Controlled Damage

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Immediate complications include skin edema, burning and itching sensation, blistering, anaphylaxis, ocular mucosal splashes, cardiac arrhythmias, and systemic toxicity or salicylism. [18] [19]

Huang, H.M.; Tsai, C.M.; Chang, C.C.; Lin, C.T.; Lee, S.Y. Evaluation of loading conditions on fatigue-failed implants by fracture surface analysis. Int. J. Oral Maxillofac. Implant. 2005, 20, 854–859. [ Google Scholar] [ CrossRef] Giannoudi M, Harwood P. Damage control resuscitation: lessons learned. Eur J Trauma Emerg Surg. 2016;42:273–82. Volpin G, Pfeifer R, Saveski J, et al. Damage control orthopaedics in polytraumatized patients- current concepts. J Clin Orthop Trauma. 2021;12:72–82. Hogel F, Gerlach UV, Sudkamp NP, et al. Pulmonary fat embolism after reamed and unreamed nailing of femoral fractures. Injury. 2010;41:1317–22. Guerado E, Bertrand ML, Cano JR, et al. Damage control orthopaedics: State of the art. World J Orthop. 2019;10:1–13.

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Pape HC, Halvachizadeh S, Leenen L, et al. Timing of major fracture care in polytrauma patients: an update on principles, parameters and strategies for 2020. Injury. 2019;50:1656–70. Macek, W. Fracture Areas Quantitative Investigating of Bending–Torsion Fatigued Low-Alloy High-Strength Steel. Metals 2021, 11, 1620. [ Google Scholar] [ CrossRef] Pape HC, Giannoudis P, Krettek C. The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery. Am J Surg. 2002;183:622–9. In a later scene, she adds, “There’s a whole world out there beyond our reach just because of our colour.” Glogau RG, Matarasso SL. Chemical peels. Trichloroacetic acid and phenol. Dermatol Clin. 1995 Apr. 13 (2):263-76. [QxMD MEDLINE Link].

Identifying the risk factors and conducting a comprehensive patient assessment before proceeding with a chemical peel is imperative. Adopting an interprofessional team approach is optimal for enhancing overall outcomes and mitigating complications associated with facial peels. Only an experienced healthcare professional should evaluate patients for chemical peeling treatment If anesthesia is warranted, it is essential for both a primary care clinician and an anesthesiology specialist to assess the patient's suitability. In the case of phenol peels, conducting liver and kidney function tests can help minimize the risk of toxicity. To ensure effective peeling, the clinician should initiate a priming process. This preparation should commence 2 to 4 weeksbefore the procedure and involves the application of a topical agent on the skin. This process thins the stratum corneum layer, thereby enhancing the depth of penetration. [11] A frequently prescribed priming agent is all-trans retinoic acid, or tretinoin, typically in the form of 0.025% to 0.05% cream. Alternative options encompass salicylic and glycolic acids at concentrations ranging from 5% to 10%. For patients at risk of hyperpigmentation, a 2% to 4% hydroquinone cream can be used before and after the procedure to decrease postinflammatory pigmentary reactions. This is achieved by targeting and inhibiting melanocyte tyrosinase. In cases where patients have a history of herpes simplex viral infection, considering a course of acyclovir is advisable, and some authors even routinely prescribe prophylactic antivirals as a precaution. [16] File:Mark on Hit Support inventory icon.png Mark on Hit Support File:Mark on Hit Support inventory icon.png Charge Cooldown: {11 /10.45 /9.9 /9.46 /9.02 /8.69 /8.36 /8.14 /7.92 /7.7 /7.48 /7.26 /7.15 /7.04 /6.93 /6.82 /6.765 /6.71 /6.655 /6.6} seconds

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skill_rankup_desc: Non-Physical Damage Reduction {10 /10.9 /11.9 /12.8 /13.7 /14.6 /15.5 /16.4 /17.3 /18.1}% Macek, W.; Branco, R.; Trembacz, J.; Costa, J.D.; Ferreira, J.A.M.; Capela, C. Effect of multiaxial bending-torsion loading on fracture surface parameters in high-strength steels processed by conventional and additive manufacturing. Eng. Fail. Anal. 2020, 118, 104784. [ Google Scholar] [ CrossRef]