LASIK for hyperopia by cumulative treatment of up to +8.33 D with the MEL 80 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability when applying specialized protocols, including epithelial monitoring. [J Refract Surg. 2017;33(5):314-321.].
Keloid following circumcision has been described in the literature despite the rarity of its occurrence in penile skin. In this paper, we review the literature and report the successful management of post-circumcision keloid scarring in a 2-year-old boy. After circumcision a 2-year-old boy of African origin developed keloid scarring at the circumcision site. This was treated with three intralesional injections of triamcinolone acetate over 3 months, followed by surgical excision. There was no recurrence at 6 months after excision. To our knowledge this is the 12th case of keloid following paediatric circumcision described in the literature. There is a wide range of techniques described but all are recurrence free at 6 months following repeated intralesional triamcinolone acetate injection and surgical excision. While there is no current consensus in treating post-circumcision keloid, we find that intralesional injection followed by surgical excision provides an acceptable aesthetic result, which is recurrence free.
BackgroundPsychiatric in-patients are often transferred to an emergency department for care of minor wounds, incurring significant distress to the patient and cost to the service.AimsTo improve superficial wound management in psychiatric in-patients and reduce transfers to the emergency department.MethodThirty-four trainees attended two peer-led suturing and wound management teaching sessions, and a suturing kit box was compiled and stored at the Royal Edinburgh Hospital. Teaching was evaluated using Kirkpatrick's model, and patient transfer numbers were acquired by reviewing in-patient Datix reports and emergency department case notes for 6 months before and after teaching.ResultsThe proportion of patients transferred to the emergency department decreased significantly from 90% 6 months before the workshop to 30% 6 months after (P < 0.05). Trainees engaged positively and there was a significant increase in self-confidence rating following the workshop (P < 0.05). The estimated cost saving per transfer was £183.76.ConclusionThe combination of a peer-led workshop and on-site suturing kit box was effective in reducing transfers to the emergency department and provided a substantial cost saving.Declaration of interestNone.
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