Rosemary F. Kelly

Clinical results of decompressivedermotomy-fasciotomy**

Seventy-three dermotomy-fasciotomies (DFs) wereperformed in 68 patients from 1986 to 1991. A database record was compiled on each patient. Variables included age, mode of injury, method of initial wound closure, and associated injuries. A multivariate stepwise logistic regression analysis was performed to determine which variables were associated with wound complications. Thirty-eight percent of patients who underwent DF developed wound complications. One hundred percent of those patients with postoperative arterial or graft thrombosis developed wound complications (P DF is frequently necessary in the treatment of patients with compartment syndrome but is associated with significant morbidity. This study suggests that closure of DF wounds utilizing skin graft allows for continued osteofascial decompression while concomitantly minimizing invasive sepsis.

Chest Pain and Progressive Miliary Infiltrates in an Elderly Man

(CHEST 2009; 135:578–582) A n 81-year-old man presented with persistent dyspnea and left pleuritic chest pain for 2 months following a left lower lobe pneumonia treated at another institution. He denied undergoing thoracentesis or pleural catheter drainage during treatment of the pneumonia. He reported resolution of cough, and denied hemoptysis, fever, night sweats, or weight loss. His exposure history included working on a farm as a teenager and in iron mines for 4 years in the 1950s, and retail sales work thereafter. He was a life-long nonsmoker, had no significant travel history outside of Minnesota, and his only pets were two cats and a dog. He specifically denied exposure to tuberculosis, asbestos, or silica. His medical history was significant for hypertension, gastroesophageal reflux disease, and prostatic adenocarcinoma (Gleason grade 3 4, score 7), treated with radiation therapy 5 years previous, with a currently normal serum prostate specific antigen. His medications included atenolol, felodipine, hydrochlorothiazide, lisinopril, omeprazole, and entericcoated acetylsalicylic acid. Physical examination revealed small mobile cervical adenopathy, decreased breath sounds at the left lung base, and no edema or