Australasian Journal of Plastic Surgery最新文献_第7页

Perioperative antibiotic prophylaxis in Australian burns patients 澳大利亚烧伤患者围手术期抗生素预防

Australasian Journal of Plastic Surgery Pub Date : 2022-03-31 DOI: 10.34239/ajops.v5n1.286

Patrick Lu, D. Holden, A. Padiglione, H. Cleland

{"title":"Perioperative antibiotic prophylaxis in Australian burns patients","authors":"Patrick Lu, D. Holden, A. Padiglione, H. Cleland","doi":"10.34239/ajops.v5n1.286","DOIUrl":"https://doi.org/10.34239/ajops.v5n1.286","url":null,"abstract":"Background: Perioperative antibiotic prophylaxis is perceived to reduce intraoperative bacteraemia and prevent surgical site infections, however, the evidence for its use in burns surgery is limited. Excessive use of perioperative antibiotics has become a growing concern. The authors aimed to audit the prescribing practices of perioperative antibiotic prophylaxis at the Victorian Adult Burns Service and determine whether the duration of antibiotic prophylaxis influenced the risk of postoperative wound infection, bacte-raemia and antibiotic resistance.\u0000Methods: This retrospective chart review included all acute adult burns patients who had an operation between November 2018 and November 2019. Basic demographic data, burn specific data and data on perioperative antibiotic use were collected. The outcome measures were wound infection, bacteraemia, other infections and presence of resistant organisms. \u0000Results: Results demonstrated that almost all patients (98.6%) received perioperative antibiotic prophylax-is. In comparison, there was no significant difference between the rate of postoperative wound infection, bacteraemia or antibiotic resistance between patients receiving a short or long course of antibiotics. \u0000Conclusion: The results of our study demonstrate variable use of perioperative antibiotic prophylaxis with-in one burns unit. There were many cases of unsubstantiated use of long courses of antibiotics without apparent benefit for clinical outcomes of wound infection or bacteraemia. With the growing concern over antibiotic overuse and development of resistance, there is an increasing need for development of clear guidelines for antibiotic use in burns surgery.","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126949162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microsurgical scalp reconstruction and cranioplasty refined 显微外科头皮重建和颅骨成形术完善

Australasian Journal of Plastic Surgery Pub Date : 2022-03-31 DOI: 10.34239/ajops.v5n1.292

Sonia Sinclair, Kiane J Zhou, J. Yip, S. Aggarwal, A. Jukes, Jonathan R. Clark, Brindha Shivalingham, S. Ch’ng

{"title":"Microsurgical scalp reconstruction and cranioplasty refined","authors":"Sonia Sinclair, Kiane J Zhou, J. Yip, S. Aggarwal, A. Jukes, Jonathan R. Clark, Brindha Shivalingham, S. Ch’ng","doi":"10.34239/ajops.v5n1.292","DOIUrl":"https://doi.org/10.34239/ajops.v5n1.292","url":null,"abstract":"Introduction: Microsurgical free flap scalp reconstruction is commonly the only reconstructive option in certain challenging patient cohorts. We describe the technical refinements that have streamlined our ap-proach to microsurgical scalp reconstruction and cranioplasty. \u0000Methods: Virtual surgical planning for multiple failed cranioplasty cases involves fashioning an implant with a 3 mm offset. Intramuscular dissection of the latissimus dorsi (LD) vascular pedicle, distal to its bifurcation, is routinely performed, and can increase pedicle length by up to 4 cm without the need for tedious dissec-tion in the axilla. Anastomoses to the superficial temporal vessels distal to their bifurcation in the parietal scalp are reliable and safe. The sequence of surgery is in reverse to the conventional sequence, with the free flap vascularised before craniectomy/cranioplasty is performed to decrease the duration of synthetic im-plant exposure. \u0000Results: Thirty-nine cases were performed in 35 patients over a five-year period. An LD-based free flap in various permutations was the commonest free flap option (n = 31). The superficial temporal artery and vein were choice recipient vessels in 82 per cent and 74 per cent of cases, respectively, with the former demon-strating higher anatomical consistency. Complications included free flap venous congestion successfully salvaged (n = 1), infected polymethylmethacrylate cranioplasty requiring explantation (n = 1), subdural haematoma requiring craniotomy for evacuation (n = 1) and free flap donor site haematoma (n = 2).\u0000Conclusion: Our technical refinements offer a streamlined and reliable procedure of complex scalp recon-struction and cranioplasty.","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132722000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

On randomised trials of surgical timings for cleft palate repair 腭裂修复手术时机的随机试验

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.217

S. Young, S. Lee, David Machin, S. Tan, Qingshu Lu

{"title":"On randomised trials of surgical timings for cleft palate repair","authors":"S. Young, S. Lee, David Machin, S. Tan, Qingshu Lu","doi":"10.34239/ajops.v4n2.217","DOIUrl":"https://doi.org/10.34239/ajops.v4n2.217","url":null,"abstract":"Background: In this article we review randomised controlled trials (RCTs) comparing palatal surgery at different ages to examine their design features and quantify their conclusions.\u0000Method: A literature search of RCTs comparing surgical timings for cleft palate and/or lip repair from 1 January 2004 to 31 December 2013 was undertaken. This supplements an earlier systematic review of 62 RCTs in cleft lip and palate from 1 January 2004 to 31 December 2013 in English using the Cochrane Central Register of Controlled Trials, MEDLINE® and EMBASE with key words ‘cleft lip’ or ‘cleft palate’.\u0000Results: Four RCTs were identified, each comparing palate surgery at different lower (six, nine and 12 months) and upper (12, 18 and 36 months) ages with velopharyngeal competence (VPC) also at different ages (three, four, more than four or five years). These surgical and assessment age differences prevent a synthesis using meta-analysis techniques. Nevertheless, three RCTs indicate that VP function is more impaired with later surgery. Two ask questions about the type of surgery; one suggests that VPC is greater with Furlow palatoplasty than von Langenbeck surgery and the other that one technique appears to have better VPC at six months and the other at 12 months.\u0000Conclusion: The role of the timing of palatal surgery with respect to VPC remains unclear. We propose an international strategy that is designed to establish the optimal age for palatal surgery in infants requiring palate and/or lip repair.","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122004860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Collaborative research in Australasian plastic surgery 澳大利亚整形外科的合作研究

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.337

Guy Hm Stanley, Melissa J. Hirth, Michael Findlay

引用次数: 0

How to do lower limb reconstruction using the keystone perforator island flap 如何应用楔状穿支岛状皮瓣进行下肢重建

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.341

F. Behan

引用次数: 1

Surgeon-driven preoperative psychiatric evaluation of plastic surgery patients 外科医生驱动的整形手术患者术前精神评估

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.253

Phillipa Van Essen, Natasha Keillor, Randall Long, N. Dean

{"title":"Surgeon-driven preoperative psychiatric evaluation of plastic surgery patients","authors":"Phillipa Van Essen, Natasha Keillor, Randall Long, N. Dean","doi":"10.34239/ajops.v4n2.253","DOIUrl":"https://doi.org/10.34239/ajops.v4n2.253","url":null,"abstract":"Objectives: Dissatisfaction with body image is common in patients seeking corrective plastic surgery. However, surgery may not be suitable for every patient. Surgery can enhance quality of life in mentally healthy patients but those with psychopathology such as body dysmorphic disorder (BDD) tend to have poorer outcomes. For these patients, surgery is not always recommended and psychiatric care can have a useful role. This paper aimed to estimate the rates of psychopathology in a select group of elective plastic surgery candidates and discuss the role of preoperative psychoplastic referral in triaging these candidates. \u0000Method: A retrospective cohort study of patients considering elective surgery at Flinders Medical Centre in South Australia referred by their surgeon for psychoplastic evaluation from 2010 to 2016. Medical records were reviewed to determine compliance with psychiatric referral, the number and types of psychiatric diagnosis and rates of subsequent surgery.\u0000Results: We found 83 per cent (54/65) of surgical candidates assessed by our psychiatrist had a mental illness. Post-traumatic stress disorder (n=19, 34.5%) and major depressive disorder (n=19, 34.5%) were most common. Nine patients (13.6%) were diagnosed with BDD. A total of 57 (87.7%) patients were considered to need some kind of psychiatric care to improve potential surgery outcomes. \u0000Conclusions: In our study, the rate of psychopathology in patients referred for psychiatric evaluation suggests that careful screening is important for clinical decision making. A combined surgical /psychiatric approach is effective in ensuring vulnerable patients are identified and managed appropriately.","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120941500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corneal neurotisation for neurotrophic keratopathy with a sural nerve autograft: a case report 自体腓肠神经移植治疗神经营养性角膜病变1例

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.236

David Moore, C. Samarawickrama, K. Tumuluri, Q. Ngo

引用次数: 0

Targeted muscle reinnervation in quadruple amputees: self-reported outcomes 定向肌肉神经移植在四肢截肢者:自我报告的结果

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.216

Emma-Leigh Rudduck, F. Bruscino‐Raiola, M. Angliss, S. Gray, D. Gow, Abby Hutchinson

引用次数: 0

South Australian facial trauma: a population analysis of social economic deprivation and facial fractures 南澳大利亚面部创伤:社会经济剥夺和面部骨折的人口分析

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.307

J. Diab, B. Grave, W. Flapper, P. Anderson, David David, Mark H. Moore

{"title":"South Australian facial trauma: a population analysis of social economic deprivation and facial fractures","authors":"J. Diab, B. Grave, W. Flapper, P. Anderson, David David, Mark H. Moore","doi":"10.34239/ajops.v4n2.307","DOIUrl":"https://doi.org/10.34239/ajops.v4n2.307","url":null,"abstract":"\u0000\u0000\u0000Background: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. Part one of this paper includes methods and results; part two includes discussion and conclusion. The two papers should be read together.\u0000Method: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January\u00002012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402].\u0000Results: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p<0.05). Orbitozygomatic fractures were the most common type of facial fracture (27.7%). Indigenous patients were more likely (OR=2.8) to have surgery compared to non–indigenous patients (p<0.05). There were no significant differences in length of stay between socioeconomic groups (F(4,964.387)=2.091, p = 0.080).\u0000Conclusion: Socioeconomic status strongly influences the mechanisms on injury, types of fracture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.\u0000\u0000\u0000","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"38 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123526629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The role of scar massage in cleft lip surgery 疤痕按摩在唇裂手术中的作用

Australasian Journal of Plastic Surgery Pub Date : 2021-09-29 DOI: 10.34239/ajops.v4n2.238

Leonardo Zandavalli Cordova, William Alexander, D. Chong

{"title":"The role of scar massage in cleft lip surgery","authors":"Leonardo Zandavalli Cordova, William Alexander, D. Chong","doi":"10.34239/ajops.v4n2.238","DOIUrl":"https://doi.org/10.34239/ajops.v4n2.238","url":null,"abstract":"\u0000\u0000\u0000\u0000Introduction: Despite advances in surgical technique for cleft lip, minimal evidence exists for methods of scar management, particularly scar massage. Some parents express concern that lip massage creates pain and distress to their children. This study aims to determine whether scar massage has enough cosmetic advantage to justify its use.\u0000Method: We reviewed 33 unilateral complete cleft lip repairs performed at our institution. Information on repair technique, suture material and scar management were recorded. Parent questionnaires and clinical photography were used with a panel of eight trained blinded observers asked to assess photos taken 24 months postoperatively. Scars were graded using a scale of 1 (very poor) to 5 (excellent). Twenty patients were included.\u0000Ethics approval was obtained from The Royal Children’s Hospital Melbourne Research Ethics and Governance office with HREC reference number QA/60562/RCHM-2019.\u0000Results: Frequency of scar massage was not associated with a better scar score (p= 0.36). Both the technique of repair and type of suture material used had greater effect on scar grading than massage therapy.\u0000Discussion: Problematic scarring following cleft lip surgery is a challenging outcome. This is the first study aiming to explore the effect of scar massage following cleft lip surgery.\u0000Conclusion: We found no conclusive evidence to support the use of scar massage in the postoperative care of cleft lip patients. Limitations include the retrospective nature of the study, low patient numbers and heterogeneity of surgical techniques. Nevertheless, there was no correlation seen between the frequency of massage and scar quality. Lip scar massage can cause significant pain to patients and distress to their family, warranting further studies to justify its use.\u0000\u0000\u0000\u0000","PeriodicalId":264055,"journal":{"name":"Australasian Journal of Plastic Surgery","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116136005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0