Few reports exist regarding the use of an artificial dermal substitute ([ADS] Integra™) in the treatment of finger injuries. This retrospective case series evaluated the use of ADS as a bridge for finger reconstruction following complex injuries. The authors’ facility treated 26 complex finger injury patients using ADS. Graft take was 92.3% (22/26), with most patients experiencing satisfactory range of motion (88.5% or 23/26). The authors conclude that ADS, as a bridge for reconstruction of complex finger injuries, offers advantages, such as improved contour, functionality, and decreased need for native flaps.  Read full article here

Acknowledgements

All patients have been informed of potential publication and all steps to ensure patient confidentiality have been taken. All authors have had access to all data, have seen and approved this manuscript, and have no financial conflicts or other interests to disclose.

References

1. Moiemen NS, Vlachou E, Staiano JJ, Thawy Y, Frame JD. Reconstructive surgery with Integra dermal regeneration template: histological study, clinical evaluation, and current practice. Plast Reconstr Surg. 2006;117(7 Suppl):160S–174S.

2. Evans DM, Bernardis C. A new classification for fingertip injuries. J Hand Surg Br. 2000;25(1):58–60.

3. Bhavsar D, Tenenhaus M. The use of acellular dermal matrix for coverage of exposed joint and extensor mechanism in thermally injured patients with few options. Eplasty. 2008;8:e33.

Morgan P. Lorio, MD, FACS; Sarah Howell, BS, MS; and Brandon M. Lewis, AS are from the Neuro-Spine Solutions, P.C., Bristol, TN. Georgios Ziakas, MD is from Grundy Surgical, Richmond, TX. Kimberly Masker, CHT is from The Hand Center, Bristol Regional Medical Center, Bristol, TN.

Address correspondence to:
Morgan P. Lorio, MD, FACS
Neuro-Spine Solutions, P.C.
240 Medical Park Blvd., Ste 2700
Bristol, TN 37620
mplmd@neurospinesolutions.net

Source: woundsresearch.com

“To exclude patients from fusion will save money; rationing spinal care will cripple the back bone of America.”

On July 12, 1982 at 10am I fell approximately 35 feet at work from scaffolding and literally broke my back. I recovered from the fractures but suffered from an insidious onset of low back degenerative disc disease. This problem was underscored in 1997 as I required an L5/S1 diskectomy for left leg radiculopathy. My leg pain was greatly improved but my back pain worsened. By 2005 I was wearing a TENS unit ramped up to the maximum and requiring cortico-steroids and anti-inflammatory treatments to have anything akin to a normal life. Crippled and hunched over by the pain, claudicating at 50 feet my patient, a nurse, who was scheduled for surgery cancelled until I got better so that I could perform her spinal surgery.

I had a discographic workup by Dr. Charles April and then had a combined intertransverse facet fusion with PLIF interbody by Dr. John Logan and Dr. Donald Dietze; orthopedic and neurosurgeon respectively.

Since the fusion I no longer require meds for my previous spinal maladies. I no longer am imprisoned in a back brace for support. I have a healthier professional, social, and family life. With a new back I was able to hunt for red stag in the Andes, and return to Asia to adopt my fourth child; and yes, repair the nurse I mentioned earlier. As the official spokesperson for Spine Health Foundation I have helped spearhead a project that provides spine care, yes fusion at times, to those uninsured or under insured.

A British philosopher in the 1900′s said “In the last resort, we must accept as true a proposition of which the negation is inconceivable”. Yes, lumbar fusion works for degenerative disc disease. Aesop said “Every truth has two sides. It is well to look at both sides before we commit ourselves to either side”. To exclude patients from fusion will save money; rationing spinal care will cripple the back bone of America.

Morgan Lorio, MD
Chair
ISASS Coding and Rembursement Task Force

AHRQ has requested comments on spinal fusion for painful lumbar degenerative disc or joint diseases.

The deadline for comments is 11:59pm on February 21, 2012. Visit this link to submit your comments:

AHRQ: Comments on Key Questions

It has been brought to my attention that YOUR IMMEDIATE ACTION IS REQUIRED regarding a time sensitive notice issued by the Agency of Healthcare Research and Quality (AHRQ). Summarized, AHRQ has requested comments on spinal fusion for painful lumbar degenerative disc or joint diseases. It is our timely duty, and it is imperative that we respond with a strong front supporting the care of our spinal patients. As spinal surgeons, we must be actively involved in this worthy endeavor.

I STRONGLY ENCOURAGE YOUR ACTION. ISASS will forward a statement with the ISASS Lumbar Fusion Policy Statement. I plan to formulate my own testimonial this week in both written and YouTube format. I implore each of you to act as well – every spinal surgeon member should send any support letter, article, case experience, and/or testimonial available to AHRQ.

The deadline for comments is 11:59pm on February 21, 2012. Visit this link to submit your comments:

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