Background: Chronic venous leg ulcer reduces the patients' activities and their overall quality of life. Platelet-rich plasma (PRP) was previously investigated as promising less invasive management for leg ulcers.This study aims: To re-assess the efficacy and safety of PRP in the management of chronic leg ulcers due to venous factors.Patients/Methods: RCT enrolled 80 patients who clinically presented with chronic venous leg ulcers. Forty patients were allocated randomly for the treatment with autologous platelet-rich plasma (PRP). Intradermal and subdermal injection of PRP by 27guage syringe weekly, in all edges and in the granular floor of the ulcer for 4-6 sessions. Another 40 patients managed by conventional treatment by compression and dressing for the same period were allocated as Group B. Objective assessment achieved by the percentage of reduction of the size of the ulcer area, rate of healing, incidence of recurrence, and if side effects have been reported.Results: PRP therapy showed better results and high p value significance when compared to conventional therapy.
Conclusion:This study shows that PRP is effective and significant in promoting the wound healing process in chronic leg venous ulcers. PRP is simple, safe, and has a short learning curve technique.
Background: Local flabs and skin grafts are conventional methods of repair congenital syndactyly. Skin grafting for syndactyly repair is time consuming, has the potential risks of scar contracture and web creep and the results obtained are not always as functional and aesthetic as desired. In this article, we describe a graft-less surgical technique for web reconstruction in the correction of congenital simple syndactyly by using the dorsal metacarpal double winged advancement flab for web reconstruction with primary closure.
Patients and Methods:Between March 2016 and May 2017, 10 paediatric patients with 14 congenital simple sydactylies were reconstructed with the dorsal metacarpal double winged advancement flab. Complex syndactylies, Apert syndrome, Poland syndrome, traumatic and or post-burn syndactylies were excluded from the study. Operation time, intraoperative complications, early and late post-operative complications were followed-up clinically, and photographs were taken, including dorsal and volar views before and after the operation as well as at 2 month regular intervals for 1 year. The patient age ranged from 9 months to 48 months (median of 28.5 months). The minimum follow-up period was 12 months (range, 12-28 months; mean, 21.4 months).Results: The mean operation time was approximately 78 minutes (65-90min.) Soft tissue defects were closed primarily without skin grafting in all cases. All the flabs survived completely without early complications such as infection, vascular compromise or delayed healing. No occurrence of long-term complications including web creep, flexion contractures, angulation deformity, or abnormal scarring formation were found during the follow-up period. Cosmetical and functional satisfactory outcomes were achieved in all cases without secondary revision.
Conclusion:The dorsal metacarpal double winged advancement flab is a graft-less solution for web spac reconstruction is non-tight congenital simple syndactyly.
Background:In the open rhinoplasty technique, the soft tissue and ligaments are vulnerable to injury. Reconstruction of the ligaments is not performed routinely. The authors aimed to assess the effect of preservation of the nasal ligaments (ie, scroll, septocolumellar, and Pitanguy ligaments) in open-approach rhinoplasty. Methods: In this prospective cohort study, 32 patients underwent open rhinoplasty with ligament preservation after receiving precise training on five cadavers. Results: All patients had improved aesthetic and functional outcome in the early postoperative period with long-lasting preservation of tip projection and results. No patient needed secondary revision surgery for tip dropping or malrotation. The objective findings and subjective assessments were satisfying for the patients and surgeons. Conclusions: Refinements of nasal surgery have no limits. This study suggests that nasal ligament reconstruction, including of the scroll, septocolumellar, and Pitanguy ligaments, could maintain nasal tip projection and rotation for a long time.
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