SUMMARY An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.
Background: Edward Talbot Ely (1850-1885) lived a tragically short life of 35 years, but at the age of 31 years, in 1881, he recorded the landmark case of the first otoplasty in the medical literature [10]. Prominent ears "Dumbo Ears" are probably the ear deformity that most people are aware of. Is a very common problem, and according to literature occurs in 5 % of the Caucasian population [1], causing bullying and reducing self-esteem, also leading to serious consequences for individuals social integration [2]. This paper describes a unique approach based on other available techniques developed to increase productivity and enhance performance. Methods: In 2014, a non-government organization was created specializing in Otoplasty for patients as young as 7 years old who have an aesthetical complaint or is a victim of bullying. Our technique corrects the 3 parts of the ear. The surgeries are performed in an outpatient setting with a minimal charge for material and medication. The procedure is done with local anesthesia and light sedation allowing maximum comfort for the patient and the surgeon. There is no hospitalization.
Many articles report that macrotia is a rare ear deformity, but this is not the reality that we encounter in our service. In accordance with anthropometric studies of the ears, we consider that an aesthetically normal ear measures 6.0 cm in length on the vertical axis and 3.7 cm on the horizontal axis in boys, with ear growth maturing at 13 years of age, and 5.91 cm in length on the vertical axis and 3.37 cm on the horizontal axis, with ear growth maturing at age 12 in girls. When the measurements exceed these averages, we consider that the patient has macrotia. The authors describe a new technique of surgical correction of macrotia that results in an average reduction of 1.7 cm on the vertical axis and 0.8 cm on the diagonal axis with an average surgical time of forty-five minutes, fast learning curve, and little scarring. This technique also allows it to be combined with otoplasty and correction of the lobe length. Because of these items we call the technique High-Performance Macrotia Surgery. Level IV: Evidence is obtained from multiple time series with or without the intervention, such as case studies.
Objectives This study proposes a new surgical alternative for the most common deformity in the ears, the so-called "protruding/prominent ears", which is a condition that affects 5% of the Caucasian population (Goulart et al. in Rev Bras Cir Plast 26:602–607, 2011). This technique comes with the benefits of reduced surgical time, shallow learning curve, and a low revision rate. Methods We studied a total of 213 patients with an indication for otoplasty from January 2020 to January 2021. Women made up 65% of the study population, while men made up 35%, with an average age of 21 years, the youngest being 7 years of age. The technique presented here corrects all the deformities that cause protruding ears and can be performed together with other ear surgeries, such as surgical treatment of macrotia and lobuloplasty. All surgeries were performed in an outpatient setting under local anesthesia and sedation. Results All surgeries followed a performance-optimized protocol, with an average total surgical time of 45 min for a bilateral approach. Revision surgery was needed in 2% of cases, with the most frequent complaint being asymmetry in the upper third of the ears. The complication rate was approximately 7.5%, with 1 case of hematoma, 1 case of mild infection, 2 cases of altered ear sensitivity, 3 cases of keloid scar formation, 6 cases of asymmetry in the upper third of the ears, and 3 cases of irregularities or spikes in the antihelix cartilage. Patient satisfaction was measured using the McDowell/Wright Objectives and Outcome Index (McDowell in Plast Reconstr Surg 41:17–27). Conclusion The proposed performance technique is a viable alternative to optimize the surgical time of otoplasty in an outpatient setting. This technique can be performed together with other corrective ear surgeries, has a shallow learning curve, and has a low revision rate. Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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