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Download Free Merge Pdf Files . Free and safe download. Download the latest version of the top software, games, programs and apps in 2019. FIGURE 25-3 Injection of leg telangiectasias Hand traction is employed to keep the skin taut The needle is bent at a 30-degree angle and inserted just below the skin surface, bevel side up Injections are performed slowly to maintain low pressure on the vessel wall to minimize extravasation of sclerosant injection should be stopped or extravasation can occur Prior to injecting, the needle may be bent at an angle of 20 degrees to 45 degrees Upward hand traction is employed by the sclerotherapist using the nondominant hand or by an assistant to keep the skin taut Sclerosant is injected slowly to allow adequate time for contact with the endothelium as well as to prevent vascular distention and rupture A small amount of sclerosant is used at each puncture site (approximately 01 to 03 cc for telangiectasias and 05 to 1 cc for reticular veins) in order to minimize side effects such as ulceration caused by extravasation Reticular veins are treated at intervals of approximately 3 cm along the length of the vessel, proximal to distal Larger vessels, such as reticular veins, are injected before smaller vessels, such as venulectasias and telangiectasias, and areas of arborization are treated before isolated linear areas Immediately upon withdrawal of the needle, the treatment areas should be compressed manually Then each area is taped with either dry cotton balls or dental rolls, and wrapped with Coban or an elastic wrap (Box 25-1) The patient is instructed to keep this in place for a minimum of 4 hours, after which time grad- pdf compression software windows 7: Download Pdf Compressor for Windows - Best Software & Apps split merge pdf files software free download PDFMate Free PDF Merger - PDF joiner, splitter and image to PDF ...
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