Multiple techniques are available for closing skin defects, such as skin grafts, flaps and tissue expansion. The tissue extender MID SEW (MID, France) was developed to achieve dermatotraction or suture reinforcement. The aim of this study was to evaluate the effectiveness and safety of this innovative silicone extender for large surgical wounds.
A single-centre retrospective and observational study on an unselected consecutive cohort of patients treated with a tissue extender was conducted. Indications, initial and final wound surfaces, and adverse events (AEs) were retrieved from electronic medical records. The main outcome measure was the time to complete wound closure.
We identified 50 patients from July 2017 to December 2018. Patients underwent cutaneous tumour-wide excision (n=44), or pilonidal disease surgical treatment (n=6). The average initial wound area was 53.3±42.4cm2. Healing was complete, without secondary dehiscence, within the first seven days after device withdrawal for 41 patients (82%). At least one AE was experienced by eight patients (16%) during the study period: five inflammation; five wound dehiscence; two skin necrosis; and one pain.
This case series suggests that the tissue extender may be effective and safe in its dermatotraction and suture reinforcement indications in the treatment of large wounds after wide excision of skin cancer or treatment of pilonidal disease.
This work was supported in part by the Hospices Civils de Lyon, France and in part by the University Claude Bernard Lyon 1, France. OB co-owns the patent on the MID SEW system. The authors have no other conflicts of interest to declare.

BACKGROUND: Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged procedures under local anesthesia. The purpose of this study was to assess pain during dermatologic surgery, describe perioperative pain management, and identify factors that influence pain perception.
METHODS: This prospective, monocentric study included inpatients undergoing dermatologic surgery under local anesthesia from April to December 2021. Preoperative demographic data, a pain questionnaire, and four psychometric questionnaires (PCS, LOT-R, SFQ, PHQ-9) were collected. Postoperative pain and analgesic use during the first 24 hours were recorded.
RESULTS: A total of 120 patients (with a total of 191 interventions) were included in the study. Mean postoperative pain was reported to be very low (NRS < 2). Preoperative pain and expected postoperative pain were found to be predictive of postoperative pain. There was a strong correlation between catastrophizing and preoperative anxiety (r = 0.65) and a moderate correlation between depression and preoperative anxiety (r = 0.46).
CONCLUSIONS: Dermatologic surgery under local anesthesia is generally considered painless. During preoperative counseling and assessment, attention should be paid to patients who fear surgery, report pain, or anticipate postoperative pain, as they have an increased risk of experiencing postoperative pain.

Understanding patient non-adherence to prescribed antibiotics can inform clinical practices, patient counseling, and antibiotic efficacy study design in dermatology. The primary objective was to determine the rate of and reasons for antibiotic non-adherence in the dermatologic surgery setting. The secondary objective was to test the applicability of previously studied survey questions for antibiotic non-adherence screening in the dermatologic surgery setting. Five academic outpatient dermatologic surgery centers across the United States conducted one multicenter prospective cohort study. Dermatologic surgery patients ≥ 18 years of age who were prescribed an antibiotic were included as part of this study. 15.2% (42/276) of patients did not adhere to their antibiotic regimen after dermatologic surgery. Most common reasons for incomplete antibiotic courses included forgotten antibiotics (42.9%,18/42) and side effects (28.6%, 12/42). Previously evaluated questions to identify and predict non-adherence had modest performance in the dermatologic surgery setting (Area under the curve of 0.669 [95% CI (0.583-0.754)]). Antibiotic non-adherence after skin surgery is prevalent and commonly due to reasons that physicians can address with patients.

暂无摘要。

暂无摘要。

暂无摘要。

暂无摘要。

暂无摘要。

BACKGROUND Microdiscectomy is a minimally-invasive surgical technique for treating far lateral lumbar disc herniation (FLLDH). This retrospective study from a single center in Turkey aimed to evaluate midlinelumbar discectomy in 20 patients with far lateral lumbar disc herniation. MATERIAL AND METHODS We collected clinical data of 20 patients (11 men, 9 women) operated for FLDDH between January 2006 and January 2022. Patients\' age, sex, surgical level, examination findings, motor deficit, duration of operation, complications during the operation and preoperative/postoperative 6 month visual analogue Scala (VAS), preoperative/postoperative 6th month Oswestry Disability Index (ODI) scores were evaluated. RESULTS The patients were 11 men (55%) and 9 women (45%), with a mean age of 52.08±11.21 years. The mean duration of symptoms before the operation was 3.4 weeks. Laseque sign positivity was found in 86.4% of the patients. Motor deficit was present in 30% of the patients. After 6-month follow-up, preoperative VAS value decreased from 9.35±0.75 to 0.84±0.75. Preoperative and postoperative VAS score averages were significantly different (P=0.0001). Operation ODI values were 73.63±3.76 before and after surgery, and decreased to 14.81±3.63 at 6 months. CONCLUSIONS The term distal lateral disc herniation was first defined in the literature in 1974 when the disc was seen in a different location than the normal location compared to the facet. Far lateral disc herniation can be operated on successfully with midline skin incision.

暂无摘要。