Aesthetic assessment instrument for breasts reconstruction.

INTRODUCTION: Few validated aesthetic assessment instruments in breast reconstruction use discrete scales to facilitate studies with multiple evaluators. OBJECTIVE: This research aimed to propose an aesthetic assessment scale for reconstructed breasts. METHODOLOGY: A scale was suggested using discrete variables, with responses ranging from 1 to 10, and the responses for each category could be summed to obtain an average that could be used in studies with multiple evaluators. To test the instrument suggested in this study, 5 experienced plastic surgeons assessed 46 patients. For all the analyses, a rejection level for the null hypothesis of 5% (p < 0.05) was adopted. RESULTS: The suggested scale obtained valid intraclass correlation coefficients, with 0.9 for the overall aesthetic evaluation of the breast and the lowest being 0.77 for defining the inframammary fold. We observed good diagnostic accuracy in all comparisons, with the area under the curve ranging from 0.85 to 0.97. Regarding convergent validity, we observed correlations of 0.77 (p < 0.001) between breast volume and volume symmetry, 0.66 (p < 0.001) between breast shape and contour naturalness. The test-retest reliability was 0.708, which is considered good. CONCLUSION: The results of this study support the effectiveness of the proposed new aesthetic evaluation scale, revealing consistency among different evaluators and over time. Convergent validation strengthens the relationship between the variables of the new scale and those of the Garbay scale. Furthermore, the robust diagnostic accuracy highlights the clinical utility of the new scale in assessing aesthetic outcomes in breast reconstructions.

Patient satisfaction and quality of life in breast reconstruction: assessment of outcomes of immediate, delayed, and nonreconstruction.

OBJECTIVES: This study was conducted aiming to assess the quality of life and satisfaction of women who had mastectomy treated with and without breast reconstruction. RESULTS: A total of 81 women who had mastectomy were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of women who had mastectomy who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life.

Revisão integrativa sobre terapêutica do prurido após queimadura / Integrative review on burns pruritus therapeutics

Objetivo: Realizar levantamento da literatura existente a respeito do tratamento de prurido em pacientes após queimadura e elaborar algoritmo terapêutico. Método: Revisão integrativa com pesquisa nas bases de dados do Periódicos CAPES com o uso dos descritores “burns”, “pruritus” e “therapeutics”. Resultados: Foram encontrados 1.987 artigos, sendo que, destes, 713 seguiam os critérios de inclusão e foram analisados. Conclusões: A literatura existente sobre esse tema ainda é escassa e é importante a realização de ensaios clínicos controlados e prospectivos de qualidade científica direcionados a essa temática.

Purpose: To review the existing literature on burns pruritus. Method: Integrative review with databases earchusing the terms “burns”, “pruritus” and “therapeutics”.Results: 1.987 articles were found of which 713 matched the inclusion criteria and were assessed. Conclusions: The literature on this subject is still very limited and it is important to perform high quality controlled and prospective clinical trials regarding this theme.