RESUMO
OBJECTIVES: To assess current variation in the management of pinna haematoma (PH) and its effect on outcomes. DESIGN: Multicentre retrospective observational record-based study. SETTING: Eleven hospitals around the UK. PARTICIPANTS: Eighty-three patients above the age of 16 with PH. OUTCOME MEASURES: The primary outcome measure was recurrence rate of PH over a 6-month period post-treatment, assessed by treatment type (scalpel incision vs needle aspiration). Secondary outcome measures assessed the impact of other factors on recurrence, infection and cosmetic complications of PH over a period of 6 months. RESULTS: After adjusting for confounding factors, involvement of the whole ear, and management within an operating theatre were associated with a lower rate of recurrence of pinna haematoma. The drainage technique, suspected aetiology, choice of post-drainage management, grade and specialty of practitioner performing drainage, the use of antibiotic cover and hospital admission did not affect the rate of haematoma recurrence, infection or cosmetic complications. CONCLUSIONS: Where possible PH should be drained in an operating theatre. Multicentre randomized controlled trials are required to further investigate the impact of drainage technique and post-drainage management on outcome.
Assuntos
Pavilhão Auricular , Otopatias/terapia , Hematoma/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Otopatias/complicações , Otopatias/epidemiologia , Feminino , Hematoma/complicações , Hematoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Recidiva , Estudos Retrospectivos , Reino Unido , Adulto JovemRESUMO
With the advent of high resolution real-time sonographic scanning machines, fetal gender can be determined in most pregnancies of more than 25 weeks. In 72 of 112 consecutive pregnancies, fetal genitalia were well visualized and there were no errors in prediction of fetal gender. In the 40 failures, the fetal genitalia could not be detected, hence, determination was not volunteered. Follow-up showed that the failure group was equally divided between males and females, emphasizing that lack of visualization did not imply a female perineum. The reasons for failure and success, scanning techniques, and a brief review of fetal genital embryology are discussed. Caution of potential psychological effects on the parents is raised.
