ABSTRACT
BACKGROUND: As the ptotic brow drops below the supraorbital rim, it can exacerbate dermatochalasis by pushing the adjacent skin of the upper lid further down. AIM: The purpose of this study was to evaluate the outcomes associated with a combined pretrichial brow lift and upper lid blepharoplasty in patients with dermatochalasis and mild to moderate brow ptosis. MATERIALS AND METHODS: A retrospective case series of 46 patients with dermatochalasis and mild to moderate brow ptosis treated with a combined, bilateral pretrichial brow lift and upper lid blepharoplasty from January 2008 to December 2011. Main outcome measures included measurements of brow lift at 3 months post-operatively, complications encountered, patient satisfaction and surgeon satisfaction. RESULTS: Outcomes from 46 patients were evaluated. The mean brow lift was 1.85 mm at the lateral canthus, 1.54 mm at the lateral limbus, 1.31 mm at the mid-pupil, and 1.07 mm at the medial limbus. Brow lift at the lateral canthus was significantly more elevated than at the medial limbus (P < 0.001). Minor complications were encountered in seven of 46 patients (15.2%). Mean patient satisfaction score was 3.20 and surgeon satisfaction 3.24 (max = 4, very satisfied). CONCLUSIONS: The modified pretrichial brow lift offered effective lateral lift that complements an upper lid blepharoplasty. This technique was met with a high degree of patient and surgeon satisfaction, and had a minimal complication profile.
ABSTRACT
PURPOSE: Risk management is integral to the provision of contemporary health care. As maternity practices change and with a commitment on women being at the centre of care, one strategy has been for women to retain their records during the antenatal period. This paper explores the return rate of the pregnancy handheld record in a major tertiary facility and discusses the risk management implications when the record is not available upon presentation to the treating practitioner. PROCEDURE: Four audits were conducted over a 2 year period to determine the return rate of the pregnancy handheld record at time of admission for labour and birth. A total of 1096 records were returned out of a possible 1256 during the study. FINDINGS: A 6.6% increase in the return rate was achieved over the 4 audit periods (82-88.5%) with an overall return rate of 85%. PRINCIPLE CONCLUSIONS: Our audit highlights the need for consumers, clinicians and heath care facilities to consider the advantages and disadvantages of the pregnancy handheld record, as well as the medico-legal responsibilities that ultimately fall back on the health facility.