Orthopedics

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By Scott Sherman

''The e-book fulfills a massive want within the box of emergency medication. It represents an development in content material over the former version. Emergency room and pressing care amenities will locate this paintings so much necessary as they deal with sufferers with extremity-related accidents or problems. four Stars!'' — Doody's evaluate carrier (Doody's )

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Antimicrobial dressings 1. , Silverlon) 2. Xeroform: 3% bismuth tribromophenate–impregnated gauze E. Negative pressure wound therapy 1. “Wound vac” therapy 2. Consists of using a sponge, occlusive dressing, and vacuum a. Reduces edema b. Removes exudates from leaky blood vessels/lymphatic channels to improve oxygen diffusion c. Removes harmful enzymes and inflammatory mediators 3. Most commonly used in a. Venous stasis ulcers b. Lymphatic leaks c. Diabetic wounds 4. *Must not use over a. Normal skin b.

Bone morphogenic protein [BMP]) B. Indications 1. Promote and enhance healing: Delayed union, nonunion, osteotomies, or other sites of poor healing potential 2. Bridge bony defects: Fill cortical defects (comminuted fractures and tumor excision), provide continuity 3. Fill cavities: In cases of cyst, tumor, or sequestrum removal 4. Arthrodesis: Replacement of native joint with bone graft 5. Provide structural support to implanted devices C. Donor sites: Selection depends on quantity, type, vascularity of bone desired, donor site morbidity, and patient characteristics 1.

Free flap C. Reconstructive elevator 1. Often best solution is not simplest 2. , free flap may be the best first choice if superior result is unmatched by other options, even if simpler option can also be used). 3. In reality, this is the method in which flap selection is typically done. D. Flap selection considerations 1. Goals of intervention 2. Shape, contour, and structural needs of reconstruction 3. Location of the defect 4. Size of the defect 5. Exposed and underlying structures 6. , previous radiation, vascular disease, tissue necrosis) 7.

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