Annals of plastic surgery
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Annals of plastic surgery · Jun 2015
Randomized Controlled TrialEvaluation of 2 novel devices for calculation of fluid requirements in pediatric burns.
The Parkland formula for maintenance and resuscitation fluid requirements in the first 24 hours after pediatric burns is widely used, but calculation errors frequently occur. Two different novel aids to calculation, a dedicated electronic device and a mechanical disc calculator, are described and compared with the conventional method of calculation (pen and paper, assisted by a general purpose calculator). ⋯ Both novel devices provide safer and faster alternatives to conventional methods for calculation of fluid requirements in pediatric burns.
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Annals of plastic surgery · Apr 2015
Randomized Controlled TrialThe efficacy of tranexamic acid and corticosteroid on edema and ecchymosis in septorhinoplasty.
The aim of this study was to investigate the efficacy of tranexamic acid (TA) and methylprednisolone on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open septorhinoplasty (oSRP). Seventy-five patients performing hump extraction and osteotomies were allocated into 3 groups as follows: group 1, 25 patients as control; group 2, 25 patients who were administered oral TA as first dose 1 g starting 2 hours before surgery, 3 g daily in divided doses (1 g, every 8 hours) for 5 days; and group 3, 25 patients who were administered a single dose of 1 mg/kg intravenous methylprednisolone at the beginning of the surgery. Operation time, amount of intraoperative bleeding, and complications were recorded. ⋯ Patients given TA showed significantly less intraoperative bleeding compared with controls and patients who were administered methylprednisolone. We observed that the administration of methylprednisolone significantly decreases periorbital edema and ecchymosis. Additionally, our results support that TA use in patients who underwent oSRP with osteotomies was found clinically and statistically effective for prevention of bleeding during oSRP operations and reduction of both periorbital edema and ecchymosis.
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Annals of plastic surgery · Jan 2015
Randomized Controlled Trial Comparative StudyA prospective randomized controlled trial comparing N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), and subcuticular suture for closure of surgical incisions.
The use of tissue adhesives for the closure of surgical incisions is increasing. Few studies directly compare tissue adhesives to one another or focus on the difference in wound closure time between tissue adhesives. We compared the use of N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), or subcuticular suture in incisions resulting from reduction mammoplasty, mastopexy, panniculectomy, and abdominoplasty. ⋯ Our results demonstrate a decreased time required for wound closure using N-butyl-2 cyanoacrylate compared to both suture and octyl cyanoacrylate regardless of incision type with no significant difference in scar width or satisfaction ratings.
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Annals of plastic surgery · Dec 2014
Randomized Controlled TrialProspective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis.
Most randomized trials have shown similar results with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR); however, there are studies suggesting less postoperative pain, faster improvement in grip and pinch strength, and earlier return to work with the endoscopic technique. The goal of this study was to prospectively examine subjective and functional outcomes, satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient, serving as their own control. ⋯ This interim analysis, using the same patient as an internal control, suggests that both OCTR and ECTR are well tolerated with no differences in functional outcomes, symptom severity and functional status questionnaires, or complications. Although there were no differences between groups using our study metrics, patients still preferred the ECTR, demonstrated by significantly higher overall satisfaction scores at the conclusion of the study.
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Annals of plastic surgery · May 2014
Randomized Controlled TrialThe Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.
We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. ⋯ Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more likely to use self-directed on-line education because of its easy accessibility and interactive format. Our global rating scale can help ensure residents are achieving appropriate technical milestones.