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Du W, Wang H, Zhao C, Cui Z, Li J, Zhang W, Yu Y, Peng X. Postoperative facial prediction for mandibular defect based on surface mesh deformation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101973. [PMID: 39089509 DOI: 10.1016/j.jormas.2024.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES This study aims to introduce a novel predictive model for the post-operative facial contours of patients with mandibular defect, addressing limitations in current methodologies that fail to preserve geometric features and lack interpretability. METHODS Utilizing surface mesh theory and deep learning, our model diverges from traditional point cloud approaches by employing surface triangular mesh grids. We extract latent variables using a Mesh Convolutional Restricted Boltzmann Machines (MCRBM) model to generate a three-dimensional deformation field, aiming to enhance geometric information preservation and interpretability. RESULTS Experimental evaluations of our model demonstrate a prediction accuracy of 91.2 %, which represents a significant improvement over traditional machine learning-based methods. CONCLUSIONS The proposed model offers a promising new tool for pre-operative planning in oral and maxillofacial surgery. It significantly enhances the accuracy of post-operative facial contour predictions for mandibular defect reconstructions, providing substantial advancements over previous approaches.
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Affiliation(s)
- Wen Du
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China
| | - Hao Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China
| | - Chenche Zhao
- College of Engineering, Peking University, China
| | - Zhiming Cui
- School of Biomedical Engineering, ShanghaiTech University, Shanghai 201210, China
| | - Jiaqi Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China
| | - Wenbo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China
| | - Yao Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, China.
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Bigham A, Islami N, Khosravi A, Zarepour A, Iravani S, Zarrabi A. MOFs and MOF-Based Composites as Next-Generation Materials for Wound Healing and Dressings. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2311903. [PMID: 38453672 DOI: 10.1002/smll.202311903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/09/2024] [Indexed: 03/09/2024]
Abstract
In recent years, there has been growing interest in developing innovative materials and therapeutic strategies to enhance wound healing outcomes, especially for chronic wounds and antimicrobial resistance. Metal-organic frameworks (MOFs) represent a promising class of materials for next-generation wound healing and dressings. Their high surface area, pore structures, stimuli-responsiveness, antibacterial properties, biocompatibility, and potential for combination therapies make them suitable for complex wound care challenges. MOF-based composites promote cell proliferation, angiogenesis, and matrix synthesis, acting as carriers for bioactive molecules and promoting tissue regeneration. They also have stimuli-responsivity, enabling photothermal therapies for skin cancer and infections. Herein, a critical analysis of the current state of research on MOFs and MOF-based composites for wound healing and dressings is provided, offering valuable insights into the potential applications, challenges, and future directions in this field. This literature review has targeted the multifunctionality nature of MOFs in wound-disease therapy and healing from different aspects and discussed the most recent advancements made in the field. In this context, the potential reader will find how the MOFs contributed to this field to yield more effective, functional, and innovative dressings and how they lead to the next generation of biomaterials for skin therapy and regeneration.
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Affiliation(s)
- Ashkan Bigham
- Institute of Polymers, Composites and Biomaterials, National Research Council (IPCB-CNR), Naples, 80125, Italy
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Piazzale V. Tecchio 80, Naples, 80125, Italy
| | - Negar Islami
- Department of Biotechnology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Arezoo Khosravi
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul, 34959, Turkiye
| | - Atefeh Zarepour
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600 077, India
| | - Siavash Iravani
- Independent Researcher, W Nazar ST, Boostan Ave, Isfahan, Iran
| | - Ali Zarrabi
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, 34396, Turkiye
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, 320315, Taiwan
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Pérez-Bertólez S, Godoy-Lenz J. Primary repair of esophageal atresia Gross type C via thoracoscopic magnetic compression anastomosis: Is it the best option? World J Gastrointest Surg 2024; 16:1474-1481. [PMID: 38817291 PMCID: PMC11135306 DOI: 10.4240/wjgs.v16.i5.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/23/2024] Open
Abstract
Magnetic compression anastomosis is a promising treatment option for patients with complex esophageal atresia; but, at the present time, should not be the first therapeutic option in those cases where the surgeon can perform a primary anastomosis of the two ends of the esophagus with acceptable tension.
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Affiliation(s)
- Sonia Pérez-Bertólez
- Department of Pediatric Surgery, Sant Joan de Deu Hospital, University of Barcelona, Barcelona 08950, Spain
| | - Jorge Godoy-Lenz
- Department of Pediatric Surgery, Clínica Alemana of Santiago, Santiago 7650568, Chile
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Alharbi Z, Khashab RM, Farran E, Bamatraf MS, Almaghrabi MT, Khamis SF, Ahmed KD. Knowledge and Practice of Scar Treatment Among Health Care Physicians in Saudi Arabia. Cureus 2024; 16:e60057. [PMID: 38854222 PMCID: PMC11162814 DOI: 10.7759/cureus.60057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/11/2024] Open
Abstract
Background The processes of wound healing and scar formation are complex phenomena that are determined by an intricate interplay of molecules and cells. A deviation from the anticipated trajectory of scarring can lead to the formation of hypertrophic scars and keloids. A wide range of therapeutic methodologies have been employed in the treatment of scars. This research paper seeks to enhance patient outcomes and the efficacy of scar repair as a whole by determining the knowledge of scar treatment and implementation in clinical practice in Saudi Arabia and thereby incorporating scientific findings into practical settings. Materials and methods This cross-sectional study, which included 237 participants, aimed to provide descriptive data on the knowledge and common practice of Saudi Arabian healthcare physicians with regard to scar prevention, treatment, and evaluation during the period from November 15, 2023, to December 11, 2023. Results In routine clinical practice, the most commonly employed subjective method for scar assessment is patient and observer scar assessment (162 (68.4%)) while the Modified Vancouver Scar Scale (91 (38.4%)) was commonly used for research purposes. However two-dimensional photography is the most frequently employed objective method in clinical practice (54 (22.8%)) and biomechanical properties (58 (24.5%)) for research purposes. Silicone scar therapy in the form of sheets or gel is the primary preventive measure in the prevention of keloids/hypertrophic scars across various patient populations. Corticosteroid injections and silicone are primary interventions within the initial 18-month period. Conclusion Although significant progress has been made in the field of scar management, standardization of procedures and increased adherence to evidence-based guidelines are still required.
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Affiliation(s)
- Ziyad Alharbi
- Clinical Sciences, Fakeeh College for Medical Sciences, Jeddah, SAU
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | | | - Eyas Farran
- Medicine, Fakeeh College for Medical Sciences, Jeddah, SAU
| | | | - Maan T Almaghrabi
- Pediatric Plastic Surgery and Burns, King Abdulaziz Medical City, Riyadh, SAU
| | - Sherif F Khamis
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | - Kausar D Ahmed
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
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Sander M, Rebner B, Wiens R, Shoimer I, Vallerand I, Sander M. Wound care practices following in-office cutaneous surgery among family physicians in Canada. J Wound Care 2024; 33:S14-S21. [PMID: 38683817 DOI: 10.12968/jowc.2024.33.sup5.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Family physicians (FPs) in Canada routinely perform in-office cutaneous surgery. There is strong evidence to support a moist wound healing environment, resulting in faster healing times and improved cosmesis. However, the wound care practices of FPs have not been previously studied. We aimed to examine the postoperative wound care practices of FPs after in-office cutaneous surgery. METHOD An online survey was distributed to Canadian FPs to determine post-surgical wound care practices. The survey examined moist versus dry wound healing and the reasons for these recommendations were explored. Additional wound care practices were also studied. Appropriate statistical analyses were undertaken. RESULTS A total of 573 (91.5%) FPs completed the survey. Just under half (49.2%) of FPs recommended moist wound healing to their patients, while the remaining respondents (50.8%) recommended dry wound healing. The most endorsed reason for both moist and dry wound care recommendations was prior training (63.1% and 65.3%, respectively). Most physicians (57.2%) recommended the use of a cream or ointment postoperatively. While there appeared to be consensus on recommending sun avoidance after cutaneous surgery (77.7%), additional wound care practices varied, including: the use of dressings; cleansing practices; smoking cessation; reduction in physical activity; photoprotection; water exposure; and scar treatment/cosmetic use. CONCLUSION Almost half of FPs in Canada responding to the survey did not recommend moist wound healing despite strong evidence to support this practice. We also noted a diverse range of postoperative wound care practices after in-office cutaneous surgery. Therefore, these results highlight a critical need for consistent wound care recommendations following cutaneous surgery for FPs in Canada.
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Affiliation(s)
| | - Bruce Rebner
- Faculty of Medicine, University of British Columbia, Canada
| | - Robyn Wiens
- Faculty of Medicine, University of British Columbia, Canada
| | - Ilya Shoimer
- Department of Medicine, University of Calgary, Canada
| | | | - Megan Sander
- Skin Health and Wellness Centre, Calgary, Alberta, Canada
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Gill HS, O-Wern L, Tiwari P, Gill GKS, Goh C, Hung J, Lee JT, Lim TC, Lim J, Yap YL, Nallathamby V. Postoperative Scar Management Protocol for Asian Patients. Aesthetic Plast Surg 2024; 48:461-471. [PMID: 37943348 DOI: 10.1007/s00266-023-03696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Postoperative scar formation remains a morbidity for patients even with the advent of minimally invasive techniques. Furthermore, the significant difference between the Asian and Caucasian skin results in poorer postoperative scar outcomes in Asians, supporting the need for an evidence-based scar management protocol. METHODS Following a literature review of the PubMed and the Cochrane databases over the past 10 years, we constructed a novel postoperative scar management protocol for the Asian skin, utilized in a Singaporean tertiary healthcare institution. RESULTS We describe a timeline-based scar protocol from the point of skin closure to a minimum of 1 year of follow-up. We support the use of intraoperative botulinum toxin for selected high-risk individuals upon skin closure with a follow-up regimen in the postoperative setting. For recalcitrant keloids, we have described a multimodal therapy comprising elements of intralesional steroids, botulinum toxin, lasers, surgery, and radiotherapy. CONCLUSIONS A consolidated postoperative scar management protocol provides the necessary guidance for improved scar outcomes in the Asian skin. There is inherent potential in expanding the protocol to include post-traumatic and burn wounds or support other skin types including the Caucasian skin. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Hargaven Singh Gill
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Low O-Wern
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Priya Tiwari
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
| | - Gurveer Kaven Singh Gill
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Chance Goh
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Janet Hung
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Jing Tzer Lee
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Thiam Chye Lim
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Jane Lim
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Yan Lin Yap
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Vigneswaran Nallathamby
- Department of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
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Kachare MD, Barrow BE, Sozer SO. Secondary Body Contouring. Clin Plast Surg 2024; 51:173-190. [PMID: 37945073 DOI: 10.1016/j.cps.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Body contouring surgeries, common yet intricate owing to unique patient characteristics, often necessitate revisions or secondary procedures. Balancing patient expectations and surgical limitations while methodically addressing shortcomings is crucial. This article aims to provide an extensive understanding of managing such complex cases, thus enhancing the reader's approach to secondary body contouring surgeries.
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Affiliation(s)
- Milind D Kachare
- Private Practice, El Paso Cosmetic Surgery, 651 South Mesa Hills Drive, El Paso, TX 79912, USA.
| | - Brooke E Barrow
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University, 2301 Erwin Road, Durham, NC 2771, USA
| | - Sadri Ozan Sozer
- Private Practice, El Paso Cosmetic Surgery, 651 South Mesa Hills Drive, El Paso, TX 79912, USA
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Kennedy DL, Hettiaratchy S, Alexander CM. Clinical evaluation of post-surgical scar hyperaesthesia: a longitudinal observational pilot study. Scars Burn Heal 2024; 10:20595131241230742. [PMID: 38450365 PMCID: PMC10916468 DOI: 10.1177/20595131241230742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
Introduction The mechanisms underlying persistent scar pain are not fully elucidated and evidence for the clinical evaluation of scar pain is limited. This pilot observational study investigated participation data and sought to identify objective clinical scar evaluation measures for future trials. Methods With ethical approval and consent, adults undergoing planned hand surgery were enrolled from one NHS hospital. At 1- and 4-months post-surgery scar thermal and mechanical pain thresholds were evaluated with quantitative sensory testing; peri-scar inflammation with infrared thermometry and pliability with durometry. Participation data were analysed with descriptive statistics; the association of clinical measures with patient reported scar pain was analysed. Results Twenty-one participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No adverse events or dropouts resulted from clinical scar evaluation. Seventy percent of participants reported undertaking topical, nonprescription scar treatment independently. Neuropathic Pain Symptom Inventory (NPSI) scores were dispersed across the score range, capturing variability in participant-reported scar symptoms. Scar morphology, pliability and inflammation were not associated with scar pain. Differences between scar and contralateral skin in thermal and mechanical pain sensitivity were identified. Conclusion People with acute hand scars participate in clinical research and independently initiate scar treatment. Clinical testing of acute post-surgical hand scars is well tolerated. The NPSI demonstrates utility for exploring scar pain symptoms and may support the elucidation of mechanisms of persistent scar pain. Clinical tests of thermal and mechanical and sensitivity are promising candidate clinical measures of scar pain for future trials. Lay Summary Background: it is unknown why some scars remain painful long-term. We do not know if scar flexibility, inflammation or sensitivity to temperature or pressure relate to scar pain. We investigated if patients would enrol in scar research, if scar testing was tolerated and if clinical tests are useful for future scar studies. Study conduct: with ethical approval and consent, adult hand surgery patients were enrolled from one NHS hospital. Scar pain, inflammation and response to thermal, sharp and pressure tests were assessed at 1- and 4-months after surgery. Statistically, we analysed study participation, tolerance for clinical scar tests and if the scar tests related to scar pain. Findings: 21 participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No participants were injured due to scar testing. 70% of participants reported treating their scar independently. Neuropathic Pain Symptom Inventory (NPSI) allows participants to give a broad range of answers about their scar symptoms. Scores for clinical tests of scar flexibility and inflammation did not relate to participant-reported scar pain. Scars were more sensitive to tests of pin prick and cold than unaffected skin. What we learned: people with new hand scars participate in research and independently initiate scar treatment. Clinical testing of post-surgical hand scars is well tolerated. The NPSI is useful for exploring scar pain symptoms and may help us to learn about persistent scar pain. Pinprick and cold clinical tests may be useful objective pain tests for future scar research.
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Affiliation(s)
- Donna L. Kennedy
- Therapy Department, Imperial College Healthcare NHS Trust, London, UK
- Human Performance Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Shehan Hettiaratchy
- Plastic and Reconstructive Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Caroline M. Alexander
- Therapy Department, Imperial College Healthcare NHS Trust, London, UK
- Human Performance Group, Department of Surgery and Cancer, Imperial College London, London, UK
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Elawad M, Alyousef SZH, Alkhaldi NK, Alamri FA, Bakhsh H. Scar Ectopic Pregnancy as an Uncommon Site of Ectopic Pregnancy: A Case Report and Literature Review. Life (Basel) 2023; 13:2151. [PMID: 38004291 PMCID: PMC10672687 DOI: 10.3390/life13112151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/03/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
A cesarean scar pregnancy is a rare type of ectopic pregnancy that occurs when a fertilized egg implants in the scar from a previous cesarean section. It is a serious condition that can lead to significant morbidity and mortality if not managed promptly and appropriately. In this literature review and case report, we discuss the etiology, diagnosis, and management of cesarean scar pregnancy. We conducted a comprehensive search of relevant literature using electronic databases and included studies that reported on the diagnosis and management of cesarean scar pregnancy. We also present a case report of a patient with cesarean scar pregnancy who was managed surgically. The diagnosis of cesarean scar pregnancy is primarily done via transvaginal or transabdominal ultrasound, and medical or surgical management can be used depending on the gestational age, hemodynamic status, and patient preferences. The surgical approach, which involves hysteroscopy, laparoscopy, or laparotomy, is usually preferred, since it is associated with fast recovery and lower recurrence rates. However, it is crucial to consider the patient's plans for future fertility when selecting the management approach. In conclusion, cesarean scar pregnancy is a rare but potentially life-threatening condition that requires prompt and appropriate management. Early diagnosis and treatment can prevent significant morbidity and mortality, and surgical management is usually preferred due to its higher success rates and lower recurrence rates.
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Affiliation(s)
- Mamoun Elawad
- Obstetrics & Gynecology Department, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | | | - Njoud Khaled Alkhaldi
- Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (N.K.A.); (F.A.A.)
| | - Fayza Ahmed Alamri
- Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (N.K.A.); (F.A.A.)
| | - Hanadi Bakhsh
- Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (N.K.A.); (F.A.A.)
- Department of Obstetrics and Gynecology, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
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10
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Ho MP, Hughes H, Fleming P. The Attitudes of Patients Toward Orthopaedic Post-surgical Scars. Cureus 2023; 15:e47975. [PMID: 38034173 PMCID: PMC10686239 DOI: 10.7759/cureus.47975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background Post-surgical scars (PSS) are an expected consequence of surgery. Several factors have previously been associated with PSS satisfaction including patient age and time elapsed post-operative. Little data are available regarding patient attitudes toward orthopaedic PSS. Knowledge of patient attitudes and the various associated factors may allow physicians to administer peri-operative care to mitigate the potential negative effects of PSS. Our study aims to investigate the attitudes of patients toward their PSS using quantitative scar assessment scales and to identify factors associated with PSS satisfaction. Methods We conducted a retrospective study with a follow-up. We included all patients with orthopaedic PSS on their upper or lower limbs between two and 18 weeks postoperative attending Cork University Hospital, Ireland, between February and August 2022. Patients completed an initial baseline questionnaire and then a follow-up questionnaire six months post-operative. The Patient and Observer Scar Assessment Scale (POSAS) evaluated PSS satisfaction. The European Quality of Life 5 Domain (EQ-5D), alongside several Likert scales, evaluated the patient's quality of life (QoL). Results In total, 91 patients were included. The mean POSAS score was 28.41 (95% CI, 25.85-30.97). Younger patient age (p=0.045) and decreased time passed post-operatively (p=0.002) were associated with poorer PSS satisfaction. Patients reporting their PSS appearing worse than expected were more likely to agree that their QoL had been adversely affected by it (p=0.001). Conclusion Most patients were satisfied with their orthopaedic PSS. This study identified several factors associated with poor PSS satisfaction. Our finding, which associated patient scar expectations and QoL, is novel and has not been previously examined. Accordingly, peri-operative interventions, including scar expectation management, may be implemented to mitigate scar-related QoL impact.
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Affiliation(s)
- Martin P Ho
- Department of Trauma and Orthopaedic Surgery, Cork University Hospital, Cork, IRL
| | - Hannah Hughes
- Department of Trauma and Orthopaedic Surgery, Cork University Hospital, Cork, IRL
| | - Patrick Fleming
- Department of Trauma and Orthopaedic Surgery, Cork University Hospital, Cork, IRL
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Meng J, Wang G, Zhou L, Jiang S, Qian S, Chen L, Wang C, Jiang R, Yang C, Niu B, Liu Y, Ding Z, Zhuo S, Liu Z. Mapping variation of extracellular matrix in human keloid scar by label-free multiphoton imaging and machine learning. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:045001. [PMID: 37038546 PMCID: PMC10082605 DOI: 10.1117/1.jbo.28.4.045001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/26/2023] [Indexed: 05/18/2023]
Abstract
Significance Rapid diagnosis and analysis of human keloid scar tissues in an automated manner are essential for understanding pathogenesis and formulating treatment solutions. Aim Our aim is to resolve the features of the extracellular matrix in human keloid scar tissues automatically for accurate diagnosis with the aid of machine learning. Approach Multiphoton microscopy was utilized to acquire images of collagen and elastin fibers. Morphological features, histogram, and gray-level co-occurrence matrix-based texture features were obtained to produce a total of 28 features. The minimum redundancy maximum relevancy feature selection approach was implemented to rank these features and establish feature subsets, each of which was employed to build a machine learning model through the tree-based pipeline optimization tool (TPOT). Results The feature importance ranking was obtained, and 28 feature subsets were acquired by incremental feature selection. The subset with the top 23 features was identified as the most accurate. Then stochastic gradient descent classifier optimized by the TPOT was generated with an accuracy of 96.15% in classifying normal, scar, and adjacent tissues. The area under curve of the classification results (scar versus normal and adjacent, normal versus scar and adjacent, and adjacent versus normal and scar) was 1.0, 1.0, and 0.99, respectively. Conclusions The proposed approach has great potential for future dermatological clinical diagnosis and analysis and holds promise for the development of computer-aided systems to assist dermatologists in diagnosis and treatment.
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Affiliation(s)
- Jia Meng
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Guangxing Wang
- Xiamen University, School of Public Health, Center for Molecular Imaging and Translational Medicine, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen, China
| | - Lingxi Zhou
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Shenyi Jiang
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Shuhao Qian
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Lingmei Chen
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Chuncheng Wang
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Rushan Jiang
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Chen Yang
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Bo Niu
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Yijie Liu
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Zhihua Ding
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
| | - Shuangmu Zhuo
- Jimei University, School of Science, Xiamen, China
- Address all correspondence to Zhiyi Liu, ; Shuangmu Zhuo,
| | - Zhiyi Liu
- Zhejiang University, College of Optical Science and Engineering, International Research Center for Advanced Photonics, State Key Laboratory of Modern Optical Instrumentation, Hangzhou, China
- Zhejiang University, Jiaxing Research Institute, Intelligent Optics and Photonics Research Center, Jiaxing, China
- Address all correspondence to Zhiyi Liu, ; Shuangmu Zhuo,
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12
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Huang C, Gold S, Radi R, Amos S, Yeung H. Managing Dermatologic Effects of Gender-Affirming Therapy in Transgender Adolescents. Adolesc Health Med Ther 2022; 13:93-106. [PMID: 36237602 PMCID: PMC9552673 DOI: 10.2147/ahmt.s344078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022] Open
Abstract
Transgender adolescents seek gender-affirming medical care to address gender identity and incongruence. Improved understanding of the dermatologic impact of gender-affirming medical care such as pubertal suppression, hormone therapy, and surgeries can enhance patient outcome. Pubertal suppression treats dysphoria associated with development of secondary sex characteristics, including androgen-driven acne. Gender-affirming hormone therapy influences acne and hair development in transgender adolescents. Dermatologists can help manage skin effects associated with chest binding and gender-affirming hormone therapy and surgery. Provision of patient-centered gender-affirming care in dermatologic and multidisciplinary settings is essential to improve skin and overall outcomes of gender-affirming therapy.
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Affiliation(s)
- Christina Huang
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Gold
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Rakan Radi
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Seth Amos
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA,Clinical Resource Hub, Veterans Affairs Southeast Network Veterans Integrated Service Network 7, Decatur, GA, USA,Correspondence: Howa Yeung, Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road NE Suite 100, Atlanta, GA, 30322, USA, Tel +1 (404) 727-9838, Fax +1 (404) 727-5878, Email
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13
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Lacquaniti A, Salvi F, Russo A, Marcheselli A, De Rosa R, Caroselli C. Adhesive strips for wound closure of cardiovascular implantable electronic devices. J Cardiovasc Med (Hagerstown) 2022; 23:626-628. [PMID: 35904998 DOI: 10.2459/jcm.0000000000001320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Fabio Salvi
- Geriatrics, Geriatric Emergency Unit and Aging Research Centre - INRCA-IRCCS, Ancona, Italy
| | - Antonella Russo
- Emergency Department, Parodi Delfino Hospital, Colleferro (Rome)
| | | | | | - Costantino Caroselli
- Geriatrics, Geriatric Emergency Unit and Aging Research Centre - INRCA-IRCCS, Ancona, Italy
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14
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Parikh UM, Mentz J, Collier I, Davis MJ, Abu-Ghname A, Colchado D, Short WD, King A, Buchanan EP, Balaji S. Strategies to Minimize Surgical Scarring: Translation of Lessons Learned from Bedside to Bench and Back. Adv Wound Care (New Rochelle) 2022; 11:311-329. [PMID: 34416825 DOI: 10.1089/wound.2021.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Significance: An understanding of the physiology of wound healing and scarring is necessary to minimize surgical scar formation. By reducing tension across the healing wound, eliminating excess inflammation and infection, and encouraging perfusion to healing areas, surgeons can support healing and minimize scarring. Recent Advances: Preoperatively, newer techniques focused on incision placement to minimize tension, skin sterilization to minimize infection and inflammation, and control of comorbid factors to promote a healing process with minimal scarring are constantly evolving. Intraoperatively, measures like layered closure, undermining, and tissue expansion can be taken to relieve tension across the healing wound. Appropriate suture technique and selection should be considered, and finally, there are new surgical technologies available to reduce tension across the closure. Postoperatively, the healing process can be supported as proliferation and remodeling take place within the wound. A balance of moisture control, tension reduction, and infection prevention can be achieved with dressings, ointments, and silicone. Vitamins and corticosteroids can also affect the scarring process by modulating the cellular factors involved in healing. Critical Issues: Healing with no or minimal scarring is the ultimate goal of wound healing research. Understanding how mechanical tension, inflammation and infection, and perfusion and hypoxia impact profibrotic pathways allows for the development of therapies that can modulate cytokine response and the wound extracellular microenvironment to reduce fibrosis and scarring. Future Directions: New tension-off loading topical treatments, laser, and dermabrasion devices are under development, and small molecule therapeutics have demonstrated scarless wound healing in animal models, providing a promising new direction for future research aimed to minimize surgical scarring.
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Affiliation(s)
- Umang M. Parikh
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - James Mentz
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Ian Collier
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Matthew J. Davis
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Amjed Abu-Ghname
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Daniel Colchado
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Walker D. Short
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Alice King
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Edward P. Buchanan
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Swathi Balaji
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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15
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Deer TR, Russo MA, Grider JS, Pope J, Rigoard P, Hagedorn JM, Naidu R, Patterson DG, Wilson D, Lubenow TR, Buvanendran A, Sheth SJ, Abdallah R, Knezevic NN, Schu S, Nijhuis H, Mehta P, Vallejo R, Shah JM, Harned ME, Jassal N, Gonzalez JM, Pittelkow TP, Patel S, Bojanic S, Chapman K, Strand N, Green AL, Pahapill P, Dario A, Piedimonte F, Levy RM. The Neurostimulation Appropriateness Consensus Committee (NACC): Recommendations for Surgical Technique for Spinal Cord Stimulation. Neuromodulation 2022; 25:1-34. [PMID: 35041578 DOI: 10.1016/j.neurom.2021.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The field of neurostimulation for the treatment of chronic pain is a rapidly developing area of medicine. Although neurostimulation therapies have advanced significantly as a result of technologic improvements, surgical planning, device placement, and postoperative care are of equal importance to optimize outcomes. This Neurostimulation Appropriateness Consensus Committee (NACC) project intends to provide evidence-based guidance for these often-overlooked areas of neurostimulation practice. MATERIALS AND METHODS Authors were chosen based on their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches of MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar, and PubMed from the last NACC publication in 2017 to the present. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on evidence strength and consensus when evidence was scant. RESULTS This NACC project provides guidance on preoperative assessment, intraoperative techniques, and postoperative management in the form of consensus points with supportive evidence. These results are based on grade of evidence, strength of consensus, and expert opinion. CONCLUSIONS The NACC has given guidance for a surgical plan that encompasses the patient journey from the planning stage through the surgical experience and postoperative care. The overall recommendations are designed to improve efficacy and the safety of patients undergoing these neuromodulation procedures and are intended to apply throughout the international community.
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Affiliation(s)
- Timothy R Deer
- The Spine and Nerve Centers of the Virginias, Charleston, WV, USA.
| | - Marc A Russo
- Hunter Pain Specialists, Newcastle, New South Wales, Australia
| | - Jay S Grider
- UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Jason Pope
- Evolve Restorative Center, Santa Rosa, CA, USA
| | - Philippe Rigoard
- Department of Spine Surgery and Neuromodulation, PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ramana Naidu
- California Orthopedics & Spine, Larkspur, CA, USA
| | | | - Derron Wilson
- Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Timothy R Lubenow
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | | | - Samir J Sheth
- Department of Anesthesiology and Pain Medicine, University of California, Davis, Davis, CA, USA
| | - Rany Abdallah
- Center for Interventional Pain and Spine, Milford, DE, USA
| | - N Nick Knezevic
- Department of Anesthesiology and Surgery at University of Illinois, Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Stefan Schu
- Leitender Arzt Neuromodulation, Neurochirurgie, Sana Kliniken Duisburg GmbH, Duisburg, Germany
| | - Harold Nijhuis
- Department of Anesthesiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | | | - Jay M Shah
- SamWell Institute for Pain Management, Colonia, NJ, USA
| | - Michael E Harned
- UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Jose Manuel Gonzalez
- Hospital Clínico Universitario Virgen de la Victoria, Servicio Andaluz de Salud, Málaga, Spain
| | - Thomas P Pittelkow
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | - Stana Bojanic
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, England, UK
| | - Kenneth Chapman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, The Pain and Spine Institute of New York, New York, NY, USA
| | - Natalie Strand
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Alexander L Green
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, England, UK
| | - Peter Pahapill
- Functional Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alessandro Dario
- Department of Neurosurgery, ASST Settelaghi, Insubria University, Varese, Italy
| | | | - Robert M Levy
- International Neuromodulation Society, Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA
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16
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Barone N, Safran T, Vorstenbosch J, Davison PG, Cugno S, Murphy AM. Current Advances in Hypertrophic Scar and Keloid Management. Semin Plast Surg 2021; 35:145-152. [PMID: 34526861 PMCID: PMC8432993 DOI: 10.1055/s-0041-1731461] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hypertrophic scars and keloids are caused by excessive tissue response to dermal injury due to local fibroblast proliferation and collagen overproduction. This response occurs because of pathologic wound healing due to dysregulation in the inflammatory, proliferative, and/or remodeling phase. Patients with hypertrophic scars or keloids report reduced quality of life, physical status, and psychological health. Hypertrophic scars or keloids will develop in 30 to 90% of individuals, and despite their prevalence, treatment remains a challenge. Of the treatments currently available for hypertrophic scars and keloids few have been adequately supported by studies with appropriate experimental design. Here, we aim to review the available literature to provide up-to-date information on the etiology, epidemiology, histology, pathophysiology, prevention, and management options available for the treatment of hypertrophic scars and keloids and highlight areas where further research is required.
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Affiliation(s)
- Natasha Barone
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Tyler Safran
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Joshua Vorstenbosch
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Peter G. Davison
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Sabrina Cugno
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Amanda M. Murphy
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
- Division of Plastic and Reconstructive Surgery, Jewish General Hospital, Montreal, Canada
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17
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Dowgierd K, Lipowicz A, Kulesa-Mrowiecka M, Wolański W, Linek P, Myśliwiec A. Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report. Physiother Theory Pract 2021; 38:3187-3193. [PMID: 34266352 DOI: 10.1080/09593985.2021.1952672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. CASE DESCRIPTION : In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. INTERVENTION : Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. OUTCOMES : Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. CONCLUSIONS : This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.
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Affiliation(s)
- Krzysztof Dowgierd
- Department of Clinical Pediatrics, Regional Specialized Children's Hospital, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury, Olsztyn, Poland
| | - Anna Lipowicz
- Department of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, Poland
| | - Małgorzata Kulesa-Mrowiecka
- Department of Physiotherapy, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University, Medical College, Cracow, Poland
| | - Wojciech Wolański
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Paweł Linek
- Musculoskeletal Elastography and Ultrasonography Laboratory, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
| | - Andrzej Myśliwiec
- Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Science, Academy of Physical Education, Katowice, Poland.,Specialized Physiotherapy Center, Rybnik, Poland
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18
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Kurtti A, Nguyen JK, Weedon J, Mamalis A, Lai Y, Masub N, Geisler A, Siegel DM, Jagdeo JR. Light emitting diode-red light for reduction of post-surgical scarring: Results from a dose-ranging, split-face, randomized controlled trial. JOURNAL OF BIOPHOTONICS 2021; 14:e202100073. [PMID: 33788987 PMCID: PMC8919713 DOI: 10.1002/jbio.202100073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Scarring has significant esthetic and functional consequences for patients. A need exists for anti-scarring therapeutics. Light emitting diode-red light (LED-RL) has been shown to modulate skin fibrosis. The aim of this study is to evaluate the safety and efficacy of LED-RL to reduce post-operative scarring. Cutaneous Understanding of Red-light Efficacy on Scarring was a randomized, mock-controlled, single-blind, dose-ranging, split-face phase II clinical trial. Starting 1 week post-surgery, patients received LED-RL irradiation and temperature-controlled mock therapy to incision sites at fluences of 160, 320 or 480 J/cm2 , triweekly for 3 weeks. Efficacy was assessed at 1, 3 and 6-12 months. The primary endpoint was difference in scar pliability between LED-RL-treated and control sites. Secondary outcomes included Patient and Observer Scar Assessment Scale, collagen and water concentration, and adverse events. There were no significant differences in scar pliability between treated and control scars. At certain fluences, treated scars showed greater improvements in observer rating and scar pliability, reflected by greater reductions in induration, from baseline to 6 months compared to control scars. Treatment-site adverse events included blistering (n = 2) and swelling (n = 1), which were mild and resolved without sequelae. LED-RL phototherapy is safe in the early postoperative period and may reduce scarring.
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Affiliation(s)
- Alana Kurtti
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
| | - Julie K. Nguyen
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Jeremy Weedon
- Office of the SVP for Research, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Andrew Mamalis
- Department of Dermatology, The Permanente Medical Group, Modesto, CA
| | - Yi Lai
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Natasha Masub
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Amaris Geisler
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Daniel M. Siegel
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Jared R. Jagdeo
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
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19
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Falkner F, Thomas B, Mayer S, Haug V, Harhaus L, Nagel S, Kneser U, Bigdeli AK. The impact of closed incisional negative pressure therapy on anterior lateral thigh flap donor site healing and scarring: A retrospective case-control study. J Plast Reconstr Aesthet Surg 2021; 75:152-159. [PMID: 34274247 DOI: 10.1016/j.bjps.2021.05.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/21/2021] [Accepted: 05/27/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The objective of this study was to investigate whether closed incisional negative pressure therapy (cINPT) is suitable to improve anterior lateral thigh (ALT) flap donor site healing and scarring. METHODS We identified 271 ALT free flaps of widths between 7 and 9 cm and primary donor site closure performed between January 2012 to December 2019. Patients were divided into cases of cINPT versus controls without cINPT as part of this retrospective case-control review. We compared the incidences of postoperative donor site complications (wound dehiscence, infection, seroma, hematoma) and the degree of scarring severity using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scales (POSAS). RESULTS A total of 106 ALT donor sites received cINPT (39%), whereas the remaining 165 donor sites received conventional dressings (61%). The distribution of gender, age, body mass index, comorbidities, and mean flap sizes were comparable between both groups. The occurrence of surgical wound dehiscence was significantly lower in the cINPT group (2.8%), when compared to controls (9.0%) (p = 0.04). Furthermore, the mean length of postoperative hospital stay was significantly shorter in the cINPT group (19 ± 8 days versus 21 ± 11 days; p = 0.03). CINPT was associated with a more favorable donor site scar quality when assessed by VSS (p = 0.03) and POSAS (p = 0.002). CONCLUSION The use of cINPT was associated with significantly less ALT donor site complications and superior scar quality accelerating patients' postoperative recovery.
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Affiliation(s)
- Florian Falkner
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Benjamin Thomas
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Simon Mayer
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Valentin Haug
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sarah Nagel
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
| | - Amir K Bigdeli
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany.
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20
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Zhang S, Nabi O, Jiang X. New strategy of modulating incision tension: A wound tension offloading device applied before surgery. Dermatol Ther 2021; 34:e14797. [PMID: 33484082 DOI: 10.1111/dth.14797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 12/27/2020] [Accepted: 01/17/2021] [Indexed: 02/04/2023]
Abstract
Wound tension plays a key role in the process of wound healing and scar formation. Tension offloading devices have been reported to reduce postsurgical scar formation. This study aims to determine whether the application of a tension offloading device preoperatively would result in superior attenuation of scar genesis in comparison to traditional methods. Randomized, controlled trials were performed on 12 patients, 4 patients were treated both preoperatively and postoperatively, while the other 4 were treated only postoperatively. The remaining 4 patients did not receive any sort of intervention. The overall performance was analyzed over 6 months period. The skin elasticity coefficient improved significantly with the application of a tension-offloading device. Compared with control group, patients who received treatment via the device displayed a better result in scar width and regression of color. It was also shown that the use of a device in the group with twin pre-op and post-op intervention resulted in a reduction of the wound healing period in comparison to the post-op group. Application of a tension-offloading device preoperatively can reduce tensile forces acting on the incision, thereby resulting in faster wound healing and enhanced efficacy on postsurgical reapplication. The effectiveness of the device in preventing hypertrophic scar is likely to be improved by long-term application after operation.
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Affiliation(s)
- Shu Zhang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Owais Nabi
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Xian Jiang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
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21
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Modeling of Old Scars: Histopathological, Biochemical and Thermal Analysis of the Scar Tissue Maturation. BIOLOGY 2021; 10:biology10020136. [PMID: 33572335 PMCID: PMC7916157 DOI: 10.3390/biology10020136] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary Severe skin scars (i.e., hypertrophic and keloid) induce physical and emotional discomfort and functional disorders such as contractures and body part deformations. Scar’s response to treatment depends on “maturity”, which increases with time but is not merely proportional to it. When “fresh”, scars are relatively more treatable by conservative methods, while the treatment is only partially efficient. In contrast, surgery is a preferred approach for the older scars, but it is associated with a risk of the scar regrowth and worsening after excision if unrecognized immature scar tissue remains in the operated lesion. Therefore, to develop better treatment and diagnostics of scars, understanding of the scar maturation is essential. This requires biologically accurate experimental models of skin scarring. The current models only mimic the early stages of skin scar development. They are useful for testing new scar-preventing approaches while not addressing the problem of the older scars that exist for years. In our study, we demonstrate a new rabbit model of “old” scars and explore what happens to the scar tissue during maturation. We define measurable signs to delineate the scar development stages and discuss how this knowledge can improve scar diagnostics and treatment. Abstract Mature hypertrophic scars (HSs) remain a challenging clinical problem, particularly due to the absence of biologically relevant experimental models as a standard rabbit ear HS model only reflects an early stage of scarring. The current study aims to adapt this animal model for simulation of mature HS by validating the time of the scar stabilization using qualitative and quantitative criteria. The full-thickness skin and perichondrium excision wounds were created on the ventral side of the rabbit ears. The tissue samples were studied on post-operation days (PODs) 30, 60, 90 and 120. The histopathological examination and morphometry were applied in parallel with biochemical analysis of protein and glycosaminoglycans (GAGs) content and amino acid composition. The supramolecular organization of collagen was explored by differential scanning calorimetry. Four stages of the rabbit ear HS maturation were delineated and attributed with the histolomorphometrical and physicochemical parameters of the tissue. The experimental scars formed in 30 days but stabilized structurally and biochemically only on POD 90–120. This evidence-based model can be used for the studies and testing of new treatments of the mature HSs.
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Veldhuizen IJ, Lee EH, Kurtansky NR, van Hensbergen LJ, Dusza SW, Hölscher MC, van der Hulst RRWJ, Ottenhof MJ, Pusic AL, Hoogbergen MM. To see or not to see: Impact of viewing facial skin cancer defects prior to reconstruction. Arch Dermatol Res 2021; 313:847-853. [PMID: 33515277 DOI: 10.1007/s00403-021-02187-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/14/2020] [Accepted: 01/09/2021] [Indexed: 01/28/2023]
Abstract
Patient expectations of the scar after Mohs micrographic surgery (MMS) are often not realistic, leading to subsequent psychosocial sequelae such as anxiety, depression, and avoidance of social situations. When patient expectations are not met, this may also contribute to a decrease in patient satisfaction after surgery. Therefore, altering expectation levels may change patient satisfaction and psychosocial distress levels after surgery. To assess whether patient satisfaction improves in patients after MMS when patients view the surgical defect prior to reconstruction. Patients undergoing facial MMS between December 2017 and September 2019 were included. Patients received or did not receive a mirror after MMS to view the surgical defect before closing the defect. Patients were asked to complete the Dutch FACE-Q Skin Cancer before, one-week, three-months, and one-year after MMS. A total of 113 patients where included. One-hundred-eight (95.6%), 113 (100%), and 93 (82.3%) questionnaires were completed, one-week, three-months, and one-year follow-up, respectively. Satisfaction with facial appearance and appraisal of scars significantly improved over time for all patients, no such improvement was seen for appearance-related distress. Female patients who looked in the mirror had higher satisfaction with facial appearance than female patients who did not look in the mirror. Also, lower appearance-related distress scores were seen in patients who looked in the mirror prior to a flap reconstruction. Showing the defect in the mirror prior to the reconstruction may result in higher patient satisfaction in female patients and patients before undergoing a flap reconstruction.
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Affiliation(s)
- Inge J Veldhuizen
- Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands.,Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Plastic and Reconstructive Surgery, Nutrim, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Erica H Lee
- Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Lucy J van Hensbergen
- Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - Stephen W Dusza
- Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Marleen C Hölscher
- Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - René R W J van der Hulst
- Department of Plastic and Reconstructive Surgery, Nutrim, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Maarten J Ottenhof
- Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - Andrea L Pusic
- Plastic and Reconstructive Surgery Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Maarten M Hoogbergen
- Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands.
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Goh M, Gönen ZB, Sayan A, Ilankovan V. Evolution of surgical modalities in the management of rhinophyma: our experience. Br J Oral Maxillofac Surg 2020; 59:222-227. [PMID: 32951923 DOI: 10.1016/j.bjoms.2020.08.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/12/2020] [Indexed: 11/27/2022]
Abstract
Rhinophyma is a progressive disease of the nose, which is characterised by skin thickening and sebaceous hyperplasia. Patients with rhinophyma are often stigmatised due to worsening disfigurement of their nose. This can also result in functional impairment such as reduced nasal patency. Severe cases of rhinophyma are best managed with varied surgical interventions, as there is no clear 'gold standard' treatment that has been described. We present our experiences in the management of rhinophyma and the evolution of treatment modalities that have been employed over a nine-year period.
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Affiliation(s)
- M Goh
- Oral and Maxillofacial Unit, Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK.
| | - Z B Gönen
- Oral and Maxillofacial Unit, Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK; Genome and Stem Cell Center, Erciyes University, Kayseri, Turkey
| | - A Sayan
- Oral and Maxillofacial Unit, Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK
| | - V Ilankovan
- Oral and Maxillofacial Unit, Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK
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Crowley JD, Hosgood G, Appelgrein C. Seed skin grafts for reconstruction of distal limb defects in 15 dogs. J Small Anim Pract 2020; 61:561-567. [PMID: 32715484 DOI: 10.1111/jsap.13187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/03/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To report the surgical technique of seed skin grafting and clinical application for reconstruction of wounds on the distal limb of client-owned dogs. MATERIALS AND METHODS Medical records from The Animal Hospital at Murdoch University were retrospectively reviewed for dogs requiring reconstruction using seed grafting for distal limb skin defects between January 2009 and May 2020. RESULTS Fifteen dogs were included. Grafting was performed on distal limb wounds at or below the carpus or tarsus, following trauma (n = 12) or neoplasia excision (n = 3). Complete epithelialisation with minimal contracture was recorded at a median of 4 weeks (range 3 to 8 weeks) after implantation. Median follow-up was 37 months (range 3 to 55 months) after grafting. Postoperative complications included epidermal inclusion cyst in two dogs. Good functional outcome with acceptable cosmesis despite sparse hair growth was achieved in all cases. CLINICAL SIGNIFICANCE Seed grafting is a simple technique that can be used reliably to reconstruct wounds on the distal limb in dogs where other reconstructive techniques are not suitable. Complete epithelialisation with sparse hair growth, good long-term functional outcome and minimal complications can be expected.
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Affiliation(s)
- J D Crowley
- College of Veterinary Medicine, Murdoch University, Murdoch, WA, 6150, Australia
| | - G Hosgood
- College of Veterinary Medicine, Murdoch University, Murdoch, WA, 6150, Australia
| | - C Appelgrein
- College of Veterinary Medicine, Murdoch University, Murdoch, WA, 6150, Australia
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Abstract
BACKGROUND Dermatologists routinely perform office-based surgical procedures that result in cutaneous wounds. Wound care instructions are an important resource for postoperative patients. As there is no consensus on the ideal wound care regimen after dermatologic procedures, recommendations may vary. OBJECTIVE To evaluate the current recommendations for wound care following dermatologic procedures. METHODS The authors conducted a cross-sectional assessment of dermatology wound care handouts available online. The handouts were evaluated based on predefined parameters: topical agent recommendations for wound healing, caution against topical antibiotic use, and discussion of scarring, infection, bleeding, analgesia, and lifestyle considerations. RESULTS A total of 169 handouts were evaluated. The majority (84%) recommended the application of petrolatum-based products, specifically Vaseline (75%) and Aquaphor (43%). Nearly half (43%) recommended the use of topical antibiotics, whereas 24% advised patients to avoid antibiotic ointments. Handouts variably addressed scarring (36%), infection (72%), bleeding (69%), pain (66%), and lifestyle modifications (64%). CONCLUSION The instructions provided in dermatology patient handouts are highly variable, with various topical agents being recommended for wound healing. Topical antibiotics are not indicated for prophylaxis in clean dermatologic procedures but are still widely used. Greater efforts should be made to ensure that patients receive consistent and evidence-based wound care guidance.
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Kohta M, Nishigaki C. Internet-based survey of the perceptions of surgical scars of Japanese patients. Scars Burn Heal 2020; 6:2059513120928515. [PMID: 32577308 PMCID: PMC7290269 DOI: 10.1177/2059513120928515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction: The adverse aesthetic effects of post-surgical scars frequently impose a psychological burden on patients. We conducted an Internet-based questionnaire survey of Japanese individuals to explore patient satisfaction with respect to surgical scars and to identify the factors that affect their interest and experience of scar care. Method: A cross-sectional study was conducted for the previous year on patients who had undergone the following surgeries: gastrointestinal; orthopaedic; obstetric; gynaecological; and plastic. The questionnaire included: (1) measures of participant characteristics; (2) measures of interest, experience and satisfaction with scar care; (3) measures of current and desired scar condition; and (4) measures of communication with physicians or nurses. Results: A total of 214 participants were enrolled. Of these, only 90 individuals had experienced any treatment or self-care, and only 30 were satisfied with their experience. We found a significant gap between the current and desired thickness and colour of the scar (P < 0.01). On logistic regression analysis, scars located at a visible site and size of the scar were significant factors that affected the interest and experience of scar care. Only 40% of participants answered that their physician or nurse adequately understands their concerns pertaining to the scar condition. Conclusion: Only a small proportion of individuals were satisfied with their experience of scar care. Additional research in following areas is required: (1) mutual communication between patients and medical providers; and (2) development of a new care programme for the management of scars.
Scar formation at the site of surgery is a natural biological response. The cosmetic effects of scar have an adverse psychological impact on the patient owing to the visible difference between the normal skin and scar. In the present study, we explored scar satisfaction and identified the factors that affect the patient’s interest and experience with respect to scar care. An Internet-based questionnaire survey of Japanese residents was conducted. The target population included patients who underwent gastrointestinal, orthopaedic, obstetrics and gynaecological, and plastic surgery. Out of 214 participants, 90 had experienced any treatment or self-care for scar care and only 30 were satisfied with their experience. There was a gap between the current and desired condition of thickness and colour in a scar. Scars located on visible parts of the body and size of scar had the greatest impact on the patient’s interest and experience of scar care. Additional research is required in the following areas: (1) better communication between patients and medical providers; and (2) development of new care program for scar management.
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Affiliation(s)
- Masushi Kohta
- Medical Engineering Laboratory, ALCARE Co., Ltd., Sumida-ku, Tokyo, Japan
| | - Chihiro Nishigaki
- Medical Engineering Laboratory, ALCARE Co., Ltd., Sumida-ku, Tokyo, Japan
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Mulholland EJ. Electrospun Biomaterials in the Treatment and Prevention of Scars in Skin Wound Healing. Front Bioeng Biotechnol 2020; 8:481. [PMID: 32582653 PMCID: PMC7283777 DOI: 10.3389/fbioe.2020.00481] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/24/2020] [Indexed: 12/13/2022] Open
Abstract
Electrospinning is a promising method for the rapid and cost-effective production of nanofibers from a wide variety of polymers given the high surface area morphology of these nanofibers, they make excellent wound dressings, and so have significant potential in the prevention and treatment of scars. Wound healing and the resulting scar formation are exceptionally well-characterized on a molecular and cellular level. Despite this, novel effective anti-scarring treatments which exploit this knowledge are still clinically absent. As the process of electrospinning can produce fibers from a variety of polymers, the treatment avenues for scars are vast, with therapeutic potential in choice of polymers, drug incorporation, and cell-seeded scaffolds. It is essential to show the new advances in this field; thus, this review will investigate the molecular processes of wound healing and scar tissue formation, the process of electrospinning, and examine how electrospun biomaterials can be utilized and adapted to wound repair in the hope of reducing scar tissue formation and conferring an enhanced tensile strength of the skin. Future directions of the research will explore potential novel electrospun treatments, such as gene therapies, as targets for enhanced tissue repair applications. With this class of biomaterial gaining such momentum and having such promise, it is necessary to refine our understanding of its process to be able to combine this technology with cutting-edge therapies to relieve the burden scars place on world healthcare systems.
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Affiliation(s)
- Eoghan J. Mulholland
- Gastrointestinal Stem Cell Biology Laboratory, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
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Ocampo-Candiani J, Saint Aroman M, Carballido F, Darde MS, Vázquez Martínez O, Garza-Rodríguez V, Chavez-Alvarez S, Aardewijn T. Efficacy of a repair cream based on Rhealba Oat plantlets extract and active healing compounds in peelings: benefit to patient's downtime and pain. J Eur Acad Dermatol Venereol 2019; 33 Suppl 5:3-12. [PMID: 31536168 DOI: 10.1111/jdv.15829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The frequency of dermatological procedures is steadily increasing, accompanying a growing demand from patients. Chemical peels are a method of resurfacing in the treatment of various skin conditions. However, during the early healing process, patients may impose downtime on themselves. The erythema, pain and poor aesthetic appearance of the skin can lead to unwillingness to participate in social or professional activities. OBJECTIVES The objective of this study was to evaluate the tolerance and efficacy of a repair cream based on Rhealba Oat plantlets extract and active healing compounds after a peeling procedure. METHODS Men and women, aged 18-65 years, with Fitzpatrick phototype I-IV, who had previously received a medium-depth chemical peel on the face (TCA 30%) entered with their consent a clinical study evaluating the new test product based on Rhealba Oat and active healing compounds. At the beginning of the study, the selected patients received a TCA 30% medium-depth peel. Afterwards, they were treated during 29 days with the repair cream and evaluated for the benefits to downtime and pain. RESULTS Significant reductions of pain (P < 0.0114) and erythema (P < 0.0001) were observed in the study. The downtime reduction with the tested cream was 92% - from 9 days after the previous peeling procedure to 0.74 days with application of the tested cream - a difference of 8.39 days. CONCLUSION In consequence, the tested repair cream based on Rhealba Oat plantlets extract and active healing compounds brings clinical benefit to patients who undergo peeling procedures. By reducing pain and downtime, it allows patients to get back to their daily life activities a week earlier than with previous peels.
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Affiliation(s)
- J Ocampo-Candiani
- Dermatology Department, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | | | - F Carballido
- Pierre Fabre Dermo-Cosmétique, A-Derma, Lavaur, France
| | - M S Darde
- Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - O Vázquez Martínez
- Dermatology Department, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - V Garza-Rodríguez
- Dermatology Department, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - S Chavez-Alvarez
- Dermatology Department, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - T Aardewijn
- Pierre Fabre Dermo-Cosmétique, A-Derma, Lavaur, France
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Abstract
Lipotransfer for soft tissue filling is a well-established plastic and aesthetic surgical technique. Elective fat grafting is considered a safe and well-tolerated procedure. Coleman and others have reported that fat grafting may have tissue regenerative properties and not only serve as a soft tissue filler. There have been reports from our group and others that it may improve fibrosis secondary to many different pathological aetiologies including scleroderma, burn injury, lichen sclerosis, graft vs host disease, and radiation. The mechanism of action remains unclear but has been postulated that is adipose derived stem cells (ADSCs) related. Lipoaspirate has been characterised and shown to contain several cell populations including fibroblasts, endothelial cells, and ADSCs. The ADSCs have shown to secrete angiogenic, immunodulatory, and antiapoptotic factors as well as proliferate and differentiate into different cell types similarly to other stem cell sources. We have shown that ADSCs are functionally different in scleroderma patients but despite this lipotransfer produces a significant reversal in the effects of fibrosis in these patients. The advantage of lipoaspirate containing a valuable source of regenerative properties, ease of access, isolation, and processing may serve a significant future role in the treatment of fibrotic conditions.
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Affiliation(s)
- Michelle F Griffin
- University College London (UCL) Centre for Nanotechnology and Regenerative Medicine, Division of Surgery & Interventional Science, Royal Free Hospital, UCL, London, UK
| | | | - Peter E Butler
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK
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Abstract
Scarring is the response elicited by the skin surface to injury and loss of tissue material. Wound healing takes place through a complex natural repair system consisting of vascular, inflammatory and proliferative phenomena, followed by a remodelling and cell apoptosis phase. This incredible repair system is inevitable, but sometimes unpredictable due to individual differences based on multiple factors. The scar is the objective criterion of a skin surgery, both for the patient and the dermsurgeon. It is therefore crucial to establish with the patient during the preoperative consultation, the size and positioning of the expected scar, taking into account the oncologic, anatomic and surgical constraints. Scars can ideally blend into normal skin, but may also give rise to various abnormalities. We can manage and prevent these abnormalities by mastering initial inflammation, that may induce hyperpigmentation and hypertrophy. Early massage using cortocosteroid topic or anti-inflammatory moisturizers may be effective. Random individual scarring may be minimized by a dynamic personalized accompanying scarring.
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Affiliation(s)
- J M Amici
- Service de dermatologie, hôpital Saint-André, Bordeaux, France.
| | - V Chaussade
- Service de dermatologie, hôpital Saint-André, Bordeaux, France
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Abstract
Although clinical application of a pre-expanded perforator flap is primarily focused on face and neck reconstructions, such a flap has also been used to reconstruct defects in the trunk, extremities, or hands. With better understanding of the improved blood supply to the flap and the mechanism on the prefabrication of blood supply within the flap, the pre-expanded perforator flap will definitely play a more important role in reconstructive surgery and can be used in selected patients by many plastic surgeons worldwide with good reconstructive and cosmetic outcomes.
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Affiliation(s)
- Lee L Q Pu
- Division of Plastic Surgery, University of California Davis Medical Center, 2221 Stockton Boulevard, Suite 2123, Sacramento, CA 95817, USA.
| | - Chunmei Wang
- Department of Plastic and Aesthetic Surgery, Dongguan Kanghua Hospital, 1000 Dongguan Avenue, Dongguan 523080, Guangdong Province, P.R. China
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