Thyroid Gland Flap for Minimally Invasive Reconstructive Head and Neck Surgery

Changes in hormones of the thyroid axis after tracheostomy and their influence on regeneration in patients with head and neck cancer: A prospective study

This prospective study aimed to compare and evaluate changes in hormones of the thyroid axis affected by tracheostomy due to surgical treatment in patients with oral cancer. The patients were evaluated with regard to serum levels of the thyroid axis - free T3/triiodothyronine (fT3) and free T4/thyroxine (fT4), as well as thyroid-stimulating hormone (TSH) - at fixed perioperative time points: during the tumor staging about 1 week before operation, immediately before and within 6 h after operation, 2 days after operation, and about 10 days after operation. Additionally, data on the patients' characteristics (age, gender), relevant secondary diagnoses, duration of ventilation in the intensive care unit, and perioperative complications were obtained and analyzed. In total, 51 patients with an average age of 68.29 years (±11.82) were included. Analyses of thyroid hormones directly before and after tracheostomy showed a significant postoperative decrease in circulating TSH (p = 0.005) and fT3 (p < 0.001), whilst a significant increase in fT4 values (p < 0.001) was found. Nine patients showed perioperative complications, such as infection, emphysema, or requiring a revision operation. Eleven patients were diagnosed with a cardiac problem or suffered from agitation after operation. Within the limitations of the study it seems that hormonal changes following tracheostomy in critically ill patients should be monitored and thyroid hormone adjustment should be taken into account because the latter might lead to lower mortality and morbidity during hospitalization in these patients. CLINICAL TRIAL REGISTRATION NUMBER: DRKS00023942.

Clinical application of absorbable collagen thread and cosmetic suture technique in emergency treatment of children's facial trauma

AIM

To explore the effect of absorbable collagen thread and cosmetic suture technique on scar inhibition after emergency facial trauma in children, and to explore the application value of absorbable collagen thread in emergency facial trauma.

METHODS

Children who received emergency treatment of facial trauma in plastic surgery department from January 2021 to January 2022 were analysed retrospectively, and were divided into absorbable collagen thread group and non-absorbable nylon thread group. The general data, scar appearance and local symptoms of the two groups were analysed, and the scar appearance was scored by scar beauty rating scale and non-inferiority test was analysed statistically.

RESULTS

A total of 632 children with facial trauma were included in this study, including 458 patients with absorbable collagen thread and 174 patients with non-absorbable nylon thread. The SCAR score of the absorbable collagen thread group (3.03 ± 1.57) was similar to that of the non-absorbable nylon thread group (2.98 ± 2.39) (95% confidence interval), and the final scar outcome score was not statistically different (P > 0.05). All families of the patients were satisfied with the results of the procedure, 95% very satisfied.

CONCLUSION

The use of absorbable collagen thread and cosmetic suture technique to treat the wounds of children with facial emergency trauma, resulted in good wound healing, little scar expansion, low incidence of erythema and pigment abnormality, no obvious surgical trace, and no scar hypertrophy or atrophy. The overall impression was good, the pain of stitch removal was avoided for children's patients, and the satisfaction of family members was high. Cosmetic suture technique with absorbable sutures is worthy of clinical application.