Pediatric Postburn Flexion Contracture Release: Early Outcomes Using 2 Bloodless Techniques.

Postburn flexion contracture of the hand in children constitutes a significant proportion of postburn complications. We compared the early clinical outcomes of reconstruction of pediatric postburn flexion contracture of the digits of the hand using tourniquet or tumescent technique. A prospective randomized study of pediatric patients requiring contracture release and wound resurfacing with full-thickness skin graft between September 2020 and August 2021. Patients were randomized into groups of either tourniquet or tumescent technique for contracture release. The surface area of graft take and total active motion across joints were the outcome measures. Student t test and chi-square test were performed. Twenty-two patients were randomized into either group. The mean age of the participants was 6.09 ± 2.41 years, mostly males 31 (72.1%). A grade 3 flexion contracture was the most common (72.1%). Ninety-four digits and 178 joints were operated on, with the proximal interphalangeal joint being the most common (48.9%). The mean surface area of graft take on postoperative day 10 was significantly higher for the tumescent group than the tourniquet group, P = .001. The total active motion across the joints at 6 and 9 weeks postoperative showed a strong correlation between the total active motion across joints and the technique of release, P = .004 and .001, respectively. Tumescent technique is a feasible alternative to the tourniquet method for postburn flexion contracture release of the digits in the pediatric burned hand.

Keloid masking a parotid tumor: A rare case presentation.

A 37-year-old Nigerian woman presented with an itchy and occasionally painful scar that appeared after the healing of an acne lesion over the left parotid region, 13 years ago. She noticed a progressive increase; however, there was no history of facial weakness. Examination revealed a keloid lesion overlying a firm nontender mass. Ultrasound scan and fine-needle aspiration cytology indicated a benign tumor of the left parotid. Superficial parotidectomy was performed, and the histology revealed a keloid overlying a pleomorphic adenoma. This is an unusual presentation of keloid which developed over a pleomorphic adenoma. Hence, we report the above case for its rarity.

Résumé Une femme Nigériane de 37 ans s'est présentée avec une cicatrice qui démangeait et parfois était douloureuse, apparue après la cicatrisation d'une lésion acnéique sur le région parotide gauche, il y a 13 ans. Elle a remarqué une augmentation progressive; cependant, il n'y avait aucun antécédent de faiblesse faciale. Examen révélé une lésion chéloïde recouvrant une masse ferme non sensible. L'échographie et la cytoponction à l'aiguille fine ont révélé une tumeur bénigne du côté gauche parotide. Une parotidectomie superficielle a été réalisée et l'histologie a révélé une chéloïde recouvrant un adénome pléomorphe. C'est un peu inhabituel présentation d'une chéloïde qui s'est développée sur un adénome pléomorphe. Par conséquent, nous signalons le cas ci-dessus pour sa rareté. Mots-clés: Cicatrice chéloïde, adénome pléomorphe, rare.

Impact of the COVID-19 pandemic on surgical practice, training, and research in Nigeria.

INTRODUCTION: the rising rate of SARS-CoV-2 infections has caused perceptible strain on the global health system. Indeed, this disease is also a litmus test for the resilience of the structures in the African health system including surgery. Therefore, this study aimed to determine the impact of the COVID-19 pandemic on surgical practice, training and research in Nigeria. METHODS: it was a cross-sectional study conducted over three weeks in Nigeria among doctors in 12 surgery-related specialties. Consenting participants filled a pre-tested online form consisting of 35 questions in 5 sections which assessed demographics, infection control measures, clinical practice, academic training, research program, and future trends. Data were analyzed using Statistical Package for Social Sciences Version 20. RESULTS: a total of 384 respondents completed the form. Their mean age was 38.3 years. Lockdown measures were imposed in the state of practice of 89.0% of respondents. Most participants reported a decrease in patient volume in outpatient clinics (95.5%) and elective operations (95.8%) compared to reports for emergency operations (50.2%). They also noted a decrease in academic training [Bedside teaching (92.1%), seminar presentation (91.1%) and journal presentation (91.8%)] and research (80.5%). Except in bedside teaching, those who had other virtual academic programmes were thrice the number of those who used in-person mode for the events. CONCLUSION: COVID-19 pandemic has caused a significant change in pattern and a decrease in the volume of patients seen by surgeons in their practice as well as a decrease in the frequency of academic programs and research activities in Nigeria.

The millennial generation plastic surgery trainees in sub-Saharan Africa and social media: A review of the application of blogs, podcasts, and twitter as web-based learning tools.

The delivery of education and training in plastic surgery in Sub-Saharan Africa face increasing challenges. These include endemic shortages of plastic surgeons within postgraduate medical school faculties, the erosion of financial and clinical resources for teaching, and more recently, the millennial generation paradigm shift. It is generally accepted that the millennial generation will be more discerning and comfortable in their requirements for web-based learning content to support their education and training in plastic surgery. We reviewed current literature including original and review articles obtained through a search of PubMed database, Medline, Google Scholar, and hand searching of bibliographies of published articles using the keywords: social media, Blogs, Twitter, plastic surgery, and millennial generation. This article defines and explores Blogs, Podcasts, and Twitter, as web-based learning tools, and discusses how to leverage social media to maximize their educational value and effectiveness.s.

Résumé L'offre d'éducation et de formation en chirurgie plastique en Afrique subsaharienne est confrontée à des défis croissants. Il s'agit notamment de la pénurie endémique de chirurgiens plasticiens au sein des facultés de médecine de troisième cycle, de l'érosion des ressources financières et cliniques pour l'enseignement et, plus récemment, du changement de paradigme de la génération du millénaire. Il est généralement admis que la génération du millénaire sera plus exigeante et plus à l'aise dans ses exigences en matière de contenu d'apprentissage en ligne pour soutenir son éducation et sa formation en chirurgie plastique. Nous avons examiné la littérature actuelle, y compris les articles originaux et critiques obtenus grâce à une recherche dans la base de données PubMed, Medline, Google Scholar, et une recherche manuelle dans les bibliographies des articles publiés à l'aide des mots clés: médias sociaux, blogs, Twitter, chirurgie plastique et génération du millénaire. Cet article définit et explore les blogs, les podcasts et Twitter, en tant qu'outils d'apprentissage basés sur le Web, et explique comment tirer parti des médias sociaux pour maximiser leur valeur éducative et leur efficacité.

Pediatric keloids: A 6-year retrospective review.

BACKGROUND/OBJECTIVES: Keloids are reportedly rare at the extremes of life. We sought to describe the epidemiology of pediatric keloids seen at the plastic surgery outpatient department of the University College Hospital, Ibadan. METHODS: We retrospectively reviewed all children younger than 19 years who presented with nonburn keloids between 2008 and 2014. Data were obtained on age; duration, size, and location of the keloid; family history; mode of treatment; and outcome. Outcome variables were recurrence and wound complications. Data were analyzed using the Pearson chi-square test for discreet variables and the independent-sample t test for continuous variables. P < .05 was taken as statistically significant. RESULTS: Within the review period, 304 patients presented with keloids, of whom 40 (13.1%) were younger than 19 years. There was a female preponderance (n = 23, 57.5%). The mean age at onset of the keloid was 9.3 years (range 3 months-18 years). Thirty (75%) patients had keloids in the head and neck region. Keloids were sporadic in 31 (77.5%) patients. Nineteen (47.5%) patients had multimodal treatment for keloid. The recurrence rate was 20%. Recurrence was significantly associated with the size of the lesion (P = .003). CONCLUSION: Keloids during childhood are not rare. More attention should be paid to the management of keloids in this age group.