In this article, we describe the case of a patient suffering from labial avulsion after a human bite, initially treated with direct closure and reconstructed surgically later on. Also, a brief summary of existent recomme...In this article, we describe the case of a patient suffering from labial avulsion after a human bite, initially treated with direct closure and reconstructed surgically later on. Also, a brief summary of existent recommendations in scientific literature about the management of bite wounds is provided.
In this study, absorption capacity of the most commonly used types of wound dressings was measured with an objective, quantifiable, and easily reproducible method. The use of objective measurements allowed us to perform...In this study, absorption capacity of the most commonly used types of wound dressings was measured with an objective, quantifiable, and easily reproducible method. The use of objective measurements allowed us to perform an objective comparison of the capacity of the different types of dressings. An experimental study was performed, in which the absorptive capacity of polyurethane foams, alginate, hidrofiber, and hydrocolloid dressings was measured by using a methodology designed by the researchers. Polyurethane foams showed a higher absorption capacity than hidrofibers, alginates, and hydrocolloids when using a similar surface of dressing. A modification of dressing size after saturation was also observed, increasing its size in the case of foams and decreasing or maintaining it in the case of hidrofibers, alginates, and hydrocolloids. The results of this study show a better wound exudate management for polyurethane foams. However, when deciding which dressing to use for a specific wound, absorption capacity is not the only quality that should be taken into account, as other properties should also be considered.
This was a pilot study to examine pre- and postoperative stress experienced by women who were undergoing autologous breast reconstruction and how stress might impact wound healing, specifically examining cytokines and ot...This was a pilot study to examine pre- and postoperative stress experienced by women who were undergoing autologous breast reconstruction and how stress might impact wound healing, specifically examining cytokines and other chemical mediators in the wound environment. A nonexperimental descriptive design over time was utilized. Participants were women who were undergoing autologous abdominal breast reconstruction for breast cancer (N = 20). Data were collected preoperatively and at 24, 48, 72, and 96 hr postsurgery. Complications were monitored intraoperatively and up to 30 days postsurgery. Psychological stress was measured with the 10-item Perceived Stress Scale (PSS), the Impact of Events Scale-Revised (IES-R), and a 100-mm Visual Analog Scale (VAS). Cytokines were assayed using the 27-plex kit with a Bio-Plex Plus. Although breast cancer is considered a stressor, in this sample of women, scores of the PSS, IES-R, and VAS showed that in fact these participants experienced low levels of psychological stress. All measured biochemical mediators in serum and wound fluid were detected and trends were identified. IL-1ra, IL-6, IL-8, G-CSF, IP-10, MCP-1, MIP-1β, RANTES, and VEGF were present in the highest concentrations. Significant changes in levels of cytokines in wound fluid were observed in IL-1β, IL-2, IL-5, IL-6, IL-8, IL-9, IL-10, IL-17, FGF-basic, G-CSF, MIP-1α, PDGF-bb, MIP-1β, RANTES, and TNF-α. The remaining cytokine concentrations stayed stable over time. These findings suggest that although these women were not experiencing high levels of stress, meaningful cytokine patterns were detected.
In rhinoplasty, one of the most popular aesthetic surgical procedures worldwide, several different techniques are utilized when performing a rhinoplasty procedure. Many complications can arise postoperatively depending o...In rhinoplasty, one of the most popular aesthetic surgical procedures worldwide, several different techniques are utilized when performing a rhinoplasty procedure. Many complications can arise postoperatively depending on the surgical approach and technique utilized. A method to reduce immediate postoperative complications has been identified. The use of different colored nasal splints for various surgical procedures could assist in identifying high-risk patients to the postsurgical recovery team and the clinical staff. In this prospective 10-year study, patients were divided into 2 groups. In Group I, the green-colored splint was applied to all patients, whereas in Group II, patients were divided into 3 subgroups. Patients undergoing rhinoplasty and septoplasty, rhinoplasty, and minimally invasive rhinoplasty were placed in Subgroup I, Subgroup II, and Subgroup III, respectively. Different survey questionnaires were designed for patients, the surgical team, the postsurgical recovery team, the follow-up care team, and the clinical staff. A total of 2,680 (88%) patients were females, whereas 332 (12%) patients were males. There was no significant difference in surgeon's responses between 2 groups (p > .05). Between the 2 groups, there was a significant difference in the postsurgical recovery team and the follow-up care staff (p < .001). Patients in Group II were significantly more aware of their conditions and possible complications (p < .001). The current study reveals that patients undergoing rhinoplasty should be identified through colored splints, particularly patients whose surgery accompanies a high possibility of complications. In such patients, colored splint is a red flag for surgical and postsurgical nurses and staff who are providing health care to patients.
Hidradenitis suppurativa (HS) is a painful and debilitating, chronic inflammatory disease affecting the skin bearing apocrine glands. HS causes painful abscesses and nodules that can eventually progress to interconnected...Hidradenitis suppurativa (HS) is a painful and debilitating, chronic inflammatory disease affecting the skin bearing apocrine glands. HS causes painful abscesses and nodules that can eventually progress to interconnected sinus tracts, scarring, and contractures of the skin. There is no definitive cure for HS, but multiple treatment strategies are available to patients. Treatments range from meticulous hygiene of the affected area to wide surgical excision of all involved tissue. This case study discusses the pathophysiology of the disease, severity staging, treatment options, and a patient case.
In many parts of the United States, a plastics-trained hand surgeon can be in limited supply. Depending on individual state law, nurse practitioners can manage common and moderately complex hand conditions, the undertaki...In many parts of the United States, a plastics-trained hand surgeon can be in limited supply. Depending on individual state law, nurse practitioners can manage common and moderately complex hand conditions, the undertaking of which requires extensive training, high command of the anatomy, and knowing when referral is necessary.
The ongoing positive aging trend has resulted in many research studies being conducted to determine the characteristics of aging and what steps we can take to prevent the extrinsic signs of aging. Much of this attention...The ongoing positive aging trend has resulted in many research studies being conducted to determine the characteristics of aging and what steps we can take to prevent the extrinsic signs of aging. Much of this attention has been focused on the prevention and treatment of facial wrinkles. To treat or prevent facial wrinkles correctly, their causative action first needs to be determined. published very compelling evidence that the development of wrinkles is complex and is caused by more factors than just the combination of poor lifestyle choices.
Looks matter! "Almost from the moment of birth, each of us is judged-silently, unconsciously, and nearly instantly on the basis of everything that goes into the mix of qualities known as "physical attractiveness" (). Agi...Looks matter! "Almost from the moment of birth, each of us is judged-silently, unconsciously, and nearly instantly on the basis of everything that goes into the mix of qualities known as "physical attractiveness" (). Aging may be one of the most foreseeable facts of life. As aesthetic providers, we routinely hear concerns about the effects of aging on our looks; it is important that we address these concerns. How do we set our client/provider relationship up for success by providing superb aesthetic solutions to the age-old challenges that we are faced with every day? Having an advanced clinical knowledge, a thorough aesthetic analysis, and an aesthetic plan specific to the client's needs ensure success. The aesthetic plan requires a shift from a two-dimensional to a three-dimensional approach as well as a shift from one product and/or procedure to combination therapy. Providing safe treatments, establishing trust, managing expectations, producing positive outcomes, and creating an engaging experience will ensure loyalty, future treatments, referrals, and a long-term client/provider relationship.
The risk of infection is a concern for all medical aesthetic industry and all providers. Steps to reduce the risk and improve patient outcomes begin with vigilance to proper aseptic technique and being less concerned abo...The risk of infection is a concern for all medical aesthetic industry and all providers. Steps to reduce the risk and improve patient outcomes begin with vigilance to proper aseptic technique and being less concerned about the "beauty image" to attract new patients. This article is based on the guidelines outlined in Infection Prevention and Control for Clinical Office Practice by Public Health Ontario.
Lip enhancement is a common injection treatment that may involve several different injection techniques based on the patient's goals, expectations, and facial anatomy. It is the aesthetic provider's professional judgment...Lip enhancement is a common injection treatment that may involve several different injection techniques based on the patient's goals, expectations, and facial anatomy. It is the aesthetic provider's professional judgment to determine which technique will provide the desired results. Taking the time to provide a thorough assessment, review the potential complications, and discuss expectations is an important step in building a patient-nurse therapeutic relationship. Understanding the anatomy and the supporting structures around the perioral area will improve the overall results of a lip enhancement treatment.
Many mainstream medications were derived from plants and originally utilized in patient management well prior to the extensive research and testing processes of current pharmaceutical standards. The evolution of therapeu...Many mainstream medications were derived from plants and originally utilized in patient management well prior to the extensive research and testing processes of current pharmaceutical standards. The evolution of therapeutic management within the pharmaceutical and skin care industry often uses synthetic processing of products with less of a focus on the natural ingredients from which they were originally derived. However, more recently there has been a shift in pharmacological management to include the therapeutic use of more holistic medicines and practices and thus a broadening of the uses of nontraditional medical treatment options. This has been seen in the use of treatments, such as Manuka honey, for skin conditions and dermal injuries. It is often with off-label uses, or conditions resistant to other treatments, that then prompt the use of holistic products and the true value of the product is validated. As with the following case study, the example of the use of Manuka honey on a severe atopic contact dermatitis eczematous reaction provides further documentation and supportive evidence of the potential efficacy of the properties of this particular natural product.
Steffen LE, Johnson A, Levine BJ
… +2 more, Mayer DK, Avis NE
Plast Surg Nurs
· 2017 · PMID 29210972
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The purpose of this study was to evaluate the prevalence of met and unmet expectations after breast reconstruction among breast cancer survivors following mastectomy. A secondary objective was to examine reasons women re...The purpose of this study was to evaluate the prevalence of met and unmet expectations after breast reconstruction among breast cancer survivors following mastectomy. A secondary objective was to examine reasons women report their experiences of reconstructive surgery were better or worse than expected. As part of a larger study of breast cancer survivors, participants completed self-administered questionnaires within 8 months of diagnosis and at 6, 12, and 18 months later. At the 18-month follow-up, women who had breast reconstruction were asked whether their reconstruction was better, the same, or worse than expected. The sample consisted of 130 survivors (mean age = 48.5 years) who had breast reconstruction following mastectomy and completed the 18-month follow-up, 42% of whom reported their reconstruction was worse than expected and only 25% reported it was better. Most frequently reported reasons for reconstruction being worse than expected were related to appearance of the reconstructed breast and pain. A high percentage of patients with breast cancer undergoing breast reconstruction following mastectomy reported the results as worse than expected, with the primary reasons for dissatisfaction related to the feel and appearance of the reconstructed breast. Patients with breast cancer considering breast reconstruction need better preoperative education or understanding about what to expect from reconstruction.
According to the American Society for Aesthetic Plastic Surgery (), the number of nonsurgical treatments grew 650% from 1996 to 2016. As these procedures have evolved and improved, so have their ability to deliver result...According to the American Society for Aesthetic Plastic Surgery (), the number of nonsurgical treatments grew 650% from 1996 to 2016. As these procedures have evolved and improved, so have their ability to deliver results that enhance one's natural beauty and reverse the signs of aging. Many patients seek these procedures in the hopes of looking younger and more refreshed, but "younger" can be subjective and the patient's desired outcome may be difficult for practitioners to interpret. A recent study () of 350 women found that patients are carrying around a "memory photo" of themselves that is about 10 years younger than their actual age. Findings from this survey yielded new insights into patient perceptions of age and provides practitioners with a powerful new tool that can be applied in daily clinical practice.
Many patients undergoing plastic surgery experience significant pain postoperatively. The use of preemptive, multimodal analgesia techniques to reduce postoperative pain has been widely described in the literature. This...Many patients undergoing plastic surgery experience significant pain postoperatively. The use of preemptive, multimodal analgesia techniques to reduce postoperative pain has been widely described in the literature. This quality improvement project evaluated the implementation of a preemptive, multimodal analgesia protocol in an office-based plastic surgery facility to decrease postoperative pain, decrease postoperative opioid consumption, decrease postanesthesia care time, and increase patient satisfaction. The project included adult patients undergoing surgical procedures at an outpatient plastic and cosmetic surgery office, and the protocol consisted of oral acetaminophen 1,000 mg and gabapentin 1,200 mg. Using a pre-/postintervention design, data were collected from patient medical records and telephone interviews of patients receiving the standard preoperative analgesia regimen (preintervention group: n = 24) and the evidence-based preemptive, multimodal analgesia protocol (postintervention group: n = 23). Results indicated no significant differences between the pre- and postintervention groups for any of the outcomes measured. However, results showed that patients in both groups experienced moderate to severe pain postoperatively. In addition, adverse side effects such as dizziness and drowsiness were higher in the postintervention group than in the preintervention group. Although this quality improvement project did not meet the goals it set out to achieve for patients undergoing plastic surgery, it did illustrate the substantial presence of pain after surgical procedures. Thus, clinicians need to continue to focus on identifying targeted treatment plans that use multimodal, non-opioid-based strategies to manage and prevent postoperative pain.
Postoperative pain occurs at a high incidence after day-case surgery, with many patients reporting moderate to severe pain. A cross-sectional design was used in this study to estimate the prevalence of postoperative pain...Postoperative pain occurs at a high incidence after day-case surgery, with many patients reporting moderate to severe pain. A cross-sectional design was used in this study to estimate the prevalence of postoperative pain in the early postoperative period after day-case surgery and to determine whether there is a relationship between demographic and clinical variables. A convenient sample of 300 patients, aged between 18 and 80 years, was selected from all postoperative patients after day-case surgery over a period of 6 months. At the first 2 hr after surgery, about 70% of patients had either no pain or mild pain at rest and about 30% of patients had moderate to severe pain. About one third of these patients (103; 35.8%) reported mild pain, and about 43% of patients had moderate to severe pain on movement in the first 2 hr after surgery. Furthermore, 25.3% and 41.3% of the patients reported moderate to severe pain during the first 24 hr after hospital discharge at rest and on movement, respectively. Female patients had significantly higher pain scores than male patients (p < .001). Significant decrease in pain scores was reported in the first 2 hr after surgery (mean = 2.2, SD = 2) and within the first 24 hr after discharge (mean = 1.8, SD = 2.2, t(288) = 4.3, p =. 005) at rest. The prevalence of pain among postoperative patients after day-care surgery in Jordan is high. Young adult and female patients have higher pain scores after day-case surgery.