Vol 7 No 2 (2024)
Published:
2024-07-01
Original Article(s)
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Introduction: Mediastinitis is an important complication of open heart surgery and other thoracic operations. Deep sternal wound complications significantly increase morbidity and mortality. The best treatment for deep sternal wound following sternotomy is still under discussion. Repeated irrigation and debridement of the wound and closed chest catheter irrigation with the recent addition of plastic surgery approach such as pectoralis major flap transposition are all valid options with their own supporters.
Materials and Methods: Due to the high prevalence of deep sternal wound infection (DSWI), we conducted this retrospective descriptive study using existing information to compare conservative method of repeated irrigation and debridement with pectoralis major flap transposition. We presented the results in a descriptive and analytic method. A total of 125 patient health record with deep sternal wound infection in a ten-year period (2003-2013) were evaluated.
Results: Results of this study proved that 83.2% of patients who developed DSWI after surgery, suffered from underlying diseases such as diabetes, renal failure, etc. though no relationship was found between the presence of underlying disease and recovery. Moreover, no significant relationship was observed between diabetes and recovery. Among 125 assessed files, 50 patients received pectoralis flap, among which 48 patients recovered with sternal stabilization and only 2 patients recovered without stabilization. On the other hand, among cases without pectoralis flapping, only 67 patients’ records were available of whom only 35 patients recovered with sternal stabilization while 32 patients recovered without sternal stabilization; the recovery was significantly enhanced in the group receiving flapping.
Discussion: The only factor which improved the outcome in our assessment was using pectoralis flapping which is consistent with the results of studies published in the recent years using plastic surgery methods, i.e. pectorals muscle or omentum flapping which is associated with high success rate and reduced length of in-patient stay
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Rectus sheath hematoma (RSH) is an accumulation of blood within the rectus sheath, secondary to rupture of the epigastric arteries. It is a rare condition, accounting for 1.6-1.8% of abdominal pain cases. It is more frequentlyo bserved in women, over the age of 50. Predisposing factors include the long-term use of anticoagulants, antiplatelets, steroids or immunosuppressants, prolonged INR, pregnancy, cardiovascular disease, hematologicaldis ease, hypertension, and diabetes. The symptoms are typically described as persistent and non-radiating acuteabdominal pain that classically worsens with movements involving the abdominal wall (Carnett’s sign). Cullen’ssigns (periumbilical ecchymosis) and Gray Turner’s signs (flank ecchymosis) may also be present. In stable
patients, the management is conservative. -
Background: One of the most dangerous complications of thyroid surgery is recurrent laryngeal nerve (RLN)
paralysis. The gold standard method to assess this damage is Videolaryngoscopy. However, we aimed to modify
this approach by using Translaryngeal Ultrasonography (TLUS). We performed TLUS with a highly trained
thyroid sonographer and an endocrine surgeon in 47 patients with recurrent thyroid cancer and unilateral RLN
paralysis preoperatively, and compared the results with Videolaryngoscopy. The experienced sonographer
identified 45 injuries in 47 patients, and the endocrine surgeon found 39 vocal cord injuries. It appears that
TLUS, when performed by experienced practitioners, is a more accurate and safe modality for assessing vocal
cord function in the preoperative setting of thyroid cancer reoperation -
Introduction: The popularity of breast reduction and abdominoplasty has increased significantly over the years according to statistics from the American Society of plastic surgeons 2022. As a result, Mommy Makeover, or the procedure combining breast surgery and abdominoplasty, is not uncommon.
Patients and methods: A retrospective descriptive study that took place over a four-year period within the plastic and aesthetic surgery department of the IBN SINA UNIVERSITY HOSPITAL, Rabat, Morocco.
Results: 5 cases of Mommy Makeover operated within the plastic and aesthetic surgery department of the IBN SINA UNIVERSITY HOSPITAL, Rabat, Morocco. One case a was addressed two years after bariatric surgery. The procedure combined Breast reduction with the superior-internal pedicle technique with Wise’s pattern and abdominoplasty. No major complication was observed.
Discussion: Since the appearance of abdominoplasties combined with breast surgery, several concerns are related to this association. Venous thromboembolism is the most commonly discussed consequence in combined plastic surgery procedures. The risk of venous thromboembolism is not elevated when abdominoplasty and breast reduction are combined.
The study emphasizes the significance of cautious patient selection and attentive venous thromboembolism prevention. assess the validity of the Davison-Caprini framework for venous thromboembolism risk stratification and prophylaxis in plastic surgery. Other measures to prevent complications were cited in the literature and followed by our operating team.
Conclusion: With the help of a simple risk stratification tool that takes into account diabetes, age, BMI and ASA status, we can guarantee favorable results for women who may want combined surgery.
Introduction: The popularity of breast reduction and abdominoplasty has increased significantly over the years according to statistics from the American Society of plastic surgeons 2022. As a result, Mommy Makeover, or the procedure combining breast surgery and abdominoplasty, is not uncommon.
Patients and methods: A retrospective descriptive study that took place over a four-year period within the plastic and aesthetic surgery department of the IBN SINA UNIVERSITY HOSPITAL, Rabat, Morocco.
Results: 5 cases of Mommy Makeover operated within the plastic and aesthetic surgery department of the IBN SINA UNIVERSITY HOSPITAL, Rabat, Morocco. One case a was addressed two years after bariatric surgery. The procedure combined Breast reduction with the superior-internal pedicle technique with Wise’s pattern and abdominoplasty. No major complication was observed.
Discussion: Since the appearance of abdominoplasties combined with breast surgery, several concerns are related to this association. Venous thromboembolism is the most commonly discussed consequence in combined plastic surgery procedures. The risk of venous thromboembolism is not elevated when abdominoplasty and breast reduction are combined.
The study emphasizes the significance of cautious patient selection and attentive venous thromboembolism prevention. assess the validity of the Davison-Caprini framework for venous thromboembolism risk stratification and prophylaxis in plastic surgery. Other measures to prevent complications were cited in the literature and followed by our operating team.
Conclusion: With the help of a simple risk stratification tool that takes into account diabetes, age, BMI and ASA status, we can guarantee favorable results for women who may want combined surgery.
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Objective:
The aim of this study is to investigate the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU at Shariati Hospital from 19 February 2020 till 19 February 2021
Methods:
Our study is a cross-sectional descriptive study . There are 81 patients that are enrolled in this study. We studied the lab reports including CBC parameters (WBC, neutrophils count, neutrophil percentage ) other inflammatory markers ESR and CRP and we also study the medical records of cases for collecting the details about age, gender , length of stay in SURGERY ICU, BMI, fever, survival status, comorbidity, intubation and NIV that was referred to Shariati hospital Tehran from 19 February 2020 (30-11-1398) till 19 February 2021(1-12-1399) regarding the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU.
The data obtained was analyzed by the SPSS software and the significance value of < 0.05 was considered.
Result:
In this study, the information of 81 patients was considered. The data comes from medical records of Shariati hospital, Tehran. We took 11 variables to compare data of different patients that were recorded in registry and system of medical records in Shariati hospital, Tehran.
This study population included 81 patients, out of which 41 were female patients and 40 were male patients from age 25 to 89. In total 80.2% had mild disease vs 18.5% who had severe disease . 65 patients survived and 16 were admitted to the SURGERY ICU with endotracheal intubation and later on died. The length of stay in SURGERY ICU is 1-25 days. Out of 81 patients 52 (62.4%)have comorbidity and 29 (35.8%) don't have comorbidity. 12 patients (14.8%) receive NIV and 69 patients (85.2%) don't receive NIV. Most of the patients don't have fever.
The minimum and maximum level of CRP are 4 and 416 respectively and for LDH are 9 and 2401 respectively.
The prognostic factors for the severity of COVID-19 infection identified in this study (CRP and LDH) help predict the course of the disease at an early stage. Elevated concentrations of CRP and LDH at admission were found to be associated with a higher risk for COVID-19 severity as they are significant (p-value =0.049 and 0.048 respectively).
Conclusion:
In this study laboratory investigation showed the SURGERY ICU patients to be having significantly higher values of inflammatory markers CRP and LDH than the non-SURGERY ICU patients. LDH and CRP were superior and an effective biomarker in predicting the severity of COVID-19.
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Background: Pharyngeal packing is now widely used in head and neck surgeries after induction of anesthesia. Therefore, the present study was designed to investigate the effect of pharyngeal packing on the occurrence of sore throat and other associated symptoms in comparison with patients without pharyngeal pack in orthognathic surgeries.
Materials and methods: This study was a randomized clinical trial and the target population was patients undergoing maxillofacial surgery hospitalized in two centers, Shafa and Shahid Bahonar Hospitals in Kerman. Sixty patients assigned to two groups, including the group with saline-soaked pack and the group without the pharyngeal pack, were evaluated for the severity of sore throat at time intervals of 2, 6, 12, and 24 hours after surgery as well as the occurrence of comorbid symptoms.
Results: There was no significant difference between the two groups in terms of demographic indicators, length of surgery, and length of recovery. The severity of sore throat at all-time intervals was significantly higher in the pharyngeal pack group in comparison to the control group. Other symptoms such as dysphagia, hoarseness, nausea and vomiting, laryngeal spasm, and cough were not significantly different between the two groups.
Conclusions: The findings of the present study showed that the use of pharyngeal was associated with an increase in the severity of sore throat but had no effect on the associated symptoms. These findings can be a guide to adopting the correct approach to the use of pharyngeal packs in patients undergoing maxillofacial surgery.
