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Two Cases of COVID-Related Osteonecrosis of the Jaws: A New and Worrying Entity Is Emerging. 两例与 COVID 相关的颌骨坏死:一种令人担忧的新病例正在出现。
IF 0.9 Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.1.96
Ricardo Grillo, Sahand Samieirad, Omid Alizadeh, Seyed Hossein Hosseini Zarch, Rozita Khodashahi, Navid Kazemian, Maria da Graça Naclério-Homem

Many people were affected by COVID-19 in its severe form. Some intercurrences are still emerging. We here report two cases of COVID-related osteonecrosis of the jaws (CRONJ). Two retrospective cases were admitted into Imam Reza Hospital, Mashhad, Iran with suspected CRONJ. One patient escaped from hospital while the other showed a positive result after our proposed treatment. A new aftermath to COVID-19 infections is emerging. Maxillofacial and orthopedic surgeons should be aware of this situation. CRONJ should be on the suspect list in patients with COVID-19. Measures that are useful in the treatment carried out, as well as some measures recommended in the literature, were discussed. Surgical treatment of CRONJ appears to be an effective alternative, especially in the more aggressive cases.

许多人受到 COVID-19 的严重影响。一些并发症仍在不断出现。我们在此报告两例与 COVID 相关的颌骨坏死(CRONJ)病例。伊朗马什哈德的伊玛目礼萨医院收治了两例疑似 CRONJ 的回顾性病例。其中一名患者逃出了医院,另一名患者在我们建议的治疗后出现了阳性结果。COVID-19 感染的新后遗症正在出现。颌面外科医生和矫形外科医生应注意这种情况。COVID-19患者的可疑名单中应包括CRONJ。会议讨论了治疗中的有效措施以及文献中推荐的一些措施。手术治疗CRONJ似乎是一种有效的替代方法,尤其是对于侵袭性较强的病例。
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引用次数: 0
A Bulky Dressing Immobilization for the Congenital Hand Differences in Children. 针对儿童先天性手部差异的大块敷料固定装置。
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.92
Xiaowei Ni, Guang Yang
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引用次数: 0
Comparison of Functionality Level, Disability and Quality of Life in Subjects with Peripheral Nerve Repair in the Upper Extremity. 上肢周围神经修复受试者的功能水平、残疾程度和生活质量比较
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.68
Hossein Akbari, Amir Saraee, Leila Mirzaei, Mahsa Abolfazli, Hossein Bagheri, Peyman Akbari

Background: Peripheral nerve damage is a very important factor in patients' quality of life and functionality for various reasons. We aimed to compare the functionality level, disability and quality of life in subjects with peripheral nerve repair in the upper extremity.

Methods: This cross-sectional study was conducted on patients with nerve injuries in 2019. Among those patients, Eighty-five were selected as the sample. The instruments used in this study included the health-related quality of life standard questionnaire (SF-36), and the disability of the arm, shoulder and hand questionnaire (DASH-38). Data were analyzed by SPSS software version 22 and one-way ANOVA and Kruskal-Wallis statistical tests.

Results: Results of the Kruskal-Wallis test showed that the disability score in the groups of patients was not significant. In addition, according to the results of the one-way ANOVA test, the quality of life score was not significant among the patient groups.

Conclusion: Considering that peripheral nerve damage has a significant impact on patients' quality of life and functionality, apart from more research on the subject, it is necessary to provide support for patients to improve their quality of life.

背景:由于各种原因,周围神经损伤是影响患者生活质量和功能的一个非常重要的因素。我们旨在比较上肢周围神经修复受试者的功能水平、残疾程度和生活质量:这项横断面研究的对象是 2019 年的神经损伤患者。在这些患者中,有 85 人被选作样本。本研究使用的工具包括健康相关生活质量标准问卷(SF-36)和臂、肩、手残疾问卷(DASH-38)。数据采用 SPSS 软件 22 版进行分析,并进行单因素方差分析和 Kruskal-Wallis 统计检验:结果:Kruskal-Wallis检验结果显示,各组患者的残疾评分无显著性差异。此外,根据单因素方差分析检验结果,各组患者的生活质量评分差异不显著:考虑到周围神经损伤对患者的生活质量和功能有重大影响,除了开展更多相关研究外,还需要为患者提供支持,以提高他们的生活质量。
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引用次数: 0
Comparison of Intralesional Vitamin D with Intralesional Triamcinolone Acetonide in the Treatment of Keloids. 维生素 D 与曲安奈德治疗瘢痕疙瘩的比较。
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.44
Nader Pazyar, Sedigheh Sananzadeh, Reza Yaghoobi, Nima Bakhtiari

Background: Hypertrophic scars and keloids are disorders caused by the excessive growth of connective tissue, associated with the accumulation of collagen and cellular matrix components. These scars are caused by abnormal wound healing and can have a great impact on patients' lives. Therefore, we aimed to compare the effect of intralesional injection of vitamin D with triamcinolone acetonide in the treatment of keloid.

Methods: This study was a one-sided blind clinical trial, conducted on 22 patients (44 samples) with keloid. It was a randomized, blinded clinical trial, conducted in Imam Khomeini Hospital in Ahvaz, Iran in 2022. In each group, triamcinolone or vitamin D was injected at the lesion site with an interval of three weeks and an average of 6 sessions. The patients were re-evaluated 3 months after the end of the treatment in terms of recurrence.

Results: By examining the VSS scale in each of the groups, this scale decreased significantly in both groups after the intervention (P=0.001), which was greater in the group receiving triamcinolone (P=0.001).

Conclusion: It seems that the injection of vitamin D at the site of the lesion helps to treat it, but the effectiveness of the usual triamcinolone treatment was still higher, it is suggested to use vitamin D as an adjunctive treatment in these patients.

背景:肥厚性疤痕和瘢痕疙瘩是结缔组织过度增生引起的疾病,与胶原蛋白和细胞基质成分的堆积有关。这些疤痕是由于伤口愈合异常引起的,会对患者的生活造成很大影响。因此,我们旨在比较点内注射维生素 D 与曲安奈德治疗瘢痕疙瘩的效果:本研究是一项单侧盲法临床试验,对象为 22 例瘢痕疙瘩患者(44 个样本)。这是一项随机、盲法临床试验,于 2022 年在伊朗阿瓦士的伊玛目霍梅尼医院进行。每组在病变部位注射曲安奈德或维生素 D,间隔三周,平均 6 次。治疗结束 3 个月后,重新评估患者的复发情况:通过检查各组的 VSS 量表,干预后两组的 VSS 量表均显著下降(P=0.001),其中接受曲安奈德治疗组的 VSS 量表下降幅度更大(P=0.001):看来,在病变部位注射维生素 D 有助于治疗,但通常的三苯氧胺治疗效果仍较高,建议将维生素 D 作为此类患者的辅助治疗手段。
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引用次数: 0
Reverse Turnover Pedicled Latissimus Dorsi Muscle Flap for the Repair of Radiation Ulcer in the Back: A Case Report. 用于修复背部放射性溃疡的反向翻转足底背阔肌肌皮瓣:病例报告。
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.87
Lu Fang, Huaisheng Wang

Cases of radioactive back ulcers caused by radiation therapy have not been reported. This paper reports a matter of a 55-year-old male patient suffering from chronic back radiation ulcer after coronary stent implantation. Through the repeated and complete expansion of the rear radiation ulcer wound, the back radiation ulcer wound was successfully repaired with the reverse turnover pedicled latissimus dorsi muscle flap, and the clinical effect was satisfactory.

放射治疗引起放射性背部溃疡的病例尚未见报道。本文报告了一名 55 岁男性患者在冠状动脉支架植入术后出现慢性背部放射性溃疡的病例。通过对背部放射性溃疡创面的反复彻底扩张,采用反向翻转足背阔肌肌皮瓣成功修复了背部放射性溃疡创面,临床效果满意。
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引用次数: 0
Harmonizing Beauty and Function: A Comprehensive Exploration of Patient Satisfaction in Rhinoplasty. 美与功能的和谐统一:鼻整形术患者满意度的综合探索。
IF 0.9 Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.1.43
Ali Goljanian Tabrizi, Matin Ghazizadeh, Zahra Rootivand

Background: Rhinoplasty has become a globally prevalent esthetic procedure, necessitating precise facial analysis and comprehensive preoperative planning for favorable postoperative outcomes. We aimed to assess patient satisfaction levels concerning nasal appearance following rhinoplasty.

Methods: A case series interventional study was conducted involving 52 subjects referred to Rhinoplasty Clinics of Taleghani Hospital, Tehran, Iran from Mar 2021 to Mar 2022. Patients' satisfaction levels were evaluated using a concise checklist before and three months after surgery.

Results: The mean age of the patients was 29.23 ± 7.26 years, with 19 (36.5%) being male. Statistically significant improvements were observed in all assessed factors, including nasal obstruction, nasal size, hump presence, nasal bridge width, nasal tip bulbosity, nasal deviation, radix, nostril asymmetry, and tip ptosis (P < 0.001). These findings reveal a consistent pattern of patients' satisfaction levels predominantly shifting from moderate to low across various aspects of nasal appearance post-rhinoplasty.

Conclusion: The study demonstrated a significant enhancement in patients' satisfaction with their nasal appearance following rhinoplasty, indicated by statistically significant changes across all assessed factors. However, certain aspects exhibit more limited enhancement.

背景:鼻整形术已成为全球流行的美学手术,需要精确的面部分析和全面的术前规划,以获得良好的术后效果。我们旨在评估鼻整形术后患者对鼻部外观的满意度:方法:2021 年 3 月至 2022 年 3 月,伊朗德黑兰 Taleghani 医院鼻整形诊所对 52 名转诊患者进行了病例系列干预研究。术前和术后三个月使用简明检查表对患者的满意度进行评估:患者的平均年龄为(29.23 ± 7.26)岁,其中男性 19 人(36.5%)。所有评估因素均有明显改善,包括鼻阻塞、鼻腔大小、是否存在驼峰、鼻梁宽度、鼻尖凸度、鼻偏斜、鼻小柱、鼻孔不对称和鼻尖下垂(P < 0.001)。这些结果表明,鼻整形术后患者对鼻部外观各方面的满意度主要从中度向低度转变:研究表明,鼻整形术后患者对鼻部外观的满意度明显提高,所有评估因素都发生了统计学意义上的显著变化。然而,某些方面的改善较为有限。
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引用次数: 0
Artesian Perforator Concept. Artesian 穿孔机概念。
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.74
Ankur Khajuria, Isao Koshima, Benjamin Fink, Yutong Zou, Dinithi Liyanage, Francesca Ruccia, Ruben Y Kannan

In this article, we describe the 'Artesian Perforator Concept', based on the idea that in clinical practice, there are multiple plexuses between perforasomes in addition to the supra-fascial direct and indirect linking vessels that are present within deeper soft tissue, which form part of a deeper vascular reservoir, the equivalent of a vascular 'aquifer'. We then demonstrate the use of this concept clinically for a 45-year-old male patient with median sternotomy wound dehiscence who was reconstructed using the Internal Mammary Artery Perforator and Lateral Thoracic Artery Perforator flaps.

在这篇文章中,我们描述了 "自流孔概念",该概念基于以下观点:在临床实践中,除了存在于深层软组织中的筋膜上直接和间接连接血管外,穿孔体之间还存在多种丛状血管,它们构成了深层血管库的一部分,相当于血管 "含水层"。然后,我们在临床上演示了这一概念在一名 45 岁男性胸骨正中切开术伤口开裂患者身上的应用,该患者使用乳内动脉穿孔器和胸外侧动脉穿孔器皮瓣进行了重建。
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引用次数: 0
Pharyngoesophageal Reconstruction with A Tubed Radial Forearm Free Flap: A Case Report. 用带管前臂桡侧游离皮瓣重建咽食管:病例报告
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.77
Lugo Beltran Ignacio, Guitian González Marisol, Ornelas-Flores María Cristina, Uribe Briceño David Armando, Delcid Morazán Allan Fernando

Hypopharyngeal carcinoma is one of the most aggressive primary head and neck cancers, often managed through partial or total laryngopharyngectomy. Reconstruction after such surgeries remains a challenging procedure that often requires the use of free flaps. A 63-year-old male patient with in-situ squamous cell carcinoma of the left vocal cord treated with total pharyngolaryngectomy and primary reconstruction with a left radial forearm free flap, complicated by flap necrosis, which ended up in dismantling and gastrostomy. He was referred to the Plastic and Reconstructive Surgery Department at Centro Medico Nacional 20 de Noviembre, Mexico in 2023 to assess the reconstructive options for the hypopharynx and cervical esophagus defect. A tubular right radial forearm free flap was designed forming the anterior wall of the hypopharynx and cervical esophagus and a posterior wall for the external defect. Twelve months after his surgery, he continues tolerating oral intake without signs of stenosis or tumor recurrence. The objective in this case was based on restoring the continuity of the digestive tract and swallowing function, as well as providing skin coverage of the defects, and preventing serious complications. The radial forearm free flap has versatility in the tubular construction and a low leak rate, as well as an adequate skin island size. Conclusion: The pharyngoesophageal reconstruction with a tubed forearm free flap has favorable outcomes for restoring the gastrointestinal tract without further complications.

下咽癌是侵袭性最强的原发性头颈部癌症之一,通常通过喉咽部分或全部切除术来治疗。此类手术后的重建仍然是一项具有挑战性的手术,通常需要使用游离皮瓣。一名 63 岁的男性患者患有左声带原位鳞状细胞癌,接受了全喉切除术,并使用左桡前臂游离皮瓣进行了初次重建,但术后皮瓣坏死,最终导致手术失败并进行了胃造瘘术。2023 年,他被转诊到墨西哥新月 20 日国立医疗中心整形外科,以评估下咽和颈部食道缺损的重建方案。他设计了一个管状右桡前臂游离皮瓣,形成下咽和颈部食道的前壁,后壁用于外部缺损。手术 12 个月后,他仍能继续进食,没有出现狭窄或肿瘤复发的迹象。该病例的目标是恢复消化道的连续性和吞咽功能,同时为缺损部位提供皮肤覆盖,并预防严重并发症。前臂桡侧游离皮瓣具有管状结构的多功能性、低渗漏率以及足够的皮肤岛大小。结论使用管状前臂游离皮瓣进行咽喉食管重建,在恢复胃肠道功能方面效果良好,且不会出现更多并发症。
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引用次数: 0
Short-Term and Long-Term Therapeutic Results of Deep Flexor Tendon Repair in Zone II in Patients Referred to Imam Khomeini Hospital, Ahvaz, Southern Iran. 伊朗南部阿瓦士市伊玛目霍梅尼医院转诊患者 II 区深屈肌肌腱修复术的短期和长期治疗效果。
IF 0.9 Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.1.82
Payam Mohammadhoseini, Seyed Mohammad Mohammadi, Narjes Mousavi Nia

Background: Hand injury as an important concern for the surgeon and the patient requires proper and timely treatment to prevent complications such as infection and adhesions, and with a proper rehabilitation program, the patient returns to maximum function as soon as possible. We aimed to investigate the short-term and long-term treatment results of deep flexor tendon repair in in zone II.

Methods: This retrospective study was performed on 34 patients with 45 injured fingers in the zone II referred to Ahvaz Imam Khomeini Hospital, Ahvaz, Iran during 2017-2019. The results of deep flexor tendons repair in two groups, immediate and delayed primary repair were assessed.

Results: The mean age of the patients was 27.76 years. There was no significant remarkable between male and female in the incidence of complications such as infection, tendon rupture and adhesions. 29.4% (n=10) had poor outcome, 8.8% (n=3) had fair outcome, 29.4% (n=10) had good outcome and 32.4% (n=11) had excellent outcomes. 26.5% had adhesion and infection rate was 11.8%.

Conclusion: Among surgeons, there is consensus for the primary repair of tendon injury, but there was no significant difference between the results of immediate and delayed primary repair. Although physiotherapy has been suggested as an effective factor in improving hand function, its positive effect on the range of motion of the fingers has not been proven.

背景:手部损伤是外科医生和患者关注的一个重要问题,需要及时进行适当的治疗,以防止感染和粘连等并发症的发生,并通过适当的康复计划使患者尽快恢复最大功能。我们旨在研究 II 区深屈肌腱修复术的短期和长期治疗效果:这项回顾性研究针对 2017-2019 年期间转诊至伊朗阿瓦士市伊玛目霍梅尼医院的 34 名患者,其中 45 名患者的手指受伤部位为 II 区。评估了两组深屈肌腱修复的结果,即立即修复和延迟初级修复:患者的平均年龄为 27.76 岁。在感染、肌腱断裂和粘连等并发症的发生率方面,男性和女性没有明显差异。29.4%(10 人)疗效不佳,8.8%(3 人)疗效一般,29.4%(10 人)疗效良好,32.4%(11 人)疗效极佳。26.5%的患者有粘连,感染率为11.8%:结论:外科医生对肌腱损伤的初次修复已达成共识,但立即和延迟初次修复的结果没有显著差异。尽管物理治疗被认为是改善手部功能的有效因素,但其对手指活动范围的积极影响尚未得到证实。
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引用次数: 0
The Impact of the COVID-19 Pandemic on Reconstructive Surgery and Training Programs in Sub-Saharan Africa: A Cross-Sectional Survey. COVID-19 大流行对撒哈拉以南非洲整形外科和培训计划的影响:横断面调查。
IF 0.9 Q3 SURGERY Pub Date : 2024-01-01 DOI: 10.61186/wjps.13.2.11
Mariama Ka, Ali Modarressi, Lionel Dumont

Background: In Sub-Saharan Africa, which already faces challenges due to a lack of surgeons and facilities, the COVID-19 pandemic could significantly disrupt surgical activities and training programs. "2nd Chance", a non-governmental organization providing training program to enhance local reconstructive surgery capacity in this region since 2015, could play a crucial role in addressing these issues. We aimed to investigate the impact of the COVID-19 on the activity of sub-Saharan African reconstructive surgeons collaborating with "2nd Chance" organization and evaluate its effect on the organization's training programs.

Methods: In the course of 2022, an online cross-sectional survey was conducted among reconstructive surgeons working in sub-Saharan African countries and collaborating with "2nd Chance". The survey consisted of 57 questions covering demographics, impacts of COVID-19 on personal life, clinical and training activities.

Results: Of 469 surgeons eligible for the study, 240 were included and 51 responded. The impact of COVID-19 was felt personally in terms of health and stress. Clinical activities were severely affected, with some reporting higher mortality due to surgical cancellations and delays. Regarding training, there was a shift from practical to theoretical learning, though overall impact was moderate. One-third of participants were able to attend "2nd Chance" workshops. Among the 17 planned workshops, 9 were successfully conducted, and 4 of them exclusively featured African trainers.

Conclusion: The COVID-19 pandemic had substantial consequences on reconstructive surgery in sub-Saharan Africa, impacting more clinical practices than training programs. Collaboration between African and European trainers proved essential during the pandemic. In future pandemics, South-South collaborations should be prioritized.

背景:在撒哈拉以南非洲地区,由于缺乏外科医生和设施,本已面临挑战,COVID-19 大流行可能会严重扰乱外科手术活动和培训计划。"第 2 次机会 "是一个非政府组织,自 2015 年以来一直在该地区提供培训项目,以提高当地的整形外科能力。我们旨在调查COVID-19对与 "第二次机会 "组织合作的撒哈拉以南非洲整形外科医生活动的影响,并评估其对该组织培训项目的影响:2022 年,对在撒哈拉以南非洲国家工作并与 "第二次机会 "组织合作的整形外科医生进行了在线横断面调查。调查包括 57 个问题,涉及人口统计学、COVID-19 对个人生活、临床和培训活动的影响:结果:在符合研究条件的 469 名外科医生中,有 240 人参与了调查,51 人做出了答复。COVID-19 对个人的影响体现在健康和压力方面。临床活动受到严重影响,一些人报告说,由于手术取消和延误,死亡率上升。在培训方面,培训从实践学习转向理论学习,但总体影响不大。三分之一的参与者能够参加 "第二次机会 "讲习班。在计划举办的 17 期讲习班中,有 9 期已成功举办,其中 4 期专门由非洲培训人员授课:COVID-19大流行对撒哈拉以南非洲地区的整形外科产生了重大影响,对临床实践的影响大于对培训计划的影响。事实证明,非洲和欧洲培训师之间的合作在大流行期间至关重要。在未来的大流行中,应优先考虑南南合作。
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引用次数: 0
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World Journal of Plastic Surgery
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