Repair of Anterior Tracheal Defect by Trans-Tracheostomy Placement of Acellular Dermal Matrix

Severe infections of the neck can lead to life-threatening consequences when not treated promptly and correctly. This case report is the first to illustrate the successful use of an acellular dermal matrix to repair a tracheal defect in the setting of a severe neck infection. Laryngoscope, 2023.

A postpartum self-medication program: effect on narcotic use

Our objective was to determine the impact of a self-medication program on postpartum narcotic use. We retrospectively studied narcotic use in patients who underwent vaginal delivery before and after implementation of a self-medication program in April 1997. Narcotic use was compared between patients who delivered in January 1997 (n = 263) and those who delivered in January 1998 (n = 254). Oral narcotic use was also analyzed with respect to type of vaginal delivery (spontaneous vs. operative), extent of episiotomy or laceration, and use of epidural analgesia during labor. Narcotic use was significantly reduced (p < 0.001) in postpartum patients who participated in the self-medication program. The reduction was consistent despite the type of vaginal delivery or use of epidural analgesia during labor. A more extensive episiotomy or laceration at delivery (fourth-degree episiotomy or vaginal sulcus tear) was associated with an increase in narcotic use, although there was still a statistically significant decrease in use in patients in the self-medication program. A significant reduction in postpartum narcotic use may be achieved through implementation of a self-medication program. As a result, substantial benefits are potentially gained by both the patients and the nursing staff.