Sunday, April 11, 2021

Massive Burns after Forge Explosion: New Technique to Protect Perineal Skin Grafts Without A Diverting Ostomy

xloma.fota13 shared this article with you from Inoreader
No abstract available
View on the web

The Small 14-French (Fr) Percutaneous Catheter vs. Large (28-32Fr) Open Chest Tube for Traumatic Hemothorax (P-CAT): A Multi-center Randomized Clinical Trial

xloma.fota13 shared this article with you from Inoreader
Introduction The traditional treatment of traumatic hemothorax (HTX) has been an insertion of a large-bore 36-40 French (FR) chest tube (CT). Our previous single-center randomized controlled trial (RCT) had shown that 14Fr percutaneous catheters (PCs) (pigtail) were equally as effective as CTs. We performed a multi-center RCT, hypothesizing that PCs are as equally effective as CTs in the management of patients with traumatic HTX. (NCT03546764) Methods We performed a multi-institution prospective RCT comparing 14Fr PCs to 28-32Fr CTs in the management of patients with traumatic HTX from July, 2015 to September, 2020. We excluded patients who were in extremis and required emergent tube placement, and those who refused to participate. The primary outcome was failure rate, defined as a retained HTX requiring a second intervention. Secondary outcomes included daily drainage output, tube days, intensive care unit and hospital length of stay, and insertion perception experience (IPE) score on a scale of 1 to 5 (1=tolerable experience, 5=worst experience). Unpaired Student's t-test, chi-square and Wilcoxon rank-sum test was utilized with significance set at P
View on the web

Four-Factor Prothrombin Complex Concentrate in Adjunct to Whole Blood in Trauma-Related Hemorrhage: Does Whole Blood Replace the Need for Factors?

xloma.fota13 shared this article with you from Inoreader
Background The use of whole blood (WB) for the treatment of hemorrhagic shock and coagulopathy is increasing in civilian trauma patients. Four-factor prothrombin complex concentrate (4-PCC) in adjunct to component therapy showed improved outcomes in trauma patients. Our study aims to evaluate the outcomes of trauma patients who received 4-PCC+WB compared to WB alone. Methods We performed a three-year (2015-2017) analysis of the American College of Surgeons-Trauma Quality Improvement Program database. All adult (age ≥18 years) trauma patients who received WB were included. We excluded patients who were on preinjury anticoagulants. Patients were stratified into two groups: 4-PCC+WB versus WB alone, and matched in a 1:2 ratio using propensity score matching. Outcome measures were packed red blood cells, plasma, platelets, and cryoprecipitate transfused, in-hospital complications, hospital and ICU length of stay (LOS) among survivors, and mortality. Results A total of 252 patients (4-PCC+WB, 84; WB alone, 168) were matched. Mean age was 47±21 years; 63% were males; median injury severity score was 30 [21–40], and 87% had blunt injuries. Patients who received 4-PCC+WB had decreased requirement for pRBC (8 units vs. 10 units; p=0.04) and FFP (6 units vs. 8 units; p=0.01) transfusion, lower rates of acute kidney injury (p=0.03), and ICU LOS (5 days vs. 8 days, p=0.01) compared to WB alone. There was no difference in the platelet transfusion (p=0.19), cryoprecipitate transfusion (p=0.37), hospital LOS (p=0.72), and in-hospital mortality (p=0.72) between the two groups. Conclusion Our study demonstrates that the use of 4-PCC as an adjunct to WB is associated with a reduction in transfusion requirements and ICU LOS compared to WB alone in the resuscitation of trauma patients. Further studies are required to evaluate the role of PCC with WB in the resuscitation of trauma patients. Level of Evidence Level III Therapeutic Oral Podium Presentation: 34th EAST Annual Scientific Assembly that will be held virtually on January 13-14, 2021 There are no identifiable conflicts of interest to report. The authors have no financial or proprietary interest in the subject matter or materials discussed in the manuscript. Address for correspondence: Bellal Joseph, MD, FACS, University of Arizona, Department of Surgery Division of Trauma, Critical Care, And Emergency Surgery, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ 85724 Email: bjoseph@surgery.arizona.edu Tel: 520-626-5056 Fax: 520-626-5016 © 2021 Lippincott Williams & Wilkins, Inc.
View on the web

How We Do It: C-V Transposition Flap for Reconstruction of the Nipple–Areolar Complex After Mohs Surgery

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

Postrhytidectomy Lateral Face Telangiectasia

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

Management of Parotid Fistula After Mohs Micrographic Surgery

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

Repair of a Broad-Based Upper Lip Defect

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

New Pigmentation After Medical Treatment Suggests Increased Efficacy of Dermabrasion and Noncultured Epidermal Cell Suspension Techniques in Stable Vitiligo

xloma.fota13 shared this article with you from Inoreader
imageBACKGROUND Stable vitiligo has been treated by dermabrasion and noncultured epidermal cell suspension (NCES) effectively. However, not all patches respond well. OBJECTIVE To investigate the efficacy of new pigmentation after medical treatment in the therapy of stable vitiligo. MATERIALS AND METHODS Medical records were retrospectively reviewed from October 2016 to March 2019, and 134 patients with stable vitiligo after medical therapy were further treated with NCES. They were divided into 2 groups: 70 patients in Group 1 had new pigmentation, whereas 64 patients in Group 2 did not. Repigmentation and satisfaction of patients and third-party assessors were evaluated at 3 and 6 months postoperatively. RESULTS Repigmentation was scored as excellent (≥76%), good (51%–75%), fair (26%–50%), or poor (≤25%). Repigmentation of the 2 groups at 6 months postoperatively was excellent in 82.9% versus 23.4%, good in 10.0% versus 15.6%, fair in 7.1% versus 13.0%, and poor in 0% versus 48.4%, respectively. A positive correlation between satisfaction and repigmentation was found. CONCLUSION New pigmentation after medical treatment suggests increased efficacy of NCES in treating stable vitiligo.
View on the web

Needling as a Method to Highlight the Margins of a Vitiligo Patch During Melanocyte–Keratinocyte Transplantation

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

Minimally Invasive Transungual Tumors Enucleation With Nail Preservation for Subungual Glomus Tumors

xloma.fota13 shared this article with you from Inoreader
imageBACKGROUND Glomus tumors are benign neurovascular neoplasms, most commonly located in the subungual region. These subcutaneous nodules are characterized by intense pain and temperature sensitivity. Although surgical excision is the curative treatment, permanent nail deformity and recurrence are not uncommon after conventional surgery. OBJECTIVE This study evaluated the long-term efficacy of a modified transungual approach with nail preservation for removing subungual glomus tumors. MATERIAL AND METHODS Thirty-nine patients with clinically diagnosed and histopathologically proven glomus tumors treated at a medical center over a 13-year period (2007–2019) were retrospectively evaluated. RESULTS The 39 patients included 28 women and 11 men (ratio, 2.5:1), with a mean age of 48.9 years. Thirty-four tumors were located in the fingers and 5 in the toes. All patients returned to normal activity soon after the surgery. At a mean follow-up of 28.8 months, all were pain free or experienced minimal pain and were satisfied with treatment outcomes. One patient (2.6%) experienced recurrence. No nail deformity was observed. CONCLUSION The transungual approach with nail plate preservation is a novel and effective method for removing subungual glomus tumors with reduced postoperative pain and rapid healing, while preserving or improving the configuration of the nail.
View on the web

A Randomized, Controlled, Evaluator-Blinded, Multi-Center Study of Hyaluronic Acid Filler Effectiveness and Safety in Lip Fullness Augmentation

xloma.fota13 shared this article with you from Inoreader
imageBACKGROUND HARK was recently approved in the US for lip augmentation and correction of upper perioral rhytids. OBJECTIVE To demonstrate noninferiority of HARK versus a control (HAJV) in lip fullness augmentation at Week 8 after last injection (blinded evaluation). Secondary objectives were to evaluate the effectiveness and safety of HARK in lip fullness augmentation and correction of upper perioral rhytids. METHODS AND MATERIALS Treatment with HARK or control (randomized 2:1) was administered on Day 1 in this 48-week, evaluator-blinded study with optional touch-up at Week 4. Primary endpoint was change from baseline to Week 8 in lip fullness. Secondary endpoints included lip fullness, wrinkle severity, aesthetic improvement, subject satisfaction, adverse events, and local tolerability (subject diary entries). RESULTS The primary objective was met; HARK was noninferior to control in lip fullness augmentation at Week 8. Lip fullness and wrinkle severity improvement persisted at Week 48, and was accompanied by high aesthetic improvement and subject satisfaction scores. The mean volume of HARK injected was approximately 20% lower than control. Treatment-related adverse events and local tolerability symptoms were predominantly mild and transient. CONCLUSION HARK was noninferior to control in lip fullness augmentation at Week 8, well-tolerated, and effective throughout this 48-week study.
View on the web

Mohs Surgery for Cellular Dermatofibroma in a Child

xloma.fota13 shared this article with you from Inoreader
imageNo abstract available
View on the web

Collaboration request

Hi there How would you like to earn a 35% commission for each sale for life by selling SEO services Every website owner requires the ...