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Mortada H, Albrahim R, Alrobaiea S, Ahmad M, Abdelraheem EHA, Hakami M. A rare case of mucormycosis in a diabetic patient: diagnostic challenges and clinical management of mucormycosis hand infection. Case Reports Plast Surg Hand Surg 2024; 11:2333879. [PMID: 38567104 PMCID: PMC10986432 DOI: 10.1080/23320885.2024.2333879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
Mucormycosis hand infection in poorly controlled diabetic presented as rapidly progressive swelling, redness, pain, and necrosis unresponsive to antibiotics. Prompt diagnosis and aggressive surgery, antifungals, and diabetes management were critical, highlighting the need for early recognition and treatment of mucormycosis in diabetics.
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Affiliation(s)
- Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Plastic Surgery and Burn, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Razan Albrahim
- College of Medicine and Surgery, Princess Noura Bin Abdulrahman University, Riyadh, Saudi Arabia
| | - Saad Alrobaiea
- Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Moinuddin Ahmad
- Division of Plastic Surgery, Department of Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Muath Hakami
- Division of Plastic Surgery, Department of Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
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Mortada H, Abu Alqam R, AlNojaidi TF, Alshammari AJ, Khider M, Albarrak M, Alrobaiea S, Alalola R. Preventing and Managing Operating Room Fires in Plastic Surgery: A Review of Incidence, Risk Factors, and Recommendations with Case Experiences. J Burn Care Res 2023:irad203. [PMID: 38158891 DOI: 10.1093/jbcr/irad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Indexed: 01/03/2024]
Abstract
Fires in operating rooms are rare yet devastating incidents. There are guidelines for the prevention and management of surgical fires; however, these recommendations are based on expert opinion and case reports. Almost all surgical procedures have an oxidizer (oxygen, nitrous oxide), an ignition source (such as a laser or "Bovie"), and a fuel, which together make up the three elements of an operating room fire. Our review analyzes each fire component to decide on the most effective clinical approach for reducing the risk of fire. We investigate the incidence, risk factors, legal repercussions, preventive strategies, and the precise management of fires in the operating room, with a particular focus on plastic surgery procedures. In addition, we share insights from our own experiences and propose guidelines based on our findings to enhance safety and response measures in surgical settings. Fires most commonly occur around the head, neck, and upper chest. High-risk procedures include tonsillectomies, tracheostomies, laryngoscopies, and facial/neck surgeries. Checklists help ensure proper precautions are taken, like using moist towels and lowering oxygen concentration. If a fire erupts, prompt removal of the oxygen source and irrigation are critical. From our experience, fires spread rapidly and can cause severe burns and inhalation injuries. We share illustrative cases of surgical fires at our institution over the past decade. Our review underscores the importance of fire prevention and preparedness through safety protocols, equipment maintenance, staff training, and maintaining situational awareness. More research is needed to quantify risk factors and determine optimal management strategies when fires do occur.
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Affiliation(s)
- Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University and Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Rakan Abu Alqam
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Taif Fawaz AlNojaidi
- Plastic and Reconstructive Surgery Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Maya Khider
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maha Albarrak
- College of Medicine, Imam Mohammed University, Riyadh, Saudi Arabia
| | - Saad Alrobaiea
- Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Rayan Alalola
- Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia
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Mortada H, Alkadi D, Saqr H, Sultan F, Alturaiki B, Alrobaiea S, Aljaaly HA, Arab K, Arkoubi AY. Effectiveness and Role of Using Hyaluronic Acid Injections for Gluteal Augmentation: A Comprehensive Systematic Review of Techniques and Outcomes. Aesthetic Plast Surg 2023; 47:2719-2733. [PMID: 37407710 DOI: 10.1007/s00266-023-03458-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION There has been a rapid increase in the number of patients undergoing non-surgical gluteal augmentation in recent years, leading to an increase in the number of articles in the literature regarding the use of hyaluronic acid (HA) for gluteal augmentation. No systematic review has been published on the effectiveness of HA for gluteal augmentation. This study aimed to provide a comprehensive review regarding the effectiveness and role of using HA for gluteal augmentation. METHODS This review was conducted according to the PRISMA guidelines for reporting systematic reviews and meta-analyses. We conducted a search across MEDLINE, EMBASE, Cochrane, and Google Scholar, using the following search keywords: gluteus, buttocks, gluteoplasty, gluteal augmentation, hyaluronic acid, and filler. RESULTS Ten articles published between 2013 and 2022 that included 168 patients. The estimated duration of product effectiveness is 16.16 months. Most studies showed statistically significant improvements in patients' satisfaction. Mean volume of HA injected for optimal gluteal fat augmentation was 206.71 ml. Of included studies, two reported major complications, five patients experienced bruising and erythema as minor complications, five patients experienced effusion and inflammation at the injection site, three patients experienced gel dislocation, and one patient experienced irregular contours. CONCLUSIONS Based on our findings, HA is a predictable method for gluteal augmentation. Patients were satisfied with their outcomes. Despite gluteal augmentation with HA having a modest complication rate, it can still involve serious complications such as diffuse alveolar hemorrhage and death. There is a need for further research in a randomized control trial. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. 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)
- Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
- Department of Plastic Surgery and Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia.
| | - Danah Alkadi
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hazem Saqr
- School of Medicine, Newgiza University (NGU), Giza, Egypt
- Department of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh, USA
| | - Faris Sultan
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Batool Alturaiki
- College of Medicine, King Faisal University, Hafouf, Saudi Arabia
| | - Saad Alrobaiea
- Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Hattan A Aljaaly
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid Arab
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amr Youssef Arkoubi
- Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Mortada H, Alghamdi AM, Alshammari AN, Alrobaiea S, Alrehaili M, Kattan A. Diagnosing Schwannoma in the Wrist: a Challenging Case of Intraneural Ganglion Cyst Mimicry and a Review of Literature. Case Reports Plast Surg Hand Surg 2023; 10:2249099. [PMID: 37645560 PMCID: PMC10461494 DOI: 10.1080/23320885.2023.2249099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/12/2023] [Indexed: 08/31/2023]
Abstract
Schwannoma can rarely mimic an intraneural ganglion cyst clinically and radiographically. This is a rare case report of a wrist schwannoma mimicking an intraneural ganglion cyst. The surgery was successful, and the histopathological report confirmed the diagnosis of benign schwannoma. After two years of follow-up, the patient is still symptom-free.
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Affiliation(s)
- Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz M. Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdulmuhsen N. Alshammari
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Orthopedics, King Salman Bin Abdulaziz Medical City, Almadinah Almunawwarah, Saudi Arabia
| | - Saad Alrobaiea
- Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Musab Alrehaili
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Kattan
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Mortada H, Almutairi FF, Alrobaiea S, Helmi AM, Kattan AE, Gelidan AG, Arab K. Antiseptic Techniques in Breast Implant Surgery: Insights From Plastic Surgeons in Saudi Arabia. Aesthet Surg J Open Forum 2023; 5:ojad077. [PMID: 37746346 PMCID: PMC10516612 DOI: 10.1093/asjof/ojad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Background Breast implant surgery is a popular procedure worldwide, and the same holds true for Saudi Arabia. Ensuring a sterile surgical environment is crucial to avert postoperative infections. This study explores the various antiseptic techniques adopted by Saudi plastic surgeons during breast implant procedures. Objectives This study aims to assess Saudi plastic surgeons' adherence to antiseptic measures in breast implant surgery, and determine what types of antiseptic measures are most commonly used among Saudi plastic surgeons. Methods The authors conducted a cross-sectional survey among board-certified plastic surgeons in Saudi Arabia, collecting data through a self-administered online questionnaire. This questionnaire, which covered their demographic information and their antiseptic practices during breast implant surgery, was disseminated via a WhatsApp (Menlo Park, CA) broadcast message from May 15 to June 27, 2023. Results Of the 52 Saudi plastic surgeons who completed the questionnaire, all reported employing preoperative antibiotics and skin disinfection. Other measures included pocket irrigation (86.5%), implant irrigation (92.3%), sleeve/funnel usage (65.4%), nipple shield usage (51.9%), and glove change during the procedure (96.2%). Nearly, all respondents used only a surgical cap for head cover (96.2%) and postoperative antibiotics as prophylaxis (98.1%). However, more than half of them did not minimize door movement during the procedure (51.9%). Conclusions This study offers a valuable insight into the antiseptic practices during breast implant surgery in Saudi Arabia. The findings underline the need for further research to establish evidence-based guidelines for antiseptic practices in this field. Level of Evidence 5
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Affiliation(s)
- Hatan Mortada
- Corresponding Author: Dr Hatan Mortada, PO Box 12161, Riyadh, Saudi Arabia. E-mail:
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Mortada H, AlBraithen G, Al Jabbar I, Al Qurashi A, Alnujaim N, Alrobaiea S, Kattan AE, Arab K. Advancing Surgical Education: A Comprehensive Systematic Review with Meta-Analysis and Novel Approach to Training Models for Local Skin Advancement Flaps. Cureus 2023; 15:e42066. [PMID: 37602042 PMCID: PMC10433785 DOI: 10.7759/cureus.42066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Performing local skin flaps is a challenging task that requires cognitive and technical skills to design flaps with proper orientation to avoid distorting normal anatomy. Junior trainees need adequate exposure to gain confidence and expertise in such procedures. This article systematically reviews the literature's different local skin advancement flap training models and describes a new, easy-to-use training model. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane, Web of Science, and Google Scholar databases were searched from their inception until August 2022 for articles about local skin advancement flap training models. The meta-analysis results were pooled across the studies using a random-effects model and presented as a weighted mean difference with a 95% confidence interval (95% CI). Out of 773 reviewed articles, 18 were included in the systematic review, and four reported enough data to be included in the meta-analysis. Rhomboid and Z-plasty flaps were the most commonly taught flaps by training models. The most commonly used training models were synthetic-based, followed by animal-based models. The training models significantly increased the trainees' confidence and expertise regarding local skin flap procedures (p<0.00001) for both domains. Training models, per our reported data, significantly improve the trainees' confidence and expertise in performing local skin advancement flap procedures; continuous efforts in developing and establishing new, simple-to-use, and effective training models are strongly encouraged to further improvement of surgical education and enhance the trainees' surgical skills.
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Affiliation(s)
- Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, SAU
- Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, SAU
| | | | | | - Abdullah Al Qurashi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Nujaim Alnujaim
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Saad Alrobaiea
- Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, SAU
| | - Abdullah E Kattan
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, SAU
| | - Khalid Arab
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, SAU
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Ding J, Mellergaard M, Zhu Z, Kwan P, Edge D, Ma Z, Hebert L, Alrobaiea S, Iwasaki T, Nielsen MCE, Tredget EE. Fluorescent light energy modulates healing in skin grafted mouse model. Open Med (Wars) 2021; 16:1240-1255. [PMID: 34522783 PMCID: PMC8402934 DOI: 10.1515/med-2021-0329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/11/2021] [Accepted: 07/07/2021] [Indexed: 12/25/2022] Open
Abstract
Skin grafting is often the only treatment for skin trauma when large areas of tissue are affected. This surgical intervention damages the deeper dermal layers of the skin with implications for wound healing and a risk of scar development. Photobiomodulation (PBM) therapy modulates biological processes in different tissues, with a positive effect on many cell types and pathways essential for wound healing. This study investigated the effect of fluorescent light energy (FLE) therapy, a novel type of PBM, on healing after skin grafting in a dermal fibrotic mouse model. Split-thickness human skin grafts were transplanted onto full-thickness excisional wounds on nude mice. Treated wounds were monitored, and excised xenografts were examined to assess healing and pathophysiological processes essential for developing chronic wounds or scarring. Results demonstrated that FLE treatment initially accelerated re-epithelialization and rete ridge formation, while later reduced neovascularization, collagen deposition, myofibroblast and mast cell accumulation, and connective tissue growth factor expression. While there was no visible difference in gross morphology, we found that FLE treatment promoted a balanced collagen remodeling. Collectively, these findings suggest that FLE has a conceivable effect at balancing healing after skin grafting, which reduces the risk of infections, chronic wound development, and fibrotic scarring.
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Affiliation(s)
- Jie Ding
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Maiken Mellergaard
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Research and Development, Klox Technologies Europe Ltd, Dublin, Ireland
| | - Zhensen Zhu
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Peter Kwan
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Deirdre Edge
- Department of Research and Development, Klox Technologies Europe Ltd, Dublin, Ireland
| | - Zengshuan Ma
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Lise Hebert
- Department of Research and Development, Klox Technologies Inc., Laval, Canada
| | - Saad Alrobaiea
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Takashi Iwasaki
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 161 HMRC, Edmonton, Canada
| | - Michael Canova Engelbrecht Nielsen
- Department of Research and Development, Klox R&D Center, Guangdong Klox Biomedical Group Co., Ltd, Room 603, 6/F, Building 8, No. 6, Nanjiang Second Road, Zhujiang Street, Nansha District, Guangzhou, China
| | - Edward E. Tredget
- Divisions of Plastic and Reconstructive Surgery and Critical Care, 2D2.28 Walter C MacKenzie Health Sciences Centre & Wound Healing Research Group, 161 HMRC, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
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Alnaif N, Alrobaiea S, Azzi AJ, Thibaudeau S, Martin MH. Diagnosis of isolated extensor carpi radialis longus (ECRL) tendon avulsion fracture using ultrasound: a paradigm shift. Skeletal Radiol 2018. [PMID: 29516111 DOI: 10.1007/s00256-018-2901-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Isolated avulsion fracture of the extensor carpi radialis longus (ECRL) tendon is a rare and poorly understood injury. We present a unique case of a 45-year-old male who fell on his flexed right hand. He presented with a subtle but extremely painful mass on the dorsum of his wrist. Ultrasound (U/S) imaging of the mass revealed an avulsed bone fragment attached to the ECRL tendon, confirming the clinical suspicion of an ECRL avulsion injury. Computed tomography and magnetic resonance imaging are well-documented imaging modalities to detect tendon avulsions. As demonstrated by this case report, U/S is an excellent diagnostic tool for ECRL rupture, a cost-effective alternative that provides real-time dynamic examination of hand injuries. To our knowledge, this is the first case of ECRL avulsion diagnosed by U/S. The purpose of this case report is to educate the reader on detection and diagnosis of ECRL tendon avulsion using U/S, a time-efficient and cost-effective imaging modality that is infrequently used for this purpose.
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Affiliation(s)
- N Alnaif
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room L9.317, Montreal, Quebec, H3G 1A4, Canada
| | - S Alrobaiea
- Division of Plastic and Reconstructive Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Alain J Azzi
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room L9.317, Montreal, Quebec, H3G 1A4, Canada.
| | - S Thibaudeau
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room L9.317, Montreal, Quebec, H3G 1A4, Canada
| | - M H Martin
- Department of Radiology, McGill University Health Centre, Montreal, Quebec, Canada
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