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van den Bosch CH, van de Ven CP, Hulsker CCC, Bökkerink GMJ, Terwisscha-van Scheltinga CEJ, van de Wetering MD, Koopman MMW, van der Pal HJH, Wijnen MWHA, van der Steeg AFW. Satisfaction of Paediatric Oncology Patients, Survivors, and Nurses with the Position of Their Totally Implantable Venous Access Port (SPACE-Study). J Pediatr Surg 2024:S0022-3468(24)00003-4. [PMID: 38212153 DOI: 10.1016/j.jpedsurg.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/12/2023] [Accepted: 12/25/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND To compare paediatric oncologic vascular access ports located on the anterior thoracic wall to ports on the lower lateral thoracic wall, in terms of perceived port-related hindrance and scar-quality. METHODS A cross-sectional survey study including paediatric oncology patients (≥8-<19 yrs), caregivers (in patients <8 yrs), survivors (>22 yrs with only anterior ports) and nurses of the Princess Máxima Center, the Netherlands, was performed. The survey consisted of questions regarding satisfaction, hindrance during daily life, and port position preference. For survivors, scar-quality was assessed using the validated Patient and Observer Scar Assessment Scale (POSAS 2.0); a high score (i.e., a displeasing scar) was defined as a score higher than the third quartile of the median for that question. RESULTS In total, 147 participants were included; 83 patients/caregivers, 31 survivors, and 33 nurses. Overall, 81 % was satisfied with the position of their port. Satisfaction, hindrance and complications did not differ between anterior and lower lateral ports. For the anterior position, minimal pressure on the port during daily life was a mentioned reason to prefer this position. For the lower lateral position, less visibility of the scar and easiest access were mentioned. Of all survivors with an anterior port scar, one in five had a displeasing scar and all scars observed were widened. Female patients preferred a lower lateral port, and scar-quality was better for left-sided port scars. CONCLUSION The port position should be chosen together with patients/caregivers based on the (dis-)advantages of each position, as identified by this study. LEVEL OF EVIDENCE II.
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Affiliation(s)
- C H van den Bosch
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
| | - C P van de Ven
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - C C C Hulsker
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - G M J Bökkerink
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | | | - M D van de Wetering
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - M M W Koopman
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - M W H A Wijnen
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
| | - A F W van der Steeg
- Princess Máxima Center for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands
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Plonczak AM, Dole HP, Pimblett V, Conway L, Hague A, Falder S. What the COVID pandemic taught us about the management of pediatric minor trauma. J Plast Reconstr Aesthet Surg 2023; 84:334-340. [PMID: 37390542 PMCID: PMC10228152 DOI: 10.1016/j.bjps.2023.05.055] [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: 05/24/2022] [Revised: 04/12/2023] [Accepted: 05/25/2023] [Indexed: 07/02/2023]
Abstract
The COVID-19 pandemic necessitated a change in our practice in the management of pediatric soft-tissue injuries. Patients were managed conservatively whenever possible. Our aim in this study was to see whether this more conservative approach adversely affected clinical, and patient-reported outcomes, including scarring. A prospective record of children presenting to the plastic surgery "Early Bird" clinic for pediatric trauma between 01.04.2020 and 30.06.2020 was kept. Electronic patient records were reviewed. An outpatient telephone clinic was scheduled for all patients. Parents were asked about complications and what they thought about the scar and to rate it as either: "poor," "satisfactory," "good," or "excellent." There were 240 patients, including 136 (57%) males and 104 (43%) females. The most frequent type of injury was a facial laceration in 123 patients (51.3%), followed by hand lacerations in 43 (17.9%), fingertip injuries in 31 (12.9%), and others. Ninety out of 240 (37.5%) were offered surgery. Follow-up times ranged from 17 to 20 months. Most parents (86.2%) were happy with the scarring and reported it as "good" or "excellent." The proportion rating the scar "excellent" or "good" was similar in the non-operated cohort (i.e., 85.5%) versus the operated cohort (88.5%) (p-value 0.16). The overall complication rate of patients seen during this time was 5.9%; 7.4% in the conservatively managed and 4.9% of those who went to the theater. Despite managing more wounds, including some dog bites, conservatively, patients and parents reported low complication rates and high levels of satisfaction with the final scarring.
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Affiliation(s)
- A M Plonczak
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom.
| | - H P Dole
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom
| | - V Pimblett
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom
| | - L Conway
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom
| | - A Hague
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom
| | - S Falder
- Alder Hey Children's Hospital, E Prescot Road, Liverpool L14 5AB, United Kingdom
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Westra I, Verhaegen P, Ibrahim Korkmaz H, Braam K, Kaspers G, Niessen H, Niessen F. Investigating histological aspects of scars in children. J Wound Care 2017; 26:256-265. [DOI: 10.12968/jowc.2017.26.5.256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- I. Westra
- Department of Plastic, Reconstructive and Hand Surgery, VU Medical Centre, Amsterdam, the Netherlands
| | - P.D.H.M. Verhaegen
- Department of Plastic, Reconstructive and Hand Surgery, VU Medical Centre, Amsterdam, the Netherlands
| | - H. Ibrahim Korkmaz
- Department of Pathology, VU Medical Centre, Amsterdam, the Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), VU Medical Centre, Amsterdam, the Netherlands
| | - K.I. Braam
- Department of Pediatric Oncology/Hematology, VU Medical Centre, Amsterdam, the Netherlands
| | - G.J.L. Kaspers
- Department of Pediatric Oncology/Hematology, VU Medical Centre, Amsterdam, the Netherlands
| | - H.W.M. Niessen
- Department of Pathology, VU Medical Centre, Amsterdam, the Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), VU Medical Centre, Amsterdam, the Netherlands
| | - F.B. Niessen
- Department of Plastic, Reconstructive and Hand Surgery, VU Medical Centre, Amsterdam, the Netherlands
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Gaucher S, Martin A, Benachour I, Maladry D, Tigaud JM, Goldwasser F, Philippe HJ. Complication-related removal of totally implantable venous access port systems: Do not forget the skin scar in survivors! Eur J Surg Oncol 2017; 43:851-852. [PMID: 28148464 DOI: 10.1016/j.ejso.2016.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/10/2016] [Indexed: 11/27/2022] Open
Affiliation(s)
- S Gaucher
- Université Paris Descartes, Paris Sorbonne Cité, 75006 Paris, France; Service de chirurgie générale, plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France.
| | - A Martin
- Service de chirurgie générale, plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
| | - I Benachour
- Service de chirurgie générale, plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
| | - D Maladry
- Service de chirurgie générale, plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
| | - J-M Tigaud
- Service d'oncologie, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
| | - F Goldwasser
- Université Paris Descartes, Paris Sorbonne Cité, 75006 Paris, France; Service d'oncologie, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
| | - H-J Philippe
- Université Paris Descartes, Paris Sorbonne Cité, 75006 Paris, France; Service de chirurgie générale, plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
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