Scar Quality of Skin Graft Borders: A Prospective, Randomized, Double-Blinded Evaluation

2019 ◽  
Vol 40 (5) ◽  
pp. 529-534
Author(s):  
Kevin J Zuo ◽  
Nisha Umraw ◽  
Robert Cartotto
Keyword(s):  
Skin Graft ◽  
Normal Skin ◽  
Burn Patients ◽  
Female Age ◽  
Scar Assessment ◽  
Wound Margin ◽  
Scar Quality ◽  
The Mean ◽  
Double Blinded

Abstract Prominent scars may remain around the border of a mature skin graft (SG) at the interface of the SG with normal skin. The border of a SG may be constructed by either exactly approximating (A) or slightly overlapping (O) the edge of the SG on the wound margin. The purpose of this study was to evaluate whether A or O affects the quality of the border scar of SGs applied to burn patients. This prospective study was a within-border design in which adult burn patients requiring SGs served as their own control. Half of each study border was fashioned using O and the immediately adjacent other half was made using A. We randomly assigned O or A to the proximal or distal halves of vertical borders and the medial and lateral halves of horizontal borders. Both halves of the study border were identically fixated with staples or sutures and were managed in the same fashion postoperatively. Blinded evaluations at 3, 6, and 12 months of O and A borders were performed using the Vancouver Scar Scale (VSS), the observer component of the Patient and Observer Scar Assessment Scale (POSAS), and a global binary assessment of which half of the study border “looked better.” Blinded patients also rated each half of the study border with a 10-point Likert scale. Values are reported as the mean ± SD or median (interquartile range), as appropriate. There were 34 borders studied in 15 subjects (46.7% female, age 29 [22,57], % TBSA burn 9.7 ± 5.3, and no inhalation injuries). Study borders were constructed at 7 (5,11) days postburn, had a total length of 12 (9.3,14.5) cm, and all involved split thickness SGs of thickness 13 (12,14)/1000th of an inch. Sheet grafts were applied in 27% and meshed grafts in 73%. SGs were applied immediately after excision in 75% or after allografting in 25%. Border scars matured between 3 and 12 months with reductions in total VSS from 8 (7,8) to 4 (3,6) for O borders (P < .001) and from 8 (7,9) to 4 (1,6) for A borders (P < .001). However, there were no significant differences between O and A borders in total VSS at 3 months (P = .165), 6 months (P = .602), and 12 months (P = .358) or in total OSAS at 3 months (P = .681), 6 months (P = .890), or 12 months (P = .601). At 12 months, 60% of O borders and 40% of A borders were globally rated as “better” (P = .258). There were no significant differences in the patients’ subjective ratings of the O and A borders at 3 months (P = .920), 6 months (P = .960), and 12 months (P = .66). The scar quality at the border of a skin graft does not appear to be affected by the surgical technique used to construct the border at the time of grafting.

105 Scar Quality of Skin Graft Borders: A Prospective Randomized Double Blinded Evaluation

2019 ◽  
Vol 40 (Supplement_1) ◽  
pp. S68-S69
Author(s):  
K J Zuo ◽  
N Umraw ◽  
R Cartotto
Keyword(s):  
Skin Graft ◽  
Scar Quality ◽  
Double Blinded

scholarly journals Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: Long-term results of a prospective cohort study

Burns ◽  
2020 ◽  
Author(s):  
Catherine M. Legemate ◽  
Pauline J. Ooms ◽  
Nicole Trommel ◽  
Esther Middelkoop ◽  
Margriet E. van Baar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Skin Grafting ◽  
Long Term Results ◽  
Burn Patients ◽  
Split Skin Grafting ◽  
Patient Reported ◽  
Scar Quality ◽  
Split Skin

scholarly journals Course of scar quality of donor sites following split skin graft harvesting: Comparison between patients and observers

2020 ◽  
Vol 28 (5) ◽  
pp. 696-703
Author(s):  
Catherine M. Legemate ◽  
Pauline J. Ooms ◽  
Nicole Trommel ◽  
Harold Goei ◽  
Ymke Lucas ◽  
...  
Keyword(s):  
Skin Graft ◽  
Split Skin Graft ◽  
Scar Quality ◽  
Split Skin

scholarly journals Treatment With Oxygen-Enriched Olive Oil Improves Healing Parameters Following Augmentation-Mastopexy

2021 ◽  
Author(s):  
Adriano Santorelli ◽  
Marco Bernini ◽  
Lorenzo Orzalesi ◽  
Stefano Avvedimento ◽  
Paolo Palumbo ◽  
...  
Keyword(s):  
Olive Oil ◽  
Single Center ◽  
Surgical Wound ◽  
Surgical Scar ◽  
Scar Assessment ◽  
Lower Pain ◽  
Aesthetic Results ◽  
Scar Quality ◽  
Augmentation Mastopexy

Abstract Background Breast augmentation-mastopexy can yield an aesthetically attractive breast, but the 1-stage procedure is prone to unsatisfactory outcomes, including poor wound healing. Objectives The authors evaluated whether postsurgical application of a polyurethane bra cup coated with oxygen-enriched olive oil (NovoX Cup; Moss SpA, Lesa, Novara, Italy) would decrease pain associated with augmentation-mastopexy and improve the quality of the surgical scar. Methods This retrospective study was conducted at a single center from January 2016 to June 2019. All patients underwent 1-stage augmentation-mastopexy with the inverted T incision. For 2 weeks postsurgically, wounds were dressed either with the oxygen-enriched olive oil bra or with Fitostimoline (Farmaceutici Damor SpA, Naples, Italy). Patients indicated their pain intensity on postoperative days 2, 3, and 10, and patients and independent observers scored scar quality on the Patient and Observer Scar Assessment Scale (POSAS) 6 and 12 months after the procedure. Results A total of 240 women (120 per study arm) completed the study. All the patients had satisfactory aesthetic results, and there were no tolerability concerns with either postoperative dressing. Compared with patients in the Fitostimoline group, patients who received the oxygen-enriched olive oil bra cup had significantly lower pain levels, and their surgical scars were given better scores on the POSAS. Conclusions The results suggest that maintenance of the surgical wound in a film of oxygen-enriched olive oil for 2 weeks is a safe, effective modality for suppressing pain and promoting healing following augmentation-mastopexy.

Assessment of Scar Quality after Cleft Lip Closure

2012 ◽  
Vol 49 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Franceline A. Frans ◽  
Paul P.M. van Zuijlen ◽  
J.P.W. Don Griot ◽  
Chantai M.A.M. van Der Horst
Keyword(s):  
Linear Regression ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Scar Assessment ◽  
Scar Quality ◽  
Cleft Lip Repair ◽  
A Prospective Study

Objective To assess scar quality after cleft lip repair. Design The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar characteristics were important according to patients and observer. Setting Regular outpatient follow-up visit with the cleft palate teams of two tertiary centers. Patients All consecutive patients were asked to participate in this study after informed consent, minimally 1 year postsurgery. Main Outcome Measure Scar characteristics influencing patient and observer opinion after cleft lip repair. Results A total of 86 patients with cleft lip with or without cleft palate were included, resulting in evaluation of 99 scars. Two scar characteristics, itching and pain, were seldom a concern for the patients. Linear regression showed that scars assessed longer after surgery had a better outcome. Conclusion Scar itching and pain did not seem to have an effect on patient opinion of the quality of the scar, and the majority of the patients were more satisfied with the outcome of their scar than the observer was.

Evaluation of 50 Donor Scars Undergoing Hair Restoration Using a New Cosmetic Surgery Scar Assessment Scale

2017 ◽  
Vol 35 (3) ◽  
pp. 124-129 ◽  
Author(s):  
Muhammad Ahmad
Keyword(s):  
Cosmetic Surgery ◽  
Single Layer ◽  
Assessment Scale ◽  
Average Score ◽  
Scar Assessment ◽  
Donor Area ◽  
Minimum Score ◽  
The Mean ◽  
Scar Score

The donor area scar is of utmost importance in strip-harvest hair restoration procedure. The proper assessment of the scar is important for the subsequent sessions. This study was undertaken to evaluate the quality of scar using a new Cosmetic Surgery Scar Assessment Scale (CSSAS). The study was conducted at a private hair restoration clinic. The patients undergoing first session were included. The width of the strip ranged from 15 to 20 mm. The donor wound was closed primarily using single-layer nonabsorbable 3-0 polypropylene suture and incorporating trichophytic closure. The stitches were removed on 11th postoperative day. The scars were assessed in daylight. The patients’ scars were assessed at 12th month using a self-developed scar scale which is comprised of 10 characteristics, each subdivided into 4 points (1-4), with a minimum score of 10 and maximum of 40. The higher scores represented poor scar, whereas the low scores represented good quality scar. A total of 50 patients were included. The mean age was 27.8 years. Most of the patients (56%) aged 31 years or more. The baldness pattern varied from Norwood type III to VII. The scars were assessed using the daylight. The average scar score was 14.3 out of 40. Majority of the patients (78%) had average score which was 15 or less. The maximum scar score achieved by the patients was 23 (4%). The newly developed CSSAS is very simple. It incorporates key features including the width and mobility of scar as well.

scholarly journals Protocol and Baseline Data of a Multicentre Prospective Double-Blinded Randomized Study of Intravenous Iron on Functional Status in Patients with Chronic Kidney Disease

2020 ◽  
Vol 51 (6) ◽  
pp. 493-500
Author(s):  
Sunil Bhandari ◽  
Victoria Allgar ◽  
Archie Lamplugh ◽  
Iain C. Macdougall ◽  
Philip A. Kalra
Keyword(s):  
Exercise Capacity ◽  
Heart Function ◽  
Well Being ◽  
Iron Treatment ◽  
Iv Iron ◽  
The Mean ◽  
Double Blinded ◽  
And Function ◽  
Minute Walk

Background: Iron deficiency (ID) is common in patients with chronic kidney disease (CKD) due to an inadequate dietary intake of iron, poor absorption from the gut and increased iron losses. In addition to preventing anaemia, iron is important for normal heart function, being involved in processes that generate a necessary continuous energy supply. Treatment with intravenous (IV) iron has been suggested to lead to improvement in heart function and well-being in people with ID and CKD. In the Iron and the Heart Study, we hypothesized that IV iron treatment will primarily improve exercise capacity and may secondarily impact the feeling of well-being in comparison to placebo over 3 months in non-anaemic CKD patients who have ID. Methods: This was a prospective double-blinded explorative randomized, multi-centre study designed to compare the effects of IV iron supplementation and placebo in iron-deficient but not anaemic patients with established CKD stages 3b-5 on functional status, and in addition cardiac structure and function. The study included 54 adults with serum ferritin (SF) <100 µg/L and/or transferrin saturation <20%, randomized in a 1:1 ratio to 1,000 mg IV ferric derisomaltose or placebo. Following randomization, participants underwent baseline assessments and then received IV iron or placebo infusion. Each participant was followed up at months 1 and 3. At each visit, patients underwent clinical review, measurements of hematinics and haemoglobin (Hb), and assessments of physical function and well-being. The primary outcome was exercise capacity using the 6-minute walk test. Secondary objectives included effects on hematinic profiles and Hb concentration, changes in myocardial parameters assessed with speckle tracking echocardiography and change in patients’ quality of life. Results: Between October 2016 and April 2018, 55 from 326 individuals from 3 UK centres attended screening and were randomized. The mean (SD) age was 59.6 (11.7) years, 26 (48%) patients were male, the majority were Caucasians (42; 78%), and 32 (59%) were non-smokers. The mean (SD) body mass index was 30.3 (6.5); SF was 66.3 (44.1) µg/L, TS was 20.1 (7.4) % and Hb was 128.7 (10.1) g/L at randomization for the whole group. Mean (SD) serum creatinine was 186.7 (58.6) µmol/L, estimated glomerular filtration rate was 31.1 (9.6) mL/min/1.73 m2 and urinary albumin and protein/creatinine ratios 60.9 (133.3) and 83.8 (128.4) mg/mmol respectively. The mean (SD) C-reactive protein was 5.0 (4.4) mg/L and the mean (SD) 6-minute walk distance at baseline was 401.2 (120.2) m. Conclusion: The Iron and the Heart Trial will provide important information on the short-term effects of IV iron treatment in CKD patients with ID without anaemia on measures of exercise capacity, quality of life and mechanistic data on myocardial structure and function. Trial Registration: European Clinical Trials Database (No. 2014-004133-6; REC no. 14/YH/1209; Sponsor ref. R1766).

scholarly journals Facial and Hand Scars Appearance after Autologous Nanofat Grafting in Patients with Post Burn Scars

2020 ◽  
Vol 34 (1) ◽  
pp. 25-29
Author(s):  
Muhammad Ali Rafique Mirza
Keyword(s):  
Fat Grafting ◽  
Skin Type ◽  
P Value ◽  
Burn Scar ◽  
Multiple Treatment ◽  
Scar Assessment ◽  
Scar Quality ◽  
The Mean ◽  
Surgery Department ◽  
Age Range

Introduction: Management of unsightly post -burn scars has changed tremendously in current era of cosmetic awareness. 5-12% of all worldwide injuries are burn injuries and approximately 11 million patients need hospital care. Multiple treatment methods for scar improvement including fat grafting are under investigation. Nano fat Grafting is newer modality of fat grafting for improving scar quality. Aims & Objectives: The aim of this study was to assess the outcome of facial and hand scars appearance after autologous Nanofat grafting in patients with post burn scars. Place and duration of study: The study was performed in Plastic Surgery Department of Shaikh Zayed hospital, Lahore Pakistan from October 2018 to September 2019. Material & Methods: 30 patients with post-burn scars of face and hands were included; age range was 18 to 43 years. Skin type 2 to 4 (Fitzpatrick skin type) . Patients with skin graft, hypertrophic scars, contractures, or keloids were excluded. Scars were assessed by the patients and observer on a scale “POSAS” (Patient and Observer Scar Assessment Scale), the observer was a plastic surgeon. Scar was assessed before surgery using the POSAS scar scale. Fat was taken from the abdomen using 3mm cannulas with side holes of 1- 2mm under tumescent conditions and transferred to 10 cc syringes with luer-lock. Nano fat obtained after emulsification by passing 30 times from one syringe to another through luer-lock. The follow up was on 7th day, at 3 months and at 6 months. Results: The mean POSAS score of observer decreased significantly from admission 35.8±4.0, at 3 months 31.3± 3.8 and 6 months to 27.5± 3.0, p value < 0.05. The mean POSAS score of patients also significantly decreased, p value < 0.05 over the same time period from admission at 42.4±5.2, to 3 month 37.3±4.0 and 6 month to 32.2±3.2. Conclusion: Nano fat grafting results in improvement in scar appearance and is an effective approach towards the management post burn scar of face and hands.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

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