Developing and Establishing a Wound Dressing Team: Experience and Recommendations

Background@#The existing literature has comprehensively examined the benefits of specialized wound-care services and multidisciplinary team care. However, information on the development and integration of wound-dressing teams for patients who do not require specialized wound care is scarce. Therefore, the present study aimed to elucidate the benefits of a wound-dressing team by reporting our experiences with the establishment of a wounddressing team. @*Methods@#The wound-dressing team was established at Korea University Guro Hospital.Between July 2018 and June 2022, 180,872 cases were managed for wounds at the wounddressing team. The data were analyzed to assess the types of wounds and their outcomes.In addition, questionnaires assessing the satisfaction with the service were administered to patients, ward nurses, residents/internists, and team members. @*Results@#Regarding the wound type, 80,297 (45.3%) were catheter-related, while 48,036 (27.1%), 26,056 (14.7%), and 20,739 (11.7%) were pressure ulcers, dirty wounds, and simple wounds, respectively. In the satisfaction survey, the scores of the patient, ward nurse, dressing team nurse, and physician groups were 8.9, 8.1, 8.2, and 9.1, respectively.Additionally, 136 dressing-related complications (0.08%) were reported. @*Conclusion@#The wound dressing team can enhance satisfaction among patients and healthcare providers with low complications. Our findings may provide a potential framework for establishing similar service models.

Footplate Incision in Rhinoplasty: an Update

BACKGROUND: In 2004, we reported on 110 consecutive Asian rhinoplasty patients who were treated with the addition of a footplate incision to obtain a greater aesthetic satisfaction. We continue to perform the reported technique with several modifications, and we still think that this method contributes to Asian rhinoplasty. METHODS: A footplate incision was made along the caudal border of the footplate of the medial crura onto the floor of the nasal vestibule. This incision can be made alone or in combination with either endonasal or open rhinoplasty. It enables surgeons to achieve a further tip projection since the pressure of the skin flap is reduced on the tip. In this study, we emphasize a couple of recent changes that we made to our procedure after publication of the prior article. First, we excised the dog-ear that appeared at the caudal end of the extended footplate incision. After making the new tip, a dog ear can be seen at the posterior end of the footplate incision. Second, an inferior columellar dissection was also extended to achieve an additional tip projection and to improve the columello-labial angle. RESULTS: This study included 85 consecutive patients who underwent an aesthetic rhinoplasty using footplate incision techniques between August of 2010 and May of 2013. A total of 43 patients had an adequate follow-up time of over 12 months. The majority of the patients (40/43 cases) were satisfied with the results. CONCLUSIONS: The authors believe that a footplate incision in aesthetic rhinoplasty is safe and can reliably achieve better results for Asian patients.

Revision of a Widened Scar Using Dermal Splinting Technique

BACKGROUND: Scar revision is a fundamental technique in the field of plastic and reconstructive surgery. Methods using local flaps, such as a Z-plasty, W-plasty, or geometric broken-line closure, have been used for scar revision. Widening of scars is a frustrating event that most plastic surgeons have encountered. Several therapeutic modalities have been proposed, but frequently, the result is disappointing. We describe our experience with the use of a dermal splinting technique for scar revision. METHODS: We propose a technique by which tension on the wound is applied by tough scar tissue instead of the suture line, thereby reducing the incidence of postoperative widening. This technique was used to treat 21 nonburn scars that had widened:5 scars were facial (3 patients), 8 were on the extremities (6 patients), and 8 were on the torso (5 patients). All scars were at least 4 months old. The operations were performed between January 2003 and December 2012; follow-up was 9 to 24 months. RESULTS: Only one scar widened during the follow-up period. Overall, satisfaction with scar appearance and surgery was assessed with a visual analog scale (VAS). Mean patient satisfaction was 8.1 +/- 0.5. CONCLUSIONS: We recommend this technique in dealing with widened scars in highly tensile areas during revision surgery.