Jose De Jesus Orozco-Grados, Jorge Carrillo Cordova, Jose Antonio Garcia Garcia, Dania Y Baez Armenta, Abraham Arroyo Gonzalez, Daniel Chacon Galvis
Degloving is a type of avulsion injury that leads to the separation of the skin from its underlying tissues. It is usually caused by industrial machinery through smashing or traction mechanisms, where the patient typically tries to avoid severe trauma by pulling their hand off, resulting in this particular injury. Although free flaps have now become the standard of treatment in many institutions, the lack of this possibility makes pedicled flaps a good reconstructive option, with advantages such as low donor-site morbidity, low procedure costs, and relatively easy dissection of the flap. Since the description of the pedicled groin flap technique by McGregor and Jackson, this reconstructive option has become a versatile flap for the coverage of wounds on the hand and distal forearm. This axial-patterned cutaneous flap is based on the superficial circumflex arteriovenous system, which can provide soft-tissue coverage for moderate-to-severe injuries, especially those caused by work accidents. This article aims to describe our experience in treating five different cases of traumatic degloving hand injuries using a groin flap for coverage, with excellent aesthetic and functional results. Two of these cases resulted from degloving after a traction accident, one from a firework explosion, one from a gunshot, and finally, one as a result of an electric wound.
{"title":"Groin Flap for Reconstruction of Traumatic Degloving Hand Injury: A Report of 5 Cases.","authors":"Jose De Jesus Orozco-Grados, Jorge Carrillo Cordova, Jose Antonio Garcia Garcia, Dania Y Baez Armenta, Abraham Arroyo Gonzalez, Daniel Chacon Galvis","doi":"10.52547/wjps.12.1.63","DOIUrl":"https://doi.org/10.52547/wjps.12.1.63","url":null,"abstract":"<p><p>Degloving is a type of avulsion injury that leads to the separation of the skin from its underlying tissues. It is usually caused by industrial machinery through smashing or traction mechanisms, where the patient typically tries to avoid severe trauma by pulling their hand off, resulting in this particular injury. Although free flaps have now become the standard of treatment in many institutions, the lack of this possibility makes pedicled flaps a good reconstructive option, with advantages such as low donor-site morbidity, low procedure costs, and relatively easy dissection of the flap. Since the description of the pedicled groin flap technique by McGregor and Jackson, this reconstructive option has become a versatile flap for the coverage of wounds on the hand and distal forearm. This axial-patterned cutaneous flap is based on the superficial circumflex arteriovenous system, which can provide soft-tissue coverage for moderate-to-severe injuries, especially those caused by work accidents. This article aims to describe our experience in treating five different cases of traumatic degloving hand injuries using a groin flap for coverage, with excellent aesthetic and functional results. Two of these cases resulted from degloving after a traction accident, one from a firework explosion, one from a gunshot, and finally, one as a result of an electric wound.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/bc/wjps-12-63.PMC10200088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despina Luciana Bereczki-Temistocle, Simona Gurzu, Ioan Ioan, Golu Mihai Vlad, Gabriela Beresescu, Alina Ormenisan
An oro-antral communication represents an abnormal connection between the oral cavity and the maxillary sinus. It occurs most often after tooth extractions, improper implant placement or incorrect management of the sinus lifts. Surgical repair is challenging and most practitioners usually choose the buccal advancement flap, the palatal flap and in some cases the buccal fat pad flap to close the defect. We present a 43 year-old female of a large oro-antral communication and associated chronic sinusitis which was succesfully manged by surgery. Previous interventions including 2 buccal advancement flaps, and a double layer closure using Collagen membrane and buccal advancement flap were unsuccesful. The stepwise intervention consisted on the complete cleaning of the sinus, using the Caldwell Luc technique, followed by the closure of the oro-antral communication using Bichat fat pad flap. The particular aspect was the proper integration of the buccal fat pad flap, after 3 failed attempts, without dehiscence or any other complications. The buccal fat pad flap can be succesfully used for closure of lage oro-antral communications, even when previous methods have failed and local tissue is of poor quality.
{"title":"Successful Closure of an Oro-Antral Communication, after Three Previously Failed Attempts, Using Bichat Fat Pad Flap: A Case Report.","authors":"Despina Luciana Bereczki-Temistocle, Simona Gurzu, Ioan Ioan, Golu Mihai Vlad, Gabriela Beresescu, Alina Ormenisan","doi":"10.52547/wjps.12.1.90","DOIUrl":"https://doi.org/10.52547/wjps.12.1.90","url":null,"abstract":"<p><p>An oro-antral communication represents an abnormal connection between the oral cavity and the maxillary sinus. It occurs most often after tooth extractions, improper implant placement or incorrect management of the sinus lifts. Surgical repair is challenging and most practitioners usually choose the buccal advancement flap, the palatal flap and in some cases the buccal fat pad flap to close the defect. We present a 43 year-old female of a large oro-antral communication and associated chronic sinusitis which was succesfully manged by surgery. Previous interventions including 2 buccal advancement flaps, and a double layer closure using Collagen membrane and buccal advancement flap were unsuccesful. The stepwise intervention consisted on the complete cleaning of the sinus, using the Caldwell Luc technique, followed by the closure of the oro-antral communication using Bichat fat pad flap. The particular aspect was the proper integration of the buccal fat pad flap, after 3 failed attempts, without dehiscence or any other complications. The buccal fat pad flap can be succesfully used for closure of lage oro-antral communications, even when previous methods have failed and local tissue is of poor quality.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/38/wjps-12-90.PMC10200079.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9887504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cleft lip and cleft palate are one of the most common congenital craniofacial abnormalities in the skull and face. We aimed to investigate the prevalence of complications after primary cleft palate repair surgery, performed on patients referred to a children's hospital, and to use the information and results obtained from it to reduce the complications and improve the results of these surgeries.
Methods: In this cross-sectional-analytical study, using a census sampling method, the medical records of 94 consecutive cleft palate patients treated in Abuzar Hospital in Ahvaz, southern Iran, in the years 2019 to 2021 were studied. The rate of postoperative complications during the first week in terms of wound opening and flap necrosis and one month later in terms of fistula formation after surgery were also extracted from the files.
Results: Ninety-four patients with congenital cleft palate (57.4% male and 42.6% female) were enrolled. The gap width in all studied patients was 14 ± 5 mm. The frequency of complications of surgical wound opening, flap necrosis, oronasal fistula and hypernasality in von Langenbeck group was 9.5%, 0.15% and 28.1% respectively, and in Bardach group was 9.5 %, 15% and 33.3% respectively.
Conclusion: There were no significant differences between the two surgical methods in terms of postoperative complications. Besides, what is important in choosing a surgical method is the patient's clinical condition, the surgeon's experience and skill, and his choice.
{"title":"Comparison of the Outcomes of Surgical Repair of Cleft Palate Performed by Modified Von Langenbeck and Bardach (Two-Flap Palatoplasty) Methods.","authors":"Mehran Peyvasteh, Shahnam Askarpour, Negin Moradi, Adel Mansouri","doi":"10.61186/wjps.12.3.94","DOIUrl":"10.61186/wjps.12.3.94","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and cleft palate are one of the most common congenital craniofacial abnormalities in the skull and face. We aimed to investigate the prevalence of complications after primary cleft palate repair surgery, performed on patients referred to a children's hospital, and to use the information and results obtained from it to reduce the complications and improve the results of these surgeries.</p><p><strong>Methods: </strong>In this cross-sectional-analytical study, using a census sampling method, the medical records of 94 consecutive cleft palate patients treated in Abuzar Hospital in Ahvaz, southern Iran, in the years 2019 to 2021 were studied. The rate of postoperative complications during the first week in terms of wound opening and flap necrosis and one month later in terms of fistula formation after surgery were also extracted from the files.</p><p><strong>Results: </strong>Ninety-four patients with congenital cleft palate (57.4% male and 42.6% female) were enrolled. The gap width in all studied patients was 14 ± 5 mm. The frequency of complications of surgical wound opening, flap necrosis, oronasal fistula and hypernasality in von Langenbeck group was 9.5%, 0.15% and 28.1% respectively, and in Bardach group was 9.5 %, 15% and 33.3% respectively.</p><p><strong>Conclusion: </strong>There were no significant differences between the two surgical methods in terms of postoperative complications. Besides, what is important in choosing a surgical method is the patient's clinical condition, the surgeon's experience and skill, and his choice.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Regarding the impact of orthognathic surgery on the airway and voice, this study was carried out to investigate the effects of maxillary impaction surgery on patients' voices through acoustic analysis and articulation assessment.
Methods: This quasi-experimental, before-and-after, double-blind study aimed at examining the effects of maxillary impaction surgery on the voice of orthognathic surgery patients. Before the surgery, a speech therapist conducted acoustic analysis, which included fundament frequency (F0), Jitter, Shimmer, and the harmonic-to-noise ratio (HNR), as well as first, second, and third formants (F1, F2, and F3). The patient's age, sex, degree of maxillary deformity, and impaction were documented in a checklist. Voice analysis was repeated during follow-up appointments at one and six months after the surgery in a blinded manner. The data were statistically analyzed using SPSS 23, and the significance level was set at 0.05.
Results: Twenty two patients (18 females, 4 males) were examined, with ages ranging from 18 to 40 years and an average age of 25.54 years. F2, F3, HNR, and Shimmer demonstrated a significant increase over the investigation period compared to the initial phase of the study (P <0.001 for each). Conversely, the Jitter variable exhibited a significant decrease during the follow-up assessments in comparison to the initial phase of the study (P< 0.001).
Conclusion: Following maxillary impaction surgery, improvements in voice quality were observed compared to the preoperative condition. However, further studies with larger samples are needed to confirm the relevancy.
{"title":"What Is the Effect of Maxillary Impaction Orthognathic Surgery on Voice Characteristics? A Quasi-Experimental Study.","authors":"Hamide Ghaemi, Ricardo Grillo, Omid Alizadeh, Alireza Shirzadeh, Behnoush Ejtehadi, Masoud Torkzadeh, Sahand Samieirad","doi":"10.61186/wjps.12.3.44","DOIUrl":"10.61186/wjps.12.3.44","url":null,"abstract":"<p><strong>Background: </strong>Regarding the impact of orthognathic surgery on the airway and voice, this study was carried out to investigate the effects of maxillary impaction surgery on patients' voices through acoustic analysis and articulation assessment.</p><p><strong>Methods: </strong>This quasi-experimental, before-and-after, double-blind study aimed at examining the effects of maxillary impaction surgery on the voice of orthognathic surgery patients. Before the surgery, a speech therapist conducted acoustic analysis, which included fundament frequency (F0), Jitter, Shimmer, and the harmonic-to-noise ratio (HNR), as well as first, second, and third formants (F1, F2, and F3). The patient's age, sex, degree of maxillary deformity, and impaction were documented in a checklist. Voice analysis was repeated during follow-up appointments at one and six months after the surgery in a blinded manner. The data were statistically analyzed using SPSS 23, and the significance level was set at 0.05.</p><p><strong>Results: </strong>Twenty two patients (18 females, 4 males) were examined, with ages ranging from 18 to 40 years and an average age of 25.54 years. F2, F3, HNR, and Shimmer demonstrated a significant increase over the investigation period compared to the initial phase of the study (P <0.001 for each). Conversely, the Jitter variable exhibited a significant decrease during the follow-up assessments in comparison to the initial phase of the study (P< 0.001).</p><p><strong>Conclusion: </strong>Following maxillary impaction surgery, improvements in voice quality were observed compared to the preoperative condition. However, further studies with larger samples are needed to confirm the relevancy.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons.
Methods: This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon.
Results: The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (P value <0.05).
Conclusion: Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.
{"title":"Lessons from Self-Assessment of Post-Rhinoplasty Complaints; Analysis of 192 Candidates of Secondary Rhinoplasty.","authors":"Shahriar Loghmani, Alireza Loghmani, Shirin Loghmani, Mohammadreza Zarei, Fatemeh Maraki","doi":"10.52547/wjps.12.1.12","DOIUrl":"https://doi.org/10.52547/wjps.12.1.12","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons.</p><p><strong>Methods: </strong>This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon.</p><p><strong>Results: </strong>The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (<i>P</i> value <0.05).</p><p><strong>Conclusion: </strong>Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/ba/wjps-12-12.PMC10200093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yousef Shafaei Khanghah, Ali Foroutan, Alireza Sherafat, Mohammad Javad Fatemi, Hosein Bagheri Faradonbeh, Hossein Akbari
Background: Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.
Methods: This article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients' characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.
Results: From 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.
Conclusion: With a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.
{"title":"Implementation of Upper Extremity Trauma Registry: A Pilot Study.","authors":"Yousef Shafaei Khanghah, Ali Foroutan, Alireza Sherafat, Mohammad Javad Fatemi, Hosein Bagheri Faradonbeh, Hossein Akbari","doi":"10.52547/wjps.12.1.29","DOIUrl":"https://doi.org/10.52547/wjps.12.1.29","url":null,"abstract":"<p><strong>Background: </strong>Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.</p><p><strong>Methods: </strong>This article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients' characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.</p><p><strong>Results: </strong>From 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.</p><p><strong>Conclusion: </strong>With a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/7a/wjps-12-29.PMC10200090.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed A Elhefnawy, Sherif A Hantash, Wael H Mahmoud, Wesam I Homouda, Mohamed M Khedr
Background: Reconstruction of soft tissue defects overlying the Achilles tendon has always been a challenge. Various modalities of reconstruction have been described to resurface such defects. We aimed to assess the functional and cosmetic outcomes of all patients who had undergone reconstruction of small and medium sized soft tissue defects of the Achilles region using local fasciocutaneous island flaps.
Methods: This retrospective study was conducted from January 2020 to June 2022. 15 patients with small (≤ 30 cm2) and medium (30-90 cm2) sized soft tissue defects of the tendo-Achilles region, underwent reconstruction with local fasciocutaneous island flaps and had complete medical records, were included.
Results: Thirteen patients were male (86.7%). The mean age was 53.2 years. 5 cases (33.3%) had post-traumatic open AT injuries with skin avulsion, while ten patients (66.7%) had suture line complications after open repair of spontaneous Achilles tendon rupture. Defect sizes ranged from 12 to 63 cm2. Reverse sural flap was used in 5 patients (33.3%) and medial plantar flap in 10 patients (66.7%). All flaps survived completely. Complications were detected in 3 patients (20%); 1 distal superficial necrosis in a sural flap and 2 marginal minimal graft loss. Functional outcome was good in 12 patients (80%), excellent in 1 patient (6.7%) and fair in 2 patients (13.3%). 13 patients (86.7%) were satisfied with the cosmetic results.
Conclusion: Local fasciocutenous island flaps are reliable and simple solutions for covering small to moderate soft tissue defects overlying the Achilles Tendon, with acceptable functional and cosmetic outcomes.
{"title":"Versatility of Local Fasciocutaneous Island Flaps for Resurfacing Soft Tissue Defects Overlying the Achilles Tendon.","authors":"Ahmed A Elhefnawy, Sherif A Hantash, Wael H Mahmoud, Wesam I Homouda, Mohamed M Khedr","doi":"10.52547/wjps.12.1.20","DOIUrl":"https://doi.org/10.52547/wjps.12.1.20","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of soft tissue defects overlying the Achilles tendon has always been a challenge. Various modalities of reconstruction have been described to resurface such defects. We aimed to assess the functional and cosmetic outcomes of all patients who had undergone reconstruction of small and medium sized soft tissue defects of the Achilles region using local fasciocutaneous island flaps.</p><p><strong>Methods: </strong>This retrospective study was conducted from January 2020 to June 2022. 15 patients with small (≤ 30 cm<sup>2</sup>) and medium (30-90 cm<sup>2</sup>) sized soft tissue defects of the tendo-Achilles region, underwent reconstruction with local fasciocutaneous island flaps and had complete medical records, were included.</p><p><strong>Results: </strong>Thirteen patients were male (86.7%). The mean age was 53.2 years. 5 cases (33.3%) had post-traumatic open AT injuries with skin avulsion, while ten patients (66.7%) had suture line complications after open repair of spontaneous Achilles tendon rupture. Defect sizes ranged from 12 to 63 cm2. Reverse sural flap was used in 5 patients (33.3%) and medial plantar flap in 10 patients (66.7%). All flaps survived completely. Complications were detected in 3 patients (20%); 1 distal superficial necrosis in a sural flap and 2 marginal minimal graft loss. Functional outcome was good in 12 patients (80%), excellent in 1 patient (6.7%) and fair in 2 patients (13.3%). 13 patients (86.7%) were satisfied with the cosmetic results.</p><p><strong>Conclusion: </strong>Local fasciocutenous island flaps are reliable and simple solutions for covering small to moderate soft tissue defects overlying the Achilles Tendon, with acceptable functional and cosmetic outcomes.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/62/wjps-12-20.PMC10200086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hosseinali Abdolrazaghi, Mohammad Ramin, Hojjat Molaei
Background: Early or delayed mobilization of limb after flexor tendon rupture repairing has an effect on postoperative outcomes, however it is not yet clear whether early or late organ mobilization leads to more likelihood of recovery. We aimed to assess the effects of early and late active limb mobilization through rehabilitation after surgery on the range of motion and hand recovery.
Methods: This randomized clinical study was performed in Sina Hospital, Tehran, Iran in 2022 on 80 patients with flexor tendon damage in the zone II, who underwent reconstructive surgery of superficial and deep tendons. Patients were randomly (using random number table) divided into two groups that for one group, rehabilitation was done early (starting after three days, n = 53) and for the other group, rehabilitation was done late (starting after three weeks, n = 27). The patients were examined postoperatively and following occupational therapy and the range of motion of their involved joints was calculated.
Results: The means PIP extension Lag, PIP active flexion, DIP extension Lag, DIP active flexion and total active motion were all significantly higher in those patients planned for early mobilization as compared to those who considered for late mobilization(P=0.031). Such a significant difference was also revealed adjusting baseline parameters.
Conclusion: Compared to the delayed start of hand flexor tendon mobility, the early start of these activities is associated with a much greater improvement in the movement function of this tendon.
背景:屈肌腱断裂修复术后肢体的早期或延迟活动对术后结果有影响,但目前尚不清楚早期或晚期的器官活动更有可能导致康复。我们旨在评估术后通过康复早期和晚期积极活动肢体对活动范围和手部恢复的影响:这项随机临床研究于 2022 年在伊朗德黑兰的 Sina 医院进行,对象是 80 名在 II 区接受浅层和深层肌腱重建手术的屈肌腱损伤患者。患者被随机(使用随机数字表)分为两组,一组早期康复(三天后开始,53 人),另一组晚期康复(三周后开始,27 人)。对患者进行术后检查和职业治疗,并计算其受累关节的活动范围:结果:与考虑晚期活动的患者相比,计划早期活动的患者的PIP伸展滞后、PIP主动屈曲、DIP伸展滞后、DIP主动屈曲和总主动活动的平均值都明显更高(P=0.031)。结论:与延迟开始手部屈伸运动相比,延迟开始手部屈伸运动的患者手部主动屈伸和总主动运动量均明显增加(P=0.031):结论:与延迟开始手部屈肌腱活动相比,尽早开始这些活动与该肌腱运动功能的改善有很大关系。
{"title":"Comparison the Range of Motion Following Early Versus Late Active Mobilization after Repairing Surgery on Flexor Tendon Injury in the Zone II: A Randomized Clinical Trial.","authors":"Hosseinali Abdolrazaghi, Mohammad Ramin, Hojjat Molaei","doi":"10.52547/wjps.12.2.29","DOIUrl":"10.52547/wjps.12.2.29","url":null,"abstract":"<p><strong>Background: </strong>Early or delayed mobilization of limb after flexor tendon rupture repairing has an effect on postoperative outcomes, however it is not yet clear whether early or late organ mobilization leads to more likelihood of recovery. We aimed to assess the effects of early and late active limb mobilization through rehabilitation after surgery on the range of motion and hand recovery.</p><p><strong>Methods: </strong>This randomized clinical study was performed in Sina Hospital, Tehran, Iran in 2022 on 80 patients with flexor tendon damage in the zone II, who underwent reconstructive surgery of superficial and deep tendons. Patients were randomly (using random number table) divided into two groups that for one group, rehabilitation was done early (starting after three days, n = 53) and for the other group, rehabilitation was done late (starting after three weeks, n = 27). The patients were examined postoperatively and following occupational therapy and the range of motion of their involved joints was calculated.</p><p><strong>Results: </strong>The means PIP extension Lag, PIP active flexion, DIP extension Lag, DIP active flexion and total active motion were all significantly higher in those patients planned for early mobilization as compared to those who considered for late mobilization(<i>P</i>=0.031). Such a significant difference was also revealed adjusting baseline parameters.</p><p><strong>Conclusion: </strong>Compared to the delayed start of hand flexor tendon mobility, the early start of these activities is associated with a much greater improvement in the movement function of this tendon.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Supralevator fistula stays a challenge in general surgery. We present a case with supralevator anorectal fistula and subsequent retroperitoneal necrotizing fasciitis in which autologous platelet-rich plasma and platelet-rich fibrin glue were used for fistula closure. A 59-year-old man was admitted with pelvic pain and fever. Abdominopelvic sonography and CT scan reported a deep horseshoe-shaped anorectal abscess with extension to the pelvic floor, supralevator, psoas, retroperitoneal muscles, and kidneys. He was managed with antibiotics, abscess drainage, repeated radical surgical debridement, and necrosectomy. After 30 days, he was discharged, but he returned to the office with the complaint of purulent discharge from the hypogastric region and a diagnosis of fistula formation. Platelet-rich plasma was injected around the fistula into the tissue, and platelet-rich fibrin glue was introduced to the fistula tract. At the 11-month follow-up, the patient did not have voiding dysfunction, constipation, diarrhea, or fistula tract infection. Autologous platelet-rich plasma injection and platelet-rich fibrin glue insertion suggest a secure and effective approach for treating supralevator anorectal fistula.
{"title":"Autologous Platelet-Rich Plasma Injection and Platelet-Rich Fibrin Glue Insertion for the Treatment of Extensive Supralevator Anorectal Fistula: A Case Report.","authors":"Amin Dalili, Daryoush Hamidi Alamdari, Alimohamad Dalili, Maryam Sarkardeh, Alireza Rezapanah, Nooshin Tafazoli","doi":"10.52547/wjps.12.1.58","DOIUrl":"https://doi.org/10.52547/wjps.12.1.58","url":null,"abstract":"<p><p>Supralevator fistula stays a challenge in general surgery. We present a case with supralevator anorectal fistula and subsequent retroperitoneal necrotizing fasciitis in which autologous platelet-rich plasma and platelet-rich fibrin glue were used for fistula closure. A 59-year-old man was admitted with pelvic pain and fever. Abdominopelvic sonography and CT scan reported a deep horseshoe-shaped anorectal abscess with extension to the pelvic floor, supralevator, psoas, retroperitoneal muscles, and kidneys. He was managed with antibiotics, abscess drainage, repeated radical surgical debridement, and necrosectomy. After 30 days, he was discharged, but he returned to the office with the complaint of purulent discharge from the hypogastric region and a diagnosis of fistula formation. Platelet-rich plasma was injected around the fistula into the tissue, and platelet-rich fibrin glue was introduced to the fistula tract. At the 11-month follow-up, the patient did not have voiding dysfunction, constipation, diarrhea, or fistula tract infection. Autologous platelet-rich plasma injection and platelet-rich fibrin glue insertion suggest a secure and effective approach for treating supralevator anorectal fistula.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/4d/wjps-12-58.PMC10200087.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9517995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The purpose of this article was to systematically review maxillary sinus changes after LeFort. We examined and analyzed the anatomical abnormalities that occurred following LeFort I osteotomy, as well as the abnormalities of maxillary sinus volume (MSV) before and after the operation.
Methods: A systematic search was conducted on various databases, such as Google Scholar, PubMed, and Scopus. The articles used were in English and original. This study was conducted until September 2023, and after reviewing the articles, several keywords, such as "Maxillary sinus" and "LeFort I osteotomy", were employed. The obtained data were evaluated based on the PICO framework.
Results: Findings from 15 studies showed that the amount of MSV decreased before and after the operation (considering the three dimensions of the sinus, the measurement was performed linearly). These reduction values differed between men and women, with men having a greater reduction. As is the case with other operations, there were some side effects associated with this type of operation that some patients experienced postoperatively.
Conclusion: In both male and female patients, the MSV was reduced after one-piece and multi-segment osteotomies. Nonetheless, one-piece LeFort I osteotomy showed a higher reduction in MSV than the multi-segment osteotomy method, according to this systematic review and meta-analysis.
背景:本文旨在系统回顾LeFort术后上颌窦的变化。我们研究并分析了 LeFort I 截骨术后出现的解剖异常,以及手术前后上颌窦容积(MSV)的异常:在 Google Scholar、PubMed 和 Scopus 等多个数据库中进行了系统检索。所用文章均为英文原文。这项研究一直持续到 2023 年 9 月,在对文章进行审查后,使用了几个关键词,如 "上颌窦 "和 "LeFort I 截骨术"。根据 PICO 框架对获得的数据进行了评估:结果:15 项研究结果表明,手术前后 MSV 量均有所减少(考虑到上颌窦的三个维度,测量方法为线性测量)。男性和女性的减少值不同,男性减少得更多。与其他手术一样,这种手术也会产生一些副作用,一些患者在术后会出现这些副作用:结论:无论是男性还是女性患者,经过一片式截骨术还是多节段截骨术后,MSV 都有所降低。尽管如此,根据本系统综述和荟萃分析,一片式 LeFort I 截骨术比多节段截骨术能减少更多的 MSV。
{"title":"Assessment of Maxillary Sinus Variations Post-LeFort: A Systematic Review.","authors":"Majid Eshghpour, Touraj Vaezi, Sahand Samieirad, Ali Manafi, Alireza Ebrahimpour, Abdolrahim Shams","doi":"10.61186/wjps.12.3.3","DOIUrl":"10.61186/wjps.12.3.3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this article was to systematically review maxillary sinus changes after LeFort. We examined and analyzed the anatomical abnormalities that occurred following LeFort I osteotomy, as well as the abnormalities of maxillary sinus volume (MSV) before and after the operation.</p><p><strong>Methods: </strong>A systematic search was conducted on various databases, such as Google Scholar, PubMed, and Scopus. The articles used were in English and original. This study was conducted until September 2023, and after reviewing the articles, several keywords, such as \"Maxillary sinus\" and \"LeFort I osteotomy\", were employed. The obtained data were evaluated based on the PICO framework.</p><p><strong>Results: </strong>Findings from 15 studies showed that the amount of MSV decreased before and after the operation (considering the three dimensions of the sinus, the measurement was performed linearly). These reduction values differed between men and women, with men having a greater reduction. As is the case with other operations, there were some side effects associated with this type of operation that some patients experienced postoperatively.</p><p><strong>Conclusion: </strong>In both male and female patients, the MSV was reduced after one-piece and multi-segment osteotomies. Nonetheless, one-piece LeFort I osteotomy showed a higher reduction in MSV than the multi-segment osteotomy method, according to this systematic review and meta-analysis.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}