Ridge Preservation With and Without Primary Wound Closure: A Case Series

2013 ◽  
Vol 33 (1) ◽  
pp. 71-78 ◽  
Author(s):  
David M Kim ◽  
Nicola De Angelis ◽  
Marcelo Camelo ◽  
Marc L Nevins ◽  
Peter Schupbach ◽  
...  
Keyword(s):  
Wound Closure ◽  
Case Series ◽  
Ridge Preservation ◽  
Primary Wound Closure

scholarly journals A case series of profilometric changes in two implant placement protocols at periodontally compromised non-molar sites

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwantae Noh ◽  
Daniel S. Thoma ◽  
Jung-Chul Park ◽  
Dong-Woon Lee ◽  
Seung-Yun Shin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Case Series ◽  
Tissue Level ◽  
Ridge Preservation ◽  
Bone Augmentation ◽  
Implant Placement ◽  
Alveolar Ridge Preservation ◽  
Tissue Changes ◽  
Facial Area

AbstractInformation regarding profilometric changes at a soft tissue level following implant placement with different protocols is insufficient. Therefore, this study aimed to comparatively investigate the profilometric tissue changes with respect to late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites. Sixteen patients were randomly assigned to the following groups: implant placement 4 months post-ARP (group LP/ARP) and tooth extraction and implant placement 4–8 weeks post-extraction (group EP). Dental impressions were obtained immediately after final prosthesis insertion and at 3, 6, and 12 months. At the time of implant placement, bone augmentation was performed in the majority of the patients. Profilometric changes of the tissue contour were minimal between the final prosthesis insertion and 12 months in the mid-facial area (0.04–0.35 mm in group LP/ARP, 0.04–0.19 mm in group EP). The overall tissue volume increased in both groups (1.70 mm3 in group LP/ARP, 0.96 mm3 in group EP). In conclusion, LP/ARP and EP led to similar stability of the peri-implant tissue contour between the final prosthesis insertion and at 12 months. Moreover, the change of peri-implant tissue on the soft tissue level was minimal in both modalities.

659 Non-Burn Etiologies Treated with Autologous Skin Cell Suspension: A Case Series Demonstrating the Efficacy in Complex Wounds

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S195-S195
Author(s):  
Nicole M Kopari ◽  
Yazen Qumsiyeh
Keyword(s):  
Soft Tissue ◽  
Cell Suspension ◽  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Dermal Substitute ◽  
Wound Therapy ◽  
Skin Cell ◽  
Complex Wounds

Abstract Introduction Complex wounds (CW) resulting from necrotizing soft tissue infections (NSTIs) and soft tissue traumatic injuries create unique challenges. Radical debridement is often the first step in management but can result in disfigurement with impaired function and compromised cosmesis. The standard of care at our institution for full-thickness burn injuries of similar complexity is widely meshed autografting with application of autologous skin cell suspension (ASCS). Our study is a case series reviewing outcomes using ASCS for CW from non-burn etiology. Methods A retrospective chart review from March 2019 through July 2020 was performed to evaluate the effectiveness of ASCS and widely meshed autografting in CW. Patients presenting with CW underwent serial excisions of devitalized tissue by acute care and burn surgeons. Dermal substitute utilization for wound preparation was at the discretion of the surgeon. Definitive wound closure was achieved using ASCS in combination with a widely meshed autograft. The wounds were covered with a non-adherent, non-absorbent, small pore primary dressing along with bismuth-impregnated, petroleum-based gauze or negative pressure wound therapy dependent on wound bed contour. Further padding with gauze was applied along with compressive dressing. Results In total, 8 patients with CW were included in this review. The mean age was 58 years (range 27-85) with an equal number of males and females. Wound etiology included NSTI (n=5), degloving injury (n=2), and traumatic amputation (n=1). The average wound size measured 1,300cm2 (range 300-3,000). 50% of the patients were treated with a dermal substitute and negative pressure wound therapy prior to ASCS and autograft placement. 7 of 8 patients received split-thickness skin grafting in the ratio of 3:1 with one patient grafted at a 2:1 expansion. 7 of the 8 patients had >90% wound closure within 8-10 days of ASCS and autograft application. One patient had significant graft failure after removing surgical dressings and autograft in the early post-operative period secondary to dementia. One patient expired during the follow-up period secondary to medical comorbidities. The 6 remaining patients had durable wound closure and acceptable cosmetic outcome. All patients were discharged within 10 days of ASCS application with 4 patients discharging home and 4 patients discharging to an acute inpatient rehabilitation. Conclusions This study is the first case series to review ASCS in combination with widely meshed skin grafts in the management of CW from a non-burn etiology. Durable, timely wound closure and an acceptable cosmetic outcome was achieved in these often-challenging CW.

scholarly journals Early morbidity associated with fasciotomies for acute compartment syndrome in children

2018 ◽  
Vol 12 (5) ◽  
pp. 480-487 ◽  
Author(s):  
K. B. L. Lim ◽  
T. Laine ◽  
J. Y. Chooi ◽  
W. K. Lye ◽  
B. J. Y. Lee ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Compartment Syndrome ◽  
Wound Closure ◽  
Case Series ◽  
Skin Grafting ◽  
Acute Compartment Syndrome ◽  
Inpatient Stay ◽  
Wound Infections ◽  
Short Term ◽  
Level Of Evidence

Purpose Acute compartment syndrome (ACS) requires urgent fasciotomy to decompress the relevant muscle compartment/s prior to onset of irreversible myonecrosis and nerve injury. A fasciotomy is not a benign procedure. This study aims to describe and quantify early morbidity directly associated with fasciotomies for ACS in children. Methods Clinical charts of 104 children who underwent 112 fasciotomies over a 13-year period at a tertiary children’s hospital were reviewed. The following were analyzed: ACS aetiology, fasciotomy site, number of subsequent procedures, method of wound closure, short-term complications and length of hospital stay. Results Short-term complications included wound infections (6.7%) and the need for blood transfusion (7.7%). Median number of additional operations for wound closure was two (0 to 10) and median inpatient stay was 12 days (3 to 63; SD 11.7). After three unsuccessful attempts at primary closure, likelihood of needing skin grafting for coverage exceeded 80%. Analyses showed that fasciotomy-wound infections were associated with higher risk for four or more closure procedures. Number of procedures required for wound closure correlated with longer inpatient stay as did ACS associated with non-orthopaedic causes. Conclusion Fasciotomy is associated with significant early morbidity, the need for multiple closure operations, and prolonged hospital stay. The decision for fasciotomy needs careful consideration to avoid unnecessary fasciotomies, without increasing the risk of permanent injury from missed or delayed diagnosis. Skin grafting should be considered after three unsuccessful closure attempts. Less invasive tests or continuous monitoring (for high-risk patients) for compartment syndrome may help reduce unnecessary fasciotomies. Level of Evidence Level IV, Case series

Comparison of primary and delayed wound closure of dog-bite wounds

2013 ◽  
Vol 26 (03) ◽  
pp. 204-207 ◽  
Author(s):  
H. Xiaowei ◽  
X. Yunbei ◽  
L. Zhenhua ◽  
Y. Yeqing ◽  
Y. Jiaqi ◽  
...  
Keyword(s):  
Infection Rate ◽  
Primary Closure ◽  
Wound Closure ◽  
Systemic Infection ◽  
Dog Bite ◽  
Cosmetic Appearance ◽  
Primary Wound Closure ◽  
Bite Wounds ◽  
Delayed Closure ◽  
Closure Group

Summary Background: Primary bite wound suturing in the emergency department remains controversial in some cases. Objective: We conducted a study to investigate the infection rate and cosmetic appearance between primary wound closure and delayed wound closure in dog bite wounds in humans. Methods: All patients with bite wounds were treated with oral antibiotic medications. We adopted a randomized cohort study, dividing the patients who needed wound closure into two groups: 60 patients for primary closure, and 60 patients for delayed closure, and compared the infection rate and wound cosmetic appearance scores. Results: In the primary closure group, four people (6.7%) developed a wound infection without systemic infection. In the delayed closure group, three people (5%) developed a wound infection (p = 0.093), but there were not any patients that developed a systemic infection. Thirty-three patients (55%) in the primary closure group had optimal cosmetic scores, whereas 20 patients (33.3%) in the delayed closure group had optimal cosmetic scores (p = 0.012). Conclusion: Although primary wound closure for dog bites may be associated with a higher infection rate, the cosmetic appearance after primary closure was still acceptable.

scholarly journals Histological and morphometric aspects of ridge preservation with a moldable, in situ hardening bone graft substitute

2013 ◽  
Vol 65 (2) ◽  
pp. 429-437 ◽  
Author(s):  
M. Jurisic ◽  
Milica Manojlovic-Stojanoski ◽  
M. Andric ◽  
V. Kokovic ◽  
Vesna Danilovic ◽  
...  
Keyword(s):  
Porous Scaffold ◽  
Calcium Phosphates ◽  
Case Series ◽  
Bone Graft Substitute ◽  
Ridge Preservation ◽  
Woven Bone ◽  
Barrier Membrane ◽  
Morphometric Analyses ◽  
Implant Therapy

Biphasic calcium phosphates (BCP) are widely used in alveolar ridge regeneration as a porous scaffold for new bone formation. The aim of this case series was to evaluate the regenerative effect of the combination of BCP and polylactide-co-glycolide (PLGA) which can serve as a barrier membrane during bone regeneration. The study included five patients. Four months into the healing period, bone samples were collected for histological and morphometric analyses. The results of morphometric analysis showed that newly formed bone represented 32.2 ? 6.8% of the tissue, 31.9 ? 8.9% was occupied by residual graft and 35.9 ? 13.5% by soft tissue. Active osteogenesis was seen around the particles of the graft. The particles were occupied mostly by immature woven bone and connective tissue. The quality and quantity of newly formed bone, after the use of BCP/PLGA for ridge preservation, can be adequate for successful implant therapy after tooth extraction.

scholarly journals Evaluation of Preventive Treatment Protocols for Patients under Antiresorptive Therapy Undergoing Tooth Extraction at a Swiss University Clinic

2021 ◽  
Vol 18 (18) ◽  
pp. 9924
Author(s):  
Ellen Pick ◽  
Nicolas Leuenberger ◽  
Irina Kuster ◽  
Nicole Selina Stutzmann ◽  
Bernd Stadlinger ◽  
...  
Keyword(s):  
Tooth Extraction ◽  
Wound Closure ◽  
Oral Surgery ◽  
Preventive Treatment ◽  
Osteonecrosis Of The Jaw ◽  
Antiresorptive Therapy ◽  
Related Factors ◽  
Treatment Protocols ◽  
Primary Wound Closure ◽  
Mucoperiosteal Flap

Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing tooth extraction using preventive protocols at a Swiss university clinic. Data were retrospectively pooled from health records of patients having received a surgical tooth extraction between January 2015 and April 2020 in the Clinic of Cranio-Maxillofacial and Oral surgery, University of Zurich. A total of 970 patients received an extraction with flap elevation or wound closure during this period. A total of 104 patients could be included in the study. Furthermore, variables including age, gender, smoking, risk profile, choice, indication and duration of antiresorptive therapy, number of extractions, extraction site, surgical technique, choice and duration of antibiotics as well as the presence of postoperative inflammatory complications were assessed. Overall, 4 patients developed ARONJ (incidence of 3.8%) after tooth extraction at the same location, without previous signs of osteonecrosis. Preventive methods included predominantly primary wound closure using a full thickness mucoperiosteal flap and prolonged perioperative antibiotic prophylaxis. In accordance with current literature, the applied protocol showed a reliable outcome in preventing ARONJ when a tooth extraction is required.

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