Summary: Paraffinoma of the penis is rare and caused by paraffin liquid injection. This condition can cause significant penile deformity, ulceration, pain, and sexual dysfunction. However, it can be managed with surgical procedures to obtain normal aesthetic and functional results. Herein, we reported a 42-year-old male with penile paraffinoma who underwent excessive surgical excision of the fibrotic tissue and one-stage reconstruction using a spiral stitch full-thickness skin graft. At one year of follow-up it showed a good aesthetic outcome with no hypertrophic scars, skin contractures, penile curvature, or penile shortening. The sexual evaluation using the International Index of Erectile Function instrument also showed a good result with normal erectile function and satisfaction with sexual sensation. This case is interesting because we used the spiral stitch full-thickness skin graft technique to cover the degloving area and long-term follow-up to evaluate the aesthetic and functional results.
Platelet-rich plasma (PRP) contains many growth factors, such as FGF, which induces the production of type I collagen, and VEGF, which induces neovascularization, all of which are important in bone healing. This study aimed to evaluate the effect of PRP administration on type I collagen production, VEGF expression, and neovascularization in rat models following femoral bone implants using K-wire. Methods: An experimental randomized control study was conducted on 24 white male rats (Rattus norvegicus) in the Wistar strain that underwent K-wire implantation, where PRP was administered to the treatment groups. The amount of type I collagen was measured by immunohistochemistry VEGF expression using sandwich ELISA, and neovascularization by histopathological examination. Results:The amount of type I collagen in the treatment group (50->150/field of view) was significantly higher than the control group (0-99/field of view; p=0.003). VEGF expression in the treatment groups was significantly higher than controls: 10.90±4.47 and 2.29 ±0.92, respectively (p=0.006). Mean number of new vessels formed on fibrotic capsules in the treatment groups was significantly (p=0.007) higher than the control groups (2.69±1.03 vs 0.67±0.52). Conclusion:The use of PRP significantly increased type I collagen production, VEGF expression, and neovascularization in rat models, elucidating the potential of PRP to be used in clinical settings to enhance the bone-healing process.
Abrasion is injury to skin due to trauma that affects the surface of the epidermis or superficial epithelium, especially from friction to the depth of the dermal papillae. The basic principle of abrasion treatment is to maintain moist condition in wound surface. This study aims to compare the effectiveness of silver sulfadiazine (SSD) and gentamicin cream in the process of healing abrasions. A total of 30 samples of abrasion patients who came for treatment at the ED were sampled, and divided into 3 groups, namely wound care by providing SSD, gentamicin and tulle. The wound dimensions are assessed from the length and width measured at the 1st day, the 5th day, and the 10th day. At the 10th day assessment, SSD was found to be more effective in healing abrasions compared to other groups. The use of SSD in abrasion wound treatment is believed to have advantages in proliferation phase where SSD is a sulfonamide class antibiotic that produces synergic effects along with silver which constantly absorbs exudates and bacteria, combines chloride tissue and several other proteins in the process of wound healing.
This study examines the prevalence of infection in burn patients as represented by the clinical spesimen culture results. The purpose of this study was to obtain data on the prevalence, distribution and susceptibility pattern of microbes isolated from clinical spesimens of burn patients hospitalized at RSUD dr. dr. Zainoel Abidin. This study is descriptive observational. The retrospective data obtained from the Plastic Surgery Department and the Clinical Microbiology Laboratory. The results showed the prevalence of infection in burn patients who were hospitalized at RSUD dr. Zainoel Abidin based on clinical spesimen culture of 4.7%. Microbial patterns isolated from burn patients were Gram positive bacteria (37.5%) consisting of Staphylococcus aureus and Staphylococcus hominis. Gram negatif bacteria (62.5%) isolated consisted of Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. The clinical spesimens that showed the most bacterial growth were pus followed by blood and joint fluid. Patients with less than 40% wound area, showed the growth of Staphylococcus aureus, Acinetobacter baumannii and Klebsiella pneumoniae. Patients with wound area above 40%, showed the growth of Staphylococcus aureus, Staphylococcus hominis, Acinetobacter baumannii and Pseudomonas aeruginosa was found. The group of Gram positive bacteria had good sensitivity to the antibiotics vancomycin (100%), linezolid (100%), tigecycline (100%), clindamycin (66.7%), tetracycline (66.7%) and trimethoprim-sulfamethoxazole (66, 7%). The group of Gram negatif bacteria showed high sensitivity to Amikacin (100%).
Background: The epidemiology pattern of patients with burn injury varies widely in different parts of the world. This study aimed to identify epidemiological data from hospitalized burn injury patients in Zainoel Abidin General Hospital, a referral Hospital in Aceh. Methods: All hospitalized burn injury patient data from January 2016 to December 2017 were collected from the medical record. Data taken included Gender, age, length of stay (LOS), mortality, severity, and extent of the burn, and etiology of burn. Results: From all hospitalized patients with burn injury, the male to female ratio is 1,6:0,9. The mortality rate is 9%, while the others survive. From all etiology of burn, 57% is flame injury, 19% is electrical injury, 18% is scald burn injury, 4% is contact burn injury, and 1% is a chemical burn injury. No patient with first-degree burns was hospitalized, while 13 patients had third-degree burn injuries, and the rest had second-degree burn injuries. Conclusion: An increasing number of hospitalized patients from 2016 to 2017, from 25 patients to 42 patients. It might happen because of increasing knowledge about burn injury in society and physicians in rural areas to refer patients to the hospital with better facilities.
Bedah elekif merupakan jenis pembedahan yang dapat dilakukan penundaan atau perencanaan lebih lanjut dengan tidak membahayakan nyawa pasien. Setiap tindakan pembedahan atau operasi sekecil apapun dapat menimbulkan risiko infeksi. Infeksi nosokomial masih menjadi masalah global hingga saat ini dengan morbiditas, mortalitas yang tinggi dan menimbulkan waktu perawatan lebih lama dan biaya yang besar. Kontaminasi mikroba di tempat operasi merupakan faktor penting dalam kejadian infeksi daerah operasi (IDO). Prosedur asepsis merupakan prinsip bedah untuk mempertahankan keadaan bebas kuman untuk mencegah IDO. Penelitian ini dilakukan untuk mengetahui efektifitas Efektivitas Prosedur Irigasi Luka Pasca Operasi Elektif Ortopedi Menggunakan Campuran Natrium Klorida 0,9% dan Gentamicin Sulfat untuk Mencegah Infeksi Daerah Operasi Di RSUD dr. Zainoel Abidin Banda Aceh. Penelitian ini merupakan penelitian uji klinis (clinical trial) dengan desain paralel. Subjek penelitian yang terlibat dalam penelitian ini berjumlah 96 orang yang terbagi kedalam tiga kelompok: Kelompok NaCl 0,9% (Kelmpok A), Kelompok Gentamicin Sulfat 80 mg (Kelompok B), dan Kelompok Gentamicin Sulfat 160 mg (Kelompok C) dengan jumlah subjek pada masing – masing kelompok adalah 32 orang. Data yang diperoleh akan dianalisa menggunakan uji F (ANOVA) dengan tingkat kepercayaan 95%. Kelompok A memiliki Skor IDO: 3,34 ± 1,49, kelompok B: 2,31 ± 1,12 dan kelompok C: 2,63 ± 1,62. Uji komparatif antar ketiganya menujukkan perbedaan yang bermakna (p = 0,009). Perbandingan efektivitas Kelompok B dan Kelompok C dalam mencegah IDO tidak secara statistik tidak berbeda secara signifikan (p = 0,281). Prosedur irigasi luka pasca operasi elektif ortopedi menggunakan Gentamicin Sulfat 80 mg efektif mencegah terjadinya IDO dibandingkan dengan pencucian luka standar menggunakan NaCl 0,9%.
Introduction: Surgeries are potential procedures for Coronavirus Disease 2019 (COVID-19) transmission due to the presence of a multidisciplinary team and high-risk activities such as airway assessment and intubation. This study was carried out to assess risk of surgeries conducted at the main referral hospital in Aceh province, Indonesia during COVID-19 pandemic.Method: A Medical necessary, Time-Sensitive (MeNTS) score was used to assess risk of emergency and elective surgeries conducted at Aceh main referral hospital, Dr. Zainoel Abidin, from July to August 2020. In total, 463 surgeries were screened, consisted of 126 emergency surgeries and 337 elective procedures.Result: Orthopaedic department contributed the most with 129 patients (27.9%), while ear, nose, throat (ENT) departments contributed the least with only 16 patients (3.4%). Orthopedic surgeries had the lowest MeNTS score (36.23), while neurosurgeries had the highest MeNTS score (46.91). Most of the surgeries were elective (72.8%), and the MeNTS score for elective surgeries was higher than emergency procedures (41.0 to 39.6).Conclusion: Neurosurgeries were the highest risk procedures conducted in Aceh main referral hospital, Indonesia, followed by ENT, thoracic-vascular, and digestive surgeries. MeNTS scoring can be used as an additional screening tool in the Department of Surgery, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia to minimize the risk of COVID-19 transmission during surgical procedures.
Due to issues of limited substances and expensive cost of wound treatment, topical insulin and simvastatin are being developed due to benefits including easy to find and applicable in every health center. Topical insulin can be used in treating diabetic patient’s wound. Simvastatin contributed in wound healing process by increasing angiogenesis and lymphangiogenesis. This experimental study is using randomized post test only control design in male Wistar mice, divided in 5 treatment groups with 9 mice each : carboxymethylcellulose sodium gel, short acting insulin topical gel, long acting insulin topical gel, simvastatin topical 2% gel, and simvastatin 3% topical gel. A full thickness wound was made randomly and observed in 5 days, followed with wound biopsy and analyzing using histopathological specimen measuring the epithelial thickness, fibroblast proliferation and collagen density from each group. Long acting insulin topical gel has the highest average rate of epithelial proliferation and fibroblast proliferation. In simvastatin 3% topical gel has the highest level of collagen density level among other groups. This study showed long acting insulin topical gel significantly has better outcome than other groups.
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