Closure of skin in surgical wounds with skin stapler and conventional sutures: a comparative study

Background: Application of suture is the technique of choice for apposition of skin edges in surgical wounds. The same procedure performed with application of staplers is faster and produce better cosmetic outcomes. A comparative study between conventional suture and stapler closure of skin in abdominal surgical wounds was undertaken to study the merits and demerits of the techniques. The aim was to study the time required for closure of surgical wounds, aesthetic outcome, post-operative complications and patient’s compliance.Methods: This was a single centre, prospective, observational study, conducted upon 100 patients undergoing abdominal surgeries. 50 patients were selected for skin closure of surgical wounds with stapler and the other 50 patients for closure with conventional nylon sutures. Data were collected for time required for closure of skin, aesthetic outcome, post-operative complications and patient’s compliance for both the groups for comparison. Data were analysed using student t test for comparison and chi square test of significance. Results: There was significant better results in stapler group in terms of cosmetic outcome (96% vs 88%, p<0.001), time taken during closure (60 vs 219 seconds, p<0.001) and patient’s compliance VAS of 1.44 vs 4.58 p<0.001).Conclusions: Closure of skin with stapler is a faster method. Patient’s compliance with stapler closure is better. It produces cosmetically acceptable scar and less discomfort or pain during its removal.

Aesthetic monitoring-based assessment of oncological safety of oncoplastic management of breast cancer: a multi-center research study

Background Oncoplastic Breast surgeries (OBS) in breast cancer have evolved to preserve the cancerous breast rather than its amputation to improve postoperative cosmetic results. The lack of evidence to support the oncological safety and benefits of OBS is questionable. In this study, we evaluate various aspects of oncoplastic surgeries with a focused monitoring of aesthetic results and oncological safety. Methods This was a multi-center observational study focused on the statistics of data collected from cases who underwent oncoplastic surgeries from the cohort of breast cancer candidates at Mansoura University Hospitals/Egypt and King Faisal Medical Complex/KSA from January 2015 to June 2018. All data were analyzed carefully using SPSS v-26. Results Eighty cases who underwent different oncoplastic surgeries were included and reviewed for the aesthetic outcome and oncological safety. The recurrence rate was found to be 2.5%. The breast impact treatment scale assessment method was used to analyze the aesthetic outcomes, and average scores were accepted in 90% of patients. Conclusions The oncoplastic breast surgeries are feasible and they had a high rate of oncological safety with the maintenance of good aesthetic outcomes and patient satisfaction.

Mimical Reconstruction And Aesthetic Repair of The Nail After Resection of Subungual Melanocytic Nevus

Background: The purpose of this study is to report the outcomes of mimical reconstruction and aesthetic repair of the nail.Methods: When the width of the pigmented bands was more than 1/2 of the whole nail width, the mimical reconstruction of the nail, the lateral toe pulp island flap covered the wound via the subcutaneous channel, was performed. If the width of the pigmented bands ranged from 1/4 to 2/5 of the entire nail, the aesthetic repair of the nail, the split-thickness excision under microscope, would be carried out.Results: The average age at the time of surgery was 14.5 years. The lesions were located at the toes in 5 patients and fingers in 3 patients. No complications occurred postoperatively. In 5 patients with the mimical reconstruction of the nail, all of toenail showed well-settled flap. In three patients with the aesthetic repair of the nail, there was no nail malnutrition or deformity, and all nails have an aesthetic appearance.Conclusions: Mimical reconstruction and aesthetic repair of the nail following resection of subungual melanocytic nevus is reliable and feasible. It seems to be satisfactory that “like tissue” repairs the complex nail defects. All patients obtain an excellent aesthetic outcome.Level of Evidence: V

Tucked and treated- a case series on outcome of meshplasty with abdominoplasty for incisional hernia

Incisional hernia is the second most common type of hernia. Incisional hernia occurs in 10-20% of patients who were subjected to abdominal surgery in India. Here we are presenting a case series of 20 patients with incisional hernia and obesity. Body mass index (BMI) ranges from 28 to 35 in all cases. Females outnumbered the male in the ratio of 4:1 and 40% of cases had a previous history of caesarean section. All cases were operated by combining open polypropylene meshplasty and abdominoplasty techniques and follow up consultations were done for 1 year. 10% of cases had post-op wound infections, who were known to be diabetic. They were managed with appropriate antibiotics and maintained strict glycemic control. 90% of patients were satisfied from the procedure performed which improved their quality of life, significant cosmetic outcome and no recurrence. 10% of cases had recurrence after heavy weight lifting following surgery (BMI was 36). By incorporating the above mentioned techniques in hernia repair, recurrence rate and complications were reduced, quality of life and aesthetic outcome are enhanced.