mahdi eskandarlou

Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs and buttocks.  Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing and better cosmetics results) this study is trying to compare the outcomes of graft harvesting from scalp and lower limb.

This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb respectively. The resultant data was analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp).

Of the total 40 patients participating in this study 28 patients (70%) were male and 12 (30%) were female with and mean age of 63.62±09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among the patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal respectively. Most of the defects were deep to Galea zone. The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameter of defect in both groups were statistically meaningful while no such difference between graft diameter was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale.

Scalp can safely be used as donor site for skin graft to be used for scalp defects which is associated with better results and lower complication rates compared to other donor sites.

Burn is one of the most common events in childhood. Pain relief in burn patients helps to stabilize the patientchr('39')s hemodynamic parameters. This study aimed to investigate the effect of visual aberration on dressing replacement pain in children aged 6-12 years.

In this one-blind clinical trial with a control group, 80 children aged 6-12 years admitted to the burn ward of Besat Hospital in Hamadan were selected by Available sampling method and then randomly divided into two groups of control and visual aberration. Data were collected using a demographic profile checklist and Usher pain tool. In the visual distraction group, a cartoon of a cat and mouse was broadcast from two minutes before the end of the dressing. In both groups, pain intensity was measured and recorded 10 minutes before dressing, at intervals of two minutes during dressing, and 5 minutes after dressing. Data were analyzed using SPSS 16 software and one-way analysis of variance and analysis of variance with repeated measures.

The results showed that no significant differences were found in the demographic characteristics of children and parents between the two groups of visual distraction and control (P˃0.05). The mean scores of pain intensity at all measurement times between the two groups of visual distraction and The control had a statistically significant difference and in general, the pain intensity score in children in the visual distraction group was lower than the control group (P <0.001).

In general, the results showed that the visual distraction method is effective in reducing the severity of burn pain in children.

Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively.Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose insertion. Due to excessive bleeding through drain tube, patient was transferred to Besat Hospital of Hamadan. Surgical repair of external carotid artery successfully was done. Four days later patient developed right hemiparesis suddenly. According to MRI and color Doppler sonography finding of thrombosis of left common and internal carotid artery, reoperation was done. After thrombectomy cerebral ischemia and hemi-paralysis improved. Surgical approach to symptomatic penetrating neck trauma is oblique cervical incision, control of bleeding, repair of internal carotid, repair or ligature of external carotid artery base on some factors and preferential repair of internal jugular vein. Meticulous and fine surgical technique for both vascular repair and protection of adjacent normal vessels for avoiding to blunt trauma or compression with retractors is noticeable. Exact postoperative care as repeated clinical examination with goal of early diagnosis of internal carotid artery thrombosis and rapid diagnostic and treatment planning of this complication are important factors for taking of good result in treatment of penetrating trauma to carotid.