Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 1998
Randomized Controlled Trial Clinical TrialUse of octyl-2-cyanoacrylate for skin closure in facial plastic surgery.
Octyl-2-cyanoacrylate is a long carbon chain cyanoacrylate derivative that is stronger and more pliable than its shorter chain derivatives. One hundred and eleven patients underwent elective surgical procedures by the same surgeon using either octyl-2-cyanoacrylate or sutures for skin closure at the University of Illinois at Chicago. Most patients underwent excision of benign skin lesions with a mean wound size of 112 mm3. ⋯ The lower visual analog scale score represented a superior cosmetic outcome at 1 year with the octyl-2-cyanoacrylate as compared with sutures. This difference is statistically significant at p = 0.03. Additionally, patient satisfaction was very high in the group treated with octyl-2-cyanoacrylate.
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Plast. Reconstr. Surg. · Feb 1998
Randomized Controlled Trial Clinical TrialThe effects of hyaluronidase on the efficacy and on the pain of administration of 1% lidocaine.
Despite current clinical practice, there is no objective evidence to demonstrate the efficacy or pain on injection when hyaluronidase is added to lidocaine as an anesthetic combination for local anesthesia. To evaluate the usefulness of hyaluronidase added to lidocaine in affecting pain on injection and effectiveness of local anesthesia, a prospective, randomized, double blind study comparing 1% lidocaine preparations with and without hyaluronidase (15 U/cc) was conducted. A paired experiment was done with each subject receiving both treatments. ⋯ In addition, the hyaluronidase additive significantly decreases the amount of tissue distortion (p < 0.0001) without decreasing the efficacy of anesthetic action (p = 0.01). However, adding hyaluronidase to 1% lidocaine significantly increased the pain on injection (p = 0.0002). The injections of small amounts of hyaluronidase-containing solutions in this experiment did not produce any visible effects at 5 to 7 days after injection; however, the effect of hyaluronidase upon wound healing was not studied.
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Plast. Reconstr. Surg. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialControlled clinical study of skin donor sites and deep partial-thickness burns treated with cultured epidermal allografts.
Two clinical studies in donor sites and deep partial-thickness burns treated with banked cultured human epidermal allografts are described. Ten burn patients were subjected to donor split-thickness skin harvesting. The study was controlled, side-by-side comparative, blind, and randomized. ⋯ Wounds treated with cultured allografts showed complete reepithelialization in about 3 to 6 days. The two clinical studies showed that banked cultured epidermal allograft promotes a significantly faster epithelialization of donor sites and deep partial-thickness wounds. These results support the idea that cultured allografts should be used routinely to improve treatment of burn patients and reduce their therapy time.
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Plast. Reconstr. Surg. · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialOral premedication for local anesthesia in plastic surgery: prospective, randomized, blind comparison of lorazepam and temazepam.
Patients undergoing plastic surgical procedures under local anesthesia as inpatients were entered into a phase III randomized, blind trial designed to compare two commonly used oral premedications, lorazepam and temazepam. The effects of the drugs on each patient's memory, pain, sedation, and anxiety were assessed by questions asked of the patient, the nurse, and the surgeon. ⋯ There was no significant difference in anxiolysis between the two premedications (p = 0.20). If premedication is indicated, we advocate the use of lorazepam rather than temazepam as premedication for plastic surgical procedures to be performed under local anesthesia, provided there is adequate postoperative supervision.
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Plast. Reconstr. Surg. · Dec 1992
Randomized Controlled Trial Clinical TrialHypertrophic sternal scars: silicone gel sheet versus Kenalog injection treatment.
A prospective, randomized trial was designed to compare the standard Kenalog injection of established hypertrophic sternal scars with topical silicone gel sheets (Spenco). Fourteen poststernotomy cardiac patients with symptomatic scars were randomized to treatment in one-half of the scar with Kenalog injection. Simultaneously, the other half of the scar received the silicone gel sheet. ⋯ For the total sample of 14 subjects, 11 preferred the silicone gel, 1 expressed no preference, and 2 preferred the injection. The average time to improvement was 3.9 +/- 0.62 days (gel) versus 6.8 +/- 1.86 days (Kenalog). This study demonstrates that silicone gel sheets provide earlier symptomatic relief and a more aesthetic scar and are the preferred treatment of patients with symptomatic hypertrophic sternal scars.