RESUMO
Background: Patient scar assessment scale (PSAS) is a reliable and standard tool for assessment of scars by the observer and the patient. Till now the scale has not been translated to Hindi. The objective of the study was to translate and validate the PSAS to Hindi. Materials and Methods: We did forward and backward translation of the English PSAS together with its validation. In total, 64 patients with postburn facial scars were included. The validation committee consisted of 6 bilingual members. Results: The PSAS-Hindi showed good internal consistency with Cronbach's α of 0.86. Test-retest reliability showed good correlation with intra class coefficient being 0.94 (95% confidence interval: 0.83-0.97). Conclusion: The PSAS was successfully translated to Hindi, and cross-cultural adaptation was made.
RESUMO
Introduction: Reconstruction of segmental defects of long bones is a daunting task for surgeons. Bone transport with the help of Illizarov external fixator and vascularized free fibula flap are some of the most discussed and valid options for the same. Both techniques have their limitations and overlapping indications. However, there has been no objective evidence in the manner of a systematic review supporting one treatment method over the other. Aim: This systemic review is aimed to compare the bony union, functional outcomes, and complications of Illizarov bone lengthening and free fibula flap performed for segmental bone defects of long bones of the leg. Methods: A comprehensive search was done for all studies published before May 2023. Any observational study comparing bone transport based on Illizarov external fixator and free vascularized fibula grafting techniques for treating lower limb long bone segmental defects was entailed in this study. Results: This systematic review comprised of five retrospective studies. A total of 96 patients were treated by the Illizarov-based bone transport technique and 72 patients were treated by the free vascularized fibula grafting technique. The free vascularized fibula grafting technique yielded a shorter mean time to union (average difference 9.3 months), relatively shorter external fixator time (average difference 5.32 months), and external fixator index (average difference 0.57 months/cm). However, there was no difference in terms of bony and functional outcomes between both techniques when used for the reconstruction of bony defects in the lower limb. Total number of complications was 68 % higher in bone transport with Illizarov external fixator. However, the rates of non-union didn't differ between the groups. Conclusion: The free vascularized fibula grafting technique had a lesser time to bony union, shorter time for external fixator application, and lower incidence of complications. However, the functional and bony outcomes didn't differ between both techniques. Level of evidence: Level 4.
RESUMO
The humero-pectoral band in Poland syndrome is a rare presentation and needs urgent surgery because it restricts the shoulder abduction of the patient. In our case, instead of excising the band, we have made use of the tissue by including it in the Z-plasty flaps which make the flaps reliable even though they were supplied by a narrow base.
RESUMO
Total eyelid defect comprises full-thickness loss of both upper and lower eyelids in a patient. It is a rare and devastating condition with serious implications related to vision, which mandates early and functional reconstruction when associated with intact globe. The primary goal is to give a stable coverage for orbital protection but at the same time provide a functional reconstruction of the defect, to allow for adequate mobility of the eyelids so that the patient's vision is restored to normal with minimal disability. When the defect is massive, and in the absence of loco-regional flaps, microvascular tissue transfer is needed. In this report we describe a radial-artery-based microvascular tissue transfer with a unique innovation utilizing the contralateral frontalis muscle to reconstruct a case of unilateral total upper and lower eyelid loss.
RESUMO
INTRODUCTION: Pressure sores are agonizing complications of chronically bedridden patients. The management of these lesions particularly with respect to grades III and IV lesions are chiefly surgical and involves a multidisciplinary approach. Although there are a variety of local flap options, like fasciocutaneous flaps, musculocutaneous flaps, perforator flaps, and combinations of these to choose from, there is a paucity of literature regarding which flap is better among these in terms of complication and recurrence rates. METHODS: The databases searched were as follows: Cochrane Central Register of Controlled trials (January 2000 to July 2020), MEDLINE (January 2000 to July 2020), and EMBASE (January 2000 to August of 2020). Key words used were "pressure ulcer," "flaps," "surgery," "pressure sore" with limits, "human," and "English." Primary outcomes were "overall complication rates" and "recurrence rates." Overall complication was further categorized as flap necrosis, flap dehiscence, infection, and others. RESULTS: Thirty-nine articles were included in the final analysis. There was a statistically significant difference among the various types of flaps for overall complication, flap dehiscence, infection, flap necrosis, and recurrence rates. CONCLUSIONS: Our study indicates that musculocutaneous flaps have lower recurrence rates, and combined flaps have lower complication rates. However, various other factors, like donor site morbidity, initial defect size, operating time, intraoperative blood loss, salvage options in case of recurrence, should also be considered while choosing a flap to reconstruct a defect.
