05 was considered significant.įor the TFCC, a mean of 94.9% ± 2.7% of PGP 9.5–positive neural tissue was ablated within a mean area of 11.7 ± 2.5 mm 2 ( P =. A paired t test was used to compare treated versus untreated areas. #Patellasehne abriss software#Imaging software was used to measure fluorescence signals and compare thermally treated areas with adjacent untreated areas. Five TFCC, 5 SLIL, and 4 LTIL specimens were imaged with fluorescence microscopy. Slides were stained using a triple-stain technique for neurotrophin receptor p75, pan-neuronal marker protein gene product 9.5 (PGP 9.5), and 4′,6-diamidino-2-phenylindole for neural identification. The intact TFCC, SLIL, and LTIL were harvested from cadaveric specimens and treated with a radiofrequency probe as would be performed intraoperatively. To evaluate the effect of thermal treatment on neural tissue in the triangular fibrocartilage complex (TFCC), scapholunate interosseous ligament (SLIL), and lunotriquetral interosseous ligament (LTIL). COX-2 inhibitors seem superior to NSAID with reduced risk of post-operative haematomas. #Patellasehne abriss free#Multimodal analgesia using a COX-2 inhibitor is safe in ABR with free flaps and does not increase flap failure. No patients suffered from thromboembolic complications or gastrointestinal bleeding. We found no difference in flap loss rates between the NSAID (n = 2/132, 1.5%) and the COX-2 inhibitor groups (n = 3/128, 2.3%) (p = 0.63). Significantly, more patients were re-operated because of post-operative haematoma in the NSAID group (n = 13/132, 9.8%) than in the COX-2 inhibitor group (n = 4/128, 3.1%) (p = 0.02). Median age, ischaemia time, blood loss and operating time were similar in the two periods. Comparisons between the COX-2 inhibitor and NSAID were made. Data were collected prospectively and reviewed to compare the two periods, with special focus on reoperations due to bleeding/haematomas and flap thrombosis/failure. The same surgical team operated all patients. We report our experience in using COX-2 inhibitors as part of our post-operative MOSA after ABR using free flaps.Ī total of 132 unilateral secondary ABR were performed (DIEP or MS-TRAM) in the NSAID period (2007–2011) and 128 in the COX-2 inhibitor period (2006, 2012–2014). However, COX-2 inhibitors have been suggested to increase flap failure rates. COX-2 inhibitors are superior to NSAIDs because of the well-known side effects of NSAID treatment (bleeding/gastrointestinal ulcers). In the past, our analgesic regime after autologous breast reconstruction (ABR) included either NSAID or a selective cyclooxygenase-2 (COX-2) inhibitor. A key component of modern analgesics is the use of multimodal opioid-sparing analgesia (MOSA).
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