Successes and lessons learned after more than a decade of upper extremity and face transplantation

2013 ◽  
Vol 18 (6) ◽  
pp. 633-639 ◽  
Author(s):  
Maria Siemionow ◽  
Bahar Bassiri Gharb ◽  
Antonio Rampazzo
Keyword(s):  
Upper Extremity ◽  
Lessons Learned ◽  
Face Transplantation

Lessons Learned in Delivering an Intervention to Engage Family in Home-based Upper Extremity Therapy

2020 ◽  
Vol 101 (11) ◽  
pp. e31
Author(s):  
Sarah Blanton ◽  
Patricia Clark ◽  
Theresa McLaughlin ◽  
Heather Stewart ◽  
Sandra Dunbar
Keyword(s):  
Upper Extremity ◽  
Lessons Learned ◽  
Home Based

scholarly journals Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients

2019 ◽  
Vol 119 ◽  
pp. 42-49 ◽  
Author(s):  
Cédric Lemogne ◽  
Frank Bellivier ◽  
Eric Fakra ◽  
Liova Yon ◽  
Frédéric Limosin ◽  
...  
Keyword(s):  
Lessons Learned ◽  
Face Transplantation ◽  
Long Term Follow Up

Reconstruction of the Upper Extremity High-Voltage Electrical Injury: A Pediatric Burn Hospital’s 13-Year Experience

2021 ◽  
Author(s):  
Matthew A DePamphilis ◽  
Ryan P Cauley ◽  
Farzin Sadeq ◽  
Martha Lydon ◽  
Robert L Sheridan ◽  
...  
Keyword(s):  
Upper Extremity ◽  
High Voltage ◽  
Burn Injury ◽  
Skin Grafting ◽  
Lessons Learned ◽  
Public Health Issue ◽  
Electrical Injury ◽  
Secondary Reconstruction ◽  
Chronic Skin ◽  
Tissue Sparing

Abstract High-voltage electrical injury is a rare yet destructive class of burn injury that persists as a serious public health issue. High-voltage exposure is commonly associated with complex wounds to the upper extremities, which can be a significant challenge for burn and plastic surgeons to reconstruct. This intensive and multistage reconstructive process is especially difficult in the growing child. Maximizing upper extremity function is a top priority, as it can have a significant impact on a patient’s quality of life. Therefore, this retrospective review describes lessons learned during a 13-year experience at a specialized pediatric burn hospital with reconstruction of the upper extremity after severe high-voltage injury in 37 children. We found that adherence to the following principles can help promote meaningful functional recovery. These include: (1) frequent assessment during early acute care for the evolving need of decompression or amputation, (2) serial surgical debridement that follows a tissue-sparing technique, (3) wound closure by skin grafting or use of flaps (particularly groin or abdominal pedicled flaps) when deep musculoskeletal structures are involved, (4) early multidisciplinary intervention for contracture prevention and management including physical and occupational therapy, splinting, and fixation, (5) secondary reconstruction that focuses on the simplest possible techniques to repair chronic skin defects such as laser therapy, local tissue rearrangements, and skin grafting, (6) complex secondary reconstruction to address deeper tissue contractures or tendon and peripheral nerve deficits, and (7) amputation with preservation of growth plates, soft tissue transfer, and long-term prosthetic management when limb salvage is unlikely.

scholarly journals Building a Hand and Upper Extremity Transplantation Program: Lessons Learned From the First 20 Years of Vascularized Composite Allotransplantation

Hand ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 224-233 ◽  
Author(s):  
Shaun D. Mendenhall ◽  
Stav Brown ◽  
Oded Ben-Amotz ◽  
Michael W. Neumeister ◽  
L. Scott Levin
Keyword(s):  
Upper Extremity ◽  
Patient Selection ◽  
Pediatric Patients ◽  
Surgical Techniques ◽  
Standard Of Care ◽  
Lessons Learned ◽  
Hand Transplantation ◽  
Transplantation Program ◽  
Recent Addition ◽  
Patient Selection Criteria

Background: Upper extremity transplantation is a quality-of-life enhancing treatment for select patients with upper extremity loss. This article reviews the preoperative, intraoperative, and postoperative challenges in the upper extremity transplantation process and the lessons learned from the first 2 decades of hand transplantation. Methods: Key components of the author’s hand transplantation protocol including patient selection, donor screening, surgical rehearsal, donor procurement, transplantation, immunosuppression, and patient outcome reporting/follow-up are reported to assist other teams who wish to establish a hand transplantation program. Results: There have been many advancements in the first 20 years of hand transplantation including better patient selection criteria, the recent addition of pediatric patients, improved surgical techniques such as the use of virtual surgical planning, and improved immunosuppression protocols. Improvement has also taken place in the tracking and reporting of hand transplant outcomes, but more work is clearly needed to fully define the benefits of transplantation, especially for pediatric patients. Conclusions: Over the past 20 years, significant progress has been made in upper extremity transplantation although a number of challenges remain including how to best document and share outcome measures, optimize immunosuppression, and diagnose/treat rejection. The authors encourage upper extremity transplant programs to report their experience and protocols to advance hand transplantation as standard of care for properly selected individuals.

scholarly journals Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned

2016 ◽  
Vol 5 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Lina V Mata ◽  
Marissa A Boeck ◽  
Kevin J Blair ◽  
J Esteban Foianini ◽  
Henry B Perry ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Trauma Registry ◽  
Capture Rate ◽  
Essential Elements ◽  
Lessons Learned ◽  
Santa Cruz ◽  
Middle Income ◽  
Preliminary Results ◽  
Trauma Registries ◽  
Icd 10

ABSTRACT Aim Five million annual global deaths are attributable to injuries. Yet, a lack of reliable data leaves the true magnitude of injuries unknown in many low- and middle-income countries (LMICs), like Bolivia. Trauma registries provide a means of acquiring these data. We sought to evaluate methodology, preliminary results, and lessons learned during the implementation of a pilot, hospital-based trauma registry at one facility in Santa Cruz de la Sierra, Bolivia. Materials and methods Data collection occurred from January to September 2015 at Clínica Foianini, a private, 50-bed, third-level facility in Santa Cruz. A paper trauma registry form based on the Panamerican Trauma Society's (ATS's) essential elements model was utilized. Trained nurses completed forms at a trauma patient's initial hospital presentation. Results were analyzed via descriptive statistics. Results The registry produced 91 forms over 8 months. An ICD-10 diagnosis code search of hospital visits showed 2,816 eligible patients, with a registry capture rate of 3.2%. Most were males (59.3%) in their mid-20s with head contusions (19.8%), penetrating/lacerating upper extremity (11.0%) or head (7.7%) wounds, or upper extremity fractures (6.6%). Many forms were missing critical data, with average omissions of 12.5 per form (26.0% of questions) and 23.7 per question (26.0% of subjects). Errors averaged 1.0 per form (2.1% of questions) and 2.0 per question (2.2% of subjects). Conclusion Early efforts to implement a paper-based trauma registry at one Bolivian hospital highlight areas for improvement, mainly within education, training, and oversight. Lessons learned will inform long-term objectives to make the registry a standard hospital program across the city, and eventually throughout Bolivia, arming decision-makers with data for targeted trauma initiatives that save lives. Clinical significance These results provide insight into trauma registry implementation in LMICs, which serves to further inform the Bolivian program and can be applied to comparable initiatives in similar settings. How to cite this article Boeck MA, Blair KJ, Foianini JE, Perry HB, Mata LV, Aboutanos MB, Haider AH, Swaroop M. Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned. Panam J Trauma Crit Care Emerg Surg 2016;5(2):101-112.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting

2020 ◽  
Vol 29 (3S) ◽  
pp. 638-647 ◽  
Author(s):  
Janine F. J. Meijerink ◽  
Marieke Pronk ◽  
Sophia E. Kramer
Keyword(s):  
Large Scale ◽  
Hearing Aid ◽  
Critical Discussion ◽  
Lessons Learned ◽  
Research Note ◽  
Support Program ◽  
Large Sample Size ◽  
Long Term Effects ◽  
Communication Program ◽  
Communication Partners

Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).

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