213 A Novel, Cost-Effective and Convenient Model for Simulating Facial Wound Repair

Abstract Introduction We describe the use of a novel synthetic simulation pad for learning complex facial wound management including local flaps. The simulation pad is a cost effective and convenient model of facial wounds. We have compared the use of animal tissue to the simulation pad in the context of a workshop for surgical trainees and collected feedback from delegates. Methods Feedback was collected from 14 of 16 attending delegates. Results It was clear from feedback that animal tissue is not an ideal model of facial wounds with 71% of delegates stating that they did not consider it to be high-fidelity. The synthetic pad was rated more favourably with 100% of delegates reporting that it was a valuable exercise and well designed for local flaps. Conclusions It is imperative that training opportunities are high quality and useful to clinical practice. Techniques learnt in the context of a course or workshop are more valuable where targeted practice may occur following learning. The use of a synthetic pad is more amenable to continued practice where it may be taken home following a workshop. Feedback from this event suggests a well-designed synthetic pad is more useful than animal tissue in learning local flaps.

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Local and Regional Blocks for Complex Facial Wound Repair

Facial Plastic Surgery ◽

10.1055/s-0041-1726442 ◽

2021 ◽

Author(s):

Joy Obokhare

Keyword(s):

Wound Repair ◽

Hospital Costs ◽

Length Of Hospital Stay ◽

Related Complication ◽

Lower Face ◽

Regional Block ◽

Facial Wound ◽

Upper Face ◽

Facial Wounds ◽

Patients With Special Needs

AbstractThe location, severity, and associated injuries of the head and neck trauma dictate the type and treatment location needed for that particular patient. An in-depth knowledge of local and regional block options is vital to the proper management of facial wounds at the bedside, decreasing need for general anesthesia, anesthesia-related complication, length of hospital stay, and overall hospital costs. This article will discuss local and regional block options for the upper-face, midface, and lower face including dentition; complications of local and regional blocks and how to prevent them; and recent advances in local anesthesia. In addition, conscious sedation as an adjunct to local/regional blocks in children or patients with special needs will be discussed.

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FACIAL WOUND ASSESSMENT KIT

International Journal of Advanced Research ◽

10.21474/ijar01/13611 ◽

2021 ◽

Vol 9 (10) ◽

pp. 786-794

Author(s):

Dehhaze Adil ◽

◽

Labbaci Rim ◽

Daghouri Nada-Imane ◽

Taybi Otmane ◽

...

Keyword(s):

Wound Management ◽

After Effects ◽

Minimal Scarring ◽

Wound Assessment ◽

Aesthetic Sense ◽

Facial Wound ◽

Tissue Manipulation ◽

The Face ◽

Risk Areas ◽

Facial Wounds

Facial wounds are a frequent reason for emergency room visits. The goals of laceration repair are to achieve hemostasis, avoid infection, restore function to the involved tissues, and achieve optimal cosmetic results with minimal scarring. Therefore, these cases are most appropriately managed by plastic surgeons who have a thorough knowledge of anatomy, aesthetic sense, and meticulous expertise in atraumatic tissue manipulation, combined with the surgical skill to repair any structure. You need to know what to do and what not to do : whether to suture or leave open. What local anesthesia to use and how. What equipment to use (and have it available beforehand). Whether to give antibiotic therapy and what kind. How to avoid aesthetic or functional after-effects. Which dressing to use depending on the state of the wound. This article will serve as an aid to wound management and review repair techniques for high-risk areas of the face.

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Growth Factor-Reinforced ECM Fabricated from Chemically Hypoxic MSC Sheet with Improved In Vivo Wound Repair Activity

BioMed Research International ◽

10.1155/2017/2578017 ◽

2017 ◽

Vol 2017 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Hui-Cong Du ◽

Lin Jiang ◽

Wen-Xin Geng ◽

Jing Li ◽

Rui Zhang ◽

...

Keyword(s):

Wound Healing ◽

Growth Factor ◽

Wound Repair ◽

Cost Effective ◽

Tissue Growth ◽

Wound Management ◽

Skin Defect ◽

Therapeutic Benefits ◽

Collagen Iii

MSC treatment can promote cutaneous wound repair through multiple mechanisms, and paracrine mediators secreted by MSC are responsible for most of its therapeutic benefits. Recently, MSC sheet composed of live MSCs and their secreted ECMs was reported to promote wound healing; however, whether its ECM alone could accelerate wound closure remained unknown. In this study, Nc-ECM and Cc-ECM were prepared from nonconditioned and CoCl2-conditioned MSC sheets, respectively, and their wound healing properties were evaluated in a mouse model of full-thickness skin defect. Our results showed that Nc-ECM can significantly promote wound repair through early adipocyte recruitment, rapid reepithelialization, enhanced granulation tissue growth, and augmented angiogenesis. Moreover, conditioning of MSC sheet with CoCl2 dramatically enriched its ECM with collagen I, collagen III, TGF-β1, VEGF, and bFGF via activation of HIF-1α and hence remarkably improved its ECM’s in vivo wound healing potency. All the Cc-ECM-treated wounds completely healed on day 7, while Nc-ECM-treated wounds healed about 85.0%±8.6%, and no-treatment wounds only healed 69.8%±9.6% (p<0.05). Therefore, we believe that such growth factor-reinforced ECM fabricated from chemically hypoxic MSC sheet has the potential for clinical translation and will lead to a MSC-derived, cost-effective, bankable biomaterial for wound management.

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Development of a High-Fidelity, 3D Printed Otoplasty Surgical Simulator

Proceedings of IMPRS ◽

10.18060/23619 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Chelsey Wallace, M.S. ◽

Zahra Nourmohammadi, Ph.D. ◽

David A. Zopf, M.D., M.S.

Keyword(s):

Surgical Simulation ◽

Low Cost ◽

Cost Effective ◽

Occurrence Rate ◽

Surgical Simulator ◽

Risk Environment ◽

Surgical Simulators ◽

Protruding Ears ◽

Surgical Trainees ◽

Ear Cartilage

Background and Hypothesis: Protruding ears, also known as prominauris, are prevalent worldwide at an occurrence rate of about 5%. Children with prominauris report lower self-esteem and experience increased teasing and social isolation at school. From a functional standpoint, protruding ears can make wearing prescription glasses difficult. This increased stress and anxiety and impaired functionality lead children and families to seek treatment. One of the most effective treatments for protruding ears is otoplasty. This procedure involves an incision in the back of the ear and the placement of non-resorbable sutures to reform the ear. Alternatively, the procedure can be performed using an incisionless technique. As this is an elective procedure done commonly in children, adequate education of medical trainees is critical to ensure the proper level of skill is attained and patient satisfaction is maximized. Currently, teaching otoplasty is done with cadavers and supervised procedures with an attending. Surgical simulators are employed in the instruction of a variety of surgical procedures and allow residents to practice in a zero-risk environment. In addition, 3D printing has facilitated the development of surgical simulators allowing for a more cost-effective, consistent, and anatomically correct simulator. We developed an ear model made from silicone for trainees to practice traditional and incisionless otoplasty. Project Methods: The otoplasty surgical simulator was developed by isolating an ear from a computed-tomography scan in the Materialise software to create a 3D model. This model was then altered to create a negative mold. The mold was printed using fusion deposition printing with 1.75 MM polylactic acid filament. After printing, the mold was filled with Dragon Skin Silicone Shore 20 to simulate ear cartilage. The model was then coated in a layer of Dragon Skin Silicone Shore 10 to simulate a layer of skin. Conclusion and Potential Impact: This otoplasty simulator will next be validated by expert surgeons and then used in a surgical simulation workshop for surgical trainees. Because of the low-cost of the surgical simulator and the ease of manufacturing, this simulator can also be used to train surgeons abroad where access to surgical training may not be readily available.

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P112 SMILE: Sustaining Medical Education In a Lockdown Environment.Using social media to develop a free online access medical education platform during lockdown

BJS Open ◽

10.1093/bjsopen/zrab032.111 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

John Pascoe ◽

Paul Foster ◽

Muntasha Quddus ◽

Angeliki Kosti ◽

Francesca Guest ◽

...

Keyword(s):

Social Media ◽

Medical Education ◽

Online Survey ◽

Cost Effective ◽

User Comments ◽

Surgical Trainees ◽

Social Media Platforms ◽

Online Access ◽

Education Platform

Abstract Introduction SMILE is a free online access medical education (FOAMEd) platform created by two UK surgical trainees and a medical student that delivered over 200 medical lectures during lockdown. Method The role of Social Media in the development of SMILE was interrogated using a survey sent to all SMILE participants and by analysing activity on SMILE social media platforms. Results 1306 students responded to the online survey with 57.2% saying they heard of SMILE through Facebook. Engagement using facebook remained highest with 13,819 members, over 800 user comments and >16,000 user reactions. 4% of the students heard of SMILE through Twitter or Instagram. Facebook analytics revealed the highest level of traffic when lectures were most commonly held suggesting students used Facebook to access lectures. Other educators were able to find SMILE on social media, leading to collaborations with other platforms. Throughout the survey many mentioned how social media created and maintained a community of medical students enhancing group-based learning Conclusions We demonstrate that social media platforms provide popular and cost-effective methods to promote, sustain & deliver medical education for students and educators.

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Cost-effectiveness of negative-pressure wound therapy in adults with severe open fractures of the lower limb: evidence from the WOLLF randomized controlled trial

The Bone & Joint Journal ◽

10.1302/0301-620x.101b11.bjj-2018-1228.r2 ◽

2019 ◽

Vol 101-B (11) ◽

pp. 1392-1401 ◽

Cited By ~ 1

Author(s):

S. Petrou ◽

B. Parker ◽

J. Masters ◽

J. Achten ◽

J. Bruce ◽

...

Keyword(s):

Economic Evaluation ◽

Cost Effectiveness ◽

Lower Limb ◽

Negative Pressure Wound Therapy ◽

Cost Effective ◽

Open Fractures ◽

Wound Management ◽

Wound Therapy ◽

Subgroup Analyses ◽

The Cost

Aims The aim of this study was to estimate the cost-effectiveness of negative-pressure wound therapy (NPWT) in comparison with standard wound management after initial surgical wound debridement in adults with severe open fractures of the lower limb. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom NHS and Personal Social Services, based on evidence from the 460 participants in the Wound Management of Open Lower Limb Fractures (WOLLF) trial. Economic outcomes were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Bivariate regression of costs (given in £, 2014 to 2015 prices) and quality-adjusted life-years (QALYs), with multiple imputation of missing data, was conducted to estimate the incremental cost per QALY gained associated with NPWT dressings. Sensitivity and subgroup analyses were undertaken to assess the impacts of uncertainty and heterogeneity, respectively, surrounding aspects of the economic evaluation. Results The base case analysis produced an incremental cost-effectiveness ratio of £267 910 per QALY gained, reflecting higher costs on average (£678; 95% confidence interval (CI) -£1082 to £2438) and only marginally higher QALYS (0.002; 95% CI -0.054 to 0.059) in the NPWT group. The probability that NPWT is cost-effective in this patient population did not exceed 27% regardless of the value of the cost-effectiveness threshold. This result remained robust to several sensitivity and subgroup analyses. Conclusion This trial-based economic evaluation suggests that NPWT is unlikely to be a cost-effective strategy for improving outcomes in adult patients with severe open fractures of the lower limb. Cite this article: Bone Joint J 2019;101-B:1392–1401.

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Telemedicine for wound management

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.101330 ◽

2012 ◽

Vol 45 (02) ◽

pp. 412-417 ◽

Cited By ~ 7

Author(s):

Ravi K. Chittoria

Keyword(s):

Health Care ◽

Chronic Wounds ◽

Wound Care ◽

Cost Effective ◽

Skin Lesions ◽

Wound Management ◽

Care Practice ◽

Telemedicine Technology ◽

Store And Forward ◽

Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

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