Publications by authors named "Elizabeth M Purcell"

7 Publications

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Interdigital pilonidal sinus of the foot.

Foot (Edinb) 2009 Dec 31;19(4):227-8. Epub 2009 May 31.

Department of Plastic, Reconstructive and Hand Surgery, University College Hospital, Galway, Ireland.

Pilonidal sinus of the interdigital spaces is a common condition among barbers. The condition results from a foreign body reaction to clients' hairs. It is thought that the short sharp hairs penetrate the skin when hands are rubbed through freshly cut hair. We present an unusual case of a pilonidal sinus arising in the interdigital spaces of the foot in a female hairdresser. This is to our knowledge only the second such case reported in the literature.
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http://dx.doi.org/10.1016/j.foot.2009.04.002DOI Listing
December 2009

Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

Hand Surg 2007 ;12(1):29-34

Department of Plastic, Reconstructive and Hand Surgery, University College Hospital Galway, Newcastle Road, Galway, Republic of Ireland.

The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.
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http://dx.doi.org/10.1142/S0218810407003377DOI Listing
October 2007

The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon.

Emerg Med J 2007 Jul;24(7):455-8

Department of Plastic, Reconstructive and Hand Surgery, St James's Hospital, Dublin, Ireland.

Background: Human bite injuries are both deceptive and challenging in their presentation and management. They remain a frequent presentation to our unit, most often following late night alcohol fuelled aggression.

Aims: To audit the management of these wounds, with particular focus on infective complications and outcomes.

Methods: A three year retrospective chart review was undertaken on all patients referred to the plastic surgery unit from 1 January 2003 through to 31 December 2005.

Results: A total of 92 patients with 96 human bite wounds were identified. The majority were male (92%). Alcohol consumption was documented in 86% of cases. The majority (70%) occurred over the weekend or on a public holiday. Facial injuries made up 70% of injuries with the remainder being to the upper limb. The ear was the most common target of all facial injuries (65%). Infection was documented in 18 cases (20%), with bite injuries to the upper limb and those presenting late (>12 h) having a higher incidence of infection.

Conclusions: Human bite wounds present a challenge to any emergency department, given the many issues involved in their management. Underestimation of the complexity and potential sequelae of these wounds will result in a suboptimal outcome for the patient.
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http://dx.doi.org/10.1136/emj.2006.045054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658386PMC
July 2007

Hair-thread tourniquet syndrome in an infant with bony erosion: a case report, literature review, and meta-analysis.

Ann Plast Surg 2006 Oct;57(4):447-52

Department of Plastic, Reconstructive and Hand Surgery, University College Hospital, Galway, Ireland.

Hair-thread tourniquet syndrome is a rare condition where appendages are strangulated by an encircling strand of hair, a thread, or a fiber. The condition usually occurs in very young patients in the first few months of life. We present a unique case of a 3-month-old baby girl with hair-thread tourniquet syndrome in whom a hair cheese-wired through the skin and soft tissue of the toe and caused bony erosion of the underlying phalanx. An extensive literature review and meta-analysis of the topic are also presented.
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http://dx.doi.org/10.1097/01.sap.0000222571.98387.71DOI Listing
October 2006

Burn injury induces an early activation response by lymph node CD4+ T cells.

Shock 2006 Feb;25(2):135-40

Department of Surgery (Immunology), Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

Several reports have shown that burn injury primes the immune system for an early and vigorous proinflammatory CD4 T cell response, suggesting that injury might signal CD4 T cell activation. We addressed this possibility by investigating changes in CD4 T cell activation marker expression, proliferation, and T cell receptor (TCR) usage at several early time points after burn injury. Using a sensitive flow cytometry approach to measure changes in the expression of Ki-67 antigen, a nuclear protein detected only in proliferating cells, we observed an early burst of proliferation by lymph node, but not spleen, CD4 T cells 12 h after burn injury. In contrast, mice that were treated with the bacterial superantigen staphylococcal enterotoxin B (SEB) as a positive control for in vivo T cell activation did not show this early proliferation. Instead, we observed a significant increase in proliferating lymph node and spleen CD4 and CD8 T cells by 3 days after SEB treatment. Burn injury induced higher cell surface CD25 and CD152 expression on lymph node CD4 T cells, whereas SEB treatment increased CD25 and CD69 expression on CD4 and CD8 T cells. Finally, we found that burn injury induced a proliferative response at 12 h by an oligoclonal subset of TCR Vbeta-chain-expressing CD4 T cells (Vbeta4, Vbeta6, Vbeta11, and Vbeta14). Interestingly, CD4 T cells expressing the Vbeta11-TCR remained significantly increased in the lymph nodes 3 days after burn injury. Taken together, these findings indicate that burn injury induces an early proliferation and activation of CD4 T cells in the regional lymph nodes and that these proliferating cells show restricted TCR Vbeta-chain usage consistent with the idea that injury triggers an early T cell activation signal.
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http://dx.doi.org/10.1097/01.shk.0000190824.51653.32DOI Listing
February 2006

A different type of 'glue ear': report of an unusual case of prominent ears.

Ear Nose Throat J 2003 Sep;82(9):702-3

Department of Plastic and Reconstructive Surgery, University College Hospital, Galway, Ireland.

Prominent ears is a condition that can cause extreme psychological distress in young people. This cosmetic deformity can be corrected by otoplasty, an outpatient surgical procedure that is associated with a high rate of patient satisfaction. We report the unusual case of a teenage boy who had repeatedly applied cyanoacrylate adhesive ("superglue") to his postauricular skin in an attempt to pin back his prominent ears. This case of "glue ear" was ultimately resolved by successful otoplasty, although the residual effects of the glue resulted in delayed healing of the surgical wound.
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September 2003