Objective: Facial feminization surgery (FFS) is instrumental in gender affirmation for transgender patients. Multiprocedural FFS, the combination of multiple facial feminization procedures across multiple depths and planes during one surgery, crosses sterile and nonsterile planes in the oropharynx, nose, and frontal sinus. A closer look at the prevention and management of resulting complications of such reconstruction is necessary. Methods: We performed a retrospective review of patient demographics, operative variables, and postoperative complications on 31 FFS patients. Patients who underwent FFS between January 2020 and June 2021 were eligible for inclusion. Associations between prevention methods, procedure type, and complications were assessed by the Fisher exact test. The main effect of patient age and number of procedures on complication rate was assessed via the nonparametric Kruskal-Wallis test. Results: A total of 31 patients, with a mean age of 37 years (range: 19-65 y, SD: 13.3 y), underwent 257 procedures. Patients underwent a mean of 8 procedures (SD: 2.2) lasting 3.5 to 6 hours (mean: 5.0 h, SD: 0.9 h). Overall, 68% of patients experienced no complications. Six patients experienced a postoperative infection; 4 of these patients required return for a washout. Preventative measures implemented include: preoperative dental check, intraoperative antibiotic irrigation, locking sutures, and postoperative antibiotics. After measures were implemented, there were no further procedure-related infections recorded. Conclusions: Patients do not suffer from major complications after multiprocedural FFS. Factors such as age, irrigation method, and dental history may be important variables affecting FFS outcomes.
ObjectiveTo investigate the incidence and severity of pressure injuries among COVID-19 patients who required acute hospitalization and subsequent acute inpatient rehabilitation (AIR).DesignData was collected retrospectively from medical charts of COVID-19 patients who were admitted to AIR during April 2020–April 2021.SettingAcute Inpatient Rehabilitation at a single hospital in the greater New York metropolitan area.ParticipantsSubjects included COVID-19 patients (N = 120) who required acute hospitalization and subsequent acute inpatient rehabilitation, of whom 39 (32.5%) had pressure injuries.InterventionsNot applicable.Main outcome measure(s)The incidence, location, and severity of pressure injuries in COVID-19 patients, as well as demographic and clinical characteristics of the acute hospitalization.ResultsAmong patients who developed pressure injuries, more patients received mechanical ventilation (59% vs. 33%, P < 0.05) and tracheostomy (67% vs. 17%, P < 0.00001). The lengths of stay were longer in both the intensive care unit (ICU) (34 vs. 15 days, P < 0.005), and in acute inpatient rehabilitation (22 vs. 17 days P < 0.05).ConclusionPressure injuries were more common in COVID-19 patients who had longer lengths of stay, received mechanical ventilation or tracheostomy, during acute hospitalization. This supports the use of protocols to prioritize pressure offloading in this patient population.
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