ally drain into the innominate vein, the thymus can be easily separated from the pericardium and rotated upward to serve as a vascularized pedicle flap. The flap can separate the tracheostomy from the jeopardized substernal space. Thoracic transposition of the omentum flap could also be used to treat DSWI [5], but this would entail the additional trauma of a laparotomy. Our technique is relatively simple, and did not cause additional morbidity. The limitation of this technique may be its use in patients with a very atrophic thymus, in whom other techniques should be considered. In summary, we describe a case where a thymus pedicle flap could be used to eliminate contamination of airway bacteria in a patient with DSWI related to the tracheostomy.
References
Background: The most commonly observed pathology in chest traumas is rib fracture, and the most important clinical symptom is severe pain.Aims: To investigate the effectiveness of intramuscular opioid (IMO), intravenous patient-controlled analgesia (IVPCA) and the Fentanyl transdermal therapeutic system (TTS) in the management of rib fracture pain.Study Design: Prospective randomized clinical trial.
Methods:In our prospective and randomised study, we included 45 patients with a diagnosis of multiple rib fractures. There were three groups and intercostal nerve blockage (ICB) in the first day and oral paracetamol for five days was administered to each group as standard. In Group IMO (n=15), 4x40 mg pethidine HCl was administered to the patients, while in Group IVPCA (n=15) this was 5 µg/mL continuous intravenous fentanyl and was 50 µg fentanyl TTS in Group TTS (n=15). The demographics, injury data and vital signs of the patients were recorded. Pain was scored using Visual Analogue Scale (VAS). The pain during lying down (VAS l ) and mobilisation (VAS m ) was detected.Results: There were no differences between the three groups regarding age, sex, the trauma pattern, the number and distribution of costal fracture localisations, the presence of additional pathology, complications, thoracal catheter and the duration of thoracal catheter. No significant difference between the groups regarding systolic and diastolic arterial tension, number of breaths and beats in a minute was observed (p>0.05). We observed an improvement in the mean VAS score after treatment in all three groups. The mean VASl score significantly decreased after treatment in each group th and 5 th days were found to be higher in Group IMO than in Groups IVPCA and TTS; however, these differences were not statistically significant (p>0.05).
Conclusion:In the analgesia of patients with multiple rib fractures, TTS administration with ICB showed similar effectiveness with IVPCA administration with ICB. In the management of pain due to multiple rib fractures, TTS administration is a safe, non-invasive and effective procedure.
In this rat experiment model in which an isolated pulmonary contusion was created by blunt trauma, BS and IL-10 were observed to reduce contusion severity in the lung and minimize the inflammatory reaction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.