Davood Mehrabani, Ail Manafi,
Volume 1, Issue 2 (7-2012)
Abstract
Kn Manjunath, Ms Venkatesh,
Volume 3, Issue 2 (7-2014)
Abstract
Penoscrotal transposition (PST) is a rare anomaly of the external genitalia that can be complete or incomplete while incomplete type is more common. Various surgical methods are described for correction of incomplete PST. Modified Glenn Anderson’s method is commonly used. This method is known to cause major penile lymphoedema following surgery. Various modifications have been described to preserve the dorsal penile skin to reduce this lymphoedema. We present here our experience with M-Plasty, where the dorsal penile skin is cut in the form of V so that it breaks the constricting effect of circumferential incision and prevents lymphoedema.
Fatemeh Mohaddes Ardabili, Soybeh Pourhajari, Tahereh Najafi Ghzljeh, Hamid Haghani,
Volume 3, Issue 2 (7-2014)
Abstract
BACKGROUND
Burn is a tragedy that follows multiple problems in a patient including pain, anxiety and lack of confidence into medical team. This study evaluated the effect of shiatsu massage on pain intensity of burn patients.
METHODS
A total of 120 burn patients from Motahhari Burn Hospital and of both genders were randomly divided into 4 groups of undergoing hand massage, leg massage, both hand and leg massages, and the control group. The effect of shiatsu massage in pain relief of burned patients was evaluated. The visual analog scale (VAS) was used to assess pain in burn patients.
RESULTS
Pain intensity in the control group before and after the intervention was not statistically significant (p=1). In all massage groups, the difference for pain intensity before and after the intervention was statistically significant.
CONCLUSION
According to our data, shiatsu method over both hands and legs were effective in pain reduction and can be recommended together with analgesics to decrease the dose.
Nader Tanideh, Pedram Rokhsari, Davood Mehrabani, Soleiman Mohammadi Samani, Fatemeh Sabet Sarvestani, Mohammad Javad Ashraf, Omid Koohi Hosseinabadi, Shahram Shamsian, Nasrollah Ahmadi,
Volume 3, Issue 2 (7-2014)
Abstract
BACKGROUND
Burn is still one of the most devastating injuries in emergency medicine while improvements in wound healing knowledge and technology have resulted into development of new dressings. This study was undertaken to evaluate the healing effect of licorice in Pseudomonas aeruginosa infected burn wounds of experimental rat model.
METHODS
One hundred and twenty female Sprague-Dawley rats were randomly allocated to 4 equal groups. Group A received silver sulfadiazine ointment, Group B received 10% licorice extract and Group C was considered as control group and received gel base as the base of medication. Group D did not receive any medication and just underwent burn injury. A standard 3rd degree burn wound was produced by a hot plate with similar size about 20% of total body surface area (TBSA) and at identical temperature. After 24 h of burn production, 108 colony forming units (CFU) of toxigenic strains of P. aeruginosa (PA 103) were inoculated subcutaneously into the burnt area. After 3, 7, 14, 21 and 28 days of therapy, the animals were sacrificed and burn areas were macroscopically examined and histologically evaluated.
RESULTS
Decrease in size of the burn wounds, in inflammation and re-epithelialization were poor in groups B-D. Infection to P. aeruginosa was still visible in groups B-D but was absent in Group A. The mean histological score, tensile strength, maximum stress, yield strength and stiffness in groups B-D were lower compared with Group A.
CONCLUSION
Licorice extract in 10% concentration was shown not to be effective in healing of P. aeruginosa infected burn wounds.
Dr Yadollah Zarei, Dr Mohamad Reza Hadavi, Dr Shojaolhagh Tarogh,
Volume 4, Issue 1 (1-2015)
Abstract
BACKGROUND
Rhinoplasty is one of the most common surgeries of the plastic surgery and as well as ear, throat and nose. Intra-operative bleeding during surgery is one of the most important factors that may impair the surgeon’s job. Providing a clean blood-free surgical filed makes the operation faster, easier and with a better quality. One way to achieve this goal is to induce hypotension. This study aimed to compare the impacts and outcomes of administration of labetalol or nitroglycerin for this purpose.
METHODS
In this randomized clinical trial, 60 ASA I and ASA II patients who were referred for rhinoplasty were enrolled. Patients were randomly assigned to two groups. Labetalol was given to the first and nitroglycerin to the second group of patients. Blood pressure and the amount of intra-operative bleeding during surgery and surgeon satisfaction were measured.
RESULTS
The average age of patients was 25.9±7.52 years. The average amount of bleeding among all patients was 117.87±324.86 ml, and the average quality of the surgical site was 1.65±4.48, considering all patients. The average quality and average surgical site bleeding between the two groups was not significant.
CONCLUSION
There was a little difference between labetalol and nitroglycerine on the effect of intraoperative blood loss and surgical field quality in rhinoplasty surgery.
Dr Veena P Waiker, Dr Shanthakumar Shivalingappa,
Volume 4, Issue 1 (1-2015)
Abstract
BACKGROUND
Platelet rich plasma is known for its hemostatic, adhesive and healing properties in view of the multiple growth factors released from the platelets to the site of wound. The primary objective of this study was to use autologous platelet rich plasma (PRP) in wound beds for anchorage of skin grafts instead of conventional methods like sutures, staplers or glue.
METHODS
In a single center based randomized controlled prospective study of nine months duration, 200 patients with wounds were divided into two equal groups. Autologous PRP was applied on wound beds in PRP group and conventional methods like staples/sutures used to anchor the skin grafts in a control group.
RESULTS
Instant graft adherence to wound bed was statistically significant in the PRP group. Time of first post-graft inspection was delayed, and hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in plastic surgery unit were significantly less in the PRP group.
CONCLUSION
Autologous PRP ensured instant skin graft adherence to wound bed in comparison to conventional methods of anchorage. Hence, we recommend the use of autologous PRP routinely on wounds prior to resurfacing to ensure the benefits of early healing.
Sbd Shkelzenshkelzen B. Duci, Hma Hysni M. Arifi, Hra Hasan R. Ahmeti, Vkz Violeta K. Zatriqi, Zab Zejn A. Buja, Eth Enver T. Hoxha, Aym Agon Y. Mekaj,
Volume 4, Issue 2 (7-2015)
Abstract
BACKGROUND Advances in burn care over the past 50 years have brought about remarkable improvement in mortality rates such that survival has become an expected outcome even in patients with extensive injuries. Although these improvements have occurred in all age groups, survival in older adults still lags far behind that in younger cohorts. This study determines the outcomes of older adults with burn injury in University Clinical Center of Kosovo. METHODS This is a retrospective study that includes 56 burn patients, older than 60 years who were admitted at the Department of Plastic Surgery, between 1 January 2004 and 31 December 2013. Data processing was done with the statistical package of Stat 3. From the statistical parameters the structural index, arithmetic median, and standard deviation were calculated. RESULTS Fifty six burned patient older than 60 years were included during a 10-year period. Of the 56 elderly patients 29 were women and 27 were men with a mean age of 66.7 years (range, 60-85 years). The differences were not statistically significant for both genders regarding the causes of burn injury. CONCLUSION Considering the gradual increase of the elderly population in our country based on the data of the Ministry of Public Services, an increase is expected to the incidence of burn injuries in the population of this category of our country.
Ebrahim Nasiri, Seyed Jalal Hosseinimehr, Mohammad Azadbakht, Jafar Akbari, Reza Enayati-Fard, Sohail Azizi, Masoud Azadbakht,
Volume 4, Issue 2 (7-2015)
Abstract
Background
Burn is still a majordevastating condition in emergency medicine departments among both genders and all age groups in all developed and developing countries, leading to physical, psychological scars and economical burden. The present study aimed to determine the healing effect of topical treatment with Arnebia euchroma on second-degree burn wound in rats.
Methods
Fifty rats were divided into 4 equal groups receiving the ointment base, normal saline (NS), standard 1% silver sulfadiazine (SSD), and 5% and 10% Arnebia euchroma ointments (AEO). The mean of burn area, percentage of wound contraction, histopathological and bacteriological assessments in the injured area were dtermined during the study.
Results
Average area of wound on the 10th day was 10.2±2.3, 8.4±2.6, 12.4±2.5, 5.9±2.2 and 5.7±2 cm2 for ointment base, NS, 1% SSD, and 5% and 10% AEO, respectively. Wound size was significantly lower in 10% AEO than 1% SSD and control groups on the 10th day post-burn injury. On day 11, the percentage of wound contraction in 5% and 10% AEO was 53.9%±14.7% and 55.9±10.5% which was more than 1% SSD (15.3±10.8%). The collagen fibers were well formed and horizontally-oriented in 5% and 10% AEO groups when compared with other groups.
Conclusion
Arnebia euchroma ointment was an effective treatment for healing of burn wounds in comparison with SSD and can be regarded as an alternative topical treatment for burn wounds.
Pedro Arquero, Fabiana Zanata, Lydia Ferreira, Fabio Nahas,
Volume 4, Issue 2 (7-2015)
Abstract
Capsular contraction is a frequent complication following breast augmentation. On the other hand, capsular weakness, a not widely recognized complication, may occur around the implant. A weak capsule allows the migration of the prosthesis to the lateral region of the thoracic region or inferiorly, towards the abdomen, due to gravitational forces. The cause of capsular weakness remains unresolved. Implant malposition, with lateral or downward displacement, breast asymmetry, improper contour, with implants moving in the pocket that compromise the aesthetic outcome of breast augmentation and require surgical correction may be different symptoms from the same clinical problem. Capsular weakness is a short or mid-term complication of breast augmentation. Most techniques aim to correct the malposition by making sutures to increase the resistance to the displacement of the implant, rearrange the structures using the capsule as flaps to remodel the envelope of the new pocket, obtaining a more stable and reliable result. In this article, four cases of displacement of breast prosthesis with capsular weakness are described and the surgical treatment that included a capsulotomy and capsulorraphy is described.
Franciele Dietrich, Gustavo Lançanova Duré, Caroline Peres Klein, Vinícius Faccin Bampi, Alexandre Vontobel Padoin, Vinícius Duval da Silva, Jefferson Braga Silva,
Volume 4, Issue 2 (7-2015)
Abstract
BACKGROUND
Autologous platelet concentrate has been used to improve the function and regeneration of injured tissues. Tendinopathies are common in clinical practice, although long-term treatment is required. On the basis of lead time, we compared the effect of using platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in repairing rat Achilles tendon.
METHODS
The effectiveness of using PRP and PRF was evaluated after 14 and 28 postoperative days by histological analysis. The quantification of collagen types I and III was performed by Sirius red staining. Qualitatively, the data were verified with hematoxylin-eosin (H&E) staining.
RESULTS
In Sirius red staining, no significant treatment differences were found between groups. Statistical difference was observed only between PRP (37.2% collagen) and the control group (16.2%) 14 days after treatment. Intra-groups compared twice showed a difference for collagen I (27.8% and 47.7%) and III (66.9% and 46.0%) in the PRF group. The control group showed differences only in collagen I (14.2% and 40.9%) and no other finding was observed in the PRP group. In H&E staining, PRF showed a better cellular organization when compared to the other groups at 28 days.
CONCLUSION
Our study suggests that PRF promotes accelerated regeneration of the Achilles tendon in rats, offering promising prospects for future clinical use.
Ashkaun Shaterian, Hossein Masoomi, Jenna Martin, Keyianoosh Paydar, Garrett Wirth,
Volume 4, Issue 2 (7-2015)
Abstract
BACKGROUND
Combined procedures involving elective breast surgery at the time of abdominoplasty are frequently performed procedures in aesthetic plastic surgery. While found to be safe outpatient procedures, many surgeons elect to perform combined abdominoplasty/breast surgery as inpatient surgery. This study was performed to explore the practice of performing the combined procedure as an inpatient in the United States.
METHODS
The Nationwide Inpatient Sample database was evaluated using ICD-9CM procedural codes to identify hospitalizations where patients underwent abdominoplasty combined with breast surgery. We trended the frequency of this combined procedure, and evaluated the rate of acute post-operative complications, length of inpatient hospitalization, and total hospital charges.
RESULTS
Between 2004 and 2011, 29,235 combined abdominoplasty/breast procedures were performed as inpatient in United States. The rate of major post-operative complications in the acute hospitalization period was 1.12% and included CVA (0.02%), respiratory failure (0.6%), pneumonia (0.3%), VTE (0.1%), and myocardial infarction (0.1%). Hospitalization averaged 1.8 days and resulted in $31,177 of hospital charges. The demographics of the combined procedure transitioned as i) frequency of inpatient surgeries decreased, ii) percent of patients >50 yr increased, and iii) hospital charges increased from 2004 to 2011.
CONCLUSION
A significant number of surgeons are performing combined abdominoplasty and elective breast surgery as inpatient procedures in United States. The combined surgery is safe but is associated with small risk of major post-operative complications. A short inpatient hospitalization may be beneficial for high-risk patients interested in combined procedures, but must be analyzed against the rising costs of inpatient surgery.
Azadeh Ghaffari, Ali Manafi, Hamid Reza Moghimi,
Volume 4, Issue 2 (7-2015)
Abstract
BACKGROUND
It has been shown that topical nanoliposomal formulations improve burn healing process. On the other hand, it has been shown that liposomal formulations increase drug deposition in the normal skin while decrease their systemic absorption there is not such data available for burn eschar. Present investigation studies permeation of clindamycin phosphate (CP) through burn eschar from liposomal formulations to answer this question. In this investigation, permeation of CP through fully hydrated third-degree burn eschar was evaluated using solution, normal nanoliposomes and ultradeformable nanoliposomes.
METHODS
Liposomal CP were prepared by thin-film hydration and characterized in terms of size, size distribution, zeta potential, encapsulation efficiency and short-time stability. Then the effect of liposomal lipid concentration on CP absorption was investigated.
RESULTS
The permeability coefficient ratio (liposome/solution) and permeation lag-time ratio (liposome/solution) of CP through burn eschar at 20 Mm lipid concentration were 0.81±0.21 and 1.19±1.30 respectively, indicating the retardation effects of liposomes. Data also showed that increasing liposomal lipid concentration from 20 to 100 mM, clindamycin permeation decreased by about 2 times. There was no difference between normal liposome and ultradeformable liposome in terms of clindamycin absorption.
CONCLUSION
Nanoliposomes could decrease trans-eschar absorption of CP, in good agreement with normal skin data, and might indicate CP deposition in the eschar tissue.
Veysel Murat Isik, Kadri Ozer, Melike Oruc, Koray Gursoy, Adile Turan, Ugur Kocer,
Volume 5, Issue 1 (1-2016)
Abstract
Mehdi Eskandarlou, Mina Azimi, Soghra Rabiee, Mohammad Ali Seif Rabiee,
Volume 5, Issue 1 (1-2016)
Abstract
BACKGROUND Different methods for dressing of donor site of skin graft in burn patients have similarly pain, limitation of mobility of donor site and local complications such as infection and scar. Amniotic membrane has used for improvement of healing in some wounds. Accordingly in this study amnion was used as biologic dressing for donor site of skin graft to evaluate it’s efficacy in improvement of pain, move score and the risk of local infection. METHODS Study was done as clinical trial over 32 admitted patients in burn department of Beasat hospital. Amnion was prepared in elective caesarean section after rule out any placental site for risk of torch and viral infection. Skin graft was taken from two sites in every patient. One site dressed with amnion and another with routine dressing. Then two sites were compared about severity of pain, move score, infection and time of dressing sloughing. RESULTS Fourteen patients were women and 18 men. Mean score of pain and movement up to fourth and fifth post operative day respectively was less than control site. No difference is seen about infection and dressing slough in two sites. CONCLUSION It seems use of amnion for dressing of donor site probably cause rapid epithelialisation and wound healing and can improve pain and move score in early post operative days. Accordingly it is expected to need less analgesia and low rate of immobilization and following complications and earlier discharge of patients.
Valerio Cervelli, , Lorenzo Brinci, , Ilaria Bocchini, Barbara de Angelis,
Volume 5, Issue 1 (1-2016)
Abstract
Dr. Ali Akbar Mohammadi, Mr. Hamid Reza Tohidinik, Ms. Mitra Zardosht, Dr. S. Morteza Seyed Jafari,
Volume 5, Issue 1 (1-2016)
Abstract
BACKGROUND The alarming incidence of self- burning provoked to set up a multidisciplinary preventive program to decrease the incidence and complications of this harmful issue. This study investigated the incidence and the preventive measures in self-burn in Fars Province, southern Iran. METHODS This study was a longitudinal prospective design on trend of self-inflicted burn injuries in Fars province after setting up a regional multidisciplinary preventive plan (2009-2012). RESULTS From 18862 admitted patients, 388 (2%) committed self-burning. While the incidence showed a constant decrease in proportion of suicidal cases among all admitted patients (2.5% to 1.6%). The mean age of self-burning victims ranged from 28.3±10.8 to 30.3±11.7 years. The female victims comprised 67.4% of all suicidal burn patients (Female to male ratio: 2.18). The leading causes of suicide commitment were familial conflicts (75.6%) and psychological problems (16.7%) CONCLUSION It is crucial to continue the regional preventive programs and pave the way to set up national, and even international collaborations to alleviate relevant financial, social, cultural and infrastructural difficulties in order to have lower incidence for this dramatic issue.
Shehab Jabir,
Volume 5, Issue 2 (4-2016)
Abstract
Carina Crouch, Suresh Madhavan Anandan, Isam Al Basri, Wexham Park Hospital,
Volume 5, Issue 2 (4-2016)
Abstract
Pietro Gentile, Barbara de Angelis, Annarita Agovino, Fabrizio Orlandi, Alessandra Migner, Camilla Di Pasquali, Valerio Cervelli,
Volume 5, Issue 2 (4-2016)
Abstract
BACKGROUND
The platelet-rich plasma (PRP) and hyaluronic acid (HA) constitute a system of tissue growth that can regenerate damaged tissue. This study was performed to evaluate the effect of PRP and HA in treatment of complications of Achilles tendon reconstruction.
METHODS
We selected ten patients affected by Achilles tendon injuries resulting from post-surgical complications subsequent to tenorrhaphy and have treated them with autologous PRP in combination with HA to evaluate the improvement of lesions with wound closure.
RESULTS
The treatment with PRP and HA for post-surgical complications of Achilles tendon was effective in healing and regeneration of soft and hard tissues. The healing time was shortened, and the treated area preserved a satisfying strength in plantar flexion and extension of the ankle, denoting to a decisive improvement in texture and a more rapid healing and a good cutaneous elasticity, with a significant reduction of the costs of hospitalization and the pain already the immediate postoperatively. The functional rehabilitation in terms of deambulation and joint mobility was complete.
CONCLUSION
The treatment we proposed allowed an easier and more rapid wound closure with excellent aesthetic improvement. Furthermore, the minimally invasive technique is well tolerated by patients.
Ahmed El-Sabbagh,
Volume 5, Issue 2 (4-2016)
Abstract
BACKGROUND
Lesions in perineal area are common. The usual treatment is coverage by skin graft and flaps which may be local, pedicled or free types. In this paper V-Y flaps were used to cover the defects. METHODS
V-Y flaps were used in the gluteal area in 15 patients. Lesions were due to different causes. RESULTS
Of 15 patients, 11 were males and 4 were females. Their ages ranged from 3 weeks to 52 years old. Two cases were due to myelomeningocele, necrotizing fasciitis (2 cases) and the rest were due to bed sores (11 cases). The flaps were located over the trochanter (3 cases), ischial (6 cases) and sacral (6 cases). Good healing and durable coverage were obtained in all cases except one case.
CONCLUSION
V-Y flap as a working horse flap is recommended in the gluteal area.
