Practical Plastic Surgery - download pdf or read online

By Kryger Z.B., Sisco M.

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It is effective in children who will not tolerate a needle stick, as long as it is applied sufficiently in advance. Cocaine Cocaine is used primarily as a topical agent for septo-rhinoplasty procedures. It comes in 4% or 10% solutions. As opposed to other local anesthetics, cocaine produces significant local vasoconstriction without the addition of epinephrine. Its onset is extremely rapid (1-2 minutes), but it takes an additional 5 minutes for its vasoconstrictive effects to begin. Its duration of action is up to 3 hours.

Silver sulfadiazine (Silvadene®) is used in superficial soft tissue infections. Its effectiveness against Pseudomonas makes it a favored choice in burn treatment. Two other commonly used antibiotic agents are Bacitracin® and Neosporin®. These petroleum-based ointments are useful more for superficial infections. In addition, they can be used on surgical incisions, particularly of the face, to minimize bacterial load and provide a moist wound environment to promote epithelialization. Practical Plastic Surgery, edited by Zol B.

This is the active, uncharged form of the drug that can diffuse through the plasma membrane of the neurons. Bupivicaine, with its higher pKa, has a slower onset of action than lidocaine, which has a lower pKa. Acidic tissue, such as a hypoxic or infected wound, increases the fraction of ionized drug, thus delaying the onset and decreasing the efficacy of local anesthetics. 7 The Addition of Epinephrine A vasoconstricting agent such as epinephrine, is often added to local anesthetic solutions. This provides the following benefits: • Decreases the rate of systemic absorption • Reduces the risk of systemic side effects • Prolongs the duration of action of the anesthetic • Improved hemostasis due to its vasoconstrictive effects Premixed solutions containing epinephrine are acidified even further than plain local anesthetics.

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Practical Plastic Surgery by Kryger Z.B., Sisco M.


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