The impact of car seat giveaways on compliance among newborns in Saudi Arabia.

OBJECTIVES: Road traffic injuries are a leading cause of morbidity and mortality among children in Saudi Arabia. Previous literature suggests that poor compliance to traffic safety measures is exacerbating the burden of childhood injuries. Although car seats have been found to reduce injuries among children, their compliance remains poor nationally. The aim of this study was to evaluate whether providing free car seats for newborns is associated with the compliance of car seat use 3 months after hospital discharge. METHODS: This study was conducted in three regions of the country following a national public health campaign aimed to improve traffic safety. In November 2020, five hundred car seats were given to mothers at the time of discharge. Three months later, parents were contacted to evaluate the prevalence of compliance. In addition to estimating the prevalence of car seat use at 3 months, the analysis assessed predictors of use using a multiple logistic regression model. RESULTS: Of the 486 initial participants, 375 (77%) responded. According to the parents, 76% of children still use the car seat 3 months after hospital discharge. The age of the parents and the number of family members were significant predictors of car seat use. Smaller families (≤4 members) were 2.2 (95% confidence interval: 1.36-3.82) times more likely to comply with the car seat law 3 months after discharge than larger families. Most of the respondents (70.5%) strongly agree that child restraint systems are an essential device while driving with children. CONCLUSIONS: We found that providing free car seats for newborn children is associated with uptake of improved traffic safety, but compliance remains lower than in developed countries. Further studies are needed to facilitate improving child seat safety among large families. As the country strives to invest in reducing traffic injuries, similar initiatives may facilitate adopting safety measures among parents, which may reduce preventable injuries and improve population health.

Reconstruction Of The Burnt Nose Using A Carved Flap In Four Cases.

Techniques for reconstructing nasal defects in burns are very limited because the surrounding scar tissue makes it difficult to use local flaps. The authors report their experience using the Converse scalping flap harvested from scarred skin, placed as a mass on the nasal area, then secondarily carved to shape the nose and covered by a skin graft. This is a retrospective study of 4 patients, 3 men and 1 woman, with an average age of 45 years, who were operated on between 1994 and 2013 using this technique for postburn nasal reconstruction. Patients had 45% burns on average. The flap was weaned from its donor site at the third week and the frontalis donor area grafted. Several months later, the flap was sculpted from the outside to the inside in the three dimensions, removing the scarred epidermal areas to restore the aesthetic units of the nose, which were grafted using a full thickness skin graft. The final aesthetic result of the nasal reconstruction was evaluated by the patient and the surgical team. The four nasal reconstructions were carried out to completion. Three were rated as 'very good' (75%) and one was rated as 'good' (25%). The Converse flap modification, referred to as the "carved flap", to reconstruct the burned nose is a reliable technique, possible on a scarred forehead with no additional donor site morbidity.

Les techniques de reconstruction nasale après brûlure sont limitées. En effet, la peau cicatricielle environnante rend difficile l'utilisation de lambeaux locaux. Les auteurs rapportent leur expérience avec le lambeau scalpant de Converse prélevé en peau cicatricielle, placé en bloc sur la région nasale puis secondairement sculpté pour donner sa forme au nez et greffé. Il s'agit d'une étude rétrospective sur quatre cas, 3 hommes et 1 femme, d'un âge moyen de 45 ans, opéré entre 1994 et 2013, en utilisant cette technique de reconstruction nasale après brûlure. Les patients étaient brûlés en moyenne à 45% de la surface corporelle. Le lambeau a été sevré du site donneur à trois semaines et la perte de substance au niveau du front a été greffée. Plusieurs mois plus tard, le lambeau a été sculpté de dehors en dedans dans les trois dimensions, la peau cicatricielle a été désépidermisée sur l'unité esthétique du nez qui a été greffée en peau totale. Le résultat esthétique final de cette reconstruction nasale a été évaluée à la fois par le patient et par l'équipe chirurgicale. Les quatre reconstructions nasales ont été menées à terme. Elles ont été cotées comme très bon résultat dans 75% des cas et comme bon résultat dans 25% des cas. Ce lambeau de Converse modifié, appelé « lambeau sculpté ¼, est une technique fiable pour reconstruire un nez, possible sur un front cicatriciel et sans morbidité additionnelle au site donneur.