Journal of Plastic Surgery and Hand Surgery最新文献

{"title":"Conservative treatment of traumatic finger amputations using negative-pressure wound therapy.","authors":"Yasushi Mizutani,&nbsp;Susumu Tamai,&nbsp;Toshifumi Nakamura,&nbsp;Yusuke Hagiwara,&nbsp;Takehiko Takita,&nbsp;Kenji Kawamura","doi":"10.2340/jphs.v58.18351","DOIUrl":"https://doi.org/10.2340/jphs.v58.18351","url":null,"abstract":"<p><p>Replantation is widely regarded as the first choice of treatment for finger amputations. However, if the fingertip of a traumatic finger amputation is missing after an injury, the following procedures are often performed to reconstruct this portion: flap surgery, stump surgery, or conservative treatment, including occlusive dressings. To our knowledge, no existing English literature reports using negative-pressure wound therapy (NPWT) to treat traumatic finger amputations. We postulated that NPWT may be applied as a conservative treatment for traumatic finger amputations, promoting the growth of granulation tissue and achieving early epithelialization of the fingertips. Among the case series of five patients, we included six injured fingers comprising two index, two middle, and two ring fingers. The fingertip of each traumatic finger amputation was either missing or highly crushed, making replantation impossible. To preserve finger length with conservative treatment, we adapted an NPWT device for finger amputations. It took an average of 22.7 days for the fingertips to epithelialize. Immediately after epithelialization, there was a slight decrease in sensory perception; however, all patients showed good recovery of sensory perception after 3 months. Range of motion remained unrestricted, with no reduction in grip strength. Patients were highly satisfied with their fingertip appearance. The regenerated nail exhibited slight deformation and shortening. No complications were observed. Our novel study regarding this new conservative treatment and its outcomes revealed that healing was achieved in a relatively short period; therefore, NPWT may serve as a new conservative treatment option in the future.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"115-118"},"PeriodicalIF":1.2,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expander prosthesis and DIEP flaps in delayed breast reconstruction: Sensibility, patient-reported outcome, and complications in a five-year randomised follow-up study.","authors":"Linda Tallroth,&nbsp;Nathalie Mobargha,&nbsp;Patrik Velander,&nbsp;Magnus Becker,&nbsp;Stina Klasson","doi":"10.2340/jphs.v58.13477","DOIUrl":"https://doi.org/10.2340/jphs.v58.13477","url":null,"abstract":"<p><p>Breast reconstruction is a given choice for many women following mastectomy. There are a multitude of methods available today, and thus, comparative studies are essential to match patients with suitable methods. The aim of this study was to compare 5-year outcomes following delayed breast reconstruction with expander prosthesis (EP) and with deep inferior epigastric perforator (DIEP) flaps. Seventy-three patients, previously randomised to either a permanent EP or a DIEP flap breast reconstruction, were invited for a 5-year follow-up. Assessments included symmetry measurements, breast sensibility with Semmes-Weinstein monofilaments and patient-reported outcome (PRO) with the BREAST-Q. Complications within the first 5 postoperative years were recorded. Additionally, BREAST-Q questionnaires were collected from non-randomised patients with an EP breast reconstruction. Between 2019 and 2022, 65 patients completed the follow-ups. Symmetry and PRO were significantly higher in the DIEP flap group. However, EP-reconstructed breasts were significantly more sensate and demonstrated areas with protective sensibility, unlike the DIEP flap breasts. The overall complication rates were comparable between the two groups (p = 0.27). Regression analysis identified body mass index as a risk factor for reoperation in general anaesthesia and for wound infection. No significant differences were found in a comparison of the randomised and the non-randomised EP groups' BREAST-Q results. This randomised 5-year follow-up study found PRO to be favourable following a DIEP flap reconstruction and sensibility to be better in EP reconstructions. The complication rates were comparable; however, longer follow-ups are warranted to cover the complete lifespans of the two breast reconstruction methods.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"101-109"},"PeriodicalIF":1.2,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of women with breast implants in Sweden: a study based on the population-based mammography screening programme.","authors":"Emma Hansson, Sarah Zaya, Susanne Meyer, Alexa Freiin von Wrangel, Fredrik Wärnberg, Sophia Zackrisson","doi":"10.2340/jphs.v58.15298","DOIUrl":"10.2340/jphs.v58.15298","url":null,"abstract":"<p><strong>Background: </strong>Knowledge about the prevalence of women with breast implants is paramount in calculations of risks and in estimations of effects on screening and breast cancer treatment. Most of the estimations of prevalence made to date are rough and often based on sales data. The main aim of this study was to  calculate the prevalence of breast implants in Swedish women. The secondary aim was to investigate if it is feasible to establish the occurrence of breast implants with the help of the public mammography screening programme, in a country with a publicly funded welfare-type healthcare system and with a clear documentation of screening.</p><p><strong>Methods: </strong>Information on implants was prospectively collected from all screening attendants from 1st of February 2022 to 1st of August 2022 based on a question from the radiographer to the woman and later verified on the mammogram.</p><p><strong>Results: </strong>During the study period 4,639 women were screened, of which 182 had implants (3.9%). The  frequency varies between 1.6 and 6.4% in different age groups.</p><p><strong>Conclusion: </strong>The prevalence of breast implants in Swedish women is estimated to be around 4%. The population-based mammography screening programme in countries with a publicly funded welfare-type healthcare system and a clear documentation of mammography screening attendance, seems to be a feasible way to establish the prevalence of breast implants in the population. The large number of women with breast implants warrants further studies regarding the best diagnostic and treatment alternatives for this group. Pre-registration: ClinicalTrials.Gov identifier NCT05222100.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"96-100"},"PeriodicalIF":1.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41099772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single or double Kirschner wire fixation: which provides better outcomes for pediatric proximal phalanx base fractures?","authors":"Chan Ju Park,&nbsp;Kyung Jin Lee,&nbsp;Jin Soo Kim,&nbsp;Sung Hoon Koh,&nbsp;Dong Chul Lee,&nbsp;Si Young Roh","doi":"10.2340/jphs.v58.13425","DOIUrl":"https://doi.org/10.2340/jphs.v58.13425","url":null,"abstract":"<p><strong>Purpose: </strong>The most common hand fracture in children is seen at the base of the proximal phalanx. This study aims to compare clinical outcomes of single versus double Kirschner wire pinning for pediatric proximal phalanx base fractures.</p><p><strong>Patients and methods: </strong>The retrospective study enrolled patients who underwent closed K-wire pinning for proximal phalanx base fractures from January 2016 to February 2022. We divided patients into two groups based on the number of K-wire inserted (single versus double). Demographics, removal of implant, complication rate were analyzed. Patients were asked to answer the Michigan Hand Outcomes Questionnaire (MHQ) by telephone. Data including fracture type, diaphyseal axis-metacarpal head angle (DHA) and Total Active Flexion Scale (TAFS) were analyzed.</p><p><strong>Results: </strong>This study included 37 pediatric patients with proximal phalanx base fractures, treated with either single (n = 10) or double K-wire (n = 27) fixation. The mean operation time was significantly shorter for the single K-wire group. No significant differences were observed in complication rates, TAFS, implant removal times, MHQ, or pre- and post-operative DHA between the two groups.</p><p><strong>Conclusion: </strong>The single K-wire technique demonstrates similar effectiveness to the double K-wire technique in treating pediatric proximal phalanx base fractures, with the added benefit of shorter operation time. Therefore, the choice between using one or two K-wires should be determined based on the surgeon's proficiency and preference.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"82-88"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10201037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of common conditions of the musician: a narrative review for plastic surgeons.","authors":"Daniel Chu, Sahand C Eftekari, Peter J Nicksic, Samuel O Poore","doi":"10.2340/jphs.v58.7314","DOIUrl":"10.2340/jphs.v58.7314","url":null,"abstract":"<p><p>Career-related injuries and disorders in professional musicians are prevalent across all their respective instruments and fields. They often endure long hours of intensive practice that demand high levels of precision, dexterity, and flexibility of their head, neck, hands, and upper extremities. Unlike the average patient, musicians are sensitive to even mild symptoms and deficits that can interfere with performance, which can potentially be career-threatening. Increasing attention to the care of musicians motivated performing arts medicine to tailor the practice to their individual and unique needs. Plastic surgeons are at the forefront of this practice; however, there are very limited reviews discussing plastic surgery management of the common injuries and disorders in musicians. This article reviews the most relevant literature of the past several decades regarding treatment modalities of the most common conditions endured by professional instrumentalists, with an emphasis on surgical considerations in the field of plastic surgery. A thorough literature search was performed for articles that encompass the interface between plastic surgery and musicians. We examined disorders of the head, ears, eyes, nose, throat, hands, and upper extremities including stress velopharyngeal incompetence, disruption of the embouchure, nerve entrapments, arthritis, traumatic injuries, focal dystonia, Linburg-Comstock syndrome, and overuse disorder. Overall, the goal of this review is to provide a summary of the existing and successful procedures performed to address prevalent musician conditions.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"89-95"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496518/pdf/nihms-1929720.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effectiveness of conservative management for lateral epicondylitis: a meta-analysis.","authors":"Qiaojie Chen,&nbsp;Pingping Shen,&nbsp;Bo Zhang,&nbsp;Yang Chen,&nbsp;Chunli Zheng","doi":"10.2340/jphs.v58.12333","DOIUrl":"https://doi.org/10.2340/jphs.v58.12333","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the long-term (>12 months) effectiveness of conservative management for lateral epicondylitis.</p><p><strong>Data sources: </strong>PubMed and Embase databases were searched for relevant studies from inception to March 2023.</p><p><strong>Study selection and data extraction: </strong>Only English-written randomized controlled trial (RCT) with data download as well as follow up ≥12 months were acceptable. Raw data were extracted into a predefined worksheet, and quality analysis was conducted based on the Cochrane risk-of-bias tool version 2 (RoB2).</p><p><strong>Data synthesis: </strong>The standardized mean difference (SMD) with 95% confidence interval (CI) were calculated.</p><p><strong>Results: </strong>Extracorporeal shock wave therapy (ESWT) could significantly relive pain for lateral epicondylitis patients in the long term (SMD: -0.19, 95% CI [-0.36, -0.02]); however, there was no significant difference between ESWT and control groups in long-term function outcome (SMD: 0.24, 95% CI [-0.02, -0.49]). No significant difference could be observed between (1) exercise and control groups in pain (SMD: -0.21, 95% CI [-0.60, 0.18]) or function (SMD: 0.06, 95% CI [-0.11, 0.23]), (2) corticosteroids and placebo groups in pain (SMD: 0.70, 95% CI [-0.43, 1.82]) or function (SMD: -0.02, 95% CI [-0.36, 0.31]), and (3) platelet-rich plasma (PRP) in pain (SMD: -0.30, 95% CI [-0.85, 0.25]) and function (SMD: -0.08, 95% CI [-0.78, 0.62]).</p><p><strong>Conclusion: </strong>The present conventional conservative management for lateral epicondylitis, with the exception of ESWT, a lack adequate evidence supporting their long-term effectiveness.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"67-73"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10069837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostical accuracy of hyperspectral imaging after free flap surgery.","authors":"Torsten Schulz, Rima Nuwayhid, Khosrow Siamak Houschyar, Stefan Langer, Lukas Kohler","doi":"10.2340/jphs.v58.7140","DOIUrl":"10.2340/jphs.v58.7140","url":null,"abstract":"<p><p>Microsurgical free-tissue transfer has been a safe option for tissue reconstruction. This study aimed to analyze the diagnostic accuracy of hyperspectral imaging (HSI) after free-tissue transfer surgery. From January 2017 to October 2019, 42 consecutive free-flap surgeries were performed, and their outcomes were analyzed via HSI. Clinical examination of free-flap perfusion was initially performed. Clinical examination findings were subsequently compared with those of HSI. Potential venous congestion with subsequent necrosis was defined as a tissue hemoglobin index of ≥53%. Student's t-test was used to compare the results of the analysis. The evaluation of sensitivity and specificity for flap failure detection was time dependent using the Fisher's exact test. A p-value of ≤0.05 was considered statistically significant. Microsurgical tissue transfer success rate was 84%. Seven patients presented with venous congestion that caused total flap necrosis. Overall, 124 assessments were made. HSI accurately identified 12 out of 19 pathological images: four as false positive and seven as false negative. The sensitivity and specificity of HSI were 57 and 94%, respectively, compared to those of clinical examination that were 28 and 100%, respectively, within 24 h following tissue transfer. The sensitivity and specificity of HSI were 63 and 96%, respectively, compared to those of clinical examination that were 63 and 100%, respectively, within the first 72 h. A tissue hemoglobin index of ≥53% could predict venous congestion after free-flap surgery. HSI demonstrated higher sensitivity than clinical examination within the first 24 h; however, it was not superior compared to clinical findings within 72 h.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"48-55"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10063086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of patient-reported achievements of goals and core outcomes with delayed breast reconstruction in irradiated patients: latissimus dorsi with an implant versus DIEP.","authors":"Jonas Löfstrand,&nbsp;Anna Paganini,&nbsp;Mattias Lidén,&nbsp;Emma Hansson","doi":"10.2340/jphs.v58.12417","DOIUrl":"https://doi.org/10.2340/jphs.v58.12417","url":null,"abstract":"<p><strong>Background: </strong>Different women's individual goals with a breast reconstruction vary, and few studies compare techniques in light of the different goals. This study aimed to compare patient-reported core outcomes in patients reconstructed with deep inferior epigastric artery perforator (DIEP) flaps and latissimus dorsi (LD) flaps. Second, breast-related factors that the patients were particularly satisfied/dissatisfied with were analyzed.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study, which includes women who had undergone mastectomy and radiation, followed by delayed breast reconstructions with either LD flap and implant or DIEP flap during 2007-2017. The patient-reported core outcomes of overall breast-specific quality of life, normality, women's cosmetic satisfaction, self-esteem, emotional well-being, and physical well-being were analyzed using BREAST-Q.</p><p><strong>Results: </strong>The patients were divided into LD and implant (n = 135 patients) and DIEP (n = 118 patients) groups, and both were demographically similar. The median follow-up was 8 years. The DIEP group scored significantly higher than the LD and implant group in five out of six domains. A high satisfaction was reported in questions regarding the feeling or appearance when having clothes on, whereas the greatest dissatisfaction was reported regarding questions entailing symmetry and the appearance without clothes.</p><p><strong>Conclusion: </strong>After 7 years, patients' breast-specific quality of life, normality, women's cosmetic satisfaction, self-esteem, emotional well-being, and physical well-being seem to be higher in irradiated patients who have been reconstructed with DIEP flap as compared to patients reconstructed with LD flap and implant. In both groups, patient satisfaction is high regarding their appearance when clothed, whereas the lowest satisfaction scores were reported in situations without clothing.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"74-81"},"PeriodicalIF":1.2,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10063629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple nerve transfers for the management of early unilateral facial palsy.","authors":"Jose E Telich-Tarriba,&nbsp;David F Navarro-Barquin,&nbsp;Genesis Pineda-Aldana,&nbsp;Alexander Cardenas-Mejia","doi":"10.2340/jphs.v58.6527","DOIUrl":"https://doi.org/10.2340/jphs.v58.6527","url":null,"abstract":"<p><strong>Background: </strong>Early onset facial paralysis is usually managed with cross-face nerve grafts, however the low number of axons that reach the target muscle may result in weakness or failure. Multiple-source innervation, or 'supercharging', seeks to combine the advantages of different donor nerves while minimizing their weaknesses. We propose a combination of cross-face nerve grafts with local extra-facial nerve transfers to achieve earlier facial reanimation in our patients.</p><p><strong>Methods: </strong>A retrospective cohort including all patients with early unilateral facial palsy (<12 months evolution) who underwent triple nerve transfer between 2019 and 2021 was conducted. We performed single-stage procedure including zygomatic-to-zygomatic and buccal-to-buccal cross-face grafts, a nerve-to-masseter to bucozygomatic trunk transfer, and a mini-hypoglossal to marginal branch transfer. Results were evaluated using the clinician-graded facial function scale (eFACE).</p><p><strong>Results: </strong>Fifteen patients were included (eight females, seven males), mean age at the time of surgery was 48.9 ± 13.3 years. Palsy was right-sided in eight cases. The mean time from palsy onset to surgery was 5.5 ± 2.8 months. Patients showed improvement in static (70.8 ± 21.9 vs. 84.15 ± 6.68, p = 0.002) and dynamic scores (20 ± 16.32 vs. 74.23 ± 7.46, p < 0.001), as well as periocular (57.33 ± 15.23 vs. 74 ± 7.18, p = 0.007), smile (54.73 ± 11.93 vs. 85.62 ± 3.86, p < 0.001), mid-face (46.33 ± 18.04 vs. 95 ± 7.21, p < 0.001) and lower face scores (67.4 ± 1.55 vs. 90.31 ± 7.54, p < 0.001).</p><p><strong>Conclusion: </strong>The triple nerve transfer technique using cross-face nerve grafts, the nerve-to-masseter, and the hypoglossal nerve, is an effective and reproducible technique to obtain middle and lower face reanimation in cases of early facial palsy.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":"62-66"},"PeriodicalIF":1.2,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An alternative to opioid-based intravenous patient controlled analgesia in severe burn patients undergoing full thickness split graft in upper limbs.","authors":"Bo-Fu Shih,&nbsp;Fu-Yu Huang,&nbsp;Shih-Jyun Shen,&nbsp;Chih-Wen Zheng,&nbsp;Chao-Wei Lee,&nbsp;Ming-Wen Yang,&nbsp;An-Hsun Chou,&nbsp;Shiow-Shuh Chuang,&nbsp;Hsin-I Tsai","doi":"10.2340/jphs.v58.12292","DOIUrl":"https://doi.org/10.2340/jphs.v58.12292","url":null,"abstract":"<p><strong>Background: </strong>Opioids provide good analgesic effect in burn patients during acute phase, but these patients may develop tolerance after prolonged exposure. Alternative analgesic strategies such as peripheral nerve blocks appear to provide adequate pain control while sparing opioid-related side effects. The purpose of this study was to evaluate intravenous patient-controlled analgesia (IV-PCA) and continuous peripheral nerve block (CPNB-PCA) in severe burn patients with relatively young age undergoing repeated debridement and large-area full thickness skin graft (FTSG).</p><p><strong>Methods: </strong>The records of victims in dust explosion in Taiwan in 2016 from Chang Gung Memorial Hospital Pain Service Database between 2016 June and 2017 December were evaluated. The patients' demographic data including age, gender, weight, burn area, degree of burn, type of PCA regimen (IV-PCA versus CPNB-PCA), size of FTSG, and adverse effects were collected.</p><p><strong>Results: </strong>The total in-hospital morphine consumption was significantly lower in CPNB-PCA than IV-PCA group. A trend of decrease in numerical rating scores (NRS) was observed for both groups and CPNB group had comparable NRS than IV-PCA group at rest. On movement, CPNB grouped had significantly lower NRS than IV-PCA on post-operative day 3.</p><p><strong>Conclusion: </strong>Our study demonstrated that in patients requiring high dosage of opioid, CPNB may be a suitable alternative for pain control.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"58 ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9916652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}