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Ahmed MB, Almohannadi FS, Shraim BA, Aljassem G, Al-Lahham S, Alsherawi A. Surgical Written Consent in Aesthetic Plastic Surgery: A Plastic Center Audit of Surgical Consent Standards. Cureus 2024; 16:e51701. [PMID: 38187027 PMCID: PMC10768741 DOI: 10.7759/cureus.51701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 01/09/2024] Open
Abstract
Background Informed consent is a fundamental aspect of modern medical practice that requires effective communication and an ample understanding of medical ethics, patient autonomy, and the legal obligations of healthcare professionals. Maintaining high-quality surgical informed consent is a crucial step in the healthcare process. Thus, we aimed to obtain surgical written consent on abdominoplasty, suction-assisted abdominal dermo lipectomy, and lower body lifting from our hospital database over three months (January to March, 2023) to assess our level across the American Society of Plastic Surgeons (ASPS) system. Results A total of 45 surgical written consents were obtained and 37 consents remained after exclusion. Bleeding, infection, and hematoma were mentioned in more than 80% of our consents. However, important complications such as ileus and umbilical malposition were never mentioned. Overall, the completion rate of written complications ranged from 14% to 56% in comparison to data from the ASPS. Conclusions Our results show a measurable inconsistency in surgical written consents at our center. Thus, establishing a comprehensive and accurate surgical written consent will aid in protecting our center against deficient surgical written consent accusations, improve the experience of patients, and enhance the quality of service provided by our center.
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Affiliation(s)
- Mohamed B Ahmed
- Plastic and Reconstructive Surgery, Qatar University, Doha, QAT
| | | | - Bara A Shraim
- Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha, QAT
| | - Ghanem Aljassem
- Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha, QAT
| | - Salim Al-Lahham
- Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha, QAT
| | - Abeer Alsherawi
- Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha, QAT
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Ahmed MB, Al Lahham S, Aljassem G, Asnaf AAH, Alyazji ZTN, Omari RY, Al-Mohannadi FS, Alsherawi A, Vranic S. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach. Open Med (Wars) 2023; 18:20230817. [PMID: 37808165 PMCID: PMC10552910 DOI: 10.1515/med-2023-0817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Global brachial plexus injury (GBPI) mainly affects adults and causes severe life-changing consequences that lead to the deterioration of patients' quality of life. Several surgical approaches have been described and reported in the literature to improve patients' functional ability. A literature review is done on PubMed/MEDLINE and Embase using specific keywords to retrieve relevant articles assessing different surgical approaches for GBPI management. Inclusion and exclusion criteria were applied, and eligible articles were included in the review. The literature survey revealed that various surgical options had been used to manage GBPI patients. In this concise review, we discuss and compare the different surgical approaches related to GBPI and its outcome in terms of restoring elbow flexion and extension, shoulder abduction, and wrist and hand function. The primary surgical intervention relies mainly on transferring single or multiple nerves with/without nerve grafts to restore the function of the targeted muscle. Different techniques using a variety of nerve donors and recipients are compared to assess the functional outcomes of each option. Moreover, further options are addressed for delayed GBPI injuries or failed nerve transfer procedures, as in free functional muscle transfer techniques. In addition, information about brachial plexus injury cases faced in our center is presented along with our center's approach to diagnosing and managing partial and GBPI cases.
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Affiliation(s)
- Mohamed Badie Ahmed
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salim Al Lahham
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ghanem Aljassem
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ayman A. H. Asnaf
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Zaki T. N. Alyazji
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rand Y. Omari
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Abeer Alsherawi
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar
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Al Lahham S, Aljassem G, Al-Khayarin A, Sada R, Mogahed H, AlSherawi A. The Use of MartriDerm in Nail Bed Reconstruction of Thumb Injured by a Pellet. Plast Reconstr Surg Glob Open 2023; 11:e5197. [PMID: 37753331 PMCID: PMC10519470 DOI: 10.1097/gox.0000000000005197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/20/2023] [Indexed: 09/28/2023]
Abstract
Gunshot injuries to the hand and upper extremity can be divided into low and high-energy injuries. Nonballistic firearms such as pellet guns are generally considered low-energy guns but can be associated with serious morbidity and even mortality. Management is tailored according to the severity and type of injured structures. Here, we present the case of a 21-year-old soldier who accidently shot his thumb with an air gun while on a bird hunting trip, whose case was managed with extraction placement of bone graft and collagen matrix to prevent nail deformity. This case was written to increase the awareness about the need for safe use of such guns and to display the authors preferred way of management.
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Affiliation(s)
- Salim Al Lahham
- From Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Fellowship in Hand Reconstruction and Microsurgery, Ganga Hospital, India and DAFPRS fellowship, Netherlands
| | - Ghanem Aljassem
- From Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alreem Al-Khayarin
- From Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Heba Mogahed
- From Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abeer AlSherawi
- From Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Badran S, Doi SA, Iskeirjeh S, Aljassem G, Jafarian N, Clark J, Habib AM, Glass GE. Metabolic changes after nonsurgical fat removal: A dose response meta-analysis. J Plast Reconstr Aesthet Surg 2023; 77:68-77. [PMID: 36549125 DOI: 10.1016/j.bjps.2022.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Obesity-induced insulin resistance leads to the metabolic syndrome. Both bariatric surgery and surgical fat removal have been shown to improve metabolic health, but the metabolic benefits of nonsurgical fat removal remain uncertain. The aim of this paper is to establish whether nonsurgical fat removal exerts measurable, lasting metabolic benefits by way of changes to serum lipid profiles. METHODS PubMed, Cochrane CENTRAL, Embase, and clinical trials registers were searched using the Polyglot Search Translator to find studies examining quantitative changes in metabolic markers after nonsurgical body contouring procedures. The MethodologicAl STandard for Epidemiological Research (MASTER) scale was adopted for the quality assessment of the included studies. The robust-error meta-regression (REMR) model was employed. RESULTS Twenty-two studies and 676 participants were included. Peak body compositions measures manifest as a reduction of 2 units in body mass index (BMI), 1 kg of body weight (BW), 5 cm in waist circumference (WC) and 1.5 cm in abdominal fat thickness (FT), sustained up to 60 days postprocedure. Transient increases of 15 mg/dL in low-density lipoprotein (LDL), 10 mg/dl in triglycerides (TG), and 15 mg/dl in total cholesterol (TC) were observed at 2 weeks postprocedure. CONCLUSION While nonsurgical fat removal exerts sustained effects on body anthropometrics, changes to serum lipid profiles were transient. There is no compelling evidence at present to support the conclusion that nonsurgical fat removal is metabolically beneficial.
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Affiliation(s)
- Saif Badran
- Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, MO, USA; College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Suhail A Doi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sara Iskeirjeh
- College of Medicine and Public Heath, Flinders University, Adelaide, SA
| | - Ghanem Aljassem
- Department of Plastic Surgery, Hamad General Hospital, Doha, Qatar
| | - Nasrin Jafarian
- Department of Plastic Surgery, Hamad General Hospital, Doha, Qatar
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Queensland, SA, Australia
| | - Abdella M Habib
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Graeme E Glass
- Weill Cornell Medicine Qatar, Qatar Foundation, Doha, Qatar; Department of Surgery, Sidra Medicine, Doha, Qatar.
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Allahham S, Alyazji ZTN, Aljassem G, Sada R, Wani IR. A Rare Anatomical Finding of Undescribed Accessory Palmaris Longus in the Distal Forearm: A Case Report. Plast Reconstr Surg Glob Open 2022; 10:e4240. [PMID: 35506022 PMCID: PMC9053137 DOI: 10.1097/gox.0000000000004240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
Upper limb muscle anomalies and their clinical implications have been described frequently in the literature reviews. In this article, we are presenting a case of aberrant forearm muscle that had not been described before, and could be considered as a palmaris longus muscle variation. A 24-year-old man presented to the emergency department, Hamad General Hospital, Doha, Qatar, with right forearm laceration with multiple cut structures for which he was admitted for exploration and repair. Intraoperatively, flexor digitorum superficialis of the third, fourth, and fifth digits, flexor carpi radialis, and palmaris longus were injured' and all of them were repaired. We noticed an aberrant muscle-which was also injured-that originated from the distal third of the radius on its medial aspect to insert into the palmar fascia; pulling this muscle's tendon resulted in tightening of palmar fascia' same as the palmaris longus. Along with the importance of deep knowledge of typical human anatomy, hand surgeons must be aware that an aberration from normal anatomy might be anticipated, to provide the best care to our patients.
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Affiliation(s)
- Salim Allahham
- From the Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Ganga Hospital, Coimbatore, Tamil Nadu, India
- DAFPRS, Rotterdam, The Netherlands
| | - Zaki T. N. Alyazji
- From the Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ghanem Aljassem
- From the Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ruba Sada
- Customer of Patient's Experience and Staff Engagement (CPESE), Hamad Medical Corporation, Doha, Qatar
| | - Iqbal Rasool Wani
- From the Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Aljassem G, Al Lahham S, Omari R, Alyazji Z, Sada R, Alharami S, Albasti H. A simple option added for reconstruction of posterior neck defects. J Cutan Aesthet Surg 2022; 15:142-146. [PMID: 35965903 PMCID: PMC9364447 DOI: 10.4103/jcas.jcas_101_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Posterior neck defects are uncommon and are mainly caused by infections or tumors. Consequently, the reconstruction options are limited in the literature. They vary according to the size and type of the defect, and options range from grafts to free flaps. In this article, we present a series of cases where we used a transpositional locoregional flap as a simple and effective way for the coverage of posterior neck defects. Materials and Methods: In a series of 11 patients, we designed locoregional transpositional flaps unilaterally or bilaterally, according to the defect size. Dissection was carried on a subfascial plane. Results: All flaps survived without necrosis. We had two incidents of minimal wound gaping that healed without any intervention. Conclusion: In this series, we introduce a new option and its algorithm to reconstruct moderate-sized posterior neck defects using locoregional transpositional flaps, either unilaterally or bilaterally. It is simple, easy to conduct, and has a better color match and less complication rate than other options mentioned in the literature.
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Aljassem G, Aljasem H. Case report: Ectopic Cushing's syndrome in a young male with hidden lung carcinoid tumor. Int J Surg Case Rep 2017; 42:13-16. [PMID: 29202350 PMCID: PMC5723367 DOI: 10.1016/j.ijscr.2017.11.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/10/2017] [Accepted: 11/12/2017] [Indexed: 11/29/2022] Open
Abstract
Ectopic Cushing’s syndrome is a form of Cushing’s in which a tumor outside the pituitary gland produces a hormone called (ACTH). Small cell carcinoma and carcinoid of the lung comprises half of its cases. Ectopic cushing syndrome is a complicated medical problem especially when it comes to identification of the ectopic spot. The surgical treatment could be curative when the spot is determined.
Introduction Ectopic Cushing syndrome is a form of Cushing’s in which a tumor outside the pituitary gland produces adrenocorticotropic hormone (ACTH). Small cell carcinoma and carcinoid of the lung comprises half of its cases. The main purpose of this study is to present a case of ectopic Cushing syndrome caused by a hidden lung carcinoid and how to manage it. Presentation of case Here we present a case of a 26 year old young male complains of increased weight and appetite, proximal muscle weakness, easy bruising and appearing of purple striae on his abdomen, with a final diagnosis of ACTH secreting lung carcinoid. Discussion The diagnosis was made by non-invasive radiological procedures (CT scan and MRI) and serological tests. The management consisted of medical treatment which was not useful, then bilateral adrenalectomy to limit the patient symptoms. The ectopic spot was finally detected and excised surgically through thoracotomy. After six months of follow up there was no recurrence, signs and symptoms of Cushing syndrome begin to disappear. Conclusion Ectopic cushing syndrome is a complicated medical problem especially when it comes to identification of the ectopic spot. The surgical treatment could be curative when the spot is determined.
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Affiliation(s)
| | - Hazem Aljasem
- Department of Surgery, Damascus University Hospital, Syria.
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