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Oren Lapid

Publications and source records attributed to Oren Lapid.

12 recordsLinked to original sources
PubMed2007

Evaluation of the sensory deficit after sural nerve harvesting in pediatric patients.

BACKGROUND: The sural nerve is a sensory nerve that innervates the proximal part of the lateral aspect of the foot. The sural nerve is often harvested for nerve grafting. Sensory loss in the area supplied by the sural nerve could be expected, causing a lack of protective sensation and a potential risk of injury. The sensory outcome of sural nerve harvesting has not been documented in children. The aim of this study was to evaluate the sensory deficit following sural nerve harvest in infants. METHODS: The authors conducted a controlled study. Evaluation and mapping of the sensory thresholds in the sural nerve distribution were performed using the Semmes-Weinstein monofilament method on four predetermined sites on the foot. A questionnaire was used to elicit subjective findings. The inclusion criteria were children older than 6 years who had undergone bilateral sural nerve harvesting for brachial plexus reconstruction in the first year of life. Normal volunteers served as controls. RESULTS: Fourteen patients and 14 controls were enrolled in the study. Eighty-six percent of the feet that were operated on had a sensory deficit (p = 0.0001). The patients reported no concerns regarding the sensation of their feet. CONCLUSIONS: Sural nerve harvesting in children leaves a measurable sensory deficit; however, this deficit does not seem to have clinical implications for the patients.

Child↗
PubMed2006

Long-term follow-up of high-pressure injection injuries to the hand.

BACKGROUND: High-pressure injection injury is an injury caused by accidental injection of substances by industrial equipment. This injury may have devastating sequelae. The goal of this study was to assess the long-term outcome of high-pressure injection injury to the hand. METHODS: In this historical prospective study, patients who had previously sustained high-pressure injection injury were examined. Assessment included measurement of grip and pinch strength, range of motion, two-point discrimination, and use of a questionnaire regarding present complaints and return to the work force. RESULTS: Twenty-three patients were examined. Follow-up length was on average 8.5 years. The injured hand was most often (43 percent) the right dominant hand, the index in 65 percent, the thumb in 25 percent, and other locations in 10 percent. Only 43 percent of patients returned to their previous employment. Patient complaints were, in descending frequency, cold intolerance, hypersensitivity, paresthesias, constant pain, and impairment of activities of daily living. Metacarpophalangeal range of motion was decreased on average by 8.1 percent (p = 0.019), proximal interphalangeal joint range of motion was decreased by 23.9 percent (p = 0.001), and distal interphalangeal range of motion was decreased by 29.7 percent (p= 0.018). Maximum grip was decreased compared with the expected grip by 12 percent (p = 0.023). Pinch was decreased by 35 percent (p < 0.001). Two-point discrimination was increased by 49 percent (p < 0.007). CONCLUSION: This study confirms the fact that high-pressure injection injury to the hand is a significant problem. Virtually all patients suffer sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.

Accidents, Occupational↗
PubMed2006

An improvised wound closure system.

BACKGROUND: Skin stretching harnesses the same viscoelastic properties of the skin as expansion, with the difference that the forces are applied externally and not internally. An improvised system for wound closure is presented. METHOD: The system is assembled using silicone vascular loops used as sutures and the flow controllers of intravenous sets as locking devices. The wounds are gradually closed by increasing the tension applied by the devices. RESULTS: The system has been applied to nine traumatic wounds in six patients. The average size of the wounds was 70 cm; the average number of devices used was 4.3 (range, 1-9; median, 3); the average time to achieve closure was 1.55 days (range, 0-2 days; median, 2 days). CONCLUSION: This system permits the closure of wounds not suitable for closure by primary intention and avoids the use of skin grafts or flaps.

Adult↗
PubMed2005

Three-square-flip-flap reconstruction for post burn syndactyly.

INTRODUCTION: Burns of the hands may result in the formation of web space contractures-post burn syndactyly. We present our experience using the three-square technique originally described by Bandoh for minor syndactyly. METHOD: Tissues of the contracted web are regard as forming three facets of a cube. If elevated and transposed 90 degrees on their base the facets will fall into place and line the interior of the cube creating a deepened web-space. The first flap is based on the web itself either dorsally or volarly. The second flap is based distally on one of the fingers. The third flap is based laterally on the other finger. Surgery is followed by a splinting regimen. RESULTS: The design of the flaps is simple and the operation is easy to perform. This technique has achieved good functional and cosmetic results; there have been no flap losses or significant complications. CONCLUSION: The three-square-flip-flap is a simple reliable and safe method for the treatment of post burn syndactyly.

Burns↗
PubMed2005

Potential blindness: an unusual complication of lateral canthopexy.

Lateral canthopexy is a commonly performed procedure in craniofacial and cosmetic surgery. In craniofacial surgery, lateral canthal fixation is performed in conjunction with a wide range of transcranial or subcranial procedures during the process of soft tissue re-suspension. A number of fixation materials have gained popular use. A case of craniofrontonasal dysplasia is reported in which a wire loop canthopexy fixation has become disengaged 3 months after a history of trauma and rotated to present a sharp surface against the sclera. Urgent surgical exploration prevented the apparently imminent complication of globe penetration with associated threat to vision.

Blindness↗
PubMed2005

The Speedo tie-over dressing.

A system is presented for the application of tie-over dressings. Following skin grafting, the graft is secured with a tie-over dressing covered with a sheath of 3-way stretch fabric. The fabric is secured with the aid of staples. This system is easy to apply and is useful for securing grafts in otherwise difficult anatomic locations.

Bandages↗
PubMed2005

Escharotomy using an enzymatic debridement agent for treating experimental burn-induced compartment syndrome in an animal model.

BACKGROUND: In patients with deep circumferential burns, adequate resolution of burn-induced compartment syndrome (BICS) is achieved by surgical escharotomy. Surgical escharotomy is traumatic, may cause considerable blood loss, does nothing toward debridement of the burn wound, and entails possible morbidity and complications. Debridase is a Bromelain derived enzymatic preparation capable of lysing the burn eschar within 4 hours, obviating the need for surgical debridement. It has an affinity to burned necrotic tissue and does not damage healthy skin. In our clinical assessment of the Debridase efficacy, we found in several cases of deep burns of the limbs that the measured IC pressure subsided after 2-4 hours of Debridase application and none of the enzymatic escharotomy treated patients suffering from circumferential burns developed BICS. To confirm these observations we conducted this controlled study. AIM: to assess the efficacy of Debridase for treating BICS in an animal model. MATERIALS AND METHODS: A model for BICS was developed by making circumferential burns to pig legs and monitoring the anterior compartment the legs. BICS was induced in the legs of 5 pigs, 20 legs. 10 legs were treated with Debridase and 10 served as nontreated controls, treated by surgical escharotomy at the conclusion of the experiment. RESULTS: Debridase reduced BICS within 30 minutes from application. Debridase was as effective as a standard surgical escharotomy. CONCLUSION: Escharectomy using an effective enzymatic debriding agent is potentially an adequate, simple, fast and effective procedure to treat BICS, it has the added benefit of burn debridement without surgical escharotomy.

Animals↗
PubMed2004

Transdermal scopolamine use for post-rhytidectomy sialocele.

BACKGROUND: Post-rhytidectomy sialocele is a rare complication. The usual treatment uses prolonged drainage. The use of antisialogogues has been described previously, but has potential side effects. Transdermal scopolamine SCOPODERM TTS is indicated for the prevention of motion sickness and also has antisialogugue action. METHODS: An interventional case report is presented. RESULTS: The application of transdermal scopolamine SCOPODERM TTS resulted in resolution of a post-rhytidectomy sialocele within 6 days. CONCLUSION: Transdermal scopolamine delivery should be considered as an option for the treatment of post-rhytidectomy parotid fistulas.

Administration, Cutaneous↗
PubMed2004

Control of massive bleeding from facial gunshot wound with a compact elastic adhesive compression dressing.

The issue of immediate control of acute external traumatic hemorrhage is poorly dealt with in the medical literature. A compact unit incorporating the desired components capable of applying significant compression over diverse body areas has been suggested in the past but not formally demonstrated effective in practice. In this report we describe the treatment of a young man presenting with a very large, complex, profusely bleeding facial gunshot wound. The calvarium remained intact. The upper airway was diverted and secured by performing a cricothyroidotomy. A transparent elastic adhesive dressing was then applied by covering the anterior aspect of the face by a contact pad followed by sequential wrapping of the roll covering all structures between the forehead and the neck. This procedure successfully controlled the hemorrhage and maintained the victim's condition hemodynamically stable until definitive surgical intervention at the level 1 medical center. We attribute the survival of this victim to the innovative dressing technique and excellent cooperation between the trauma team and hospital staff. This case demonstrates the contribution of elastic adhesive compression dressing towards saving the lives of those inflicted by severely challenging bleeding wounds. We suggest this technique be considered by Emergency personnel working in the prehospital arena in selected cases.

Adhesiveness↗
PubMed2004

Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report.

A prospective, non-comparative study design was used to describe our experience with a bromelain-derived debriding agent, Debridase, in 130 patients with 332 deep second degree and third degree burns treated between 1984 and 1999. Debridase was applied after saturating the burns with a moist dressing for 2-24h. Debridase was applied for a period of 4h under an occlusive dressing. Mean patient age was 18.6 +/- 19.3, 42 (32.3%) were female, and 63 (48.5%) were children under age 18. Most burns were small. Debridase was applied once in 241 (72.6%) of the 332 wounds, twice in 67 (20.18%) cases, three times in 12 (3.61%) cases, and four times in 2 (0.6%) cases. The percentage debridement by number of applications was 89 +/- 21% for a single application, 77 +/- 27% for two, and 62 +/- 27% for three Debridase applications, respectively. There were no significant adverse events. The availability of a fast acting, reliable and complication-free enzymatic debriding agent may open new horizons and provide a new treatment modality for burns.

Adolescent↗
PubMed2004

Blast injury caused by a booby-trapped cellular phone.

Terrorists are recently using cellular phones to remotely detonate bombs. A patient was injured while assembling a bomb connected to a cellular phone. The patient sustained combined injury to the head and to the dominant hand which held the phone. Amputation of the hand was required, the facial injuries were reconstructed. The characteristics of this unusual type of injury are described and compared to injuries caused by other bombs and explosive devices.

Adult↗