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A clinical tip for prominent-ear-correction dressings: a simple advice for prevention of slippage
668 13. Park HJ, Lee SY, Lee CS. Complications associated with the Nuss procedure: analysis of risk factors and suggested measures for prevention of complications. J Pediatr Surg 2004;39:391e5. 14. Rokitansky AM, Frigo E, Blab E, et al. Results of modified minimally invasive correction of the funnel breast.In: Eighth Danubean symposium of pediatric surgery [Abstract] 2 Oct 2003, Bratislava, Czech Republic. 15. Saxena AK, Schaarschmidt K, Schleef J, et al. Surgical correction of pectus excavatum: the Munster experience. Langenbecks Arch Surg 1999;384:187e93. 16. Shamberger RC, Welch KJ. Surgical repair of pectus excavatum. J Pediatr Surg 1988;23:615e22. 17. Fonkalsrud EW, Dunn JC, Atkinson JB. Repair of pectus excavatum deformities: 30 years of experience with 375 patients. Ann Surg 2000;231:443e8. 18. Jacobs JP, Quintessenza JA, Morell VO, et al. Minimally invasive endoscopic repair of pectus excavatum. Eur J Cardiothorac Surg 2002;21:869e73. 19. Sasaki M, Kawabe M, Hirai S, et al. Preoperative detection of pleural adhesions by chest ultrasonography. Ann Thorac Surg 2005;80:439e42. 20. Pircova A, Sekarski-Hunkeler N, Jeanrenaud X, et al. Cardiac perforation after surgical repair of pectus excavatum. J Pediatr Surg 1995;30:1506e8.
A.K. Saxena 21. Fonkalsrud EW, Mendoza J. Open repair of pectus excavatum and carinatum deformities with minimal cartilage resection. Am J Surg 2006;191:779e84. 22. Saxena AK. Open surgical funnel chest repair techniques. In: Second international workshop and surgical course on pectus excavatum, Graz, Austria, April 15e16, 2005. 23. Derveaux L, Clarysse I, Ivanoff I, et al. Preoperative and postoperative abnormalities in the chest x-ray indices and in the lung function in pectus deformities. Chest 1989;95: 850e6. 24. Saxena AK, Castellani C, Ho ¨llwarth ME. Surgical aspects of thoracoscopy and efficacy of right thoracoscopy in minimal invasive repair of pectus excavatum. J Thorac Cardiovasc Surg 2007;133:1201e5. 25. Saxena AK, Willital GH. Surgical repair of Pectus Carinatum. Int Surg 1999;84:326e30. 26. Saxena AK, Willital GH. Valuable lessons from two decades of pectus repair with the Willital-Hegemann procedure. J Thorac Cardiovasc Surg 2007;134:871e6. 27. Shamberger RC, Welch KJ. Surgical correction of pectus carinatum. J Pediatr Surg 1987;22:48e53. 28. Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. J Indian Assoc Pediatr Surg 2005;10:147e57.
CLINICAL TIP A clinical tip for prominent-ear-correction dressings: a simple advice for prevention of slippage
Slippage of head dressings is the most frequently encountered problem following prominent-ear correction, with reports of incidence ranging from 43% to 67%.1,2 In our unit, parents of patients are advised on the measures that may reduce slippage of dressings. Firstly, parents are advised to place two pillows on either side of the child’s head in order to prevent frequent movement of the head and loosening of the dressings during sleep. A better alternative would be the use of a V-shaped pillow or an inflatable travel pillow. Secondly, parents are also advised to use shirts or sweaters with front-fastening buttons as opposed to clothing that may require removal over the head, thus potentially disturbing the bandages.
Results During a 1-year period at our unit, we experienced five bandage slippages in 32 patients (15.6%). The mean age of these patients was 10.1 years, and majority of the patients were male (60%). The mean number of days until slippage was 4.2 days. In our practice, therefore, we observe a lower rate of bandage slippage in comparison to other published
series. This is a simple advice that could reduce the amount of disturbance to the dressings and frequent hospital visits for re-bandaging. None of the authors claim a conflict of interest or funding.
References 1. Jeffrey SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588e90. 2. Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97e100.
Reza Nassab Ali Soueid Fateh Ahmad Sanjiv Dhital Ali Juma Department of Plastic Surgery, Countess of Chester Hospital, Chester CH2 1UL, Cheshire, UK E-mail address: [email protected] ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2008.11.084
A.K. Saxena 21. Fonkalsrud EW, Mendoza J. Open repair of pectus excavatum and carinatum deformities with minimal cartilage resection. Am J Surg 2006;191:779e84. 22. Saxena AK. Open surgical funnel chest repair techniques. In: Second international workshop and surgical course on pectus excavatum, Graz, Austria, April 15e16, 2005. 23. Derveaux L, Clarysse I, Ivanoff I, et al. Preoperative and postoperative abnormalities in the chest x-ray indices and in the lung function in pectus deformities. Chest 1989;95: 850e6. 24. Saxena AK, Castellani C, Ho ¨llwarth ME. Surgical aspects of thoracoscopy and efficacy of right thoracoscopy in minimal invasive repair of pectus excavatum. J Thorac Cardiovasc Surg 2007;133:1201e5. 25. Saxena AK, Willital GH. Surgical repair of Pectus Carinatum. Int Surg 1999;84:326e30. 26. Saxena AK, Willital GH. Valuable lessons from two decades of pectus repair with the Willital-Hegemann procedure. J Thorac Cardiovasc Surg 2007;134:871e6. 27. Shamberger RC, Welch KJ. Surgical correction of pectus carinatum. J Pediatr Surg 1987;22:48e53. 28. Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. J Indian Assoc Pediatr Surg 2005;10:147e57.
CLINICAL TIP A clinical tip for prominent-ear-correction dressings: a simple advice for prevention of slippage
Slippage of head dressings is the most frequently encountered problem following prominent-ear correction, with reports of incidence ranging from 43% to 67%.1,2 In our unit, parents of patients are advised on the measures that may reduce slippage of dressings. Firstly, parents are advised to place two pillows on either side of the child’s head in order to prevent frequent movement of the head and loosening of the dressings during sleep. A better alternative would be the use of a V-shaped pillow or an inflatable travel pillow. Secondly, parents are also advised to use shirts or sweaters with front-fastening buttons as opposed to clothing that may require removal over the head, thus potentially disturbing the bandages.
Results During a 1-year period at our unit, we experienced five bandage slippages in 32 patients (15.6%). The mean age of these patients was 10.1 years, and majority of the patients were male (60%). The mean number of days until slippage was 4.2 days. In our practice, therefore, we observe a lower rate of bandage slippage in comparison to other published
series. This is a simple advice that could reduce the amount of disturbance to the dressings and frequent hospital visits for re-bandaging. None of the authors claim a conflict of interest or funding.
References 1. Jeffrey SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588e90. 2. Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97e100.
Reza Nassab Ali Soueid Fateh Ahmad Sanjiv Dhital Ali Juma Department of Plastic Surgery, Countess of Chester Hospital, Chester CH2 1UL, Cheshire, UK E-mail address: [email protected] ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2008.11.084