Can J Plast Surg
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The burn eschar serves as a medium for bacterial growth and a source of local and systemic infection. To prevent or minimize these complications, it is important to debride the eschar as early as possible. ⋯ The thickness of a single tangentially excised layer of eschar is not much greater than the actual thickness of the entire skin and often contains viable tissue. Because surgical debridement is insufficiently selective, more selective means of debriding burn eschars should be explored.
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To examine factors that affect wait times for women seeking breast reconstruction at a Canadian academic centre. ⋯ WOMEN WITH ACTIVE CANCER (DUCTAL CARCINOMA IN SITU: 43 days, invasive cancer: 40 days) had shorter wait times compared with those who had no active cancer (benign/high risk: 242 days, previously treated cancer: 343 days) (P<0.05). Women seeking delayed reconstruction had longer wait times (359 days) from referral to surgery than women seeking immediate reconstruction (98 days) (P<0.0001). Women seeking reconstruction at the time of mastectomy, with benign/high-risk disease, waited longer (242 days) than those with ductal carcinoma in situ (43 days) or invasive cancer (40 days) (P<0.001). Wait times for autologous free tissue transfer (213 days) were not significantly longer compared with implant reconstruction (116 days) (P=0.27). Women with acute cancer experienced similar wait times for implant reconstruction (44 days) as for a free tissue transfer (56 days) (P=0.46). Women with no acute cancer had similar wait times for implant (239 days) as free tissue transfer (369 days) (P=0.25). Patients requiring only plastic surgeons involved in the reconstructive effort waited longer (one surgeon: 299 days, two surgeons: 550 days) than patients requiring either two plastic surgeons and one general surgeon (130 days) or one plastic surgeon and one general surgeon (82 days) (P<0.05). Although more coordination is required with three surgeons, this is frequently associated with a diagnosis of acute cancer and, therefore, wait times are shorter.