A low fistula rate was obtained in Furlow technique palatal cleft repairs using decellularized dermis when compared with historical controls. Decellularized dermis may provide an additional barrier to wound breakdown in the postoperative period and may improve fistula rate.
Otologic injuries are frequently associated with large blasts. On August 7, 1998, a large truck bomb exploded next to the U.S. Embassy in Nairobi, Kenya. Initial patient findings and care are reviewed. Five months later, an otologic screening and care mission was then sent to comprehensively screen all remaining blast victims on site in Nairobi and to determine degree of persistent injury. Surgical care appropriate for an outpatient environment was provided. Five of 14 tympanic membranes without intervention failed to heal, while 3 of 3 with previous intervention had. Blast injury severity did not correlate to distance from blast epicenter. This may be due to channeling of the blast through the embassy building and an unpredictable pattern of blast overpressure within the building. It is recommended that comprehensive otologic screening be performed after blast events to identify occult injuries and improve outcomes. Early intervention for tympanic membrane perforation (suctioning, eversion of perforations, and paper patch) is recommended.
Suture suspension may gradually fail due to eversion of suture barbs or migration through tissues. Although the complication rate for this technique has been reported to be low, we believe that surgeons performing this procedure should be aware the rate may be higher than indicated in the literature.
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