Prospective observational study comparing burn surgeons’ estimations of wound healing after skin grafting to photo-assisted methods

Background: The study was conducted to determine the diagnostic accuracy of ankle branchial pressure index (ABPI) in predicting major amputation and duration of wound healing in diabetic foot ulcers.Methods: 105 participants (30-85 years) admitted in general surgery inpatient with diabetic foot ulcers during 18 months were enrolled in the present prospective observational study. Institutional ethics committee approved the study and written informed consent was obtained from all study participants. Data was analyzed using R and the tests of significance were chi square test and ANOVA. Area under curve (AUC) of receiver operator characteristic (ROC) was used to describe the diagnostic accuracy of ABPI. P<0.05 was considered statistically significant.Results: The mean ABPI of study participants was 0.7 with 23.8% participants having normal ABPI. Lower ABPI was associated with longer duration of ulcer healing (p=0.003). All participants with ABPI <0.3 required more than 120 days for wound healing (p<0.001) and required above knee amputation (p<0.001). AUC ROC of ABPI and major amputation is 0.987 with 92.9% sensitivity and 98.9% specificity. Significantly higher proportion of participants with ABPI ≤0.48 underwent major amputation. The AUC of ROC of ABPI on duration of wound healing was 0.953 with 84.9% sensitivity and 98.1% specificity. Conclusions: ABPI can be used as a routine tool in all patients with diabetic foot ulcers for screening peripheral arterial disease so that the decision for amputation can be made early during diabetic foot ulcers.

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A prospective observational study of follicular unit excision grafting for the management of stable vitiligo

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20194568 ◽

2019 ◽

Vol 5 (4) ◽

pp. 706

Author(s):

Raj Kumar ◽

Sunil Kumar Prajapati ◽

Santosh Kumar Singh ◽

Anil Kumar Gupta

Keyword(s):

Observational Study ◽

Medical Therapy ◽

Prospective Observational Study ◽

Social Stigma ◽

Skin Grafting ◽

Cost Effective ◽

Effective Management ◽

Color Match ◽

Follicular Unit ◽

Over Time

Background: Vitiligo is a common acquired idiopathic and often, familial hypomelanosis, which is characterized by pale white macules that enlarges centrifugally over time. In India, vitiligo is associated with marked social stigma, thus demanding its effective management. Stable vitiligo lesions known to be relatively refractory medical therapy require surgical therapies like skin grafting or grafting of invitro cultured and non-cultured melanocytes or follicular unit excision (FUE) grafting.Methods: A prospective observational study was done on patients of stable vitiligo. A total of 20 patients were enrolled and underwent FUE grafting for study of effectiveness and complication.Results: A total of 20 patients of stable vitiligo were studied with or without leukotrichia in which good to excellent response was seen in 13 (65%), fair in 6 (30%) and poor in 1 (5%) patients.Conclusions: FUE is a superior and upcoming methodology which is cost effective, reliable, less disfiguring, very low morbidity and results in good color match in patients with stable vitiligo.

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Comparison of Cutting Diathermy and Scalpel in Terms of Delay in Wound Healing and Scar Appearance in Skin Incision: A Prospective Observational Study

Istanbul Medical Journal ◽

10.4274/imj.galenos.2019.06936 ◽

2019 ◽

Vol 20 (4) ◽

pp. 338-341

Author(s):

Alpaslan Kaban ◽

Ayça Küçükyurt ◽

Ayça Durmuş ◽

Işık Kaban ◽

Fatma Ferda Verit

Keyword(s):

Wound Healing ◽

Observational Study ◽

Prospective Observational Study ◽

Skin Incision

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A prospective observational study on prevention of contractures of upper limb following burn

International Surgery Journal ◽

10.18203/2349-2902.isj20201846 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1431

Author(s):

Akash Gupta ◽

Sanjay Pandey ◽

Sandeep Kansal ◽

Atul Jain

Keyword(s):

Observational Study ◽

Surgical Management ◽

Upper Limb ◽

Prospective Observational Study ◽

Preventive Measures ◽

Skin Grafting ◽

North India ◽

Medical College ◽

Mobile Part ◽

Burn Contractures

Background: Over 1 lakh people are affected by burn every year in India and 20 thousands of them die per year. Post burn contracture is a common sequele occurring after burn. Upper limb contractures are also occurring more commonly because it is most mobile part of body and likely to be involved in burn. There are many studies on management of post burn contractures but literature about prevention of contracture is little, hence this study was conducted. The aim of this study was to recognise various preventive measures to prevent post burn contractures of upper extremity.Methods: This study was conducted in NSCBM Subharti Medical College and Hospital located in Meerut (North India) from October 2012 to October 2014 in Department of Surgery. It was a prospective observational study consisted of 80 cases who presented as acute burn of upper limb admitted in the hospital.Results: In our study early excision with skin grafting was done in 20 patients (25%) while delayed skin grafting was done in 25 patients (31%) while 35 patients (44%) were managed conservatively. In our study 20 patients reported back with a post burn contracture. The reason found was non-compliance to antideformity splint and physiotherapy.Conclusions: Early surgical management of deep burns, physiotherapy, anti-deformity position and proper splintage can significantly reduce the development of post burn contracture.

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