Annals of plastic surgery
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Annals of plastic surgery · Jan 2014
Randomized Controlled Trial Comparative StudyThe effect of reusable versus disposable draping material on infection rates in implant-based breast reconstruction: a prospective randomized trial.
Clinical infection remains a significant problem in implant-based breast reconstruction and is a physical and emotional strain to the breast reconstruction patient. Bacterial strikethrough of draping and gown material is a likely source of infection. Strategies to reduce infection in implant-based breast reconstruction are essential to improve patient outcomes. ⋯ Disposable draping material is superior to a reusable draping system in the prevention of clinical infection within the immediate postoperative period. This study did not demonstrate a clear link between intraoperative culture data and the development of clinical infection. A completely disposable gown and draping system is recommended during implant-based breast reconstruction.
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Annals of plastic surgery · Nov 2013
Randomized Controlled TrialSilver-coated nylon dressing plus active DC microcurrent for healing of autogenous skin donor sites.
Burn wounds are a significant cause of morbidity and mortality, and improved outcomes are demonstrated with early closure of both primary burn wounds and skin donor sites. Thus, technology that decreases the healing time of burns and donor sites would be potentially lifesaving. We present the results of a single-center, prospective, double-blinded, randomized controlled trial to evaluate the efficacy of silver-coated dressing with active microcurrent in comparison to silver-coated dressing with sham microcurrent on wound-closure time for autogenous skin donor sites. ⋯ In a sample size of 25 burn patients, the addition of direct microcurrent to silver-nylon dressings did not decrease time to wound closure of skin donor sites, and it did not show a difference in reported pain levels.
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Annals of plastic surgery · Feb 2013
Randomized Controlled Trial Comparative StudyA comparison of levobupivacaine and levobupivacaine-tramadol combination in bilateral infraorbital nerve block for postoperative analgesia after nasal surgery.
Our aim in this study was to investigate the effect of levobupivacaine and a levobupivacaine + tramadol combination on postoperative analgesia in intraoperative nerve block under standard general anesthetic. ⋯ Bilateral infraorbital nerve block with 0.25% levobupivacaine is an effective, reliable, and simple technique in the treatment of postoperative pain in nasal surgery. In addition, the addition of tramadol as an adjuvant to local anesthetics in this technique is safe.
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Annals of plastic surgery · Jul 2012
Randomized Controlled Trial Comparative StudyA prospective randomized trial comparing subatmospheric wound therapy with a sealed gauze dressing and the standard vacuum-assisted closure device.
Two methods of subatmospheric pressure wound therapy--wall suction applied to a sealed gauze dressing (GSUC) and the vacuum-assisted closure device (VAC)--were compared in hospitalized patients at University of Chicago Medical Center. ⋯ GSUC is noninferior to VAC with respect to changes in wound volume and surface area in an acute care setting. In addition, GSUC dressings were easier to apply, less expensive, and less painful.
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Annals of plastic surgery · Apr 2012
Randomized Controlled Trial Comparative StudyMicrosurgery education in residency training: validating an online curriculum.
Plastic surgery training has traditionally been modeled as an "apprenticeship," where faculty teach surgical skills to residents on live patients. Although this is a well-established process, the demand by the public and healthcare agencies for improved patient care, outcomes, and patient safety has led to the development of adjunct methods of teaching. The goal of this project is to assess the effectiveness of a web-based microsurgical curriculum. ⋯ Our interactive Web-based curriculum is a novel resource, teaching microsurgery in an organized, competency-based manner, which we believe is the first Web site of this nature. An individualized, self-paced Web site is ideal for plastic surgery trainees of all levels. Overall, the widespread implementation of our proposed curriculum--online self-directed training combined with regular practice sessions--will establish a strong foundation of microsurgery knowledge and skills acquisition for all plastic surgery residents.