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Biomedical subjects

R W Parsons

Publications and source records attributed to R W Parsons.

68 records · Page 4Linked to original sources

Exposure through a coronal incision for initial treatment of facial fractures.

The coronal incision approach to Le Fort III fractures gives excellent exposure for anatomical reduction and internal fixation of the fracture sites. Either an extracranial, or a combined intracranial procedure, is feasible. The exposure obtained not only facilitates the reduction and the fixation but, with the addition of transconjunctival incisions, the patient benefits by not having multiple surgical scars in the face.

Accidents, Traffic↗

The management of traumatic tattoos.

Blast injury traumatic tattooing is a discouraging problem, because concomitant injuries so often preclude adequate preventive measures at the time of injury, and treatment is frequently less than satisfactory. The patient must be cautioned that all of the tattooing is not likely to be eliminated. We favor planned staged excisions, using deep dermabrasion as a final step.

Blast Injuries↗

Reconstruction of the lower face and lips.

The first step in rehabilitation of massive lower face injuries is usually control of drooling by the Wilkie operation. When destruction is extensive, the floor of the mouth, chin, upper neck, and mandible should be first restored as a foundation on which the lower lip is independently reconstructed. Local tissue should be used as much as possible. All remnants of normal lip tissue should be conserved and utilized in the reconstruction. When both lips are damaged, upper lip segments are often best used to fill out the lower lip, with total reconstruction of the upper. Although many of the principles of treatment of these injuries are well established, there are still major unsolved problems. These include adequate support of the lower lip, maintenance of the flat shape of the lips, and determination of the end-point of surgery.

Cheek↗

Mafenide-induced pseudochondritis.

Wound infections following burns of the ear can result in the devastating complication of chondritis, requiring resection of cartilage. To prevent this, it has become common practice to dress the burned ear with mafenide acetate. We have observed six hypersensitivity reactions to the mafenide that occurred following several weeks of continuous use of the drug. The reaction mimics chondritis, causing edematous, erythematous, pruritic ears with a profuse serous exudate. There is no associated fever, systemic signs, or pain on motion of the cartilage. Treatment consists of stopping the mafenide. Recovery occurs within 72 hours. Differentiating between chondritis, with its required surgical and antibiotic treatment, and a hypersensitivity reaction is necessary to avoid further iatrogenic injury.

Adult↗