Eplasty最新文献

{"title":"Outcomes of Brachial Plexus Neurolysis in 40 Patients With Obstetric Brachial Plexus Injury.","authors":"Rahul K Nath, Chandra Somasundaram","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Severe traction injury to the brachial plexus (BP) during childbirth can induce the formation of intraneural scar tissue or neuroma in continuity. This can lead to nerve entrapment and demyelination, which inhibit axonal transport to the target muscles. Secondary complications include muscle weakness, contractures, joint deformity, and altered limb growth with prolonged and persistent disability. These patients find difficulty performing activities of daily living. BP neurolysis is one of the multistage reconstructive procedures in patients with obstetric brachial plexus injury (OBPI). The successful outcome of BP neurolysis is reported in patients with OBPI. We report improvements in all Mallet functional movements, including forearm supination angle (the Nath-modified Mallet), in 40 OBPI patients after BP neurolysis.</p><p><strong>Methods: </strong>Forty OBPI patients (25 female and 15 male with a mean age of 14 years, range 2-25 years; 29 on the right and 11 on the left) underwent BP neurolysis and follow-up evaluations with the lead author and surgeon (RKN). All these patients had undergone multiple previous surgeries, such as primary exploration, Botox, nerve transfer, humeral or forearm osteotomy, wrist tendon transfer, mod Quad, triangle tilt, and biceps tendon lengthening. Patients' pre- and postoperative shoulder functions were evaluated by the surgeon in the clinic and from photos/videos. These functional movements include shoulder abduction, external rotation, hand-to-mouth movement, hand-to-neck movement, and hand-to-spine movement, which score from 1 (no movement) to 5 (normal movement). In addition to the Mallet functional movements, the supination angle (the angle between the midline of the body and the tangential line to the palm with arms straight; neutral = 0, full supination = 90°, full pronation = -90°) was also evaluated and scored using the Nath-modified Mallet before and after BP neurolysis.</p><p><strong>Results: </strong>Of the 40 patients in this report, 37 (93%) achieved a Mallet grade of 5/5 (n = 23, 58%) or 4/5 (n = 14, 35%) in shoulder abduction after BP neurolysis. The other 3 patients had a Mallet grade of 3/5 (90 degrees) postoperatively in shoulder abduction. There was statistically highly significant improvement after BP neurolysis in shoulder abduction (3.9 ± 0.7 to 4.5 ± 0.6, <i>P</i> < .0001), external rotation (2.9 ± 1.0 to 3.8 ± 1.1, <i>P</i> < .0001), hand-to-mouth (4.2 ± 0.7 to 4.5 ± 0.7, <i>P</i> < .03), hand-to-neck (3.6 ± 0.8 to 4.2 ± 0.8, <i>P</i> < .0001), hand-to-spine (2.9 ± 1.1 to 3.4 ± 1.2, <i>P</i> < .004), forearm supination (3.8 ±1.1 to 4.2 ±1.0, <i>P</i> < .0001), the Nath-modified total Mallet score (21 ± 3.1 to 25 ± 3.3, <i>P</i> < .0001), including supination angle (40.5 ± 48.8 to 56.3 ± 41.6, <i>P</i> < .001). Improvement in the Nath-modified total Mallet functions was weakly associated with follow-up time after BP neurolysis (R = 0.17, <i>P</i> = .0003).</","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Intra-abdominal Adhesions and Uterine Scar Grade Based on Abdominal Scar Characteristics in Women With a Previous Cesarean Section: A Diagnostic Accuracy Study.","authors":"Vignesh Durai, Gowri Dorairajan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the relationship between cutaneous scar morphology and severe intra-abdominal adhesions and to predict uterine scar grade in repeat cesarean sections. It could be a valuable tool to plan elective repeat cesarean sections in patients with predicted weak uterine scars and also to have an experienced surgeon for repeat cesareans in patients predicted to have dense intra-abdominal adhesions.</p><p><strong>Methods: </strong>Preoperatively, the external scar was assessed using the Manchester score in 260 women. Intraoperatively, the Knightly score was used for adhesions at 5 different sites. The total adhesion score was categorized into scores ≤5 and >5 (severe adhesions). The uterine scar was graded using the Qureshi method and grouped into intact scar and weak scar (grades 3 and 4). Fischer exact and chi-square tests were used to compare the groups. The receiver operating characteristic curve calculated a cutoff score for predicting severe adhesions and weak scars.</p><p><strong>Results: </strong>Of the 260 patients, 63.5% had adhesions and 36.5% had no adhesions. The distortion of the skin scar had 71.3% specificity, and the texture had 84.8% sensitivity in predicting severe adhesions. Similarly, the texture had 72.2% sensitivity, and the distortion had 68.3% specificity in predicting weak uterine scar. A Manchester Scar Scale score of 9 includes the area under the curve of 0.72 for predicting severe adhesions and 0.62 for predicting weak uterine scar. A score of 9 was 66.6% sensitive and 66.5% specific, with a negative predictive value (NPV) of 93.2% for predicting severe adhesions. The same score was 55.5% sensitive and 65.1% specific, with an NPV of 90.1% for predicting weak uterine scar.</p><p><strong>Conclusions: </strong>A Manchester Scar Scale cutoff score of 9 has a high NPV for predicting severe adhesions and weak uterine scar. The texture had high sensitivity, and distortion had high specificity for predicting severe adhesions.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI in Cosmetic Surgery: A New Look at Virtual Abdominoplasty and Buttock Augmentation.","authors":"Arsany Yassa, Arya A Akhavan, Solina Ayad, Olivia Ayad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Online before-and-after photos commonly guide patient expectations in body contouring surgeries. However, recent artificial intelligence (AI) advancements allow for lifelike \"photos\" of hypothetical individuals, which patients can use in their decision-making. The accuracy of AI models, trained on divergent image sets, in showing realistic figures, cosmetic defects, and surgical outcomes is questionable. This study sought to evaluate the quality of these images.</p><p><strong>Methods: </strong>We utilized AI platforms GetIMG, Leonardo, and Perchance to create pre- and post-surgery visuals for abdominoplasty and buttock augmentation. Expert board-certified plastic surgeons and plastic surgery residents assessed the images across 11 criteria, focusing on realism and clinical value. ANOVA and Tukey honestly significant difference post-hoc tests were executed for data analysis.</p><p><strong>Results: </strong>Realism and clinical value scores among AI models (mean ± standard deviation) were not significantly different, indicating comparable performance (GetIMG 3.83 ± 0.81, Leonardo 3.30 ± 0.69, Perchance 2.68 ± 0.77; <i>P</i> > .05). Perchance significantly underperformed in size and volume accuracy (<i>P</i> = .02) and pathological feature recognition (<i>P</i> = .01 and .03). No consistent underperforming metric was identified when evaluated. The phenomenon of the \"uncanny valley\" was also identified.</p><p><strong>Conclusions: </strong>Despite some realistic and accurate surgical predictions, most AI-generated images were anatomically unrealistic, demonstrated inaccurate postoperative results, and invoked the \"uncanny valley\" effect. Given the uniformly poor performance, patients should avoid using these images for surgical decisions due to the potential of unrealistic expectations. Surgeons are advised to use real patient photos for consultations. Future research aims to compare AI images with actual before-and-after photos and include a bigger pool of experts for evaluation.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Case of Pediatric Lower Limb Verrucous Venous Malformation: Treatment Approach and Considerations.","authors":"Annie Chen-Carrington, Adam Goodreau, Brian J Strife, Laurie Shinn, Jennifer Rhodes","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Verrucous venous malformation (VVM) is a rare, congenital, low-flow vascular anomaly composed of capillaries and veins in the dermis and subcutaneous tissues. Diagnosis is difficult because knowledge of cases is rare and typically identified with sonographic imaging and elevated GLUT-1. Treatment is mired by high rates of recurrence and residual pain, with further enlargement upon resection or injury. Current management strategies include a combination of laser therapy, surgery, cryotherapy, and topical steroids, each with varying rates of success.</p><p><strong>Methods: </strong>The authors examine a case of confirmed VVM, which was initially treated with a candela pulsed dye laser and propranolol to no avail. A combination of surgical approaches were chosen.</p><p><strong>Conclusions: </strong>We now look to topical sirolimus 1% as an adjunct for this patient with residual lesions. Questions remain as to the effectiveness, optimal dose, and duration of topical sirolimus and whether this combination of surgical and topical intervention will be effective in the treatment for VVM.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmenting the Breast Reconstruction: Core Projection With Hybrid Microsurgical Breast Reconstruction With Flap and Stacked Prepectoral Acellular Dermal Matrix.","authors":"Anna E Daytz, Julia B Silverman, Raquel A Minasian, Susana Benitez Sanchez, Jina Yom, Christopher Aiello, Emma Robinson, Mark L Smith, Neil Tanna","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Many patients who require breast reconstruction prefer a flap-based approach for various reasons, including the permanence and aesthetic benefit of a breast that looks and feels natural. For patients who desire autologous breast reconstruction following mastectomy but lack adequate donor site volume, the authors utilize the novel hybrid flap, prepectoral acellular dermal matrix (HyPAD) approach. In this technique, the deep inferior epigastric perforator (DIEP) flap is augmented with a stacked acellular dermal matrix (ADM). The purpose of this study is to quantify the soft tissue augmentation and core projection achieved with this technique during autologous flap-based breast reconstruction.</p><p><strong>Methods: </strong>Consecutive patients who underwent the HyPAD technique during the study period (August 2021 to December 2022) were identified. All patients lacked adequate donor site volume and wished to avoid the placement of implants during their reconstruction. Demographic information and outcomes were assessed. Intraoperatively, the weights (g) of the mastectomy specimen, the flap donor site, and the stacked ADM were recorded.</p><p><strong>Results: </strong>During the study period, 21 patients (n = 21) were identified. The mean age of patients at the time of surgery was 48.9 ± 7.85 years. The mean body mass index was 24.1 kg/m² ± 3.3 kg/m². The mean mastectomy specimen weight was 436.35 g, and the mean flap weight was 370.73 g, posing an average discrepancy of 15.04% or 65.62 g. The average weight of the ADM used to augment the flap was 81.76 g. This weight accounted for an average of 18.07% of the total reconstructed breast weight.</p><p><strong>Conclusions: </strong>The use of ADM during autologous breast reconstruction provides patients with an alternative to implants that allows them to obtain their desired breast volume. Given the aesthetic impact that ADM has on the total amount of flap weight and projection, it is recommended that the HyPAD technique be considered for patients who desire a breast that cannot be restored with their own flap weight and wish to avoid implants.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen Matrix and Staged Skin Grafting for Plantar Reconstruction: Lessons Learned in Treatment of Palmoplantar Keratoderma.","authors":"Joowon Choi, Matthew A Applebaum, Mark E Feldmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Tissue defects of the weight-bearing surface of the foot are challenging wounds to reconstruct. Traditionally, skin grafting has had limited success in achieving both a durable and functional construct for ambulation. This case series describes a 2-staged approach to using a collagen bilayer matrix with subsequent skin grafting for plantar reconstruction in 3 sisters with palmoplantar keratoderma (PPK).</p><p><strong>Methods: </strong>Outcomes of 3 patients (ages 7, 13, and 15 years) who underwent plantar excisions of both feet for treatment of PPK were reviewed retrospectively. Data collection included tissue defect size, duration of non-weight-bearing activity, skin grafting technique, surgical complications, incidence of graft loss, total inpatient stay, and long-term functional status. Sensory outcomes were measured using Semmes Weinstein monofilament testing, along with patient-reported outcomes utilizing the Manchester-Oxford Foot Questionnaire (MOXFQ).</p><p><strong>Results: </strong>All 3 patients, totaling 6 feet, underwent plantar excisions of PPK. A collagen bilayer matrix was applied, followed by staged skin grafting (mean = 25.5 days between stages). Average total inpatient stay across treatment course was 2.6 days. There were 2 surgical site infections and 2 unanticipated returns to the operating room for excision of PPK recurrence. There were no incidences of graft loss. At an average of 6.9 years follow-up, all 3 patients had an intact reconstruction, preserved protective sensation, and normal gait and shoe-wear. Patient-reported ratings for foot pain varied from poor to excellent.</p><p><strong>Conclusions: </strong>A method of plantar reconstruction utilizing a collagen bilayer matrix and staged skin grafting is presented, demonstrating excellent long-term durability and functional outcomes.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e67"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of ChatGPT on the Plastic Surgery In-Training Examination.","authors":"Brielle E Raine, Katherine A Kozlowski, Cody C Fowler, Jordan D Frey","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Recently, the artificial intelligence chatbot Chat Generative Pre-Trained Transformer (ChatGPT) performed well on all United States Medical Licensing Examinations (USMLE), demonstrating a high level of insight into a physician's knowledge base and clinical reasoning ability.^1,2 This study aims to evaluate the performance of ChatGPT on the American Society of Plastic Surgeons (ASPS) Plastic Surgery In-Training Examination (PSITE) to assess its clinical reasoning and decision-making ability and investigate its legitimacy related to plastic surgery competencies.</p><p><strong>Methods: </strong>PSITE questions from 2015 to 2023 were included in this study. Questions with images, charts, and graphs were excluded. ChatGPT 3.5 was prompted to provide the best single letter answer choice. Performance was analyzed across test years, question area of content, taxonomy, and core competency via chi-square analysis. Multivariable logistic regression was performed to identify predictors of ChatGPT performance.</p><p><strong>Results: </strong>In this study, 1850 of 2097 multiple choice questions were included. ChatGPT answered 845 (45.7%) questions correctly, performing the highest on breast/cosmetic topics (49.6%) (<i>P</i> = .070). ChatGPT performed significantly better on questions requiring the lowest level of reasoning (knowledge, 55.1%) compared with more complex questions such as analysis (41.4%) (<i>P</i> = .001). Multivariable analysis identified negative predictors of performance including the hand/lower extremity topic (OR = 0.73, <i>P</i> = .038) and taxonomy levels beyond knowledge (<i>P</i> < .05). Performance on the 2023 exam (53.4%) corresponded to a 4th percentile score when compared with all plastic surgery residents.</p><p><strong>Conclusions: </strong>While ChatGPT's performance has shown promise in other medical domains, our results indicate it may not be a reliable source of information for plastic surgery-related questions or decision-making.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e68"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Response to Sirolimus in Patients with PIK3CA-Related Overgrowth Spectrum.","authors":"Jessica R Nye, Jackson C Green, Michael Talanker, Jose Barrera, Kate Richardson, Neethu M Menon, Adelaide A Hebert, Matthew R Greives, Autumn A Atkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><i>PIK3CA</i>-related overgrowth spectrum (PROS) is an umbrella term used to unify a heterogenous group of vascular overgrowth disorders by a shared genetic cause. Given that patients with PROS have a known, or likely, gene mutation in the PI3K/AKT/mTOR cascade, we hypothesize they experience a rapid response to inhibitors of this pathway, including sirolimus. In the following case series, we describe 3 patients with PROS and their response to sirolimus therapy. Despite their unique clinical presentations, insight into the genetic origin of their vascular overgrowth allowed for their successful treatment with the same medication.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e66"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of a Single-Institution Quality Improvement Initiative to Reduce Perioperative Blood Transfusion During Open Complex Cranial Vault Reconstruction.","authors":"Joshua M Wright, Molly F MacIsaac, S Alex Rottgers, Alexandra Miller, Jamie Fierstein, Lillian Zamora, Allison Fernandez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Craniosynostosis repair via open complex cranial vault remodeling (OCCVR) is a complicated surgical procedure associated with morbidity and blood loss, often requiring blood transfusion. The Pediatric Craniofacial Collaborative group created the Pediatric Craniofacial Surgery Perioperative Registry (PCSPR) to capture data relating to the perioperative management of children undergoing craniofacial surgery. A tertiary pediatric hospital implemented its own quality improvement (QI) initiative with the aim of reducing blood transfusion volumes and exposures in patients undergoing OCCVR. The initiative included preoperative iron supplementation, intraoperative use of cell saver and tranexamic acid, maintenance of normothermia, and restrictive transfusion protocols.</p><p><strong>Methods: </strong>Patients were included in the study if they had a diagnosis of craniosynostosis, were younger than 18 years, and underwent OCCVR. Patient demographics, comorbidities, and perioperative data were recorded using the PCSPR. Outcomes included blood transfusion volume, number of blood donor exposures, and intra and postoperative complications. Outcomes before and after the initiative were compared.</p><p><strong>Results: </strong>The median perioperative allogenic blood transfusion volume decreased from 35 mL/kg pre-QI to 24 mL/kg post-QI (<i>P</i> < .001). There was a significant decrease in the number of blood donor exposures, and the number of patients who experienced a transfusion-free perioperative period increased from 10.9% to 19.6% (<i>P</i> = .037). There were no observed differences in perioperative complications, hospital and intensive care unit length of stay, or mortality.</p><p><strong>Conclusions: </strong>This QI initiative has resulted in reduced blood transfusion volumes and reduced blood donor exposures without an increase in perioperative complications related to blood loss. Further multi-institutional research is necessary to create national standards for the anesthetic care of all patients undergoing OCVR.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e65"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Continuous Topical Oxygen Therapy in Combination to Optimize the Chronic Wound Environment Prior to Cellular, Acellular, and Matrix-Like Product Application: A Retrospective Case Series.","authors":"Naz Wahab, Windy Cole, Emma Woodmansey","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This retrospective case series details the use of a continuous topical oxygen therapy (cTOT) device for wound bed preparation prior to the application of cellular, acellular, and matrix-like products (CAMPs) on lower extremity wounds.</p><p><strong>Methods: </strong>A retrospective records review was conducted in a single outpatient wound care center. Treatment consisted of 2 weeks of cTOT followed by CAMP application. Weekly wound photos and measurements were obtained through chart review. Patients included in this study did not achieve complete wound closure within the 2-week cTOT treatment period and were transitioned to application of a CAMP as per standard practice at the lead author's clinic.</p><p><strong>Results: </strong>This study included 4 patients (5 wounds). The mean patient age was 71.8 years, and wound types included 3 diabetic foot ulcers (DFUs) and 2 venous leg ulcers (VLUs). The mean wound area reduction seen in this patient cohort was 74.7% and 76.1% at 4 and 6 weeks, respectively. Overall, a mean healing time of 8 weeks was noted across all wounds with a mean number of 6 CAMP applications.</p><p><strong>Conclusions: </strong>Wound healing should be approached in an algorithmic manner, starting with wound bed optimization. In this patient cohort cTOT proved to be an effective way to improve the quality of the wound bed, in addition to the standard cleansing and debridement, prior to CAMP application. The authors believe that this combination of topical methods might have synergistic effects and improve wound healing, and the results of this study support this assumption.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e64"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}