Demonstration of horizontal mattress suturing technique for laceration repair or wound closure in the operating room.

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Traumatic penile injury can be due to multiple factors. Penile fracture, penile amputation, penetrating penile injuries, and penile soft tissue injuries are considered urologic emergencies and typically require surgical intervention. The goals of treatment for penile trauma are universal: preservation of penile length, erectile function, and maintenance of the ability to void while standing. Traumatic injury to the penis may concomitantly involve the urethra.[1, 2] Urethral injury and repair is beyond the scope of this article but details can be found in Urethral Trauma. Penile fracture Penile fracture is the traumatic rupture of the corpus cavernosum. Traumatic rupture of the penis is relatively uncommon and is considered a urologic emergency.[3] Sudden blunt trauma or abrupt lateral bending of the penis in an erect state can break the markedly thinned and stiff tunica albuginea, resulting in a fractured penis. One or both corpora may be involved, and concomitant injury to the penile urethra may occur. Urethral trauma is more common when both corpora cavernosa are injured.[4] Penile rupture can usually be diagnosed based solely on history and physical examination findings; however, in equivocal cases, diagnostic cavernosography or MRI should be performed. Concomitant urethral injury must be considered; therefore, preoperative retrograde urethrographic studies should generally be performed. See the images below.

Tendon repair can be performed using: Local anesthesia (the immediate area of the surgery is pain-free) Regional anesthesia (the local and surrounding areas are pain-free) General anesthesia (the patient is asleep and pain-free) The surgeon makes a cut on the skin over the injured tendon. The damaged or torn ends of the tendon are sewn together. If the tendon has been severely injured, a tendon graft may be needed. In this case, a piece of tendon from the foot, toe, or another part of the body is often used. If needed, tendons are reattached to the surrounding tissue. The surgeon examines the area to see if there are any injuries to nerves and blood vessels. When the repair is complete, the wound is closed. If the tendon damage is too severe, the repair and reconstruction may have to be done at different times. The surgeon will perform one surgery to repair part of the injury, and then allow the hand to heal for a few weeks. Another surgery will be done later to complete the reconstruction and repair the tendon.

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Harper University Hospital has been accredited as a Bariatric Center of Excellence by the American Society of Bariatric Surgeons. By employing laparoscopy, this bariatric procedure is minimally invasive and results in quicker recovery time, as well as less scarring. ~ Detroit Medical Center

Blunt injury to the heart ranges from contusion to disruption. This report comprises 14 patients seen during a 6-year period with cardiac rupture secondary to blunt trauma. Eight patients were injured in automobile accidents, two patients were injured in auto-pedestrian accidents, two were kicked in the chest by ungulates, and two sustained falls. Cardiac tamponade was suspected in ten patients. Five patients presented with prehospital cardiac arrest or arrested shortly after arrival. All underwent emergency department thoracotomy without survival. Two patients expired in the operating room during attempted cardiac repair; both had significant extracardiac injury. Seven patients survived, three had right atrial injuries, three had right ventricular injuries, and one had a left atrial injury. Cardiopulmonary bypass was not required for repair of the surviving patients. There were no significant complications from the cardiac repair.

(cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging below the penis (scrotum) before birth. Usually just one testicle is affected, but about 10 percent of the time both testicles are undescended. An undescended testicle is uncommon in general, but common among baby boys born prematurely. The vast majority of the time, the undescended testicle moves into the proper position on its own, within the first few months of life. If your son has an undescended testicle that doesn't correct itself, surgery can relocate the testicle into the scrotum.

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Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS is a chronic condition that you will need to manage long term. Even though signs and symptoms are uncomfortable, IBS — unlike ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease — doesn't cause changes in bowel tissue or increase your risk of colorectal cancer. Only a small number of people with irritable bowel syndrome have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. Others will need medication and counseling.

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Vitamin D promotes the absorption of calcium and phosphorus from the gastrointestinal tract. A deficiency of vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets. Adding vitamin D or calcium to the diet generally corrects the bone problems associated with rickets. When rickets are due to another underlying medical problem, your child may need additional medications or other treatment. Some skeletal deformities caused by rickets may require corrective surgery.

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After their parents were strongly urged by their local hospital to go to Children's Hospital of Michigan, Dr. Jeffrey Taub controls an aggressive cancer in 2 month old twins. ~ Detroit Medical Center

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DMC Eye specialist restores a woman's vision by removing cataracts and installing an artificial lens. ~ Detroit Medical Center

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Preparing Syringes for Injections