Journal Club 'Autologous platelet-rich plasma (PRP) covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study'
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This study compared using autologous platelet-rich plasma (PRP) versus a dartos flap for covering the urethra after distal hypospadias repair using the Snodgrass technique. The randomized study of 180 patients found no significant difference in operative time between the PRP and dartos flap groups. Post-operative complication rates and cosmetic results were also similar between the two covering methods. The study concluded that PRP could be a low-cost alternative to other tissue grafts for urethral coverage after hypospadias repair.
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https://myclassroom.apus.edu/d2l/le/enhancedSequenceViewer/24956?url=https%3A%2F%2Ff54cbe36-23a9-4505-85fe-e251f80ec34d.sequences.a… 1/1
Review the readings and choose a subject of interest for a 10-12 page research paper.
All topics related to this course are pre-approved, but if unsure if your topic is
appropriate you can post it under the Questions for Dr. C tab and I will gladly confirm if
it will work.
Your opinion related to the topic you choose does not determine your grade. Your
grade is determined by how well you support your argument utilizing the materials
discussed in this course and research and reference material you locate. What I do not
want is a regurgitation of what is in the text. Expand on the readings, do not repeat
them. Document your facts utilizing standard APA 7th edition style. This paper is to be
submitted to me as indicated on the Course Schedule and Grading Policy Summary
Table. The paper is to be in APA format and the body of the paper is to be between 10
and 12 pages. The body of the paper does not include the title page, table of contents,
QUOTES, images, appendix or references. This is to be of high quality, free of spelling
and grammatical errors, and of original work. Plagiarism will be dealt with harshly. You
are to title your paper by your last name. For example, my paper would be called
“conkey.docx” with “.docx” being the MS Word file extension. You are to submit your
paper via the Assignments tab and corresponding assignment course site prior to the
due date as indicated in the Course Schedule and Grading Policy Summary Table.
For this assignment:
1) Your research paper is automatically processed by turnitin.com upon submission.
2) You must submit your research paper to this assignment as a Word document.
3) The research paper must be supported by a minimum of 5 academic peer reviewed
sources
Original Research ajog.org
OBSTETRICS
Skin closure at cesarean delivery, glue vs subcuticular
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Yair Daykan, MD1; Maya Sharon-Weiner, MD1; Yael Pasternak, MD; Keren Tzadikevitch-Geffen, MD;
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pregnant women undergoing a scheduled cesarean delivery were
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patients. Outcome assessors were blinded to group allocation. Scars were
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162021 Paper (due Sat of Wk 8)httpsmyclassroom.apus.e
1/6/2021 Paper (due Sat of Wk 8)
https://myclassroom.apus.edu/d2l/le/enhancedSequenceViewer/24956?url=https%3A%2F%2Ff54cbe36-23a9-4505-85fe-e251f80ec34d.sequences.a… 1/1
Review the readings and choose a subject of interest for a 10-12 page research paper.
All topics related to this course are pre-approved, but if unsure if your topic is
appropriate you can post it under the Questions for Dr. C tab and I will gladly confirm if
it will work.
Your opinion related to the topic you choose does not determine your grade. Your
grade is determined by how well you support your argument utilizing the materials
discussed in this course and research and reference material you locate. What I do not
want is a regurgitation of what is in the text. Expand on the readings, do not repeat
them. Document your facts utilizing standard APA 7th edition style. This paper is to be
submitted to me as indicated on the Course Schedule and Grading Policy Summary
Table. The paper is to be in APA format and the body of the paper is to be between 10
and 12 pages. The body of the paper does not include the title page, table of contents,
QUOTES, images, appendix or references. This is to be of high quality, free of spelling
and grammatical errors, and of original work. Plagiarism will be dealt with harshly. You
are to title your paper by your last name. For example, my paper would be called
“conkey.docx” with “.docx” being the MS Word file extension. You are to submit your
paper via the Assignments tab and corresponding assignment course site prior to the
due date as indicated in the Course Schedule and Grading Policy Summary Table.
For this assignment:
1) Your research paper is automatically processed by turnitin.com upon submission.
2) You must submit your research paper to this assignment as a Word document.
3) The research paper must be supported by a minimum of 5 academic peer reviewed
sources
Original Research ajog.org
OBSTETRICS
Skin closure at cesarean delivery, glue vs subcuticular
sutures: a randomized controlled trial
Yair Daykan, MD1; Maya Sharon-Weiner, MD1; Yael Pasternak, MD; Keren Tzadikevitch-Geffen, MD;
Ofer Markovitch, MD; Rivka Sukenik-Halevy, MD; Tal Biron-Shental, MD
BACKGROUND: The optimal choice of skin closure at cesarean RESULTS: Demographic characteristics, patients’ clinical background,
delivery has not yet been determined.
OBJECTIVE: This study compared wound complications and scar
healing following cesarean delivery between 2 methods of skin closure:
glue (Dermabond; Ethicon, Somerville, NJ) and monofilament (Monocryl;
Ethicon) epidermal sutures.
STUDYDESIGN:We conducted a randomized controlled trial in which
pregnant women undergoing a scheduled cesarean delivery were
randomly assigned to skin (epidermis) closure with glue or with a mono-
filament synthetic suture. The subcutaneous tissue was sutured for all
patients. Outcome assessors were blinded to group allocation. Scars were
evaluated >8 weeks. Primary outcome measures ...
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This study evaluated the use of vascularised fatty tissue flaps to replace excised parotid tissue and prevent Frey's syndrome in 37 patients who underwent parotidectomy between 2008-2017. The fatty flaps took an average of 17 minutes to dissect and were stable for up to 9 years of follow up. None of the patients reported symptoms of Frey's syndrome such as flushing or sweating when eating. The flaps were an easy technique that avoided donor site morbidity compared to other options and successfully prevented Frey's syndrome in all patients.
Corseting: A new technique for the management of diffuse venous malformations...
Corseting: A new technique for the management of diffuse venous malformations...Dibya Falgoon Sarkar
1) The study introduces the "corset suturing" technique for treating large diffuse venous malformations in the head and neck region. Corset suturing involves continuous suturing that incorporates the lesion and strangulates the vessels to induce occlusion.
2) The technique was performed on 90 patients with non-cutaneous venous malformations. Most lesions resolved within 4-8 weeks with minimal complications and good cosmetic outcomes.
3) While corset suturing provides an effective and low-cost alternative treatment, the study had limitations as a retrospective study without controls to fully evaluate the technique.Parathyroidectomy in chronic kidney disease (mansoura 2014)
This document outlines a 6-day workshop on parathyroidectomy in chronic kidney disease to be held in Mansoura, Egypt. The workshop aims to train surgeons from district areas in the surgical management of renal hyperparathyroidism through lectures, case discussions, and hands-on surgical training under experienced faculty. A maximum of 5 surgeons will be selected to participate in the workshop and be assessed on their medical and surgical abilities related to parathyroidectomy. Upon satisfactory completion, participants will be awarded a certificate and offered mentoring support by the faculty.
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This study examined the effects of topical vascular endothelial growth factor (VEGF) on post-surgical tracheal healing in rabbits. Rabbits underwent tracheal surgery using various reconstruction materials, including autograft patches, xenopericardium patches, intraluminal stents, and controls. Half of the reconstruction materials were pretreated with VEGF while the other halves received saline. The study found that autograft repair induced the least granulation tissue and fibrosis. Pretreating materials with VEGF reduced postoperative fibrosis and granulation tissue, except in stents which rapidly caused airway obstruction. VEGF staining suggested local VEGF production over time in addition to the applied topical VEGF.
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This document summarizes a technique for performing local/regional anesthesia for thyroid surgery. It begins by describing the patient who will undergo a parathyroidectomy due to hypercalcemia from hyperparathyroidism. It then provides background on the history and development of performing thyroid surgery under local/regional anesthesia. It proceeds to describe the relevant anatomy of the cervical plexus and its branches. It concludes by outlining the technique for performing a superficial cervical plexus block, including patient position, landmarks, local anesthetic used, and injection points along the posterior border of the sternocleidomastoid muscle at the level of the external jugular vein. The summary is provided in 3 sentences or less as requested.
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- The study evaluated the effectiveness and safety of outpatient talc pleurodesis in patients with recurrent malignant pleural effusions and low performance status (KPS ≤70).
- 64 patients underwent pleural catheter placement, with 52 patients subsequently receiving talc pleurodesis. No complications occurred during catheter placement or pleurodesis.
- Pleurodesis resulted in complete or partial symptomatic improvement in nearly all patients. The recurrence rate 30 days after pleurodesis was 13.9%. Complications included catheter obstruction and empyema in a small number of patients.
Parathyroidectomy in chronic kidney disease (mansoura 2014)
This document outlines a 6-day workshop on parathyroidectomy in chronic kidney disease to be held in Mansoura, Egypt. The workshop aims to increase awareness and standardize the surgical management of hyperparathyroidism among surgeons in rural Egyptian hospitals. Over the 6 days, attendees will receive lectures on the medical and surgical treatment of hyperparathyroidism and participate in multiple parathyroidectomy surgeries performed by experienced surgeons. The goal is to train surgeons who can then train others in their home institutions. Successful attendees will receive a certificate from the Egyptian Medical Syndicate. The workshop is sponsored by the Syndicate and Sheffield Teaching Hospitals.
ENDOSCOPIC TREATMENT OF PILONIDAL SINUS IN EGYPTIAN PATIENTS
Background: Treatment for pilonidal disease using minimally invasive methods is a reliable and successful alternative to conventional surgery, with quicker recovery, better cosmetic outcomes, and better pain management. The primary goals of this study are to assess the early outcomes of endoscopic pilonidal sinus treatment and to demonstrate the surgical approach and its adaptations. Materials and Methods: Our study was conducted on 30 patients with pilonidal sinus disease as a prospective cohort study for endoscopic treatment of the pilonidal sinus, from October 2021 to October 2022, in our surgical department at Theodor Bilharz Research Institute (TBRI). Surgical outcomes of sinus healing, pain, and discharge were reviewed in the outpatient clinic, and patient satisfaction levels were assessed through a standardized phone interview. Results: There were 24 males and 6 females, with a median age of 21.87±1.85 years (ranging from 16 to 57 years). The mean operative time was 44.17 (35-55) ±1.26 min. During the follow-up period of 24 weeks, wound closure was seen after a median of 4 weeks. Wounds were closed in 72% of patients after one month and 93% of patients after two months. 2 patients had to be re-operated due to failure: one had persistence of discharge, and the other had recurrence after 3 months. The satisfaction rate was 93.3%. Conclusions: Endoscopic pilonidal sinus treatment is a minimally invasive and cosmetically favorable procedure. To find out if it reduces recovery time and the long-term recurrence rate, a larger sample size and a longer follow-up are needed.
Parathyroidectomy in-esrd-menya
This document summarizes the experience of a single center in managing secondary hyperparathyroidism in 100 hemodialysis patients through parathyroidectomy. Key findings include:
- Patients underwent total parathyroidectomy with thymectomy and autotransplantation for severe, refractory hyperparathyroidism.
- Post-operatively, PTH levels dropped dramatically while calcium and phosphate normalized.
- Most complications were minor. The procedure effectively corrected mineralization disturbances in most patients.
- The center established an educational program to train local surgeons in safely performing this operation.
Steam catheter
This study assessed the safety and efficacy of steam vein sclerosis (SVS) for treating the great saphenous vein in 75 patients over 12 months. At 6 months, 96% of treated veins were successfully obliterated as assessed by duplex ultrasound. Quality of life scores improved significantly at 6 months for both physical and mental components. SVS achieved obliteration rates similar to other thermal ablation techniques with minimal post-operative pain and no major complications reported.
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Extensor tendon injury
This document summarizes different types of extensor tendon injuries and their treatment. It discusses mallet finger injuries, describing 4 types and their respective treatments which may include splinting or surgical repair. It also covers Boutonniere deformity, its causes, and potential surgical treatments like Fowler tenotomy or Littler tendon graft. Finally, it outlines different injury zones 1-9, from the DIP joint to the muscle belly, and recommendations for treatment including splinting, suturing, or tendon repair depending on the specific zone and nature of the injury.
Flexor tendon injury
This document discusses flexor tendon injuries and repair techniques. It covers anatomy of the flexor tendons and pulleys, mechanisms of injury, zones of injury, and various repair and reconstruction methods. For zone 1 and 2 injuries, it describes techniques like primary repair, pull out sutures, tendon grafting, and pulley reconstruction. It also outlines rehabilitation protocols and complications that can occur with different procedures.
Replantation
This document discusses various aspects of replantation surgery including:
1. It describes different types of amputation mechanisms and different levels of replantation from fingertips to major limbs.
2. It provides details on preoperative management, bench work to prepare tissues for repair, and the sequence of replanting arteries, veins, nerves, tendons, and skin closure.
3. Postoperative management focuses on monitoring for thrombosis, use of anticoagulants like aspirin and dextran, and rehabilitation through gentle range of motion exercises.
Tenosynovitis disorders of the Upper Extremity
The document discusses several types of tenosynovitis disorders including intersection syndrome, De Quervain's tenosynovitis, trigger finger, and lateral epicondylitis. Intersection syndrome involves tendonitis of the first and second extensor compartment tendons from repetitive friction. De Quervain's tenosynovitis is inflammation of the tendons of the thumb from overuse. Trigger finger causes difficulty extending the finger due to thickening around the A1 pulley. Lateral epicondylitis, or tennis elbow, is a strain at the origin of the extensor tendons causing pain with wrist and elbow movement. The document provides details on symptoms, examinations, treatments including splinting, injections
Congenital Thumb Deformities
This document discusses several congenital thumb deformities, including types of thumb hypoplasia, clasped thumb, and triphalangeal thumb. It describes the characteristics and classifications of each condition and recommendations for treatment, which may include splinting, tendon transfers, web space corrections, or bone excisions and fusions. Workup may involve imaging and testing to assess the specific thumb abnormality and rule out associated syndromes. The goal of treatment is to improve function by restoring thumb extension, opposition, and web space width.
Congenital Melanocytic Nevi + Tissue Expander
This document discusses congenital melanocytic nevi (CMN) and the use of tissue expanders in their treatment. It defines CMN as rare pigmented birthmarks that form during fetal development. It classifies CMN by size and describes their characteristics, histologic features, differential diagnosis, risk of malignant transformation, and associations with neurological conditions. The document outlines the use of tissue expansion to replace excised CMN with expanded skin of similar texture and color. It discusses expander types, the expansion process, complications, and applications for different anatomical sites.
Foot and ankle reconstruction.ppt
This document provides information on foot and ankle reconstruction following trauma or other conditions. It discusses relevant anatomy, comorbidities like diabetes and neuropathy that must be considered, examination steps, investigation options, and various reconstructive techniques. Reconstruction options range from local flaps and skin grafts for smaller defects to pedicled and free flaps for larger or complex cases. Post-operative care involves non-weight bearing, elevation, and gradual rehabilitation. The document aims to guide evaluation and selection of the best reconstructive approach based on individual patient and wound factors.
Journal Club 'Hypospadias repair with the glanular-frenular collar (GFC) tech...
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Conducted by: Prof Arif Mateen
Author: Hüseyin Özbey, Şeref Etker
Journal: Journal of Pediatric Urology
Published: 23 September 2016Hair Transplantation - Dr Mujtuba Pervez Khan
This document discusses hair transplantation techniques and procedures. It provides information on hair anatomy, the hair loss cycle, patterns of hair loss, patient consultation and evaluation, pre-operative therapies and preparation, anesthesia techniques for donor and recipient sites, follicular unit extraction and transplantation methods, graft preparation and storage, recipient site implantation, and post-operative care. Potential complications of hair transplantation are also outlined.
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This document discusses abdominoplasty, also known as a tummy tuck. It describes the common problems that abdominoplasty addresses such as excess skin and fat from pregnancy, weight loss, or weight gain. It covers the anatomy, patient history, examination, gender differences, techniques, post-operative care, and potential complications of abdominoplasty. Techniques discussed include mini abdominoplasty, full abdominoplasty, circumferential lipectomy, belt lipectomy, and lower body lift. The goal of abdominoplasty and its variations is to remove excess skin and fat from the abdomen and waist area to create a firmer, tighter, and more toned appearance.
Hypospadias
- Hypospadias is a congenital condition where the urethral opening is on the underside of the penis rather than at the tip. It can range from mild to severe forms.
- The cause is usually unknown but may involve genetic factors or exposure to chemicals during pregnancy. Risk increases with family history, maternal age over 35, or in vitro fertilization.
- Treatment involves surgery to reposition the urethral opening, which is usually done between ages 6-18 months. The goal is to create a normal appearing penis and allow for normal urination and sexual function.
- Surgical techniques vary depending on the severity but aim to lengthen and tubularize the urethra
Craniofacial Microsomia
This document discusses craniofacial microsomia, which involves hypoplasia of the structures derived from the first and second brachial arches. It may cause asymmetry of the orbit, mandibular hypoplasia, ear deformities, and nerve dysfunction. The etiology involves vascular insult to the developing brachial arches. Management involves thorough assessment and a variety of surgical procedures depending on the severity, including distraction osteogenesis and bone grafting. Treatment aims to correct anatomical abnormalities, restore function, and improve aesthetics.
Fat grafting in Plastic Surgery
Fat grafting involves harvesting fat from areas like the abdomen through liposuction and refining it to separate viable fat cells from other components. The purified fat is then reinjected into areas like the face and breasts through microdroplet injections between skin layers to augment volume. Potential complications include irregular contours, necrosis of grafted fat, and infection. However, stem cells found in fat tissue are also being researched for uses like wound healing, skin engineering, and repairing various organs. Fat grafting is a popular aesthetic procedure that has been improved through techniques preserving high viability of transplanted fat cells.
Management of hand and wrist fractures
This document provides an overview of the management of hand fractures. It discusses the goals of treatment which include restoring anatomy, reducing malrotation and angulation, maintaining reduction with minimal surgery, and rapid mobilization. Most closed hand fractures can be treated with closed reduction and splinting, while unstable or intra-articular fractures often require operative fixation techniques like K-wiring, tension band wiring, plating, or external fixation. Common fractures of the hand including metacarpals, phalanges, and thumb are described along with appropriate treatment options and techniques. Potential complications of treatment are also outlined.
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
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Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Journal Club 'Autologous platelet-rich plasma (PRP) covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study'
- 1. Autologous platelet-rich plasma (PRP) covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study Abdelaziz Yehya Mahmoud, Samir Gouda, Ibrahim Gamaan and Mohamed A Baky Fahmy Pediatric Surgery Department, Al-Azhar University Hospitals, Cairo, Egypt Presenter: Dr Mujtuba Pervez Khan Resident Plastic and Reconstructive Surgery DUHS/CHK
- 2. Literature Soft tissue coverage over the urethra, important factor affecting the outcome Protective layer between the neo-urethra and the skin reduces fistulas and overall complications Despite the use of covering flaps in hypospadias surgery, it is still a matter of debate by some authors. PRP is an autologous concentrate of platelets in a small volume of plasma containing biologically active factors responsible for hemostasis, synthesis of new connective tissue and revascularization
- 3. PRP for hair loss PRP for Arthritis
- 5. PRP for Alveolar Cleft
- 6. Discussion >250 techniques have been reported Fistula rate varies from 3 to 10% Different techniques for second layer coverage No accordance among pediatric urologists on the most effective technique
- 8. Tunica vaginalis Buccal / Lower lip mucosa graft
- 9. Dartos layer Fibrin glue layer Spongioplasty
- 10. Aim To evaluate and to compare the use of PRP covering layer and dartos flap layer in regard to complication rates in Snodgrass (TIP) hypospadias repair.
- 11. Methods RCT October 2011 to December 2016 Total 180 patients Mean age 27.9 months Randomization was achieved through sealed envelopes
- 12. Group A (n= 90) PRP layer group Lost to follow up = 3 Group B (n= 90) Dartos flap group Lost to follow up = 5
- 13. Inclusion Criteria Primary cases Sub coronal, distal and mid penile with minimal chordee Exclusion Criteria Proximal hypospadias UCF Moderate to severe chordee Previous topical androgen therapy
- 14. Parameters Operative time Early and late post op complications Urinary stream Aesthetic appearance
- 15. Operative Procedure 10cc blood drawn PRP extracted by double centrifuge Calcium chlorate was added Incubated at 37°C for 3 mins until red clot was obtained
- 17. Operative Procedure PRP sheet was applied (vicryl 7/0) after tubularization (vicryl 6/0) Skin was closed 8 -12 F catheter was used Dressing removed on 4th P.O.D Catheter kept for 7-10 days Urinary stream was observed in all patients
- 18. Statistical Analysis 95% confidence interval 80% power of the study 5% error Chi squared test was applied P <0.050 was considered significant
- 19. Results
- 20. Results A, PRP group = 124.6 minutes B, Dartos group = 136.4 minutes P >0.10, statistically insignificant Operative time
- 22. Results A slit-like neo-meatus on the tip of the glans was obtained in most of the cases. Parents were asked to evaluate the cosmetic appearance of the penis as good, acceptable, bad or indifferent. The cosmetic result was reported as good in 73% of group A and 69% of group B. Cosmetic appearance
- 23. Critique Introduction Methods Statistics Results Conclusion
- 24. Strengths No additional cost involved as in fibrin glue May be reproducible in out setup
- 25. Limitations Single center study Small randomized study Needs comparison with other techniques
- 26. In our setup…
- 28. Thankyou.