Internet-based survey of the perceptions of surgical scars of Japanese patients

The Impact of Platysma Closure on Post-Thyroidectomy Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Aim

This systematic review and meta-analysis of randomized controlled trials (RCTs) compare the impact of platysma muscle layer closure technique among patients undergoing thyroidectomy in terms of postoperative outcomes, specifically pain.

Methods

Five electronic databases (PubMed, Scopus, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials) were searched from inception until July 22, 2023. The Cochrane risk of bias tool 2 was employed for risk of bias (ROB) assessment. Data were pooled as mean difference (MD), standardized MD (SMD), or risk ratio (RR) based on data type (continuous or dichotomous) using RevMan software.

Results

This meta-analysis included four RCTs with a total of 426 patients. Three RCTs had a low risk of bias, while one had some concern regarding bias. The overall MD of the postoperative pain score favored the non-closure group over the closure group (MD = 0.63; 95% CI: [0.09, 1.18]; P = 0.02). However, no significant differences were observed between the two groups in terms of patient scar assessment scale (MD= -0.61; 95% CI: [-3.39, 2.17]; P = 0.67), observer scar assessment scale (SMD = 0.26; 95% CI: [-0.30, 0.81]; P = 0.37), length of the scar (MD = 0.27; 95% CI: [-0.12, 0.67]; P = 0.17), wound infection (RR = 0.63; 95% CI: [0.13, 3.16]; P = 0.57), and seroma or hematoma (RR = 3.00; 95% CI: [0.49, 18.55]; P = 0.24).

Conclusion

Our findings suggest that the platysma muscle layer closure during thyroidectomy might lead to increased postoperative pain but does not significantly impact scar outcomes or postoperative complications.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-024-04503-3.

The Attitudes of Patients Toward Orthopaedic Post-surgical Scars

Background Post-surgical scars (PSS) are an expected consequence of surgery. Several factors have previously been associated with PSS satisfaction including patient age and time elapsed post-operative. Little data are available regarding patient attitudes toward orthopaedic PSS. Knowledge of patient attitudes and the various associated factors may allow physicians to administer peri-operative care to mitigate the potential negative effects of PSS. Our study aims to investigate the attitudes of patients toward their PSS using quantitative scar assessment scales and to identify factors associated with PSS satisfaction. Methods We conducted a retrospective study with a follow-up. We included all patients with orthopaedic PSS on their upper or lower limbs between two and 18 weeks postoperative attending Cork University Hospital, Ireland, between February and August 2022. Patients completed an initial baseline questionnaire and then a follow-up questionnaire six months post-operative. The Patient and Observer Scar Assessment Scale (POSAS) evaluated PSS satisfaction. The European Quality of Life 5 Domain (EQ-5D), alongside several Likert scales, evaluated the patient's quality of life (QoL). Results In total, 91 patients were included. The mean POSAS score was 28.41 (95% CI, 25.85-30.97). Younger patient age (p=0.045) and decreased time passed post-operatively (p=0.002) were associated with poorer PSS satisfaction. Patients reporting their PSS appearing worse than expected were more likely to agree that their QoL had been adversely affected by it (p=0.001). Conclusion Most patients were satisfied with their orthopaedic PSS. This study identified several factors associated with poor PSS satisfaction. Our finding, which associated patient scar expectations and QoL, is novel and has not been previously examined. Accordingly, peri-operative interventions, including scar expectation management, may be implemented to mitigate scar-related QoL impact.

Fractional ablative carbon dioxide laser treatment of facial scars: Improvement of patients' quality of life, scar quality, and cosmesis

BACKGROUND

Disfiguring facial scars can be a massive burden on patients' psychosocial health and severely impact patients' self-esteem.

AIMS

The aim of this study was to analyze whether ablative fractional carbon dioxide laser (CO2-AFL) treatment can positively influence facial scarring and quality of life (QoL) while improving the aesthetic appearance.

PATIENTES/METHODS

Patients with facial scars who had received CO2-AFL treatment between May 2019 and May 2020 were included in a retrospective study. The post-interventional course and patient and/or observer reported outcomes were inquired before and three months after treatment. Primary outcomes were changes in the Patient and Observer Scar Scale (POSAS) and QoL (Short Form (SF) 36). In addition, two independent examiners evaluated the aesthetic outcome by comparing initial scarring with the post-intervention results using photographs.

RESULTS

A total of 16 patients with facial scars were included. Most of the scars were caused by burns (43.8%) or trauma (31.3%). The post-interventional course was uneventful. Overall POSAS scores improved decisively for both observers (n=2) and patients (n=16) (p<0.001 and p<0.001). Also, there was an improvement in QoL with an increase in emotional well-being (p=0.043) and social functioning (p=0.01). Furthermore, the aesthetic outcome was significantly enhanced (p=0.001) after treatment.

CONCLUSION

The CO2-AFL offers a safe and effective treatment for disfiguring facial scars. We have shown that improvement of scar appearance and scar quality was meaningful to the patient, with a significant impact on a patient's life quality. Based on these findings we suggest including the CO2-AFL in the facial scar treatment concept.