RESUMO
Post burn flexion contracture of the hand in children constitutes a significant proportion of post burn complications. We compared the early clinical outcomes of reconstruction of pediatric post burn flexion contracture of the digits of the hand using tourniquet or tumescent technique. A prospective randomised study of pediatric patients requiring contracture release and wound resurfacing with full thickness skin graft between September 2020 and August 2021. Patients were randomised 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-squared test were performed. Twenty-two (22) patients were randomised into either group. The mean age of the participants was 6.09 ± 2.41 years, mostly males 31 (72.1%). A grade three (3) flexion contracture was the most common (72.1%). Ninety four (94) digits and one hundred and seventy eight (178) joints were operated on with the proximal interphalangeal joint (PIPJ) being the most common (48.9%). The mean surface area of graft take on post operative day ten (10) was significantly higher for the tumescent group than the tourniquet group, p =0.001. The total active motion across the joints at six (6) and nine (9) weeks post operative showed a strong correlation between the total active motion across joints and the technique of release, p=0.004 and 0,001 respectively. Tumescent technique is a feasible alternative to the tourniquet method for post burn flexion contracture release of the digits in the pediatric burned hand.
RESUMO
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.
