Annals of plastic surgery
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Annals of plastic surgery · Jul 2019
Randomized Controlled Trial Comparative StudyEffects of Dressing Materials on Donor Site Morbidity: A Comparative Study at a Tertiary Hospital in Kenya.
Skin graft donor wounds should heal with rapid epithelialization resulting in good aesthetic and minimal donor site morbidity. Several dressing materials are now available for the dressing of the donor sites. Few studies have, however, been done to compare the efficacy of these dressing materials. ⋯ Paraffin gauze dressed wounds were the most infected at 22%. In conclusion, all the 4 dressing materials had different scores among the factors assessed. Hydrocolloids dressings and silver hydrofiber dressing would, however, be the preferred dressing materials for the donor site based on these study findings as reflected by the high epithelialization low infection rates and less pain.
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Annals of plastic surgery · Feb 2018
Randomized Controlled Trial Comparative StudyEfficacy of Lyophilised Platelet-Rich Plasma Powder on Healing Rate in Patients With Deep Second Degree Burn Injury: A Prospective Double-Blind Randomized Clinical Trial.
Platelet-rich plasma (PRP) is a kind of plasma that is rich in platelets after processing. It includes various growth factors and cytokines, which speed up the process of wound healing and hemostasis. The PRP solution used in this study is diluted from lyophilized PRP powder, which decreased the possibility of contamination, facilitated the storage, and prolonged the storage life. ⋯ The wound closure at 3 weeks showed a significant difference in PRP group (P < 0.05). The healing rate of PRP group reached nearly 80% and made a breakthrough of 90% in 3 weeks, showing a significant difference compared with the control group (P < 0.05). Lyophilized PRP can be considered as an effective treatment to increase healing rate in patients with deep second-degree burn injury.
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Annals of plastic surgery · May 2016
Randomized Controlled TrialEffects of A Novel Decision Aid for Breast Reconstruction: A Randomized Prospective Trial.
The choice to undergo mastectomy and breast reconstruction is a highly personal decision with profound psychosocial effects, and ultimately, the decision between implant- and autologous tissue-based reconstruction should be made based on a combination of factual information and the patient's personal values and preferences. Unfortunately, patients undergoing breast reconstruction surgery may experience decision regret. Decision aids promote patient involvement in decision making by not only providing standard information about options, but also emphasizing comparative risks, benefits, and alternatives, and most importantly by providing clarification exercises regarding personal values to guide patients toward an individualized decision. ⋯ The use of decision aids in breast reconstruction surgery may help decrease decisional conflict and regret through promoting improved information sharing and shared decision making, which are highly important in this particular setting, patient population, and in our move toward greater patient-centered care.
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Annals of plastic surgery · Dec 2015
Randomized Controlled TrialA New Method to Control Tendon Tension in the Transfer of Extensor Indicis Proprius to Extensor Pollicis Longus Rupture.
This study evaluated the outcomes of extensor indicis proprius (EIP) transfer based on varying degrees of thumb extension after EIP transfer and elongation of the EIP. A total of 24 cases with extensor pollicis longus (EPL) ruptures who underwent EIP to EPL transfer were analyzed prospectively. The EIP transfer was performed with neutral wrist positioning. ⋯ Extension of the thumb at the interphalangeal joint was -5.2° in group I and 7.2° in group II, demonstrating statistically significant differences. No significant differences were found between the 2 groups in other parameters. In EIP transfer, thumb in extension after transfer and EIP elongation is recommended for restoring thumb extension at the interphalangeal joint.
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Annals of plastic surgery · Aug 2015
Randomized Controlled TrialThe Importance of the Trigeminal Cardiac Reflex in Rhinoplasty Surgery.
Trigeminocardiac reflex (TCR) consists of bradycardia or asystole along with hypotension and apnea coinciding with stimulation of the trigeminal nerve. During rhinoplasty procedures, we noticed that local anesthetic solution (LAS) application to the columellar area results in bradycardia. We planned to conduct a randomized prospective study on 47 patients undergoing rhinoplasty to demonstrate the characteristics of TCR arising from the columella. ⋯ We concluded that stimulation of a sensory branch of the trigeminal nerve in the columellar area leads to TCR under general anesthesia by eliciting clinical hypotension with a drop in systolic BP and in HR of more than 20% compared to the baseline level.Knowing the existence of a certain TCR area will be helpful to the surgeon and anesthesiologist to exercise extra vigilance and to make continuous and meticulous monitoring of the electrocardiogram, HR, and BP during which the TCR may be precipitated such as local anesthetic infiltration to the columellar area in rhinoseptoplasty operations.