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Hong JS, Yoo SJ, Shin HK. A new technique of suturing using adhesive skin closure for uncooperative patients. Int Wound J 2022; 19:1821-1828. [PMID: 35293122 PMCID: PMC9615285 DOI: 10.1111/iwj.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/25/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022] Open
Abstract
Open wounds are usually closed with suture. However, young patients often do not cooperate and prevent proper suture placement. Young patients are often terrified of mild pain and wholly uncooperative, which is why we introduce this timesaving, less painful, more aesthetic technique of placing and removing stitches. 104 patients with facial lacerations aged 5 to 15 years were treated at a single center from May 2019 to March 2021. Patients were randomly assigned equally to a simple interrupted suture group (the SI group) or a continuous locking with Steri‐Strip group (the CS group). Suture times, times for stitch removal, pain scores at stitch removal and mature scar scores were evaluated. Suture and stitch removal times were significantly shorter, and pain scores at stitch removal and observer scar assessment scale scores were lower in the CS group. Patient scar assessment scale score was non‐significantly lower in the SI group. This study shows that the novel continuous locking with the Steri‐Strip technique is easier and quicker to perform, causes less pain when removing stitches, provides better aesthetic results than the simple interrupted suture technique and suggests the continuous locking with Steri‐Strip technique would be very useful for uncooperative young patients.
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Affiliation(s)
- Joon-Shik Hong
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Hea-Kyeong Shin
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
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Han L, Zhao Z, Zhang J, Kong X, Yang C, Peng L, Lv LY, Li C, Wang S, Wei GH. Experience performing partial fistulectomy through a single incision to treat pyriform sinus fistula in children. Int J Pediatr Otorhinolaryngol 2021; 151:110973. [PMID: 34781114 DOI: 10.1016/j.ijporl.2021.110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES The surgical treatment of pyriform sinus fistula (PSF) is improving. The aim of this study was to investigate the effect of partial fistula excision in children with PSF assisted by using methylene blue. METHODS According to the method used to treat PSF infection, the patients were divided into a conservative treatment group, a single incision group (the children drained the abscess through the incision at the dermatoglyph of the cricothyroid joint), and a non single incision group (the children drained the abscess through the incision in the most obvious area of the abscess or ulceration). The data were retrieved from the electronic medical records (EMRs) and hospital information system (HIS). The patient and observer scar assessment scale (POSAS) scores at 6 months after fistula resection were compared. RESULTS A total of 239 patients diagnosed with PSF underwent partial resection of the fistula through cervical approach with methylene blue. The success rate of the operation was 100%. The average operation time was 32 ± 13.2 min. The average hospital stay was 1 ± 0.2 days. There were 2 cases of transient hoarseness and 6 cases of wound infection. There were 17 patients in the conservative treatment group, 81 patients in the single incision group and 145 patients in the nonsingle incision group. The average POSAS scores of the three groups were 2.56 ± 0.6, 3.12 ± 0.84 and 4.56 ± 1.56, respectively, with significant differences among the three groups (P < 0.05). CONCLUSIONS Partial fistulectomy assisted by using methylene blue through a single incision in the neck for the treatment of PSF in children yields a high success rate, fewer postoperative complications and greater comfort than traditional surgery. This alternative surgery can be used to treat PSF in children.
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Affiliation(s)
- Liling Han
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Zhenzhen Zhao
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Jun Zhang
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China.
| | - XiangRu Kong
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Chao Yang
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Liang Peng
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Lin Ya Lv
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - ChangChun Li
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Shan Wang
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
| | - Guang Hui Wei
- Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, Chongqing Key Laboratory of Pediatrics, China
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Ramanathan D, Chu S, Prendes M, Carroll BT. Validated Outcome Measures and Postsurgical Scar Assessment Instruments in Eyelid Surgery: A Systematic Review. Dermatol Surg 2021; 47:914-920. [PMID: 33988553 DOI: 10.1097/dss.0000000000003077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Determining which postsurgical scar assessment instruments, if any, cover important eyelid outcome measures can either attest to the strength of one or more instruments or reveal the need for a more comprehensive scale. OBJECTIVE To systematically review validated outcome measures after eyelid surgery and postsurgical scar assessment tools to see whether any individual or combination of 2 assessment tools encompass all relevant, validated eyelid outcome measures. METHODS Systematic reviews of validated eyelid outcome measures and postsurgical scar assessment tools were conducted using PubMed/MEDLINE and Ovid. Outcome measure papers that met inclusion criteria were sorted into 8 categories: Patient Subjective, Visual Function, Mechanical Function, Daily Activities, Adverse Effects, Aesthetic Quantitative: Clinical Measurements, Aesthetic Qualitative: Global, and Aesthetic Qualitative: Specific. Outcome measure papers were categorized into tiers of evidence support, and assessment tools were evaluated based on which outcome measures each covered. RESULTS No one or combination of 2 assessment tools covered all selected eyelid outcome measures. Although measures related to the subjective patient experience were included in several of the assessment scales, none covered measures of visual function or eyelid-specific clinical measurements. CONCLUSION There is currently no existing postsurgical scar assessment instrument that covers all important eyelid-specific outcome measures.
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Affiliation(s)
- Diya Ramanathan
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Sherman Chu
- Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Northwest, Lebanon, Oregon
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Mark Prendes
- Department of Ophthalmology and Visual Sciences, University Hospitals, Case Western
- Reserve University School of Medicine, Cleveland, Ohio
| | - Bryan T Carroll
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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Reliability of the Patient and Observer Scar Assessment Scale in Evaluating Linear Scars after Thyroidectomy. Adv Skin Wound Care 2021; 34:1-6. [PMID: 33979825 DOI: 10.1097/01.asw.0000744344.46898.6e] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the reliability of the Patient and Observer Scar Assessment Scale (POSAS) with the Vancouver Scar Scale (VSS) in evaluating thyroidectomy scars. METHODS At 6 months after the operation, 112 patients who underwent thyroid surgery via collar neck incision were evaluated by two blinded plastic surgeons and two senior residents using the VSS and the observer component of the POSAS. In addition, the observer-reported VAS score and patient-reported Likert score were evaluated. Internal consistency, interobserver reliability, and correlations between the patient- and observer-reported outcomes were examined. RESULTS The observer component of POSAS scores demonstrated higher internal consistency and interobserver reliability than the VSS. However, the correlations between the observer-reported VAS score and the patient-reported Likert score (0.450) and between the total sum of patient and observer component scores (0.551) were low to moderate. CONCLUSIONS The POSAS is more consistent over repeated measurements; accordingly, it may be considered a more objective and reliable scar assessment tool than the VSS. However, a clinician's perspective may not exactly match the patient's perception of the same scar.
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Hjellestad M, Strand LI, Eide GE, Brekke R, Nesheim A, Gjelsvik BEB. Clinimetric properties of a translated and culturally adapted Norwegian version of the Patient and Observer Scar Assessment Scale for use in clinical practice and research. Burns 2020; 47:953-960. [PMID: 33139075 DOI: 10.1016/j.burns.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/26/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To translate and culturally adapt the Patient and Observer Scar Assessment Scale, POSAS, to Norwegian and explore its test-retest, intra- and inter-tester reliability. METHODS POSAS was translated into Norwegian following international guidelines in collaboration with an international translation bureau. Twenty-six adults and 24 children were recruited from a burns outpatient clinic. Three observer-categories: doctor, nurse and physiotherapist, assessed the patients' scars and scored the Observer scale for estimating inter-tester reliability. Photos of the scars were taken and used to score the Observer scale a second time for examining intra-tester reliability. The patients or parents/next of kin rated their scar on the Patient scale at the clinic and after two days at home for examining test-retest reliability. Intraclass correlation (ICC) and Kappa were used for statistical analysis. RESULTS A Norwegian version of POSAS (POSAS-NV) was developed. Inter-tester ICC of the Observer parameters varied between 0.203 and 0.728, and for the total sum score, ICC=0.528 (0.280-0.708). Intra-tester ICC of the Observer scale ranged between 0.575 and 0.858. The Patient scale demonstrated high test-retest reliability. CONCLUSIONS Intra-tester reliability of the Observer scale and test-retest reliability of the Patient scale of POSAS-NV were found satisfactory, but not inter-tester reliability of the Observer scale.
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Affiliation(s)
- Marit Hjellestad
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Ragnvald Brekke
- National Burns Centre, Haukeland University Hospital, Bergen, Norway
| | - Anne Nesheim
- National Burns Centre, Haukeland University Hospital, Bergen, Norway
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Kant SB, Mosterd K, Kelleners-Smeets NWJ, Van der Hulst RRWJ, Piatkowski A. Measuring aesthetic results after facial skin cancer surgery by means of the FACE-Q. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01625-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Background
Skin cancer is the most commonly occurring type of cancer. However, the influence of facial skin cancer surgery on patients’ perceived aesthetic appearance is poorly understood. The objective of this study was to provide an insight into how patients perceive the aesthetic outcome of facial skin cancer surgery by means of a specialised patient-reported outcome measure designed for the aesthetic evaluation of the face: the FACE-Q.
Methods
A total of 47 patients with non-melanoma skin cancer who were scheduled for Mohs’s micrographic surgery (MMS) or standard surgical excision (SE) were included. These patients filled out three different FACE-Q questionnaires: satisfaction with facial appearance, social function, and satisfaction with outcome. Follow-up was conducted after baseline at 1 month and 3 months post-surgery.
Results
No significant differences were detected between baseline and follow-up regarding social function and satisfaction with facial appearance. However, after 3 months, patients were significantly more satisfied with the result of surgery when compared with the 1-month post-surgery follow-up.
Conclusions
The perceived aesthetic appreciation of patients does not seem to be significantly influenced by facial skin cancer SE or MMS surgery in this 3-month follow-up study.
Level of evidence: Not ratable.
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Electrosclerotherapy as a Novel Treatment Option for Hypertrophic Capillary Malformations: A Randomized Controlled Pilot Trial. Dermatol Surg 2020; 46:491-498. [DOI: 10.1097/dss.0000000000002191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Lenzi L, Santos J, Raduan Neto J, Fernandes CH, Faloppa F. The Patient and Observer Scar Assessment Scale: Translation for portuguese language, cultural adaptation, and validation. Int Wound J 2019; 16:1513-1520. [PMID: 31599117 DOI: 10.1111/iwj.13228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 09/01/2019] [Accepted: 09/03/2019] [Indexed: 11/28/2022] Open
Abstract
Evaluating scars is fundamental to analyse the outcome of treatments that include surgical intervention. Scales facilitate this type of assessment, but most of these measuring instruments are in different languages. The Patient and Observer Scar Assessment Scale (POSAS) is one of the most robust instruments available in the literature for the evaluation of scars, although there is no validated version in Brazilian Portuguese. The aims of this study were to culturally translate and validate POSAS for the Portuguese language of Brazil and to test its reproducibility, face validity, content, and construct. Following the methodology proposed by Beaton DE, Bombardier C, Guillemin F, Ferraz, MB, Spine 2000, 25, 3186, the questionnaire was translated and adapted to the Brazilian culture. The reproducibility, face, content, and construct validity were then analysed. In all, the scale was applied to 35 patients with postoperative scars (patient version) and 35 hand surgery specialists (version for the observer). The internal consistency was tested by Cronbach's alpha, and construct validation was performed by correlating the translated instrument with the Brazilian Portuguese translation of the Vancouver Scar Scale (VSS). The cultural adaptation of POSAS Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP) was confirmed. Both subscales showed strong internal consistency (Cronbach's α = 0.77-0.93), demonstrating reliability. The reproducibility was excellent, and the adapted scale demonstrated significant intra- and inter-observer reproducibility (r > 0.9) (P < 0.05). The validity of the construct was significant and showed good sensitivity between POSAS EMP/UNIFESP and the VSS. This study confirmed that POSAS EPM/UNIFESP can be used to evaluate patients with surgical scars in the Brazilian population. It has proven to be useful for clinical and research purposes, lending itself to capturing medical opinions and those of the patients themselves.
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Affiliation(s)
- Lgs Lenzi
- Department of Orthopedics and Hand Surgery, Escola Paulista de Medicina-UNIFESP, São Paulo, Brazil
| | - Jbg Santos
- Department of Orthopedics and Hand Surgery, Escola Paulista de Medicina-UNIFESP, São Paulo, Brazil
| | - J Raduan Neto
- Department of Orthopedics and Hand Surgery, Escola Paulista de Medicina-UNIFESP, São Paulo, Brazil
| | - C H Fernandes
- Department of Orthopedics and Hand Surgery, Escola Paulista de Medicina-UNIFESP, São Paulo, Brazil
| | - F Faloppa
- Department of Orthopedics and Hand Surgery, Escola Paulista de Medicina-UNIFESP, São Paulo, Brazil
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Zhang J, Miller CJ, O'Malley V, Bowman EB, Etzkorn JR, Shin TM, Sobanko JF. Patient and Physician Assessment of Surgical Scars: A Systematic Review. JAMA FACIAL PLAST SU 2019; 20:314-323. [PMID: 29392275 DOI: 10.1001/jamafacial.2017.2314] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Importance Surgical scarring affects patients by distracting the gaze of onlookers, disrupting social interactions, and impairing psychosocial health. Patient and physician agreement regarding ideal scar characteristics is important in developing congruent expectations after surgery. Objective To summarize published studies assessing patient and physician ratings of surgical scars, rates of patient and physician agreement in scar assessment, and elements of cutaneous scar assessment that differ between patients and physicians. Evidence Review A literature search of Ovid/Medline, PubMed, and EMBASE was conducted from January 1, 1972, to August 1, 2015. Prospective studies comparing scars from different surgical techniques using at least 1 physician-reported and patient-reported scar measure were included. Strength of studies was graded according to the Oxford Centre for Evidence-Based Medicine guidelines. Findings The review identified 29 studies comprising 4485 patients. Of the 29 included studies, 20 (69%) were randomized clinical trials (RCTs), 5 (17%) were prospective, nonrandomized studies, and 4 (14%) were descriptive studies. Disagreement between patients and physician evaluation of scars occurred in 28% (8 of 29) studies, with only patients rating scar difference in 75% (6 of 8) of these cases. Patients were more likely to value scar depth while physicians were more likely to value scar pigmentation and relief. Conclusions and Relevance Methodologically rigorous studies that include clinician- and patient-reported scar outcomes are uncommon. Studies that incorporate subjective and objective scar grading reveal disagreement between patients and clinicians. Of the incision and wound closure techniques assessed, few affected patient- and clinician-reported outcomes, but the evidence remains weak and future studies are recommended.
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Affiliation(s)
- Junqian Zhang
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | | | | | - Eric B Bowman
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Jeremy R Etzkorn
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Thuzar M Shin
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Joseph F Sobanko
- Department of Dermatology, University of Pennsylvania, Philadelphia
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Nguyen JK, Weedon J, Jakus J, Heilman E, Isseroff RR, Siegel DM, Jagdeo JR. A dose-ranging, parallel group, split-face, single-blind phase II study of light emitting diode-red light (LED-RL) for skin scarring prevention: study protocol for a randomized controlled trial. Trials 2019; 20:432. [PMID: 31307501 PMCID: PMC6631489 DOI: 10.1186/s13063-019-3546-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/29/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Skin fibrosis is a significant global health problem that affects over 100 million people annually and has a profoundly negative impact on quality of life. Characterized by excessive fibroblast proliferation and collagen deposition, skin fibrosis underlies a wide spectrum of dermatologic conditions ranging from pathologic scars secondary to injury (e.g., burns, surgery, trauma) to immune-mediated diseases. Effective anti-scarring therapeutics remain an unmet need, underscoring the importance of developing novel approaches to treat and prevent skin fibrosis. Our in vitro data show that light emitting diode-red light (LED-RL) can modulate key cellular and molecular processes involved in skin fibrosis. In two phase I clinical trials (STARS 1 and STARS 2), we demonstrated the safety and tolerability of LED-RL at fluences of 160 J/cm2 up to 480 J/cm2 on normal human skin. METHODS/DESIGN CURES (Cutaneous Understanding of Red-light Efficacy on Scarring) is a dose-ranging, randomized, parallel group, split-face, single-blind, mock-controlled phase II study to evaluate the efficacy of LED-RL to limit post-surgical skin fibrosis in subjects undergoing elective mini-facelift surgery. Thirty subjects will be randomly allocated to three treatment groups to receive LED-RL phototherapy or temperature-matched mock irradiation (control) to either periauricular incision site at fluences of 160 J/cm2, 320 J/cm2, or 480 J/cm2. Starting one week post-surgery (postoperative days 4-8), treatments will be administered three times weekly for three consecutive weeks, followed by efficacy assessments at 30 days, 3 months, and 6 months. The primary endpoint is the difference in scar pliability between LED-RL-treated and control sites as determined by skin elasticity and induration measurements. Secondary outcomes include clinical and photographic evaluations of scars, 3D skin imaging analysis, histological and molecular analyses, and adverse events. DISCUSSION LED-RL is a therapeutic modality of increasing importance in dermatology, and has the potential to limit skin fibrosis clinically by decreasing dermal fibroblast activity and collagen production. The administration of LED-RL phototherapy in the early postoperative period may optimize wound healing and prevent excessive scarring. The results from this study may change the current treatment paradigm for fibrotic skin diseases and help to pioneer LED-RL as a safe, non-invasive, cost-effective, portable, at-home therapy for scars. TRIAL REGISTRATION ClinicalTrials.gov, NCT03795116 . Registered on 20 December 2018.
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Affiliation(s)
- Julie K Nguyen
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Jeremy Weedon
- Statistical Design & Analysis Research Division, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jeannette Jakus
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Edward Heilman
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - R Rivkah Isseroff
- Dermatology Service, Sacramento VA Medical Center, Mather, CA, USA.,Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - Daniel M Siegel
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Jared R Jagdeo
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. .,Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY, USA.
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12
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Konstantinow A, Fischer T, Zink A. Neck rejuvenation by direct anterior medial cervicoplasty: the modified zigzag-plasty according to Tschopp. J Eur Acad Dermatol Venereol 2017; 32:805-811. [PMID: 29283463 DOI: 10.1111/jdv.14776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/27/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Conventional cervicofacial rhytidectomy has become the standard treatment of skin excess of the ageing neck. However, some patients want to avoid an extensive surgical procedure, especially if the anterior neck is the predominant problem zone. OBJECTIVE To report on the efficacy and safety of a zigzag-shaped skin excision combined with platysma plication. METHODS AND MATERIALS We present a retrospective case review series of six female patients. Skin excess was marked preoperatively using the skin pinching technique, then transferred to a zigzag-shaped area and finally excised using the method according to Tschopp, which is described. Patients were followed up for at least 1 year. RESULTS All patients (age: 55-82 years, median: 65 years) were very satisfied with the results. On an overall patient satisfaction scale of 1-10 (1 being the best), the scars were graded on average 1.85 (median: 2) 1 year after surgery. No scar hypertrophy, functional impairment, nerve damage or other serious complications were observed. CONCLUSION In selected patients, the direct anterior zigzag-shaped excision poses an effective, safe and easy surgical option for both skin excess and fat excess and platysma banding. The technique is easily reproducible, with low morbidity and high patient satisfaction.
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Affiliation(s)
- A Konstantinow
- Department of Dermatology and Allergology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - T Fischer
- Department of Dermatology and Allergology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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Liu X, Nelemans PJ, Frenk LD, Sengers H, Tuinder SM, Steijlen PM, Mosterd K, Kelleners-Smeets NW. Aesthetic outcome and complications of simple interrupted versus running subcuticular sutures in facial surgery: A randomized controlled trial. J Am Acad Dermatol 2017; 77:911-919. [DOI: 10.1016/j.jaad.2017.04.1128] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 11/25/2022]
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Vercelli S, Ferriero G, Bravini E, Stissi V, Ciceri M, Rossetti S, Bianchi S, Sartorio F. Cross-cultural adaptation, reproducibility and validation of the Italian version of the Patient and Observer Scar Assessment Scale (POSAS). Int Wound J 2017; 14:1262-1268. [PMID: 28782201 DOI: 10.1111/iwj.12795] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/02/2017] [Indexed: 11/30/2022] Open
Abstract
The Patient and Observer Scar Assessment Scale (POSAS) is one of the most robust instruments to assess scar quality, but there is no Italian version, and no other competing instruments are available in Italian. The aim of this study was to translate and validate an Italian version of POSAS (POSAS-I). POSASv2.0 was culturally adapted in accordance with international standards. The psychometric assessment included acceptability/feasibility, internal consistency, reproducibility, construct validity and sensitivity to change. Cultural equivalence of POSAS-I with the English version was confirmed. The validation study included 102 subjects with surgical scars. Both subscales demonstrated acceptable internal consistency (Cronbach's α = 0·72-0·80). Reproducibility of the OSAS-I (ICCs = 0·93-0·94; SEM = 1·8 points; MDC95 = 5·1 points) was superior to that of PSAS-I (ICC = 0·65; SEM = 5·7 points; MDC95 = 15·7 points). OSAS-I showed moderate to good correlations with the Vancouver Scar Scale (VSS), Global Rating of Change Scale (GRCS) and PSAS-I. Sensitivity to change was large for PSAS-I (effect size = 1·08; standardised response mean = 0·96) and moderate to large for OSAS-I (ES = 0·69; SRM = 0·92). This study confirmed that POSAS-I can be used to assess patients with surgical scars in the Italian population. OSAS-I is useful for clinical and research purposes, while PSAS-I should be better used to capture patients' own opinions and symptoms in clinical settings.
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Affiliation(s)
- Stefano Vercelli
- Laboratory of Ergonomics and Musculoskeletal Disorders Assessment, Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA-SB, Scientific Institute of Veruno, IRCCS, Novara, Italy
| | - Giorgio Ferriero
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA-SB, Scientific Institute of Lissone, IRCCS, Lissone, Italy
| | | | | | | | - Sara Rossetti
- Clinica La Vialarda - Presidio di Policlinico di Monza SpA, Biella, Italy
| | | | - Francesco Sartorio
- Laboratory of Ergonomics and Musculoskeletal Disorders Assessment, Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA-SB, Scientific Institute of Veruno, IRCCS, Novara, Italy
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