bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of the Consort Statement to Randomized Controlled Trials Comparing Endoscopic and Open Carpal Tunnel Release
Authors: Thoma Achilleas , Chew Roderick T , Sprague Sheila , Veltri Karen 
Published: February 2017

Background The CONSORT (Consolidated Standards of Reporting Trials) statement was developed by a group of clinical trialists, biostatisticians, epidemiologists and biomedical editors as a means to improve the quality of reports of randomized controlled trials (RCTs). The purpose of the present study is to assess the reporting quality of published RCTs that compare endoscopic carpal tunnel release (ECTR) with open carpal tunnel release (OCTR) using the CONSORT statement. Methods A computerized literature search was conducted to identify all RCTs published from January 1989 to November 2004 that compared ECTR with OCTR. Foreign language studies were also included, and translated versions of these studies were obtained. Two investigators independently reviewed each eligible article and determined whether the authors reported on each of the 22 items of the CONSORT statement. Disagreements were resolved by consensus. The mean scores for studies published before the introduction of the CONSORT statement and those published afterward were compared. Similarly, a comparison was made between foreign language studies and those published in English. Results Eighteen RCTs comparing ECTR with OCTR met the inclusion criteria. The total scores on the CONSORT checklist ranged from 3 to 20, with a mean score of 9.83±3.79 (the maximum possible score was 22). The six studies published in foreign language journals had a statistically significantly lower mean score than the studies published in English language journals (7.00±2.76 versus 11.25±3.49, respectively; P<0.05). The mean score was higher for studies published after 1996 than for those published in 1996 or earlier (12.14±3.80 versus 8.36±3.11, respectively; P<0.05). Conclusions The quality of reporting improved over time, but no study met all 22 criteria of the CONSORT statement. The CONSORT scores were higher for studies published after 1996 and for studies published in English language journals. Despite the improvement after 1996, most of these RCTs only reported one-half of the items listed on the CONSORT statement. Future investigators of surgical RCTs should make an effort to comply with the CONSORT checklist.
Silver-coated nylon dressings for pediatric burn victims
Authors: Borsuk Daniel E , Gallant Michel , Richard Diane , Williams H Bruce 
Published: February 2017

Background Silver dressings are a proven method for burn treatment. Current challenges associated with burn treatment include pain management and limited hospital resources. A new silver-coated nylon dressing was used at the Montreal Children's Hospital (Montreal, Quebec) to help reduce traumatic dressing changes and cost. Methods Burn victims in a pediatric patient population were followed over two years. Patients were excluded if they were evaluated more than 48 h postburn or if the burn affected less than 5% of the total body surface area. The same burn team admitted and treated all case subjects, and one dressing nurse recorded and monitored all progress throughout the study to ensure standardization. Results Fifteen patients were included in the study. The average number of dressing changes needed was 4.13, with a median of three changes. The average total body surface area burned was 8%, with a mean of 13.9 days before superficial wounds were re-epithelialized. The average length of in-hospital stay was four days. The cost was $388 less for silver-coated nylon dressings than for silver sulfadiazine cream for seven days of treatment. Silver-coated nylon dressings did not leave any residue or pseudoeschar on the wounds and were easily maintained at home. Conclusion The silver-coated nylon dressings are as effective as other silver dressings used for pediatric burn victims. The dressings are less traumatic, require fewer resources and do not leave wound residue compared with other dressings.
A Geometric Method for Nipple Localization
Authors: Khan Humayun Ayub , Bayat Ardeshir 
Published: February 2017

Background An important part of preoperative assessment in breast reduction surgery is to locate the site of the nipple-areola complex for the newly structured breast. Inappropriate location is difficult to correct secondarily. Traditional methods of nipple localization taught and practiced suggest the nipple to be located anterior to the inframammary fold. Trying to project this point on the anterior surface of the breast requires either large calipers or feeling the posteriorly placed finger on the anterior surface of a large breast. This certainly introduces some subjectivity to the calculation. Objectives To introduce an easy and accurate method of nipple localization to reduce the learning curve for trainee surgeons. Methods Aesthetic placement of the nipples is at the lower angles of an equilateral or a short isosceles triangle on the chest with its apex at the sternal angle. This triangle can be thought of as two right-angled triangles with their Y-axis on the median plane. The base and vertical limb are measured, and the hypotenuse is calculated. The location of the lower angle is marked on the anterior surface of the breast and represents the new position of the nipple. Results Forty patients had nipple localization performed in the above-described manner, with satisfactory placement of the nipple-areola complex. Conclusions The above technique introduces some objective measurements to the localization of the nipple in breast reduction surgery. It is easy to practice, and infuses confidence in trainees marking their initial breast reductions.
A New Technique of Internal Suture Mastopexy for Mild to Moderate Breast Ptosis
Authors: Mahabir Raman Chaos , Zamboni William A 
Published: February 2017

Background Current mastopexy techniques rely on incisions on the breast to correct ptosis. Trading a ptotic breast for a visibly scarred breast can be a difficult choice. Objective and Methods A technique of internal suture mastopexy that consists of plicating sutures placed in the superficial fascia of the breast from the deep surface is presented. The procedure leaves no scar on the breast and may be safer than other techniques when combining mastopexy with augmentation. Results The senior author has performed this procedure on over 120 patients, with a mean follow-up of two years. Patients and the surgeon have expressed satisfaction with the procedure. Conclusion Based on this experience with over 120 patients, the authors believe that internal suture mastopexy is an effective alternative in selected patients.
Identification of Mandibular Fracture Epidemiology in Canada: Enhancing Injury Prevention and Patient Evaluation
Authors: Czerwinski M , Parker WL , Chehade A , Williams HB 
Published: February 2017

Background Mandibular fractures can lead to significant functional and aesthetic sequelae if treated improperly. They may act as an indicator of concomitant trauma and are very demanding on the public health care system. Thus, knowledge of mandibular fracture epidemiology is critical to effective prevention, as well the establishment of accurate trauma evaluation protocols. Objectives To identify the epidemiology of mandibular fractures treated at a level 1 Canadian trauma centre, clarify the pathogenesis of these epidemiological patterns and suggest potential targets for preventive efforts. Methods A retrospective review of all mandibular fracture patients presenting to the Montreal General Hospital between 1998 and 2003 was performed. Medical records and digitized radiographic imaging were used to collect patient demographics and injury data. Results The chart review identified 181 patients with 307 mandibular fractures. Fifty-two per cent of the fractures occurred in individuals 21 to 40 years of age, 78% of patients were male, and there was wide ethnic diversity. Sixty percent of patients had multiple mandibular fractures; 29% were symphyseal/parasymphyseal fractures, 25% were condylar fractures and 23% were angle fractures. Assault was the most common mechanism of injury, with 29% of fractures involving alcohol or illegal drug use. Thirty percent of patients had an associated facial fracture, and more than one-third had another major injury. Conclusions The present epidemiological review reveals several potential prevention targets as well as significant trends. Further research into the impact of these preventive measures could more objectively identify their impact on mandibular trauma.
Economic Analysis of Open Approach Versus Conventional Methods of Zygoma Fracture Repair
Authors: Czerwinski Marcin , Ma Stephanie , Motakis Dimitrios , Lee Chen 
Published: February 2017

Background As resource allocations in health care are being increasingly guided by cost containment issues, surgical professionals must consider the costs associated with various procedures. The present study identifies the financial costs attributed to the two principal treatment options available for zygoma fractures: The Gillie's method and open reduction and internal fixation (ORIF). Methods Patients were included if they sustained an isolated zygoma fracture and were treated within 10 days of injury using either ORIF or the Gillie's method. Those who suffered concomitant injuries or required orbital floor exploration and repair were excluded. The end point, which consisted of the total cost required to bring a patient to preinjury facial appearance and function, incorporated the cost of primary treatment and that of any secondary procedures required to correct unfavourable outcomes. Results In total, 45 patients were included: 25 were treated with Gillie's method and 20 were treated with ORIF. The cost associated with the primary treatment of zygoma fractures was found to be higher for ORIF than Gillie's method, amounting to $1,811 and $715, respectively. However, when taking into account potential repair of unsatisfactory results, the final sum totalled $1,930 and $3,725, respectively. This difference was statistically significant. Conclusion To the authors’ knowledge, this is the first study to objectively examine the cost of the Gillie's method and ORIF in the repair of zygoma fractures. Although the initial cost of ORIF is higher, the final cost of the Gillie's method is greater. Thus, surgeons should not allow higher initial costs to deter them from using more extensive and accurate techniques.
Porcine Wound Healing in Full-Thickness Skin Defects Using Integra™ with and Without Fibrin Glue with Keratinocytes
Authors: Melendez Mark M , Martinez Rodrigo R , Dagum Alexander B , Mcclain Steve A , Simon Marcia , Sobanko Joseph , Zimmerman Thomas , Wetterau Meredith , Muller Douglas , Xu Xiaoti , Singer Adam J , Arora Balvantray 
Published: February 2017

Background An artificial dermal matrix such as Integra (Integra Life Sciences Corporation, USA) provides a wound bed template for vascular and fibrocyte ingrowth as well as collagen remodelling. Dermal repair leads to epidermal and basement membrane regeneration. Burn wounds in particular have been shown to benefit from Integra by enhanced wound healing. Objective To evaluate the effect of fibrin glue to modify the integration of Integra in large excised cutaneous wounds. It was hypothesized that applying fibrin glue on a wound bed would reduce the time needed for matrix vascularization and incorporation of Integra and take of the cultured keratinocytes. Methods Four separate full-thickness wounds were created on the dorsum of two swine. Wound beds were randomly assigned to either application of fibrin glue or no application of fibrin glue before application of Integra. Full-thickness biopsies were performed at days 7, 14, 21, 29 and 35. On day 21, keratinocytes were applied either as sheets or aerosolized fibrin glue suspension. Results Histological analysis revealed a wave of inflammatory cells and early granulation tissue ingrowth into the Integra from the fascia below on day 7. Only this initial phase was augmented by application of fibrin glue to the wound bed. By day 14, most and by day 21, all of the Integra thickness was incorporated. Accelerated dermal repair proceeded from the base with new collagen deposition in Integra spaces. There was no evidence of keratinocyte engraftment, although re-epithelialization occurred at wound edges extending onto the incorporated Integra. Conclusions It appears there is an acceleration of early phase (day 7 to day 21) dermal incorporation with fibrin glue application to the wound bed, perhaps secondary to increased cellular migration. Day 21 appears to be too early to apply cultured keratinocytes either as sheets or aerosolized suspension.
Are There Any Correlations Between Social and Hand Functions in Patients with Carpal Tunnel Release Surgery Postoperatively?
Authors: Marchie Alfonse , Mahoney James 
Published: February 2017

Background Carpal tunnel syndrome is one of the most common and disabling work injuries in North America. Patients with carpal tunnel syndrome are often associated with substantial productivity loss and cost both at work and at home. Several studies have examined the relationship of social supports as a predictor of returning to work following carpal tunnel release surgery (CTRS). However, no studies published to date have examined the relationship between social support and the ability to perform activities of daily living after having CTRS. Objective To examine whether a correlation exists between the degree of social support and hand function in terms of the ability to perform activities of daily living in patients who have had CTRS. Methods Patients in the present cross-sectional study were evaluated with two standardized questionnaires at least two months postoperatively following CTRS. The questionnaires consisted of the Multidimensional Scale of Perceived Social Support, which evaluated social support, and QuickDASH, which evaluated hand function. A correlation analysis was then performed to identify any relationships between the two questionnaires. Results In a sample of 20 patients, correlation analyses revealed that perceived social support was significantly associated with hand function scores postoperatively (r=−0.73, P<0.01). In addition, a statistically significant relationship existed between social support and the preoperative self-rating pain scores (r=−0.51, P<0.05). These results indicate that there is a strong association between the degree of social support and the ability to perform hand activities of daily living following CTRS.
Transfixion Incision As An Initial Technique in Nasal Tip Deprojection
Authors: Solomon Philip , Rival Richard , Mabini Aimee , Boyd Jennifer 
Published: February 2017

Background The overprojected nasal tip presents a significant challenge to the surgeon performing rhinoplasty. Full transfixion incision as a means of dealing with this deformity has been studied only in combination with other surgical methods. Objectives To determine whether transfixion incision alone would result in significant nasal tip deprojection, and if skin thickness had an effect on the extent of deprojection the procedure yielded. Method Seventy-two consecutive patients with an aesthetic goal of nasal tip deprojection were enrolled. The sole surgical means of deprojection used was transfixion incision. Subjects were categorized as thin-, medium- or thick-skinned based on the surgeon's analysis. These groups were compared in terms of their postprocedural nasal tip deprojection. Results Using transfixion incision as the sole means of correcting this deformity resulted in a mean nasal tip deprojection of 1.6 mm (ranging from 0 mm to 3 mm). Patients in the thin skin group had a mean deprojection of 2.12 mm. This was significantly greater than for both the medium- and thick-skinned groups. There was no significant difference between the medium- and thick-skinned groups. Conclusions Surgeons may use skin thickness when planning interventions for correcting nasal tip overprojection. When used alone, transfixion incision resulted in tip deprojection comparable with that achieved when combined with other methods, particularly for thin-skinned patients. Surgeons can thus use a graduated approach in which transfixion incision, the least destructive method, is used before proceeding with other interventions.
Decreasing Expander Breast Infection: A New Drain Care Protocol
Authors: D Murray John , T Elwood Eric , E Jones Glyn , Barrick Pa-C Rebecca , Feng Jack 
Published: February 2017

BACKGROUND Risk factors for expander reconstruction infection are well known. However, drain use as a risk factor for the development of infection is unclear. OBJECTIVE To review a simple method for drain use to help reduce rates of infection in expander breast reconstruction. METHODS Two hundred consecutive single-surgeon (JDM) immediate first-stage expander breast reconstructions were retrospectively reviewed. The records were reviewed for history and physical examination, intraoperative technique, perioperative management, adjuvant therapy, and outcome with respect to expander infection necessitating premature explantation within the first eight weeks. Infection was defined on clinical basis, with or without culture positivity. All expanders (Mentor, USA) were the same model (textured, port-integrated and biodimensional). Two consecutive series of reconstructions were then created. The first series included 177 reconstructions while the second series included 23 reconstructions. Unlike the first series, the second series introduced a protocol in which all reconstructions received mupirocin 2% cream to the drain sites and all drains were removed at the end of the first week. Additionally, in the second series, all expanders were secluded from direct in vivo contact with the closed suction drain either by the use of an intervening Alloderm sling (LifeCell Corporation, USA, 15 of 23 breasts) or by subdermally tunnelling the drain superficial to an adequate fatty subcutaneous layer (eight of 23 breasts). RESULTS Patients who developed infection in the first series and all patients in the second series shared statistically the same level of aggregate risk factors (P=0.531). The infection rate (5.65%, 10 infections in 177 breasts) in the first series was statistically greater than in the second series (0%, 0 in 23 breasts, P=0.001). CONCLUSIONS The present study found that percutaneous closed suction drains do serve as an increased risk for expander infection. However, early results indicate that in vivo protection of the expander with Alloderm or subdermal tunnelling, topical antibiotic ointment use and early drain removal may significantly reduce expander infection.
Contribution of the Ulnar Digits to Grip Strength
Authors: Methot Jennifer , J Chinchalkar Shrikant , S Richards Robert 
Published: February 2017

PURPOSE To determine the contribution of ulnar digits to overall grip strength. SUBJECTS Fifty individuals (25 men and 25 women; 100 hands) with a mean age of 35.6 years (range 19 to 62 years) were tested. Exclusion criteria included previous history of hand injuries, entrapment neuropathies and systemic diseases. METHODS Ethics approval was granted before testing. A calibrated Jamar dynamometer (Lafayette Instrument Company, USA) was used to test subjects in three configurations: entire hand – index, middle, ring and little fingers; index, middle and ring fingers; and index and middle fingers. Little and ring fingers were excluded using generic hand-based finger splints. The order of testing was kept constant, and subjects were tested three times on each hand for each configuration. The average of the three trials at each configuration was recorded. Subjects received 1 min of rest between each testing configuration. The data were analyzed using a 3×2 repeated measures ANOVA with hand dominance and configuration as the within-subject factors, followed by two independent sample t tests to compare flexor digitorum superficialis (FDS) independence and FDS nonindependence on right and left hand grip strength measurements in the index, middle, ring and little condition. RESULTS Univariate results demonstrated that grip strength was significantly predicted by the interaction between hand dominance and configuration, while the parsing of the interaction term demonstrated greater grip strength across all levels of configuration for the dominant and nondominant hand. There were no significant differences between FDS independence and FDS nonindependence for either hand on grip strength. DISCUSSION The results indicate a significant decrease in grip strength as ulnar fingers were excluded. Furthermore, exclusion of the little finger has differing effects on the grip strength of the dominant and nondominant hands – the dominant hand had a greater loss of strength with the little finger excluded than the nondominant hand. CONCLUSIONS The ulnar two digits play a significant role in overall grip strength of the entire hand. In the present study, exclusion of the ulnar two digits resulted in a 34% to 67% decrease in grip strength, with a mean decrease of 55%. Exclusion of the little finger from a functional grip pattern decreased the overall grip strength by 33%. Exclusion of the ring finger from a functional grip pattern decreased the overall grip strength by 21%. It is clear that limitation of one or both of the ulnar digits adversely affects the strength of the hand. In addition, there was no significant difference between grip strength of FDS-independent and FDS-nonindependent subjects for either hand.
Keyhole Pattern for Preoperative Marking for Reduction Mammaplasty
Authors: Jardini Barbosa Marcus Vinícius , Xerfan Nahas Fábio , Angelo Sabia Miguel , Masako Ferreira Lydia 
Published: February 2017

BACKGROUND There are many techniques used for reduction mammaplasty; however, the most frequently performed procedures result in an inverted T scar. Preoperative marking is an important step for the success of the procedure, especially for surgeons at the initial learning stage. However, there is no consensus regarding the best method. In 1981, Strömbeck designed a pattern for preoperative marking for reduction mammaplasty. This pattern provides stable parameters that promotes an acceptable symmetry marking. OBJECTIVE To evaluate the use of the Strömbeck pattern for preoperative marking for reduction mammaplasty. METHODS Fifty-seven patients who underwent reduction mammaplasty between April 2006 and April 2007 were prospectively evaluated. Patient ages ranged from 17 to 61 years; the mean body mass index was 22.2 kg/m2. After defining the standard landmarks of the breast, preoperative markings were made using the Strömbeck pattern. Breast reduction surgery was performed under local anesthesia with sedation. Postoperative results were evaluated according to a numerical visual analogue scale, at the seven-, 15-and 30-day follow-up periods. The Student's t test and the Kruskal-Wallis test were used for statistical analysis (P<0.05). RESULTS The mean weight of resected breast tissue was 317.5 g for the right breast and 305.8 g for the left breast (P=0.17). Scores obtained using a visual analogue scale showed a progressive increase in the scores during the postoperative follow-up period (P<0.0001). CONCLUSION The use of the Strömbeck pattern enabled surgeons to perform reduction mammaplasty with good postoperative results as seen in the follow-up periods.