scholarly journals Scrotal bridge flap reconstructive surgery for extensive penile paraffinoma: steps and outcomes from a single center: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Muhammad Arif Khairudin ◽  
Syahril Anuar Salauddin ◽  
Hamid Ghazali
Keyword(s):  
Reconstructive Surgery ◽  
Medical Records ◽  
Late Complication ◽  
Case Series ◽  
Complete Excision ◽  
Case Presentation ◽  
Flap Technique ◽  
Fibrotic Tissue ◽  
Operation Duration ◽  
The Mean

Abstract Background To describe our scrotal bridge flap technique in reconstructive surgery for extensive penile paraffinoma, a debilitating late complication of penile subcutaneous foreign material injection intended to achieve penile augmentation. Case presentation We reviewed the medical records of 10 patients who underwent reconstructive surgery with the scrotal bridge flap technique for penile paraffinoma at our center between 2016 and 2019. Complete excision of fibrotic tissue and the overlying skin was performed, and penile resurfacing was achieved by mobilizing the scrotal skin superiorly to wrap around the penile shaft, leaving a skin bridge at the median raphe. All 10 patients successfully underwent scrotal bridge flap penile reconstruction with satisfying results. The mean operation duration was 286.1 min (range 213–363 min). No immediate major complications were observed in any of the patients, and no patients required revision surgery. Conclusion The scrotal bridge flap technique is a reliable method for reconstructive surgery after the excision of penile paraffinoma.

scholarly journals Treatment of hallux rigidus with percutaneous arthrodesis

2018 ◽  
Vol 12 (2) ◽  
pp. 90-95
Author(s):  
Vitor Baltazar Nogueira ◽  
Miguel Viana Pereira Filho ◽  
Mauro Cesar Mattos e Dinato ◽  
Márcio De Faria Freitas ◽  
Rodrigo Gonçalves Pagnano
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Conventional Technique ◽  
Hallux Rigidus ◽  
Time Level ◽  
First Metatarsophalangeal Joint ◽  
The Mean ◽  
Pain Improvement ◽  
Consolidation Time

Objective: The objective of this study was to describe the percutaneous arthrodesis technique with single medial portal of the first metatarsophalangeal joint and to evaluate the results of a series of nine cases (10 feet) with a diagnosis of hallux rigidus subjected to this technique, comparing the results with literature data regarding the conventional technique. Methods: This was a retrospective, observational study performed by analysis of medical records and radiographs of nine patients undergoing percutaneous arthrodesis of the hallux metatarsophalangeal joint. Gender, age, consolidation time, level of postoperative pain and degree of patient satisfaction were evaluated. Results: Eight patients were female, and one patient was male. The mean age was 68.7 years, the mean consolidation time was 8 weeks, the consolidation ratio was 70%, there was pain improvement in the postoperative period, and all patients considered themselves satisfied with the surgery. Conclusion: Percutaneous arthrodesis of the metatarsophalangeal hallux joint potentially yields results similar to those of the conventional method demonstrated in the literature but uses smaller incisions.Level of Evidence IV, Therapeutic Studies, Case Series.

scholarly journals Smoking and Stroke in Appalachian Kentucky

2018 ◽  
pp. 1-4
Author(s):  
Dignan Mark ◽  
Dignan Mark ◽  
Kitzman Patrick ◽  
S Gutti Subhash ◽  
N Gutti Swathi ◽  
...  
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Eastern Region ◽  
Retrospective Case ◽  
Series Design ◽  
Stroke Prevalence ◽  
Appalachian Kentucky ◽  
The Mean ◽  
Stroke Type ◽  
Stroke Belt

This project used a retrospective case series design to investigate factors associated with stroke in a rural area in Appalachian Kentucky. The south-eastern region of the U.S. is often referred to as the ‘stroke belt,’ and includes the Appalachian region of the state of Kentucky. Data were collected from medical records of patients from a neurology practice and regional hospital with a diagnosis of stroke from March 2012 through November 2015. Data were collected without personal identifiers and included demographic characteristics, stroke type, treatments received, and referrals for additional care including rehabilitation. Data from a total of 84 stroke cases diagnosed between March 2012 and November 2015 were included. Of the 84 cases, 46 (54.8%) were female and all but one was Caucasian. The distribution by race is consistent with the population of the region. The stroke cases ranged in age from 41 to 92 (M=66.3) and the age at stroke diagnosis ranged from 40 to 90 (M=65.7). Fourteen (16.7%) had evidence of a previous stroke at diagnosis. For smokers, the mean age at diagnosis was 62.7 for smokers while for non-smokers it was 67.5. The study reported smoking rates that were nearly three-times the national average, and the smokers in this study were found to have stroke onset approximately five-years earlier than non-smokers. The results from this case series support the need for further investigation on stroke prevalence and factors contributing to continued risk for stroke in Appalachia.

scholarly journals Keystone-design perforator island flaps for the management of complicated epidermoid cysts on the back

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chi Sun Yoon ◽  
Hyo Bong Kim ◽  
Young Keun Kim ◽  
Hoon Kim ◽  
Kyu Nam Kim
Keyword(s):  
Postoperative Complications ◽  
Medical Records ◽  
Summary Score ◽  
Assessment Scale ◽  
Complete Excision ◽  
Epidermoid Cysts ◽  
Scar Assessment ◽  
Tension Change ◽  
The Mean ◽  
Surgical Modality

Abstract Complicated epidermoid cysts (ECs) occur commonly on the back, but few reports have described their management. We present our experience in managing patients with ECs on the back using a keystone-design perforator island flap (KDPIF) reconstruction, thereby focusing on reduction and redistribution of wound tension. Altogether, 15 patients (average age, 48.067 ± 14.868 years) underwent KDPIF reconstructions after complete excision of complicated ECs on the back. We retrospectively reviewed the medical records and clinical photographs of all patients. Final scar appearance was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). All patients had ruptured ECs, while 6 patients also had cellulitis of the surrounding tissues. All defects, after complete excision of ECs and debridement of surrounding unhealthy tissues, were successfully covered with KDPIF. The mean ‘tension-change’ at the defect and donor sites was −4.73 ± 0.21 N and −4.88 ± 0.25 N, respectively (p < 0.001). The mean ‘rate of tension-change’ at the defect and donor sites was −69.48 ± 1.7% and −71.16 ± 1.33%, respectively (p < 0.001). All flaps survived with no postoperative complications. The mean observer scar assessment scale (OSAS) summary score and patient scar assessment scale (PSAS) total score were 14.467 ± 5.069 and 15.6 ± 6.512, respectively. Overall, we suggest that KDPIF reconstruction is a good surgical modality for the management of complicated ECs on the back.

scholarly journals Management of adult spontaneous spondylodiscitis and its rising incidence

2015 ◽  
Vol 97 (6) ◽  
pp. 451-455 ◽  
Author(s):  
A Sur ◽  
K Tsang ◽  
M Brown ◽  
N Tzerakis
Keyword(s):  
Case Series ◽  
Intravenous Antibiotic ◽  
Case Presentation ◽  
Reactive Protein ◽  
Incidence Estimate ◽  
Management Guidance ◽  
Incidence Estimation ◽  
Rising Incidence ◽  
The Mean ◽  
Developed World

Introduction Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. Methods The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995–1999 and 2008–2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008–2011 patient cohort. Results The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995–1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. Conclusions Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.

scholarly journals Osteodiscitis Post- COVID-19 Infection: A Case Series

2021 ◽  
Author(s):  
Majid Rezvani ◽  
Amirhosein Zohrevand ◽  
Najmeh Namazee ◽  
Soheil Fallahpour ◽  
Saeid Saghaei ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Common Factor ◽  
Case Series ◽  
Case Presentation ◽  
Screw Insertion ◽  
Retrospective Assessment ◽  
Pedicular Screw ◽  
The Mean ◽  
Almost All ◽  
Clinical Conditions

Abstract Background: Coronavirus disease (COVID-19) is an infectious disease. It affects almost all organs of the human body. Lumbar osteodiscitis is an infection of the vertebral body and disc. The association of COVID-19 with osteodiscitis has not been reported in the literature so far. The purpose of this study was to describe a series of four cases manifested as post-COVID-19 osteodiscitis.Case presentation: We performed a retrospective assessment of the clinical, radiological, and microbiological features of adult post-COVID-19 patients who underwent surgery for unstable lumbar osteodiscitis at our hospital. The mean age of patients was 45.8±7.8 years. All the patients were treated according to their clinical conditions through a combined surgical approach as laminectomy, facetectomy, pedicular screw insertion, and fusion. The clear causes of infection were not recognized by routine methods, and COVID-19 was the only common factor in patients in the last 6 to 8 weeks.Conclusions: This case series suggest that osteodiscitis could be one of the possible side effects after COVID-19 infection.

scholarly journals Outcome of successful graft take of Integra and split thickness skin graft after the release of post-burn neck contracture.

2021 ◽  
Vol 28 (01) ◽  
pp. 106-112
Author(s):  
Abdul Malik Mujahid ◽  
Fraz Ahmed Tarar ◽  
Farrukh Aslam Khalid ◽  
Yawar Sajjad ◽  
Usman Ishaque ◽  
...  
Keyword(s):  
Skin Graft ◽  
Reconstructive Surgery ◽  
Case Series ◽  
Scar Tissue ◽  
Split Thickness Skin Graft ◽  
Skin Staples ◽  
Graft Take ◽  
Thickness Skin ◽  
Insignificant Difference ◽  
The Mean

Objective: To determine the frequency of the successful graft take of Integra™ and split thickness skin graft after the release of post-burn neck contracture. Study Design: Descriptive Case Series. Setting: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Lahore. Period: 1st October, 2017 to 30th September, 2018. Material & Methods: A total of 70 cases, those who full filled the inclusion criteria were included in the study through non-probability consecutive sampling. Informed consent was obtained from all the patient. Integra was applied in all the patients after the release of contracture and excision of scar tissue and was inspected every 3-5 days. After 3 weeks, the outer layer of silicone sheet was removed and replaced by thin split-thickness skin graft. The graft was secured with skin staples, absorbent gauze and the crepe bandage. All the patients were followed up regularly and the final outcome was assessed at 6 weeks. Results: The mean age of the patients was observed as 34.51 ± 14.19 years with age range of 11to 59 years. Among these 70 patients 61.4% were male and 38.6% were females. The mean body mass index was observed to be 22.59 + 3.68 kg/m2. Out of these 70 patients, the outcome in terms of successful graft take with Integra treatment was achieved in 60 (85.7%) patients. On stratification, statistically insignificant difference was observed for the effect modifiers like age, gender and BMI. Conclusion: In our study we found that Integra and STSG can be considered as one of emerging and promising modality in burn management and reconstructive surgery with the significantly high success rate in terms of complete re vascularization and skin graft take.

scholarly journals NSQIP as a Predictor of Length of Stay in Patients Undergoing Free Flap Reconstruction

OTO Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 2473974X1668569 ◽  
Author(s):  
Charles A. Riley ◽  
Blair M. Barton ◽  
Claire M. Lawlor ◽  
David Z. Cai ◽  
Phoebe E. Riley ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Head And Neck ◽  
Free Flap ◽  
Reconstructive Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Flap Surgery ◽  
Improvement Program ◽  
Free Flap Surgery ◽  
The Mean

Objective The National Surgical Quality Improvement Program (NSQIP) calculator was created to improve outcomes and guide cost-effective care in surgery. Patients with head and neck cancer (HNC) undergo ablative and free flap reconstructive surgery with prolonged postoperative courses. Methods A case series with chart review was performed on 50 consecutive patients with HNC undergoing ablative and reconstructive free flap surgery from October 2014 to March 2016 at a tertiary care center. Comorbidities and intraoperative and postoperative variables were collected. Predicted length of stay was tabulated with the NSQIP calculator. Results Thirty-five patients (70%) were male. The mean (SD) age was 67.2 (13.4) years. The mean (SD) length of stay (LOS) was 13.5 (10.3) days. The mean (SD) NSQIP-predicted LOS was 10.3 (2.2) days ( P = .027). Discussion The NSQIP calculator may be an inadequate predictor for LOS in patients with HNC undergoing free flap surgery. Additional study is necessary to determine the accuracy of this tool in this patient population. Implications for Practice: Head and neck surgeons performing free flap reconstructive surgery following tumor ablation may find that the NSQIP risk calculator underestimates the LOS in this population.

scholarly journals A comparative study for tension-reducing effect of Type I and Type II keystone perforator island flap in the human back

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chi Sun Yoon ◽  
Yu Taek Kong ◽  
Soo Yeon Lim ◽  
Junekyu Kim ◽  
Hyun Woo Shin ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Comparative Study ◽  
Reconstructive Surgery ◽  
Island Flap ◽  
Type I ◽  
Type Ii ◽  
Complete Excision ◽  
Tension Change ◽  
Before And After ◽  
The Mean

AbstractThe keystone perforator island flap (KPIF) is popular in reconstructive surgery. However, despite its versatility, its biomechanical effectiveness is unclear. We present our experience of KPIF reconstruction in the human back and evaluate the tension-reducing effect of the KPIF. Between September 2019 and August 2020, 17 patients (51.82 ± 14.72 years) underwent KPIF reconstruction for back defects. In all cases, we measured wound tension at the defect and donor sites before and after KPIF reconstruction using a tensiometer. All defects occurred after complete excision of complicated epidermoid cysts and debridement of surrounding tissues. The defects were successfully covered with Type IIA KPIFs. All flaps survived, and there were no significant postoperative complications. The mean “tension change at the defect after Type I KPIF” and “tension change at the defect after Type II KPIF” were − 2.97 ± 0.22 N and − 5.59 ± 0.41 N, respectively, (P < 0.001). The mean “rate of tension change at the defect after Type I KPIF” and “rate of tension change at the defect after Type II KPIF” were − 36.54 ± 1.89% and − 67.98 ± 1.63%, respectively, (P < 0.001). Our findings confirm the stepwise tension-reducing effect of KPIF and clarify the biomechanics of this flap.

scholarly journals Intraoperative and Postoperative Intraocular Lens Opacifications: Analysis of 42545 Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiaochen Wang ◽  
Xiaoming Wu ◽  
Yunhai Dai ◽  
Yusen Huang
Keyword(s):  
Intraocular Lens ◽  
Medical Records ◽  
Case Series ◽  
Retrospective Case ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Medical University ◽  
Hydrophobic Acrylic ◽  
Best Corrected Visual Acuity

Purpose. To assess the types and causes of intraocular lens (IOL) turbidity in a tertiary eye center. Setting. Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China. Design. Retrospective case series. Methods. Patients who underwent uncomplicated phacoemulsification and IOL implantation for cataract between January 2015 and December 2019 were included. Medical records were reviewed of participants with intraoperative or postoperative IOL opacification for clinical data, artificial crystal materials, and causes of the opacification. Results. A total of 42545 IOLs were implanted in the five years, comprising 25471 (66.0%) hydrophilic IOLs, 11881 (27.9%) hydrophobic IOLs, and 2601 (6.1%) hydrophilic-hydrophobic acrylic IOLs. Among the operated eyes, 14 eyes (13 patients) experienced IOL opacification, which was permanent for 10 IOLs, including 7 (0.6%) hydrophilic IOLs (860UV) and 3 (0.2%) hydrophilic-hydrophobic acrylic IOLs (L-312). The mean interval between surgery and diagnosis of permanent opacification was 34.4 ± 18.4 (SD) months (range, 12 to 59 months). Permanent IOL clouding led to a statistically significant reduction in best corrected visual acuity (mean, 0.64 ± 0.4 logMAR; P < 0 .004 ). Acute IOL clouding occurred in four eyes during the implantation of a hydrophilic-hydrophobic acrylic IOL of L-312, 809M, or 839M and returned to transparency several hours later. All four procedures were performed in winter, with the mean outside temperature being −5.75°C. Conclusions. The rate of IOL opacification was 0.03%. Both delayed postoperative and acute intraoperative opacifications occurred with various characteristics in IOLs made of different materials and designs. Clinicians should be aware of this risk for cataract surgery.

scholarly journals Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: A Case Series

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Su Jin Lee ◽  
Taehwa Kim ◽  
Woo Hyun Cho ◽  
Doosoo Jeon ◽  
Seungjin Lim
Keyword(s):  
Angiotensin Ii ◽  
Potential Benefit ◽  
Case Series ◽  
Angiotensin Ii Receptor Blockers ◽  
Angiotensin Ii Receptor ◽  
C Reactive Protein ◽  
Case Presentation ◽  
Reactive Protein ◽  
Receptor Blockers ◽  
The Mean

Introduction. Dysfunction in the renin-angiotensin-aldosterone system (RAAS) has been observed in patients with coronavirus disease 2019 (COVID-19). It is presumed that the effect of reducing interleukin-6 (IL-6) levels by angiotensin II receptor blockers (ARBs) by RAAS modulation. We investigated changes in angiotensin II and IL-6 levels in four COVID-19 patients treated with ARBs. Case Presentation. Cases 1 and 2 were who had not received ARBs before and were newly administered ARBs. Case 3 restarted ARBs after discontinuation for 7 days, and case 4 received an increased dose of ARBs. The mean in angiotensin II levels (607.5 pg/mL, range: 488–850 pg/mL, reference   range < 100   pg / mL ), C-reactive protein (CRP) (10.58 mg/dL, range 4.45-18.05 mg/dL), and IL-6 (55.78 pg/mL, range: 12.86–144.82 pg/mL, reference   range < 7   pg / mL ) was observed at the admission in all patients. Upon clinical improvement, the mean decrease in CRP (1.02 mg/dL, range 0.06-3.78 mg/dL) and IL-6 (5.63 pg/mL, range 0.17-20.87 pg/mL) was observed in all patients. Conversely, angiotensin II levels gradually increased. Conclusion. This report supports the potential benefit of ARBs to improve the clinical outcomes of COVID-19 patients by controlling RAAS dysfunction.

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