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Goverman, Jeremy

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Goverman

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Jeremy

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Goverman, Jeremy

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    Publication
    A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall
    (BioMed Central, 2018) Brown, Darnell J.; Lu, Kuo Jung G.; Chang, Kristina; Levin, Jennifer; Schulz, John; Goverman, Jeremy
    Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL. The internal degloving caused significant devascularization of the overlying soft tissue and skin which required surgical drainage of hematoma, abdominal wall reconstruction with tangential excision, allografting, negative pressure wound therapy, and ultimately autografting. Conclusion: MLL is a rare, often overlooked, internal degloving injury. Surgeons must maintain a high index of suspicion when dealing with third degree friction burns as they may mask underlying injuries such as MLL, and a delay in diagnosis can lead to increased morbidity.
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    Raman Spectroscopy for Label-Free Identification of Calciphylaxis
    (Society of Photo-optical Instrumentation Engineers, 2015-08-11) Lloyd, William R.; Agarwal, Shailesh; Nigwekar, Sagar; Esmonde-White, Karen; Loder, Shawn; Fagan, Shawn; Goverman, Jeremy; Olsen, Bjorn; Jumlongras, Dolrudee; Morris, Michael D.; Levi, Benjamin
    Calciphylaxis is a painful, debilitating, and premorbid condition, which presents as calcified vasculature and soft tissues. Traditional diagnosis of calciphylaxis lesions requires an invasive biopsy, which is destructive, time consuming, and often leads to exacerbation of the condition and infection. Furthermore, it is difficult to find small calcifications within a large wound bed. To address this need, a noninvasive diagnostic tool may help clinicians identify ectopic calcified mineral and determine the disease margin. We propose Raman spectroscopy as a rapid, point-of-care, noninvasive, and label-free technology to detect calciphylaxis mineral. Debrided calciphylactic tissue was collected from six patients and assessed by microcomputed tomography (micro-CT). Micro-CT confirmed extensive deposits in three specimens, which were subsequently examined with Raman spectroscopy. Raman spectra confirmed that deposits were consistent with carbonated apatite, consistent with the literature. Raman spectroscopy shows potential as a noninvasive technique to detect calciphylaxis in a clinical environment.