Continuous versus interrupted sutures for facial surgery repair: a randomized prospective study.

BACKGROUND: The cosmetic appearance of a facial scar is a concern for patients undergoing Mohs micrographic surgery (MMS). Although suturing technique may influence scar cosmesis, few studies have been published comparing suturing methods for MMS repair. OBJECTIVE: To compare the cosmetic appearance of facial MMS scars sutured with either continuous or interrupted percutaneous nylon sutures. MATERIALS AND METHODS: Patients with facial MMS defects were randomized to have half their scar sutured with interrupted 5-0 nylon stitches, whereas the other half of the scar was closed with running 5-0 nylon stitches. The appearance of each half of the scar was assessed at 1 week, 8 weeks, and 6 months by the principal investigator. Blinded photographic evaluation at 1 week and 6 months was completed by a plastic surgeon and general dermatologist. RESULTS: A total of 105 patients were entered into the trial, and 101 completed all time point assessments. There was no statistically significant difference in scar outcome using each of the 3 scar assessment scales, at any time point, for any assessor (blinded and nonblinded). CONCLUSION: Interrupted and continuous 5-0 nylon sutures result in an equivalent final cosmetic appearance of facial MMS scars. Given its advantages, running sutures may be the preferred closure technique for facial repair.

Chemical composition and fatty acid content of some spices and herbs under Saudi Arabia conditions.

Some Saudi herbs and spices were analyzed. The results indicated that mustard, black cumin, and cress seeds contain high amount of fat 38.45%, 31.95% and 23.19%, respectively, as compared to clove (16.63%), black pepper (5.34%) and fenugreek (4.51%) seeds. Cress, mustard, black cumin and black pepper contain higher protein contents ranging from 26.61 to 25.45%, as compared to fenugreek (12.91%) and clove (6.9%). Crude fiber and ash content ranged from 6.36 to 23.6% and from 3.57 to 7.1%, respectively. All seeds contain high levels of potassium (ranging from 383 to 823 mg/100 g), followed by calcium (ranging from 75 to 270 mg/100 g), Magnesium (ranged from 42 to 102 mg/100 g) and iron (ranged from 20.5 to 65 mg/100 g). However, zinc, manganese and copper were found at low levels. The major fatty acids in cress and mustard were linolenic acid (48.43%) and erucic acid (29.81%), respectively. The lenoleic acid was the major fatty acid in black cumin, fenugreek, black pepper and clove oils being 68.07%, 34.85%, 33.03% and 44.73%, respectively. Total unsaturated fatty acids were 83.24, 95.62, 86.46, 92.99, 81.34 and 87.82% for cress, mustard, black cumin, fenugreek, black pepper and clove, respectively. The differences in the results obtained are due to environmental factors, production areas, cultivars used to produce seeds and also due to the different methods used to prepare these local spices.

The use of olive oil for skin health in a Saudi population: A cross-sectional study.

The use of topical olive oil (OO) for skin health is common among Saudis and worldwide. Therefore, this cross-sectional study is aimed at assessing the use of topical OO for skin health among Saudis in Riyadh, Saudi Arabia. The questionnaire was administered to Saudis at four different malls in Riyadh, Saudi Arabia. A total of 401 participants were enrolled in the study. The results showed that the average knowledge score of the participants was 3.4±0.3 (out of 5) and 87% had fair knowledge. The top source of knowledge among the participants was friends/relatives. In the attitude section, the average score was 4.1±0.5 (out of 5). Females had a higher attitude score 4.2±0.5 as compared to males 4±0.5 (P=0.03). The most common reason for using topical OO among the participants was skin moisturizing (73%). Female gender was the only significant factor associated with the use of topical OO (P<0.001). The use of topical OO for skin health is highly prevalent in Riyadh, Saudi Arabia. Therefore, more awareness of the benefits and adverse effects of topical OO use is required especially from health educational organizations. The preliminary results of this study suggest further research with a larger sample in an academic setting across the nation.

When simple hernia is not that simple: Treatment of concomitant pathology in acute care surgery, a case report.

INTRODUCTION: Obstructed colon cancer is not an uncommon surgical emergency. Many other surgical diseases may overlap their presenting symptoms. This paper aims to report a colon cancer case with delayed diagnosis due to a long-standing para-umbilical hernia (PUH). CASE REPORT: 60-year-old female patient presented to our emergency department (ED) with an obstructed PUH. The patient underwent watchful conservative management many times before due to associated comorbidities. This history of recurrent intestinal obstruction and incomplete regain of regular bowel habits after every hospital admission raises the possibility for concealed pathology. Further investigations, including computed tomography (CT), revealed a suspicion of an obstructed malignant mass at the colon's splenic flexure accompanied with complete bowel obstruction. The patient and their family consulted for exploratory laparotomy and the possibility of stoma formation. The intra-operative finding was constant with a small ventral defect, and a dilated bowel loops up to a left colon transition zone. We achieved left hemicolectomy with a primary anastomosis after intra-operative bowel lavage. The postoperative period was uneventfully, and the patient was discharged home after seven days of admission. Follow up in the outpatient surgical clinic for three months revealed no recordable complications. The patient had transferred to the oncology center for the completion of adjuvant therapy. DISCUSSION: This case had a small PUH with recurrent obstruction. The delay in its management was due to the patient's comorbidities. However, the incomplete resolution of patient symptoms during watchful oversight increases the likelihood of another hidden pathology that required further investigation. We expanded CT indication in such patients to find the exact cause of patient symptoms, especially chronic constipation and incomplete recovery after every admission. While concurrent pathology is the norm in elective surgery and can be dealt with safely, in non-elective surgery, a thorough search about the patient's exact complaints is mandatory to decrease morbidity and mortality rates. CONCLUSION: In the same patient, both colon cancer and abdominal wall hernias can produce conflicting symptoms and delay diagnosis. However, with a high index of suspicion and correlation of patient symptoms, can be safely managed without morbidity.

Repigmentation of vitiligo-associated leukotrichia after autologous, non-cultured melanocyte-keratinocyte transplantation.

BACKGROUND: Many cases of leukotrichia are associated with vitiligo. Hair follicles are believed to be the source of melanocytes for skin repigmentation using standard medical therapy for vitiligo. Vitiliginous areas with overlying leukotrichia usually fail to achieve repigmentation by conventional medical treatments as a result of a deficient melanocyte reservoir. Even after the successful repigmentation of vitiliginous skin by medical therapies, leukotrichia hairs may remain depigmented, causing a major psychological impact to the patient. In such cases, surgical treatments may help to achieve the repigmentation of leukotrichia hairs. Reports of successful repigmentation in leukotrichia using different surgical treatments for vitiligo are few. OBJECTIVE: This study reports the benefit of autologous non-cultured melanocyte-keratinocyte transplantation (MKT) in patients with vitiligo-associated leukotrichia. METHODS: We report four cases of vitiligo-associated leukotrichia treated with MKT. RESULTS: All four patients showed significant repigmentation in vitiligo-associated leukotrichia after MKT. CONCLUSIONS: Melanocyte-keratinocyte transplantation may represent a good therapeutic option for the repigmentation of vitiligo-associated leukotrichia. This series includes only four responsive cases. Larger prospective studies are needed to determine the true response rate and mechanism of repigmentation.