical and demographic data, and elbow HO were recorded and were analyzed with logistic regression. Associations of oxandrolone with HO were examined in a mouse model. Mice were administered oxandrolone or vehicle control following burn/tenotomy to examine any potential effect of oxandrolone on HO and were analyzed by Student's t test. Subjects who received oxandrolone had a higher incidence of elbow HO than those that did not receive oxandrolone. However, when controlling for oxandrolone administration, oxandrolone duration, postburn day oxandrolone initiation, HO risk score category, age, sex, race, burn size, and year of injury, there was no significant difference between rates of elbow HO between the two populations. In agreement with the review, in the mouse model, while there was a trend toward the oxandrolone group developing a greater volume of HO, this did not reach statistical significance.
Background: Most cases of collision tumors (CTum) usually present with 2 histologic cell types. We report a unique CTum case comprised of 4 cell populations. Additionally, we performed a systematic review of the current literature published on head and neck collision tumors (HNCTum). Methods: Eighty-one-year-old male presents with a scalp lesion of several years’ duration. PET/CT scan demonstrated increased uptake in the scalp. Wide local excision with free flap reconstruction was performed and tissue pathology reviewed. Database search of HNCTum was performed and reported. Results: Specimen histopathology consisted of melanoma, squamous cell carcinoma, basal cell carcinoma, and pleomorphic dermal sarcoma. Thirty-one articles met inclusion criteria: 11 thyroid, 7 cutaneous, 7 laryngeal, 2 lymph nodes, 2 salivary gland, 1 glottic, 1 maxillary sinus, and 1 tonsil. Conclusion: We present a highly unique CTum case of 4 different cell populations. The systematic review provides a comprehensive report of HNCTum in literature.
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