THE EFFECT OF A HYPNOTIC-BASED ANIMATED VIDEO ON STRESS AND PAIN REDUCTION IN PEDIATRIC SURGERY

Pediatric Wound Closure by a Tension-Relief System

Surgical reconstruction in pediatric patients can often be complex. Primary wound closure is almost always the preferred technique in the reconstructive ladder; however, it is not always possible in pediatric patients. We report the pediatric use of the TopClosure Tension-Relief System, an innovative skin-stretching technique for secure primary wound closure of large defects. We modified the technique by fixating it to a protective dressing instead of the patient's skin, thus avoiding both staple scars and pain. A retrospective review of 112 patients aged 7 days to 18 years who underwent Tension-Relief System-assisted surgery at a tertiary medical center from 2010 to 2020 was conducted. Cases included congenital deformities, traumatic wounds, burn scars, and complicated-wounds, with or without hardware or deep tissue exposure. The use of the system avoided the need for multiple surgical sessions and for local or regional flaps. The technique was simple to use, with few complications, and led to satisfactory aesthetic and functional outcomes. The findings support using the technique in children and adolescents with challenging tension wounds. Herein, we report on our experience with the Tension-Relief System and detail four cases in which early or immediate closure was successfully achieved.

Relaxation with heat and procedural information to diminish anxiety in presurgical patients of hernia surgery

Presurgical anxiety has been associated with postsurgical pain and complications, therefore we decided to compare two psychological interventions in order to reduce presurgical anxiety-state and pain in patients undergoing hernia surgery. Patients undergoing the presurgical consultation for hernia repair (umbilical or inguinal), were invited. The group of procedural information consisted in administering an informative brochure after the presurgical consultation, while the relaxation with heat group (RWH) consisted in giving a heat pack to the patients while asking them to think in the benefits of the surgery and instructions of relaxation were given, this was performed at the operating theater before surgery. Anxiety-state and pain levels were measured after presurgical consultation and a day after just before surgery. Ninety-five patients were included in 3 groups of study (control = 36, procedural information = 31 and RWH = 28); when we included only those individuals with moderate or high anxiety at the presurgical consultation, we found that procedural information (-4.72 ± 6.10) and RWH diminished anxiety (-9.29 ± 6.91) but only RWH group reached statistical significance when compared with control group (-9.29 ± 6.91 vs -0.56 ± 9.82, p = 0.007). In conclusion, RWH produced a significantly higher reduction of anxiety-state before hernia surgery.