1
|
Lescarbotte F, Romano G, Balleyguier C, Arfi Rouche J, Ilenko A, Leymarie N. [Extensive transfixing skin necrosis after breast biopsy under local anesthesia: About four cases]. ANN CHIR PLAST ESTH 2024; 69:27-33. [PMID: 37121845 DOI: 10.1016/j.anplas.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Local anesthetics with adrenaline are widely used in routine practice and have long proven their benefits and safety. The rare complications due to their use mainly concern immuno-allergic and vascular mechanisms. DESCRIPTION In this article, we present four similar cases of early transfixing skin necrosis occurring after radioguided breast biopsy under local anesthesia using epinephrine local anesthetics in the context of a diagnostic approach to breast cancer. DISCUSSION Although the literature is comforting about the use of local anesthetics, even on the extremities, severe skin complications continue to be reported sporadically. The analysis and understanding of these phenomena would allow, in the long run, to avoid them and to reduce their importance. CONCLUSION The occurrence of skin necrosis after breast biopsy under radiographic control is rare and seems to be related to the local anesthetic procedure. Although similar cases have been reported in the literature, it does not seem possible today to conclude on the exact physiopathology of these complications. A better knowledge of the pathophysiology of these complications would help to avoid their occurrence in the future.
Collapse
Affiliation(s)
- Francois Lescarbotte
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France.
| | - Golda Romano
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Corinne Balleyguier
- Department of Medical Imagery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Julia Arfi Rouche
- Department of Medical Imagery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Anna Ilenko
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| | - Nicolas Leymarie
- Department of Plastic and Breast Surgery, Gustave-Roussy Cancer Campus, Grand Paris, France
| |
Collapse
|
2
|
Zhou X, Zhong Y, Pan Z, Zhang J, Pan J. Physiology of pregnancy and oral local anesthesia considerations. PeerJ 2023; 11:e15585. [PMID: 37404472 PMCID: PMC10315135 DOI: 10.7717/peerj.15585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.
Collapse
Affiliation(s)
- Xueer Zhou
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunyu Zhong
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zijian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiankang Zhang
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
3
|
Estrella EP, Gavino SOJ. Flexor tendon laceration of the hand from opening a glass ampoule. BMJ Case Rep 2022; 15:15/10/e250439. [PMID: 36220261 PMCID: PMC9557275 DOI: 10.1136/bcr-2022-250439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sharps and needlestick injuries are serious work-related injuries to the hand in healthcare workers (HCWs). We present two cases of HCWs with hand injuries from opening a medicinal glass ampoule. The index finger (IF) was involved in both cases, with an associated flexor tendon injury, presenting as inability to flex the proximal and distal interphalangeal joints. Sensation was intact, and radiographs showed no foreign body.The surgical repair of the flexor tendon injury was carried out using the Wide-awake Local Anaesthesia No Tourniquet technique. The quality of the repair was tested intraoperatively. Physiotherapy involved gradual progression of finger flexion from 30% to 50% to full range of motion. At 36 and 42 months follow-up, they regained the IF range of motion and returned to work.Flexor tendon injuries from opening medicinal glass ampoules are rare but can be devastating, with a long rehabilitation process after surgical repair.
Collapse
Affiliation(s)
| | - Sarah Olivia Javier Gavino
- Department of Orthopedics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| |
Collapse
|
4
|
Dankert JF, Mercer NP, Kaplan DJ, Kanakamedala AC, Chen JS, Colasanti CA, Hurley ET, Stone JW, Kennedy JG. In-Office Needle Tendoscopy of the Tibialis Posterior Tendon with Concomitant Intervention. Arthrosc Tech 2022; 11:e339-e345. [PMID: 35256973 PMCID: PMC8897571 DOI: 10.1016/j.eats.2021.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/29/2021] [Indexed: 02/03/2023] Open
Abstract
Tendoscopy has been recognized to be a useful technique in the diagnosis and treatment of early tibialis posterior tendon (TPT) dysfunction. Although open surgical procedures for advanced TPT disease have led to excellent outcomes, disagreement persists concerning the correct management algorithm for early TPT dysfunction. Recent developments in needle tendoscopy have provided a minimally invasive option for direct evaluation and intervention throughout the forefoot, midfoot, and hindfoot. The goal of this manuscript is to describe the technique for performing in-office needle tendoscopy targeting the TPT with a discussion of indications and opportunities afforded by an in-office procedure over the traditional operating room suite.
Collapse
Affiliation(s)
- John F. Dankert
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | - Nathaniel P. Mercer
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | - Daniel J. Kaplan
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | - Ajay C. Kanakamedala
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | - Jeffrey S. Chen
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | | | - Eoghan T. Hurley
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A
| | - James W. Stone
- Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - John G. Kennedy
- New York University Langone Health, NYU Langone Orthopedic Hospital, New York, New York, U.S.A.,Address correspondence to John G. Kennedy, M.D., New York University Langone Health, NYU Langone Orthopedic Hospital, New York, NY, U.S.A.
| |
Collapse
|
5
|
Rougereau G, El Khoury G, Châtelain L, Zadegan F, El Khoury E, Ollat D. WALANT in hand surgery: ischemic complications and their medicolegal implications in France: a systematic review of the literature and of French legal databases. Hand Surgery and Rehabilitation 2022. [DOI: 10.1016/j.hansur.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/27/2021] [Accepted: 01/13/2022] [Indexed: 11/24/2022]
|
6
|
Schindelar L, Townsend CB, Ilyas AM, Matzon JL. The Impact of Intraoperative Nursing Care on Perioperative Complications During Wide-Awake Local Anesthesia Hand Surgery. Journal of Hand Surgery Global Online 2022; 4:385-388. [DOI: 10.1016/j.jhsg.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
|