Autologous Blood Versus Suture Conjunctival Limbal Graft as Pterygium Surgery Treatment

2019 ◽  
Vol 44 (2) ◽  
pp. 77
Author(s):  
Putu Budhiastra
Keyword(s):  
Retrospective Study ◽  
Visual Function ◽  
Autologous Blood ◽  
Healing Process ◽  
Graft Loss ◽  
Suture Technique ◽  
Corneal Surface ◽  
Ocular Irritation ◽  
Pterygium Surgery ◽  
Pterygium Excision

Introduction and Objective: A Pterygium is an elevated, superficial, external ocular mass that usually forms over the perilimbal conjungtiva and extends onto the corneal surface. A Pterygium can cause a significant alteration in visual function in advanced cases. It become inflamed, resulting in redness and ocular irritation. Pterygium excision surgery has been using many methods. There are three choices of method to attach the graft: by suturing, fibrin glue or autologous blood. The purpose of this study is to learn about the efficacy of autologous blood versus suturing conjungtival limbal graft (CLG) on pterygium excision surgery Methods: Retrospective study of 18 patients underwent Pterygium excision surgery with autologous blood gluing compared to suturing the graft. Six patients underwent CLG surgery with suturing and 12 patients were treated with autologous blood gluing. Suturing process was done with nylon 10-0 and the suture was released 7 days after surgery, whereas the graft on the patient with autologous blood CLG was placed and left there for about 10 minutes. Both groups were evaluated after day 1, 1st week, 2nd week and 1st month. Any report of irritating sensation, graft loss, and healing process were recorded thoroughly. Result: Patients with sutured CLG were complaining of uncomfortable sensation on their cornea until one week before suture was released, all grafts were attached until a month. Out of 12 patients with autologous blood CLG method, there were no complain of irritability on cornea until a week, 4 patients lost the graft on the first day, two patients grew granuloma on the second week, 10 patients start healing on the second week. Conclusion: There are still limitations to pterygium excision with autologous blood CLG compared to pterygium excision with CLG suture technique.

scholarly journals Releasable Suture versus Autologous Blood for Pterygium Surgery using Conjunctival Autografts

2020 ◽  
Author(s):  
Gautam Singh Parmar ◽  
Bhushan Ghodke ◽  
Ashok Kumar Meena
Keyword(s):  
Autologous Blood ◽  
Graft Loss ◽  
Patient Comfort ◽  
Duration Of Surgery ◽  
Pterygium Surgery ◽  
The Mean ◽  
One Year ◽  
Retrospective Comparative Study ◽  
Single Suture

Purpose: To evaluate the efficacy of releasable single suture (RS) for conjunctival autograft (CAG) and to compare it with sutureless gluefree (SG) technique in pterygium surgery. Methods: We conducted a retrospective comparative study on patients with primary pterygium who underwent CAG. In 150 patients, CAG was additionally secured by a single 10-0 nylon releasable suture (RS) which was released on the first postoperative day. In 47 patients, no suture was applied, and CAG was allowed to stick to the scleral bed by autologous fibrin only (SG group). The duration of surgery and size of CAG (in mm2) was noted in both groups. All patients completed one year of follow-up. Factors that were studied included graft stability, patient comfort, complications, and recurrence. Results: The mean age of patients in RS and SG groups was 39.6 ± 11.8 and 47.3 ± 13.8 years, respectively. The mean duration of surgery was 4.84 ± 1.34 min in RS group and 4.90 ± 1.42 min in SG group (P = 0.001). The size of CAG used in both groups was comparable with more stability in RS group postoperatively. Graft retraction rate in RS group was 5.3% (1 mm retraction in CAG more than 36 mm2) with no event of graft loss. The graft loss occurred in 6.3% of eyes in SG group. The recurrence rate in RS group was 4%, while in SG group it was 6.3% (P = 0.4). Conclusion: RS, by augmenting the autologous blood mechanism, may offer an easy-to-learn option for pterygium surgery with good stability even in large-sized CAGs.

scholarly journals Comparison between Autologous Blood and Fibrin Glue for Adhering Conjunctival Autografts after Pterygium Excision- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Mona Sune ◽  
Pradeep Sune
Keyword(s):  
Clinical Trial ◽  
Fibrin Glue ◽  
Autologous Blood ◽  
Randomised Clinical Trial ◽  
Mild Degree ◽  
Group A ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Group B

Introduction: Fibrin glue is a biological tissue adhesive and acts on the principle of final stages of the coagulation cascade. The cost of commercially available products is very high and not affordable for the patients of low socio-economic strata. As an alternative, pterygium surgery was done using patient’s own blood to adhere the conjunctival autograft to scleral bed by the process of coagulation of fibrin from the oozing blood from the blood vessels under the flap. Aim: To compare autologous blood and fibrin glue for adhering conjunctival autografts after pterygium excision. Materials and Methods: It was a randomised clinical trial. Total 97 subjects with primary pterygium who visited the Ophthalmology Department were randomised into two groups. In group A (n=31), patients had undergone pterygium excision wherein conjunctival autograft was attached by fibrin glue. In group B (n=66) the graft was attached by autologous blood present on the scleral bed. Mean operative time for the procedures were compared. Follow- up was done for 12 months and all subjects were examined for postoperative pain, foreign body sensation, inflammation, graft stability and recurrence. Results: The mean age of patients in group A was 48.32±14.3 years (21-65 years), and in group B was 54.48±15.67 (23-74 years). Mean operating time in group A was 23.21±9.4 minutes and 13.7±4.3 minutes in group B, (p-value=0.001). Postoperative pain of mild degree was present in all the 31 (100%) subjects of group A. In group B, pain was absent in 32 (48.5%) and mild degree in 34 (51.5%) subjects. No recurrence was found in both the groups. Mean follow-up period was 11.4 months. Conclusion: This study concludes that autologous blood is a useful alternative method for graft attachment in pterygium surgery without the untoward complications related to fibrin glue.

scholarly journals Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

2020 ◽  
pp. 7-14
Author(s):  
Suchita Singh ◽  
Prabha Sonwani ◽  
M. Shrivastava
Keyword(s):  
Autologous Blood ◽  
Suture Technique ◽  
Interventional Study ◽  
Surgical Time ◽  
Conjunctival Autograft ◽  
Department Of Ophthalmology ◽  
Pterygium Surgery ◽  
Group 5 ◽  
Conjunctival Autografting ◽  
Primary Pterygium

Aim: To compare the post-operative inflammation, surgical time and complications in conjunctival autografting with oozed autologous blood versus sutures in primary pterygium surgery. Study Design: Prospective interventional study. Place and Duration of Study: Department of Ophthalmology, CIMS, Bilaspur (C.G), India. (Jan 2017-May 2018). Methodology: 80 eyes of 80 patients (25 to 75 years) presented with primary pterygium up to grade 3 were included in this prospective interventional study presented in eye OPD, CIMS, Bilaspur (CG). All the procedures and post-operative evaluation was done by the same surgeon. All the patients were divided into two groups on alternate basis. 40 patients received conjunctival autografting with oozed autologous blood (CAGb) and 40 patients received sutures (CAGs). These two groups were then compared for post-operative inflammation, surgical time and complications (day 1, day 5, 2 weeks, 1 month and 3 month). Result: Total 80 patients were evaluated after surgery. Progressive pterygium was observed in more than 50% cases in both groups. Post-operative inflammation and discomfort was significantly lower in CAGb group compared to CAGs group (P<.001). Mean surgical time was also significantly less in CAGb group (11.6±2 min) compared to CAGs group (21.6±3min) (P<.001). In CAGb group 5% patients had graft displacement while none in CAGs group. Granuloma formation was higher in CAGs group (12.5%) compared to CAGb group (7.5%). Subgraft haemorrhage was 10% in CAGb and 17.5% in CAGs group. Dellen formation was seen in 3 patients in CAGb and 4 patients in CAGs. Recurrence rate was higher in suture group (5/40 in CAGs vs 1/40 in CAGb). Conclusion: Our study concludes that placement of conjunctival autograft with oozed autologous blood as adhesive after pterygium excision is an effective, less inflammatory and less time consuming approach, with significantly lower rates of post-operative complications. This can be used as a better alternative to suture technique.

scholarly journals PROPARACAINE;

2012 ◽  
Vol 19 (06) ◽  
pp. 872-876
Author(s):  
MUHAMMAD IMRAN SALEEM ◽  
MUHAMMAD FARHAN SALEEM ◽  
MUHAMMAD ARSHAD
Keyword(s):  
Computer Software ◽  
Topical Anesthesia ◽  
Eye Drops ◽  
Corneal Surface ◽  
Topical Anesthetic ◽  
Duration Of Surgery ◽  
Quasi Experimental ◽  
Vicryl Suture ◽  
Pterygium Surgery ◽  
Pterygium Excision

Objective: To evaluate the efficacy of proparacaine 0.5% as a topical anesthetic in pterygium surgery. Study Design: Quasi-Experimental study. Place and Duration: Eye Unit-II, Bahawal Victoria Hospital, Bahawalpur, from December 2010 to April 2011.Methodology: Thirty patients affected by primary pterygium underwent pterygium excision under topical anesthesia using proparacaine 0.5%eye drops. Pterygium excision was performed along with dissection of the degenerative conjunctival tissue, scraping of the corneal surface withsurgical blade No.15, meticulous dissection of the underlying Tenon's capsule, preparation of a free conjunctival graft from the superotemporalsector of healthy conjunctiva, and positioning of this graft to the area of bare sclera using 6/0 vicryl suture. Computer software SPSS (version10) was used to analyze the data. Results were considered statistically significant at p<0.05. Results: It was possible to perform all theprocedure under topical anesthesia using 0.5% Proparacaine eye drops without a need of supplemental subconjunctival or peribulbaranesthesia. Pain reported by the patients, recorded by a Visual Analog Scale (VAS) with 0-4 grades, and was mild to moderate during the entiresurgical procedure. Conclusions: Topical proparacaine 0.5% is a safe and effective anesthetic in pterygium surgery. The long lastinganesthesia with this agent permits performing the surgical procedure with low pain felt by the patients with a resultant low surgical invasivity anda short duration of surgery.

scholarly journals Pterygium Excision with Autologous Blood Autograft Fixation: Experience of a District Hospital of Bangladesh

2017 ◽  
Vol 29 (2) ◽  
pp. 46-50
Author(s):  
Md Mahmud Ul Huda ◽  
Sajed Abdul Khaleque
Keyword(s):  
Autologous Blood ◽  
Graft Loss ◽  
Self Control ◽  
Department Of Ophthalmology ◽  
Study Population ◽  
Grade Ii ◽  
Recurrent Pterygium ◽  
Pterygium Excision ◽  
Control Study ◽  
Conjunctival Hemorrhage

A prospective interventional self-control study to see the outcome of suture less and glue free limbal conjunctival autograft for the management of primary and recurrent pterygium was carried out using patient's own blood as a bio-adhesive to secure the graft in position, in the Department of Ophthalmology, 250 bedded General Hospital Jamalpur from 15.09.16 to 30.11.16 and followed up upto July 2017. A total of 48 cases (44 were primary nasal pterygium and 4 were recurrent pterygium) were included in the study. Regarding type of the pterygium, out of 48 patients 3(6.25%) were grade I, 21(43.75%) were grade II, 13(27.08%) were grade III and 11(22.92%) were grade IV. The mean age of the study population was 32±2 years. The male and female distribution was 18 and 30 respectively. All the eyes followed by bandaging for 24-48 hours and were examined for graft dislodgement, recession, edema sub-conjunctival hemorrhage. Out of 48 eyes only 1 (2.1%) had sub-conjunctival hemorrhage, 2 (4.2%) edema and 3 (6.3%) had graft recession after 24 to 48 hrs of operation. All the complications were resolved 1-2 month. There was no recurrence of pterygium. No recurrence, graft loss or granuloma was recorded. No other complication was noted. Suture less and glue free limbal conjunctival autografting following pterygium excision is an effective and safe option for the management of primary pterygium.Medicine Today 2017 Vol.29(2): 46-50

662 Single Surgeon Experience Using a Polyactide-based Copolymer Dressing to Over and Secure Split Thickness Skin Grafts in Burn Patients.

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S186-S187
Author(s):  
Eduardo Navarro ◽  
Tera Thigpin ◽  
Joshua S Carson
Keyword(s):  
Skin Graft ◽  
Outer Layer ◽  
Healing Process ◽  
Graft Loss ◽  
Total Body Surface Area ◽  
Surgeon Experience ◽  
Pain Outcomes ◽  
Total Body ◽  
Operative Notes

Abstract Introduction In both partial thickness burns and skin graft donor sites, coverage with Polylactide-based copolymer dressing (PLBC dressing) has been shown to result in expedited healing and improved pain outcomes when compared to more traditional techniques. These advantages are generally attributed to the way in which PLBC remains as an intact coating over the wound bed throughout the healing process, protecting wounds from the contamination and microtraumas associated with changes more conventional dressings. At our institution, we began selectively utilizing PLBC as a means of securing and protecting fresh skin graft, in hopes that we would find similar benefits in this application. Methods Clinical Protocol-- The PLBC dressing was used at the attending surgeon’s discretion. In these cases, meshed STSG was placed over prepared wound beds. Staples were not utilized. PLBC dressing was then placed over the entirety of the graft surface, securing graft in place by adhering to wound bed through intercises. (Staples were not used.) The graft and PLBC complex was further dressed with a layer of non-adherent cellulose based liner with petroleum based lubricant, and an outer layer of cotton gauze placed as a wrap or bolster. Post operatively, the outer layer (“wrap”) of gauze was replaced as needed for saturation. The PLBC and adherent “inner” liner were left in place until falling off naturally over the course of outpatient follow-up. Retrospective Review-- With IRB approval, patients treated PLBC over STSG between April 2018 to March 2019 were identified via surgeon’s log and pulled for review. Documentation gathered from operative notes, progress notes (inpatient and outpatient) and clinical photography was used to identify demographics, mechanism of injury, depth, total body surface area percentage (TBSA%), size of area treated with PLBC dressing, graft loss, need for re-grafting, signs of wound infection, antibiotic treatment, and length of stay. Results Twenty-two patients had STSG secured and dressed with PLBC. Median patient age was 36.5 years. Median TBSA was 5.1%, and median treated area 375 cm2. Follow up ranged from 21 to 232 days post-operatively, with two patients lost to follow up. All patients seen in outpatient follow up were noted to have “complete graft take” or “minimal” graft. None of the areas treated with PLBC dressing required re-grafting. There were no unplanned readmissions, and no wound infections were diagnosed or treated. Practitioners in in-patient setting and in follow up clinic reported satisfaction with the PLBC dressing. Conclusions The PLBC dressing was a feasible solution for securing and dressings STSGs. Future work is needed to determine whether its use is associated with an improvement in patient outcomes.

scholarly journals ROLE OF PLATELET RICH PLASMA IN TREATMENT OF CHRONIC NON-HEALING VENOUS ULCER

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Firdaus A. Dekhaiya ◽  
Jignesh K. Joshi ◽  
Sarav Bamania
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Healing Process ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Venous Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Adhesive Proteins ◽  
Autologous Platelet

Introduction: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the lower limbs. Considering that PRP is a source of growth factors, and consequently has mitogenic, angiogenic, and chemotactic properties, it represents an adjunctive treatment for recalcitrant wounds. Moreover, PRP provides the wound with adhesive proteins, such as fibrinogen, which are important in wound healing. PRP contain more amount of platelets, cytokines and growth factors which are dispersed in a very small amount of plasma which can be prepared from a sample of centrifuged autologous blood. Application of PRP has been reported to be effective in both acute as well as chronic non healing venous ulcers. Aim and Objective: To evaluate the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Material and Method: A Prospective study conducted on 100 patients of chronic venous ulcers admitted in Sir T. Hospital Bhavnagar from June 2018 to June 2019 after fulfilled our inclusion and exclusion criteria. PRP then injected intalesionally inside and around the periphery of the wound/ulcer. This process was done once/week for 12 weeks. At every week, the area and volume of ulcer was calculated and photographs were taken. Result: All the patients showed healing of the ulcer with reduction in size of ulcer more than 90% was observed in 72 patients, followed by 80–90% reduction in wound size in 18 patients after the 12 weeks follow-up. Overall, significant reduction in size of ulcer was observed in all the treated patients. Conclusion: Autologous platelet rich plasma (PRP) as an autologous method, it is biocompatible, simple, safe, affordable and less expensive procedure in the treatment of chronic venous ulcers. PRP is found to be useful in improving and enhancing the healing process in chronic venous leg ulcers without any side effect. Keywords:  Venous ulcer, Platelet rich plasma

Venous Thromboembolism and the Risk of Death and Graft Loss in Kidney Transplant Recipients

2017 ◽  
Vol 46 (4) ◽  
pp. 343-354 ◽  
Author(s):  
Ngan N. Lam ◽  
Amit X. Garg ◽  
Greg A. Knoll ◽  
S. Joseph Kim ◽  
Krista L. Lentine ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Venous Thromboembolism ◽  
General Population ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Risk Of Death ◽  
Increased Risk

Background: The implications of venous thromboembolism (VTE) for morbidity and mortality in kidney transplant recipients are not well described. Methods: We conducted a retrospective study using linked healthcare databases in Ontario, Canada to determine the risk and complications of VTE in kidney transplant recipients from 2003 to 2013. We compared the incidence rate of VTE in recipients (n = 4,343) and a matched (1:4) sample of the general population (n = 17,372). For recipients with evidence of a VTE posttransplant, we compared adverse clinical outcomes (death, graft loss) to matched (1:2) recipients without evidence of a VTE posttransplant. Results: During a median follow-up of 5.2 years, 388 (8.9%) recipients developed a VTE compared to 254 (1.5%) in the matched general population (16.3 vs. 2.4 events per 1,000 person-years; hazard ratio [HR] 7.1, 95% CI 6.0-8.4; p < 0.0001). Recipients who experienced a posttransplant VTE had a higher risk of death (28.5 vs. 11.2%; HR 4.1, 95% CI 2.9-5.8; p < 0.0001) and death-censored graft loss (13.1 vs. 7.5%; HR 2.3, 95% CI 1.4-3.6; p = 0.0006) compared to matched recipients who did not experience a posttransplant VTE. Conclusions: Kidney transplant recipients have a sevenfold higher risk of VTE compared to the general population with VTE conferring an increased risk of death and graft loss.

Sign in / Sign up

Export Citation Format

Share Document