RESUMEN
Local administration of corticosteroids has been demonstrated to have both beneficial and detrimental effects on wound healing. The advantages of limiting localized edema must be weighed against corticosteroids' disadvantageous inhibition of the normal growth factor profile production that is essential for would healing. A single-center prospective, randomized, controlled, single-blind study of 57 patients undergoing hair restoration surgery (HRS) by one of three different surgeons revealed: 1) no dehiscence along the donor wound; 2) no statistically significant difference (p < 0.05) in wound edge apposition noted between patients receiving or not receiving intralesional corticosteroids at any of the four measured scalp regions and 3) a non-statistically significant trend emerged suggesting the benefit of corticosteroid at the temples (points of decreased donor closing tension) versus its potential hindrance along the mastoids (points of increased tension). These results suggest that peri-incisional triamcinolone acetonide (PITMC) does not have a statistically significant effect on donor wound edge apposition within 8-10 days of HRS. A subtle, though not statistically significant, trend emerged demonstrating the benefit of PITMC with respect to early phase donor wound edge apposition in areas of least donor closing tension and the hindrance of PITMC in regions of increased tension.
Asunto(s)
Cicatriz/tratamiento farmacológico , Glucocorticoides/administración & dosificación , Cabello/trasplante , Piel/efectos de los fármacos , Triamcinolona Acetonida/administración & dosificación , Cicatrización de Heridas/efectos de los fármacos , Adulto , Femenino , Glucocorticoides/farmacología , Humanos , Inyecciones Intradérmicas , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cuero Cabelludo , Método Simple Ciego , Triamcinolona Acetonida/farmacologíaRESUMEN
We reviewed the results of 10 patients (10 elbows) who underwent surgical reconstruction for clinically symptomatic posterolateral rotatory instability of the elbow. The symptoms resulted from previous dislocation or a hyperextension or varus stress injury of the elbow. Two elbows had underlying preexisting varus deformity. Surgical reconstruction was performed with a tendon graft in 6 elbows and reattachment of the lateral ulnar collateral ligament to the humerus in 4. Postoperatively, no patient had residual instability or a positive pivot shift test in the elbow. Results were graded as excellent or good in 8 and fair in 2. All patients with excellent results had surgical reconstruction with a tendon graft. Subjective assessment revealed that all 10 patients were satisfied with the outcome of the surgery. Accurate recognition of posterolateral rotatory instability of the elbow is important for appropriate management. Surgical ligament reconstruction or repair is the most favorable treatment option for restoration of normal elbow function. The choice of reconstruction with a tendon graft appeared to produce better results than the reattachment of the injured ligament by itself in achieving an excellent outcome.