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The effect of burn first aid on clinicaloutcomes: A retrospective analysis of 4,918 patients
1606 Introduction and aims: Surgical debridement of the burned hand is challanging (intricate anatomy and considerable poten studies demonstrated that selectial morbidity). Previous burn tive enzymatic debridement with a Bromelain debriding agent NexoBrid (NXB) can reduce surgical burden and preserve viable tissue. Material and methods: First study: A single arm study of 99 deeply burned hands assessing the debriding efficacy and safety of NXB, surgery (excisional debridement, autografting and escharotomy). Study 2: RCT multicenter, randimized, controlled twoarms study assessing the implication of using a fast, enzymatic NXB debriding agent in deep hand burns compared to standard of care (SOC). Results: Study 1 of 99 deeply burned hands demonstrated the debriding efficacy and safety of NXB, in reducing surgical burden (excision, autografting and escharotomy). RCT study 2: 52 burn patients (72 deep hand burns). In the NXB group 4 of 31 hand burns (12.9%) required excision compared to 29 of 41 (70.7%) in the SOC group (p < 0.0001). The mean percentage of the burn wound area excised in the NXB group was 3.5 12.5% compared to 52 41.4% in the SOC group (p < 0.0001). In both studies, none of the NXB treated hands required escharotomy (0/130) compared to 4 of 41 (9.7%) in the SOC group. The RCT results corroborate first study data of 99 burned hands. Conclusion(s): NXB demonstrated a statistically significant reduction of burn wound excision and autografting compared to SOC and seemed to prevent the need for emergency escharotomy.
LESSONS LEARNED FROM REVISION COSMETIC BREAST IMPLANT SURGERY: MOTIVATION, TRENDS AND A PRACTICAL APPROACH Anita Mohan a, Taj Tomouk b, Laura Fopp a, Charles M. Malata a,c a
Addenbrooke’s University Hospital, United Kingdom Cambridge University Medical School, United Kingdom c Anglia Ruskin University Postgraduate Medical Institute, Cambridge & Chelmsford, United Kingdom b
Introduction: Primary bilateral breast augmentation is the commonest aesthetic procedure in the UK and USA. Occasionally revision breast implant surgery is warranted. Multiple indications and complexity of surgery make it difficult to generalise the approach and patients present with a gamut of implant generations. We present a practical approach based on the senior author’s experience. Methods: Over 2000 cosmetic breast implant procedures were carried out between 2001e2013 by the senior surgeon (CMM) and 106 patients had revision implant surgery. We retrospectively reviewed clinical and hospital records of these women; 5 patients were excluded due to incomplete information. Results: A total of 101 patients and 180 breasts underwent revision implant surgery. 20% of patients had their original augmentation performed by the senior author. The time interval between original augmentation surgery and revision was 9.4 years (range 6 monthse47 years). 20% of patients had previous revision surgery. Indications for surgery were more commonly implant related factors (n Z 61 patients), including capsule contracture, rupture; patient or aesthetic factors, including ptosis, change in shape and desire for a change in size. Surgery approach was categorised into capsule surgery, removal or exchange of implant, change of plane to the implant pocket and management of the skin
Abstracts envelope. Overall satisfaction was high, however 8/101 patients were not completely satisfied. Conclusion: Revision cosmetic breast implant surgery is an increasing part of many surgeons’ practice in private and public sectors. We present a systematic practical approach to manage these complex cases and lead to more predictable outcomes.
THE EFFECT OF BURN FIRST AID ON CLINICALOUTCOMES: A RETROSPECTIVE ANALYSIS OF 4,918 PATIENTS Varun Harish, Peter Maitz Concord Repatriation General Hospital, Australia Introduction and aims: The effect of first aid on burn injuries has been extensively studied in experimental burn models. However, its effect on clinical outcomes in burn injured patients has yet to be demonstrated. The purpose of this study was to assess the impact of burn first aid on wound-related clinical outcomes. Material and methods: All patients with <10% total body surface area (TBSA) burns presenting to our outpatient service between 2007 and 2012 were identified. Patients whose first aid status was unknown were excluded. Information regarding patient demographics, burn injury details, first aid adequacy, and clinical outcomes were collected. Statistical analysis correlating first aid adequacy and clinical outcomes was performed. Results: 4918 patients were identified. Adequate first aid was received in 2859 patients (58.2%) and inadequate first aid in 2,059 patients (41.8%). There was no statistically significant difference in TBSA (P > 0.05) between the two groups. Adequate first aid did not lead to a statistically significant reduction in depth or need for skin grafting (P < 0.05). Irrespective of skin grafting, adequate first aid led to faster complete re-epithelialisation (P < 0.001 for nongrafted and grafted cohorts) and less outpatient visits (P < 0.01 for non-grafted patients; P Z0.01 ٲfor grafted patients). Conclusion(s): This is the largest study examining the effect of first aid on clinical outcomes. First aid has a profound beneficial impact with respect to wound-related clinical outcomes.
TEN-YEAR RESULTS FROM THE NATRELLEâ 410 ANATOMICAL FORM STABLE SILICONE BREAST IMPLANT CORE STUDY G. Patrick Maxwell a,b, Bruce W. Van Natta c, Bradley P. Bengtson d,e, Diane K. Murphy f, Mark W. Clemens g a
Loma Linda University School of Medicine, United States Vanderbilt University School of MedicineUnited States c Meridian Plastic Surgeons, United States d Bengtson Center for Aesthetics and Plastic Surgery, United States e Michigan State University, United States f Allegan, United States g MD Anderson Cancer Center, United States b
Background: Natrelleâ 410 silicone gel breast implants were approved by the FDA in 2013 and the 10-year study supporting their approval has been completed. This publication updates the previously-reported 6-year results. Methods: This prospective, pivotal, multicenter study enrolled 941 subjects: 492 augmentation, 156 revision-
LESSONS LEARNED FROM REVISION COSMETIC BREAST IMPLANT SURGERY: MOTIVATION, TRENDS AND A PRACTICAL APPROACH Anita Mohan a, Taj Tomouk b, Laura Fopp a, Charles M. Malata a,c a
Addenbrooke’s University Hospital, United Kingdom Cambridge University Medical School, United Kingdom c Anglia Ruskin University Postgraduate Medical Institute, Cambridge & Chelmsford, United Kingdom b
Introduction: Primary bilateral breast augmentation is the commonest aesthetic procedure in the UK and USA. Occasionally revision breast implant surgery is warranted. Multiple indications and complexity of surgery make it difficult to generalise the approach and patients present with a gamut of implant generations. We present a practical approach based on the senior author’s experience. Methods: Over 2000 cosmetic breast implant procedures were carried out between 2001e2013 by the senior surgeon (CMM) and 106 patients had revision implant surgery. We retrospectively reviewed clinical and hospital records of these women; 5 patients were excluded due to incomplete information. Results: A total of 101 patients and 180 breasts underwent revision implant surgery. 20% of patients had their original augmentation performed by the senior author. The time interval between original augmentation surgery and revision was 9.4 years (range 6 monthse47 years). 20% of patients had previous revision surgery. Indications for surgery were more commonly implant related factors (n Z 61 patients), including capsule contracture, rupture; patient or aesthetic factors, including ptosis, change in shape and desire for a change in size. Surgery approach was categorised into capsule surgery, removal or exchange of implant, change of plane to the implant pocket and management of the skin
Abstracts envelope. Overall satisfaction was high, however 8/101 patients were not completely satisfied. Conclusion: Revision cosmetic breast implant surgery is an increasing part of many surgeons’ practice in private and public sectors. We present a systematic practical approach to manage these complex cases and lead to more predictable outcomes.
THE EFFECT OF BURN FIRST AID ON CLINICALOUTCOMES: A RETROSPECTIVE ANALYSIS OF 4,918 PATIENTS Varun Harish, Peter Maitz Concord Repatriation General Hospital, Australia Introduction and aims: The effect of first aid on burn injuries has been extensively studied in experimental burn models. However, its effect on clinical outcomes in burn injured patients has yet to be demonstrated. The purpose of this study was to assess the impact of burn first aid on wound-related clinical outcomes. Material and methods: All patients with <10% total body surface area (TBSA) burns presenting to our outpatient service between 2007 and 2012 were identified. Patients whose first aid status was unknown were excluded. Information regarding patient demographics, burn injury details, first aid adequacy, and clinical outcomes were collected. Statistical analysis correlating first aid adequacy and clinical outcomes was performed. Results: 4918 patients were identified. Adequate first aid was received in 2859 patients (58.2%) and inadequate first aid in 2,059 patients (41.8%). There was no statistically significant difference in TBSA (P > 0.05) between the two groups. Adequate first aid did not lead to a statistically significant reduction in depth or need for skin grafting (P < 0.05). Irrespective of skin grafting, adequate first aid led to faster complete re-epithelialisation (P < 0.001 for nongrafted and grafted cohorts) and less outpatient visits (P < 0.01 for non-grafted patients; P Z0.01 ٲfor grafted patients). Conclusion(s): This is the largest study examining the effect of first aid on clinical outcomes. First aid has a profound beneficial impact with respect to wound-related clinical outcomes.
TEN-YEAR RESULTS FROM THE NATRELLEâ 410 ANATOMICAL FORM STABLE SILICONE BREAST IMPLANT CORE STUDY G. Patrick Maxwell a,b, Bruce W. Van Natta c, Bradley P. Bengtson d,e, Diane K. Murphy f, Mark W. Clemens g a
Loma Linda University School of Medicine, United States Vanderbilt University School of MedicineUnited States c Meridian Plastic Surgeons, United States d Bengtson Center for Aesthetics and Plastic Surgery, United States e Michigan State University, United States f Allegan, United States g MD Anderson Cancer Center, United States b
Background: Natrelleâ 410 silicone gel breast implants were approved by the FDA in 2013 and the 10-year study supporting their approval has been completed. This publication updates the previously-reported 6-year results. Methods: This prospective, pivotal, multicenter study enrolled 941 subjects: 492 augmentation, 156 revision-