Pattern of maximum voluntary contraction in patients with temporomandibular disorder before and after speech therapy with and without use of elastic bandages / Padrão de contração voluntária máxima em pacientes com disfunção temporomandibular antes e após terapia fonoaudiológica com e sem uso de bandagem elástica

ABSTRACT Purpose: to verify if there is an electromyographic difference during maximal (maximum) voluntary contraction of the masseter and temporalis muscles in patients with temporomandibular disorders, before and after speech therapy intervention with and without the use of therapeutic elastic bandages. Methods: an analysis of secondary data from a clinical intervention study, carried out with 17 adult volunteers, diagnosed with temporomandibular muscle dysfunction with or without disc displacement with reduction. The Bandage Group received manual therapy associated with elastic bandages and the No Bandage Group received only manual therapy. Surface electromyography was performed to record the Maximum Voluntary Contraction before and after four weeks of speech therapy intervention. For exploratory analysis, the Mann Whitney and Wilcoxon paired tests were used, with P<0.05. Results: in the Bandage Group, there was a statistically significant decrease in electrical activity during Maximum Voluntary Contraction in the masseter and temporalis muscles on the left side at the post-therapeutic moment. Comparing the pre- and post-intervention between Bandage Group and No Bandage Group, a statistical difference was found in the electrical activity values of the Maximum Voluntary Contraction in the left temporal muscle. Conclusion: manual myofunctional speech therapy, associated or not with the use of therapeutic elastic bandages, impacts the muscle activity of the masseter and temporal muscles during Maximum Voluntary Contraction, whether the values demonstrate relaxation and/or equivalence of the electromyographic values of the masticatory muscles.

RESUMO Objetivo: verificar se há diferença eletromiográfica durante contração voluntária máxima dos músculos masseter e temporal de pacientes com disfunção temporomandibular, antes e após intervenção fonoaudiológica com e sem uso de bandagem elástica terapêutica. Métodos: foi realizada a análise de dados secundários de estudo do tipo intervenção clínica, com 17 voluntárias, adultas, com diagnóstico de disfunção temporomandibular muscular com ou sem deslocamento de disco com redução. O Grupo Bandagem recebeu terapia manual associada à bandagem elástica e o Grupo Sem Bandagem recebeu apenas terapia manual. Foi realizada eletromiografia de superfície para registro da contração voluntária máxima antes e após quatro semanas de intervenção fonoaudiológica. Para análise exploratória foram utilizados os testes: Mann Whitney e Wilcoxon Pareado, com p<0,05. Resultados: no Grupo Bandagem, houve diminuição estatisticamente significante da atividade elétrica durante a Contração Voluntária Máxima nos músculos masseter e temporal do lado esquerdo no momento pós-terapêutico. Na comparação do pré e pós-intervenção entre Grupo Bandagem e Grupo Sem Bandagem, constatou-se diferença estatística nos valores da atividade elétrica de Contração Voluntária Máxima no músculo temporal esquerdo. Conclusão: a terapia fonoaudiológica miofuncional manual, associada ou não ao uso da bandagem elástica terapêutica, impacta a atividade muscular dos músculos masseter e temporal durante a Contração Voluntária Máxima, sejam os valores demonstrando relaxamento e/ou equivalência dos valores eletromiográficos da musculatura mastigatória.

La banda transobturadora en el tratamiento de mujeres con incontinencia urinaria / Transobturator tape in the treatment of women with urinary incontinence i: en

El tratamiento en mujeres con incontinencia urinaria es diferente del que se efectúa en los hombres. Al respecto, actualmente se emplean las técnicas de cinta vaginal libre de tensión y cinta transobturadora para levantar la vejiga o la uretra, o ambas, hacia la posición normal. El procedimiento quirúrgico con banda transobturadora de polipropileno de monofilamento trenzado figura entre las cirugías mayores ambulatorias y se muestra como un tratamiento eficaz y seguro, cuyos riesgos son mínimos. En este trabajo se comunican brevemente algunos aspectos sobre la incontinencia en féminas, su diagnóstico, prevención y factores de riesgo asociados, así como todo el proceso de aplicación de dicha técnica.

Treatment in women with urinary incontinence is different from that in men. In this regard, the techniques of tension-free vaginal tape and transobturator tape are currently used to lift the bladder or urethra, or both, back to the normal position. The surgical procedure with a monofilament braided polypropylene transobturator band is among the major outpatient surgeries and is shown to be an effective and safe treatment, with minimal risks. In this paper, some aspects of incontinence in women, its diagnosis, prevention and associated risk factors are briefly reported, as well as the entire process of applying this technique.

Controle burocrático e suporte organizacional no setor público: efeitos mediados pelo empoderamento psicológico no engajamento / Control burocrático y apoyo organizacional en el sector público: efectos mediados por el empoderamiento psicológico en el compromiso laboral / Bureaucratic control and organizational support in the public sector: effects mediated by psychological empowerment on engagement

Resumo O presente estudo tem como objetivo investigar em que medida o controle burocrático e o suporte organizacional afetam o engajamento no trabalho de funcionários públicos e o papel mediador do empoderamento psicológico. Para alcançar esse objetivo, foi realizado um levantamento junto a 159 servidores públicos de dois tribunais de contas brasileiros, com posterior aplicação de análise fatorial exploratória, técnicas de parcelamento, análise fatorial confirmatória e regressão de mínimos quadrados ordinários (OLS). Os resultados evidenciam que há mediação total negativa entre controle burocrático e engajamento no trabalho por meio do empoderamento psicológico. O efeito do suporte organizacional no engajamento no trabalho é parcial e positivamente mediado pelo empoderamento psicológico. Assim, o empoderamento psicológico parece ser um importante mecanismo por meio do qual os funcionários públicos reagem a características do contexto de trabalho, sendo enfraquecido em situações de controle burocrático exacerbado ou de falta de suporte organizacional, com consequências para o nível de entusiasmo e dedicação. Os achados são discutidos à luz de suas implicações teóricas e práticas para a gestão no setor público.

Resumen El presente estudio tuvo como objetivo investigar hasta qué punto el control burocrático y el apoyo organizacional afectan el compromiso laboral de los servidores públicos y el papel mediador del empoderamiento psicológico. Para lograr este objetivo, se llevó a cabo una investigación cuantitativa, basada en datos recolectados de 159 servidores públicos de dos tribunales de cuentas brasileños, con la aplicación posterior de análisis factorial exploratorio, división de variables, análisis factorial confirmatorio y regresión de mínimos cuadrados ordinarios (OLS). Los resultados muestran que existe una mediación negativa total entre el control burocrático y el compromiso laboral a través del empoderamiento psicológico. El efecto del apoyo organizacional sobre el engagement en el trabajo está parcialmente y positivamente mediado por el empoderamiento psicológico. Así, el empoderamiento psicológico constituye un mecanismo importante a través del cual los servidores públicos reaccionan a las características del contexto de trabajo, debilitándose en situaciones de control burocrático exacerbado o falta de apoyo organizacional, con consecuencias en el nivel de entusiasmo y dedicación. Los hallazgos se discuten a la luz de sus implicaciones teóricas y prácticas para la gestión en el sector público.

Abstract The study investigates how bureaucratic control and organizational support affect the civil servant's work engagement and the mediating role of psychological empowerment. The research adopted a quantitative approach using data collected from 159 public servants of Brazilian courts of accounts, with subsequent application of exploratory factor analysis, parceling techniques, confirmatory factor analysis, and ordinary least squares regression (OLS). The results show a negative mediation of psychological empowerment in the relationship between bureaucratic control and work engagement and a partial and positive mediation between organizational support and work engagement. Thus, psychological empowerment constitutes an important mechanism through which civil servants react to characteristics of the work context, being weakened in situations of exacerbated bureaucratic control or lack of organizational support, with consequences for the level of enthusiasm and dedication. The findings are discussed in light of their theoretical and practical implications for management in the public sector.

Kinesiotaping in discopathies and degenerative spinal diseases: systematic review / Kinesiotaping em discopatias e doenças degenerativas da coluna vertebral: revisão sistemática / Kinesiotaping en discopatías y enfermedades degenerativas de la columna vertebral: revisión sistemática

ABSTRACT Neuromuscular taping or kinesiotaping is a technique widely used in spinal disorders. However, the scientific evidence of its use in discopathies and degenerative spine pathology is unknown. This study aimed to analyze the published clinical trials on neuromuscular taping in subjects with discopathies and degenerative spinal injuries. For this purpose, a literature search was performed following PRISMA guidelines in the following databases: PubMed, Web of Science (WOS), Scopus, Medline, and Cinahl. In analyzing bias and methodological quality, we used: the PEDro scale, Van Tulder criteria, and risk of bias analysis of the Cochrane Collaboration. A total of 5 articles were included that obtained a mean score of 6.2 on the PEDro scale. There is moderate evidence that, in the short term, neuromuscular taping reduces analgesic consumption and improves the range of motion and muscle strength in the posterior musculature. In addition, there is limited evidence that it can improve quality, while the scientific evidence on the effect of neuromuscular taping on pain is contradictory. The application of neuromuscular taping on discopathies and degenerative processes of the spine should be cautiously undertaken until more conclusive results are obtained, and the long-term effects are assessed. Level of evidence I; Systematic review.

Resumo: A bandagem neuromuscular ou kinesiotaping é uma técnica de bandagem amplamente utilizada em distúrbios da coluna vertebral. Entretanto, a evidência científica para seu uso em discopatias e na patologia degenerativa da coluna são desconhecidas. Objetivo: O objetivo deste trabalho foi analisar ensaios clínicos publicados sobre bandagem neuromuscular em sujeitos com discopatias e lesões degenerativas da coluna vertebral. Para este fim, foi realizada uma pesquisa bibliográfica seguindo as diretrizes do PRISMA nas seguintes bases de dados: PubMed, Web of Science (WOS), Scopus, Medline e Cinahl. Na análise de viés e qualidade metodológica, foram utilizados: escala PEDro, critérios de Van Tulder e análise de risco de viés da Colaboração Cochrane. Um total de 5 artigos foi incluído com uma pontuação média de 6,2 na escala PEDro. Há evidências moderadas de que, a curto prazo, a bandagem neuromuscular reduz o consumo de analgésicos, melhora a amplitude de movimento e a força muscular na musculatura posterior. Além disso, há evidências limitadas de que pode melhorar a qualidade, enquanto as evidências científicas sobre o efeito da bandagem neuromuscular na dor são contraditórias. A aplicação da bandagem neuromuscular em discopatias e processos degenerativos da coluna vertebral deve ser feita com cautela até que resultados mais conclusivos sejam obtidos e os efeitos a longo prazo sejam avaliados. Nível de evidência I; Revisão sistemática.

Resumen: El vendaje neuromuscular o kinesiotaping es una técnica de vendaje que se utiliza ampliamente en trastornos raquídeos. Sin embargo, se desconoce la evidencia científica de uso en discopatías y patología degenerativa de la columna. El objetivo de este trabajo consistió en analizar los ensayos clínicos publicados sobre el vendaje neuromuscular en sujetos con discopatías y lesiones degenerativas del raquis. Para ello, se realizó una búsqueda bibliográfica siguiendo las directrices PRISMA en las siguientes bases de datos: PubMed, Web of Science (WOS), Scopus, Medline y Cinahl. En el análisis de sesgo y calidad metodológica se utilizaron: escala PEDro, criterios de Van Tulder y análisis del riesgo de sesgo de la Colaboración Cochrane. Se incluyeron un total de 5 artículos que obtuvieron una puntuación media de 6,2 en la escala PEDro. Existe evidencia moderada de que, a corto plazo, el vendaje neuromuscular reduce el consumo de analgésicos, mejora el rango de movimiento y fuerza muscular en la musculatura posterior. Además, existe evidencia limitada de que puede mejorar la calidad, mientras que la evidencia científica sobre el efecto del vendaje neuromuscular en el dolor es contradictoria. La aplicación de vendaje neuromuscular es discopatías y procesos degenerativos del raquis debe realizarse con cautela a la espera de que se obtengan resultados más concluyentes y se valoren los efectos a largo plazo. Nivel de evidencia I; Revisión sistemática.

Effects of kinesiology taping on swallowing functions in newborns with swallowing difficulties: a randomized controlled pilot study

SUMMARY OBJECTIVE: This study investigated the efficacy of kinesiology taping application in premature infants with dysphagia. METHODS: A total of 60 premature newborns (born ≤37weeks' gestational age who reached the age ≥34 weeks of postmenstrual age) with sucking and swallowing problems were randomly assigned to the kinesiology taping group [n=31; 18 males, 13 females; mean postmenstrual age 35.4 weeks (SD 0.9 weeks, range 34-38 weeks)] or control group without kinesiology taping application [n=29; 16 males, 13 females; mean postmenstrual age age 35.6 weeks (SD 1.4 weeks, range 34-40 weeks)]. RESULTS: Kinesiology taping group yielded significant improvement in the oral reflexes (p<0.001) and in the sucking functions including tongue movement, sucking power, number of sucks and sucking pause, maintenance of alertness, jaw movement, tongue cupping, and maintenance of rhythm (p<0.001, p=0.011, p=0.002, and p=0.001, respectively). There was a significant difference in favor of the taping group with respect to the number of neonates whose feeding improved (26 (84%) vs. 7 (24%), p<0.001). CONCLUSION: The results of this study show that kinesiology taping can be applied as a safe and effective method to improve feeding functions in premature infants with sucking and swallowing difficulties.

Clinical observation of adjusting middle urethral sling tension through anatomic position during RMUS / 中华泌尿外科杂志

Objective:To investigate the safety and effectiveness of tension adjustment technique using anatomical landmarks during retropubic midurethral synthetic sling.Methods:The data of 36 consecutive female patients with urinary incontinence, who had underwent retropubic midurethral synthetic sling procedure from January to August 2019 were analyzed retrospectively. The mean age was (60.83±7.93) years old and the body mass index was (24.43±2.44) kg/m 2. Among the recruited subjects, 36 had positive stress test and Marshall-Marchetti test. 20 (55.6%) were pure stress urinary incontinence, and 16 (44.4%) were mixed urinary incontinence. The severity of incontinence was classified into mild (5 cases, 13.9%), moderate (14 cases, 38.9%), severe (13 cases, 36.1%) and very severe (4 cases, 11.1%) using one-hour pad tests. Urodynamics were performed in 17 cases, with 5 (29.4%) presented detrusor overactivity, 3 (17.7%) possessed intrinsic sphincter deficiency. For each case, the tension of the sling was adjusted based on the anatomical landmarks, i. e. using an angled clamp attached closely to the pubic symphysis ventrally and the tip parallel to the edge of hymen dorsally. All patients were catheter-free right after the procedure. The subjective and objective effectiveness, and safety (the rate of urinary retension after surgery and postvoid residual volume 3 months later) were evaluated.The subjective cure rate was was defined as complete leakage free or very mild leakage during excessive bladder filling and fierce cough. The subjective effectiveness was defined as over 50% improvement of the leakage symptom. The objective cure rate was defined as a negative stress test. Results:For all 36 patients, the median hospital stays was 8 (5-95)h. No bladder perforation or transfusion cases. All patients were catheter-free right after the procedure, with no incidence of urinary retention. 27 patients completed a 3-month follow-up, with 22 had post-void residual data, 23 had subjective effectiveness data and 23 had objective effectiveness data. The median post-void residual was 7.5 (5-64) ml, subjective cure rate was 91.3% (21/23), and objective cure rate was 95.7% (22/23). 8.7% (2/23) reported difficult urination alleviated without the necessity of clinical interference. No urethra erosion or vagina extrusion was found. At 2-year follow-up, 34 patients completed assessment by phone. The subjective cure rate was 91.2% (31/34), with only 2.9% (1/34) reported difficult urination. Besides, at 3-month follow-up, there was no difference regarding the subjective cure rate [100.0%(12/12) vs. 81.8%(9/11)]or objective cure rate [91.7%(11/12) vs. 100.0%(11/11)] between patients with stress and mixed incontinence. No difference was noted among patients with mild, moderate, severe and very severe leakage[75.0% (3/4) vs. 100.0%(6/6) vs. 90.0%(9/10) vs. 100.0%(3/3)]. Of the 12 cases with urodynamic records, the presence of detrusor overactivity [66.7%(2/3) vs. 88.9%(8/9)] or intrinsic sphincter deficiency [0(0/1) vs. 90.9%(10/11)] did not significantly affected the cure rate of the procedure. At 2-year follow-up, there was no difference regarding the subjective cure rate between patients with stress and mixed incontinence [94.7%(18/19) vs. 86.7%(13/15)]. No difference was also noted among patients with mild, moderate, severe and very severe leakage[80.0%(4/5) vs. 100.0%(13/13) vs. 83.3%(10/12) vs. 100.0%(4/4)]. Of the 16 cases with urodynamic records, the presence of detrusor overactivity [60.0%(3/5) vs. 90.9%(10/11)]or intrinsic sphincter deficiency [66.7%(2/3) vs. 84.6%(11/13)]did not significantly affected the cure rate of the procedure.Conclusions:Tension adjustment using anatomic landmarks during sling procedure is safe and feasible for urinary incontinence, with minimum complications and residual volume, and high subjective/objective cure rate.

O uso da bandagem elástica adesiva para alívio da dor no tratamento das disfunções temporomandibulares: revisão sistemática com metanálise / Use of kinesiology tape for pain relief in the treatment of temporomandibular disorders: a systematic review with meta-analysis

RESUMO Objetivos Verificar o efeito da aplicação da bandagem elástica sobre músculos mastigatórios no alívio da dor, em comparação com outras intervenções, em indivíduos com disfunções temporomandibulares. Estratégia de pesquisa Busca nas bases de dados LILACS, IBECS, CINAHL, Scopus, Web of Science, Cochrane, Embase e MEDLINE. A pergunta norteadora, utilizando-se os elementos da estratégia PICOT (população, intervenção, comparador, outcome/desfecho, tipo de estudo) foi: "A bandagem elástica promove alívio da dor em indivíduos com disfunção temporomandibular?". Critérios de seleção Foram incluídos ensaios clínicos que fizeram uso da bandagem elástica em músculos mastigatórios de indivíduos com disfunção temporomandibular, publicados em português, inglês ou espanhol. Foram excluídos os artigos que não abordavam o método de aplicação e o desfecho "intensidade da dor". A avaliação da elegibilidade foi realizada pela leitura dos títulos e resumos, bem como pela leitura dos estudos na íntegra. Foram extraídas informações sobre ano de publicação, país de condução do estudo, idade e condição clínica da amostra, tratamento e resultados da avaliação da dor. Na metanálise, realizada por meio do método do inverso da variância, a média do valor indicado na escala visual analógica foi considerada como medida de efeito da intervenção. Resultados Foram localizadas, inicialmente, 344 referências, das quais, 3 foram selecionadas. Foram identificados resultados significativamente superiores na redução da dor, em uma semana de uso da bandagem, na comparação com outras abordagens conservadoras analisadas. Conclusão Considerando os artigos incluídos, a bandagem elástica apresentou resultados significativos para maior redução da dor na primeira semana. Porém, o número reduzido de estudos e a presença de vieses limitam os achados.

ABSTRACT Purpose To verify the effects on pain relief by applying kinesiology tape on the masticatory muscles, in comparison with other interventions, in people with temporomandibular disorders. Research strategy Search in LILACS, IBECS, CINAHL, Scopus, Web of Science, Cochrane, EMBASE, and MEDLINE. The research question, based on the PICOT components, was: "Does kinesiology tape applied on to masticatory muscles relieve the pain in people with temporomandibular disorders?". Selection criteria The included articles were clinical trials using kinesiology tape on masticatory muscles in people with temporomandibular disorders, published in Portuguese, English, or Spanish. Articles whose authors had not adopted this application method and pain intensity as an outcome were excluded. Eligibility was assessed by reading their titles, abstracts, and full texts. The following information was extracted: year of publication, the country where the study was conducted, age and clinical condition of the sample, treatment, and pain assessment results. The meta-analysis, using the inverse variance method, considered the mean value indicated in the visual analog scale as the intervention effect measure. Results Initially, 344 references were retrieved, of which three were selected. Significantly better pain relief results were identified after 1 week of using the tape, in comparison with the other conservative approaches analyzed. Conclusion Considering the included articles, the kinesiology tape had significant results with greater pain relief in the first week. However, small number of studies and their biases limit the findings.

Mupirocin ointments: In vitro x In vivo bioequivalence evaluation

Abstract Bioequivalence (BE) assessment of topical drug products is a long-standing challenge. Agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have published several drafts in recent years suggesting different approaches as alternative to evaluate the BE. A proposed Topical Classification System (TCS) has even been discussed. Given the above, the objective of this research was to use in vitro and in vivo BE approaches to evaluate Brazilian marketed mupirocin (MPC) ointments, previously classified as TCS class The in vitro permeation test (IVPT) was performed by applying formulations to pig skin by Franz cells. The in vivo methodology was dermatopharmacokinetic (DPK). These approaches (in vivo tape stripping and IVPT) demonstrated capability of distinguishing among different formulations, thus making them useful methodologies for BE evaluation.

Efeito da bandagem elástica na atividade eletromiográfica de músculos periescapulares em indivíduos saudáveis / Effect of the kinesio tape on the electromyographic activity of periscapular muscles in healthy subjects

Introdução: A bandagem elástica é uma fita elástica adesiva utilizada na prevenção e reabilitação do complexo do ombro. Entretanto, existem divergências na literatura sobre seus efeitos na atividade eletromiográfica dos músculos periescapulares durante exercícios com carga. Objetivo: Avaliar os efeitos da bandagem elástica na atividade eletromiográfica de músculos periescapulares durante o movimento de flexão do ombro sem carga e com halter em indivíduos saudáveis. Métodos: Vinte e seis indivíduos do sexo masculino realizaram o movimento de flexão do ombro sem carga e com halter com a bandagem elástica sobre o trapézio descendente. Foram avaliadas as atividades eletromiográficas de trapézio descendente, trapézio ascendente e serrátil anterior. São comparados os valores de pico e RMS em percentual da contração isométrica voluntária máxima através da ANOVA One Way. Resultados: Na flexão de ombro com halter ocorreu diminuição do pico da atividade eletromiográfica do trapézio descendente (p = 0,035). Não houve influência sobre os demais músculos periescapulares (p > 0,05). Conclusão: A bandagem elástica diminuiu o pico da atividade eletromiográfica do trapézio descendente durante a flexão do ombro com halter. Pode-se aplicar este resultado na prevenção de indivíduos que podem tender a aumentar a atividade do trapézio descendente. (AU)

Introduction: The kinesio tape is an elastic adhesive tape used in the prevention and rehabilitation of the shoulder complex. However, there are divergences in the literature about its effects on the electromyographic activity of the periescapular muscles during load exercises. Objective: To evaluate the effects of kinesio tape on the electromyographic activity of the periescapular muscles during the flexion of the shoulder without load and with a dumbbell in healthy subjects. Methods: Twenty-six male individuals perform the flexion movement of the shoulder without load and halter with and kinesio tape over the upper trapezius muscle. The electromyographic activities of upper trapezius, lower trapezius and anterior serratus were evaluated. Normalized Peak and RMS through percentage of maximum voluntary isometric contraction were compared using ANOVA One Way. Results: During flexion of the shoulder with a dumbbell, the electromyographic activity of the upper trapezius (p = 0.035) decreased. We did not observe influence on the other periescapular muscles (p > 0.05). Conclusion: The kinesio tape decrease the peak value of the upper trapezius during the flexion of the shoulder with dumbbell. We can apply this result to individuals who may increase the activity of the upper trapezius. (AU)

Uso do taping linfático na prevenção da formação de equimoses em abdominoplastia e lipoaspiração / Use of lymphatic taping to prevent the formation of ecchymosis in abdominoplasty and liposuction

Introdução: Uma das intercorrências mais comuns em pós-operatório de cirurgia plástica de lipoaspiração e abdominoplastia é a equimose, e seu tratamento e prevenção fazem parte da rotina do fisioterapeuta dermatofuncional. O objetivo é avaliar a ocorrência de equimose de pacientes submetidas à abdominoplastia e/ou lipoaspiração tradicional de abdome e flancos, e correlacionar estatisticamente essas ocorrências com o tratamento de taping linfático no transoperatório. Métodos: Ensaio clínico controlado, composto por 20 pacientes do sexo feminino, com idade entre 20 e 60 anos divididos em dois grupos: 10 no grupo controle (GC) e 10 no grupo experimental (GE). Todas as mulheres que apresentavam indicação cirúrgica de abdominoplastia e/ou lipoaspiração de abdome e flancos. O GC foi apenas avaliado no pré-operatório e no 4º dia de pós-operatório, enquanto o grupo GE foi avaliado no pré-operatório, recebeu tratamento transoperatório com aplicação de taping linfático e foi reavaliado no 4º dia de pósoperatório. Resultados: O grupo experimental apresentou uma melhor resposta na resolução da equimose (p=0,01) quando comparado ao grupo controle. Conclusão: Neste estudo, o uso do taping linfático no transoperatório de abdominoplastia e lipoaspiração, reduziu ou anulou a formação de equimose no pós-operatório, contribuindo para a diminuição do número de atendimentos fisioterapêuticos, incidência de quadro álgico e acelerando assim o restabelecimento dos pacientes no pósoperatório das cirurgias de abdominoplastia e/ou lipoaspiração.

Introduction: Ecchymosis is one of the most common complications in the postoperative period of plastic liposuction and abdominoplasty surgery. Its treatment and prevention are part of the routine of the dermatofunctional physiotherapist. The objective is to evaluate the occurrence of ecchymosis in patients undergoing abdominoplasty and/ or traditional liposuction of the abdomen and flanks and statistically correlate these occurrences with the treatment of lymphatic taping during the operation. Methods: Controlled clinical trial, composed of 20 female patients, aged between 20 and 60, divided into 10 in the control group (CG) and 10 in the experimental group (EG). All women had a surgical indication of abdominoplasty and/or liposuction of the abdomen and flanks. The CG was only evaluated preoperatively and on the 4th postoperative day, while the EG group was evaluated preoperatively, received transoperative treatment with application of lymphatic taping and was reevaluated on the 4th postoperative day. Results: The experimental group presented a better response in the resolution of ecchymosis (p=0.01) when compared to the control group. Conclusion: In this study, the use of lymphatic taping during the transoperative period of abdominoplasty and liposuction reduced or annulled the formation of ecchymosis in the postoperative period, contributing to the decrease in the number of physical therapy visits, the incidence of pain and thus accelerating the reestablishment of patients from abdominoplasty and/or liposuction surgeries.

Effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis

Scapular dyskinesis is an abnormality in scapula static or dynamic position. There are several techniques for scapular dyskinesis conservative treatment, including Kinesio Tape application, which is used to promote and support scapula joint alignment, decrease pain and improve local muscle control. The study aim to investigate the effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis. Fourteen subjects with scapular dyskinesis performed flexion and scaption movements in two conditions: (1) without load and (2) holding a dumbbell. A scapular tape was applied over the lower trapezius (Y shaped) muscle with a 20% tension. Kinematic data were captured with 10 infrared cameras and analyzed based on Euler angles, peak values of upward rotation, internal rotation, and posterior tilt angles. To compare the situations with and without kinesio tape the repeated measures two-way ANOVAs (α = 0.05) was performed using SPSS software. Scapular tape increase upward rotation and posterior tilt during flexion of the shoulder. No interaction (Load x KT) was found during flexion, suggesting that KT effect in the peak values is the same, regardless the load condition. Scapular tape decreases internal rotation during scaption and a significant interaction was found between load x KT, suggesting the effect of using KT could depend the load u sed during this movement. The results suggest that kinesio tape may can be use as assistant to increase upward rotation, posterior tilt and decrease internal rotation in scapular dyskinesis subjects. (AU)

A modified banding technique: experience of a center / Uma técnica de bandagem modificada: experiência de um centro

ABSTRACT Background: A well-functioning vascular access is vital to patients on regular hemodialysis. Banding the access is indicated in high-flow-associated steal syndrome. It allows for the reduction of access flow while maintaining distal limb perfusion. Nonetheless, this procedure has some limitations as it can cause hemorrhage, infection, aneurysm formation, thrombosis of access in cases of overbanding, or otherwise insufficient reduction of vascular flow. Other surgical techniques to achieve the same benefit would be useful. Methods: We performed a modified banding technique without endovascular placement of the angioplasty balloon, which is a viable alternative to other techniques. This surgery was performed in patients on chronic dialysis with steal syndrome. Pre- and post-operative access flows were measured and resolution of symptoms was recorded. Primary patency rate was defined as the intervention-free access survival from the operative time. Results: We verified that this technique allowed for access flow reduction in all our six patients, with total resolution of symptoms in all patients. Primary patency rate at 12 months was 100%. No major complications were noted during our follow-up. Conclusions: This technique allows for correction of high-flow arteriovenous fistulas in an efficient and safe way, and can be a viable alternative to other banding procedures.

RESUMO Introdução: Um acesso vascular em bom funcionamento é vital para pacientes em hemodiálise regular. A bandagem do acesso é indicada na síndrome de roubo associada a alto fluxo. Permite a redução do fluxo de acesso enquanto mantém a perfusão distal do membro. No entanto, este procedimento tem algumas limitações, pois pode causar hemorragia, infecção, formação de aneurisma, trombose de acesso em casos de excesso de bandagem (overbanding) ou, de outra forma, redução insuficiente do fluxo vascular. Outras técnicas cirúrgicas para obter o mesmo benefício seriam úteis. Métodos: Foi realizada uma técnica de bandagem modificada sem colocação endovascular do balão de angioplastia, que é uma alternativa viável às outras técnicas. Esta cirurgia foi realizada em pacientes em diálise crônica com síndrome de roubo. Os fluxos de acesso pré e pós-operatório foram medidos e a resolução dos sintomas foi registrada. A taxa de permeabilidade primária foi definida como a sobrevivência do acesso livre de intervenção desde o tempo operatório. Resultados: Verificamos que essa técnica permitiu redução do fluxo de acesso em todos os nossos seis pacientes, com resolução total dos sintomas em todos os pacientes. A taxa de patência primária em 12 meses foi de 100%. Nenhuma complicação maior foi observada durante nosso acompanhamento. Conclusões: Esta técnica permite a correção de fístulas arteriovenosas de alto fluxo de forma eficiente e segura, podendo ser uma alternativa viável a outros procedimentos de bandagem.

Effect of preoperative urodynamic study on urinary outcomes after transobturator sling / Efeito do estudo urodinâmico pré-operatório nos resultados pós-operatórios do sling transobturador

Abstract Objective To evaluate whether performing preoperative urodynamic study influences postoperative urinary symptoms of women with stress urinary incontinence that underwent transobturator sling. Methods Retrospective analysis of patients treated for stress urinary incontinence by transobturator sling from August 2011 to October 2018. Predictor variables included preoperative urodynamic study, age, incontinence severity, body mass index, preoperative storage symptoms and previous anti-urinary incontinence procedure. Outcome variables were postoperative subjective continence status, storage symptoms and complications. Logistic regression after propensity score was employed to compare outcomes between patients who underwent or not pre-operative urodynamic study. Results The present study included 88 patients with an average follow-up of 269 days. Most patients (n = 52; 59.1%) described storage symptoms other than stress urinary incontinence, and 38 patients (43.2%) underwent preoperative urodynamic studies. Logistic regression after propensity score did not reveal an association between urinary continence outcomes and performance of preoperative urodynamic study (odds ratio 0.57; confidence interval [CI]: 0.11-2.49). Among women that did not undergo urodynamic study, there was a subjective improvement in urinary incontinence in 92% of the cases versus 87% in those that underwent urodynamic study (p = 0.461). Furthermore, postoperative storage symptoms were similar between women who did not undergo urodynamic study and those who underwent urodynamic study, 13.2% versus 18.4%, respectively (p = 0.753). Conclusion Preoperative urodynamic study had no impact on urinary incontinence cure outcomes as well as on urinary storage symptoms after the transobturator sling in women with stress urinary incontinence.

Resumo Objetivo Avaliar a influência do estudo urodinâmico pré-operatório nos resultados miccionais pós-operatórios em mulheres com incontinência urinária de esforço submetidas a sling transobturador. Métodos Análise retrospectiva de mulheres com incontinência urinária de esforço submetidas a sling transobturador entre agosto de 2011 e outubro de 2018. As variáveis preditoras pré-operatórias, entre outras, foram a realização do estudo urodinâmico, gravidade da incontinência e sintomas urinários de armazenamento. As variáveis de desfecho pós-operatórias foram o status subjetivo da continência, sintomas de armazenamento urinário e complicações cirúrgicas. A regressão logística após o escore de propensão foi empregada para comparar os resultados entre os pacientes que foram submetidos ou não ao estudo urodinâmico pré-operatório. Resultados Foram incluídas no presente estudo 88 pacientes com um seguimento médio de 269 dias. A maioria das pacientes apresentava sintomas miccionais de armazenamento (n = 52; 59,1%) concomitantes à incontinência urinária de esforço. Um pouco menos da metade das pacientes (n = 38; 43,2%) foram submetidas a estudo urodinâmico pré-operatório. A regressão logística após o escore de propensão não revelou associação entre os resultados de continência urinária e a realização de estudo urodinâmico pré-operatório (odds ratio 0,57; intervalo de confiança [IC]: 0,11-2,49). Além disso, os sintomas de armazenamento urinário pós-operatórios foram similares entre as pacientes que não realizaram e aquelas que realizaram o estudo urodinâmico, 13,2% e 18,4% respectivamente (p = 0,753). Conclusão O estudo urodinâmico pré-operatório não teve impacto nos resultados de continência urinária, bem como nos sintomas de armazenamento urinário após o sling transobturatório.

Prevención del linfedema posquirúrgico en cáncer de mama mediante rehabilitación fisioterapéutica: estudio comparativo entre drenaje linfático manual y kinesiotape / Prevention of postsurgical lymphedema in breast cancer through physiotherapeutic reha- bilitation: a comparative study between manual lymphatic drainage and kinesiotape

Se realizó un estudio con diseño cuantitativo, de tipo observacional descriptivo; cuya población de estudio estuvo constituida por 142 pacientes de sexo femenino, diagnosticadas con cáncer de mama en la Unidad Oncológica Solca-Chimborazo, durante el período 2014-2019; con el objeti - vo de describir el tratamiento fisioterapéutico en ese contexto de investigación. Los datos fueron recolectados a partir de las respectivas historias clínicas. A partir de 2015, se observó un predo- minio de pacientes adultos con edades comprendidas entre 36 y 65 años. De las 142 pacientes que conformaron la población estudiada, solo 5 desarrollaron linfedema posquirúrgico. La mayoría de las pacientes incluidas en el estudio fueron intervenidas quirúrgicamente (65); 59 de las cuales recibieron tratamiento de drenaje linfático manual. Entre la población elegida en la Unidad Oncológica de Solca-Chimborazo se evidenció que la aplicación de terapia de rehabili - tación mediante drenaje linfático manual posquirúrgico reduce la posibilidad de aparición de linfedema a largo plazo.

This research aimed to describe the physiotherapeutic treatment in this research context. A study was carried out with a quantitative design, of a descriptive observational type. The study popula- tion consisted of 142 female patients, diagnosed with breast cancer at the Solca-Chimborazo Oncology Unit, during the period 2014-2019. The data were collected from the respective medi- cal records. Since 2015, a predominance of adult patients aged between 36 and 65 years was observed. From the 142 patients that made up the study population, only 5 developed postsurgi- cal lymphedema. Most of the patients included in the study underwent surgery (65); 59 received manual lymphatic drainage treatment. Among the population chosen in the Solca-Chimborazo Oncology Unit, it was evidenced that the application of rehabilitation therapy through postope- rative manual lymphatic drainage reduces the possibility of long-term lymphedema develop - ment.

Antilipoperoxidative and anti-inflammatory efficacy of multifunctional sunscreens containing ferulic acid

Unprotected chronic exposure to ultraviolet radiation generates many harmful effects to human skin and UV filters are essential to health, however, traditional sunscreens do not provide enough protection against cutaneous oxidative stress, a process amplified by UV radiation. Therefore, is been proposed the development of multifunctional photoprotective formulations, acting in the absorption/reflection of UV radiation and assisting in cutaneous homeostasis. In the present study, ferulic acid is used in conjunction with two sunscreens, bemotrizinol and ethylhexyl triazone, for the determination of biosafety and efficacy methods, using techniques that better elucidate the effects of ferulic acid. Skin permeation assays were performed by applying a formulation containing the three substances in the stratum corneum of volunteers, which were removed by the tape stripping method (ex vivo) with follow quantification by high performance liquid chromatography (HPLC). The test was able to evaluate the penetration depth of the substances, characterizing them. In addition, the simultaneous quantification of the three substances was performed by a single and fast method, facilitating their analysis and improving the technique. Also, TBARS (thiobarbituric acid reactive substances) assays were performed in stratum corneum removed by tape stripping (ex vivo), evaluating the potential of cutaneous lipid peroxidation, with or without ferulic acid. To date, it is the first time that TBARS method is used to characterize the stratum corneum (ex vivo) and quantified by HPLC. The protocol developed may aid in the efficacy of antioxidant agents in studies aimed at elucidating the level of lipid peroxidation caused by drugs and cosmetics, and even in carrying out baseline studies characterizing different ethnicities and genders. As last, an anti-inflammatory in vivo assay with Laser Doppler flowmetry equipment was used to compare the sunscreen formulation with or without ferulic acid. Data indicated that the antioxidant reduced the angular coefficient of the perfusion units, mitigating the inflammatory effects. Furthermore, a significant difference was found between the genders, suggesting a more pronounced inflammatory reaction in women. Ferulic acid proved to be a valuable resource, besides being safe and raise the SPF of sunscreens, it also mitigates the effects of inflammation

A exposição crônica desprotegida à radiação ultravioleta (UV) contribui para o desenvolvimento de câncer de pele e os filtros solares são relevantes para evitar tais efeitos prejudiciais, porém, os protetores solares tradicionais não geram proteção suficiente contra o estresse oxidativo cutâneo. Logo, espera-se o desenvolvimento de formulações fotoprotetoras multifuncionais, atuando não somente na absorção e/ou reflexão da radiação UV, mas, também, auxiliando na homeostase cutânea, com presença de agentes antioxidantes. No presente estudo foi utilizado o ácido ferúlico conjuntamente com dois filtros solares, o bemotrizinol e a triazona de octila, para determinação de métodos de segurança e eficácia, utilizando técnicas que melhor elucidem e comprovem os efeitos do ácido ferúlico. Foram realizados ensaios de permeação cutânea pela aplicação tópica de formulação contendo as três substâncias em voluntários, sendo o estrato córneo retirado pelo método de tape stripping (ex vivo) com subsequente quantificação por cromatografia líquida de alta eficiência (CLAE). O ensaio pôde avaliar a profundidade de penetração das substâncias, caracterizando-as. Ademais, a quantificação simultânea das três substâncias foi efetuada por método único e rápido, facilitando análise com aprimoramento da técnica. Em adição, foi realizado ensaios de TBARS (substâncias reativas ao ácido tiobarbitúrico) em estrato córneo removido por tape stripping (ex vivo), para avaliar o potencial de peroxidação lipídica cutânea, contendo ou não o ácido ferúlico. Até o presente momento, é a primeira vez que o método TBARS é utilizado para caracterização do estrato córneo (ex vivo) e quantificada por CLAE. O protocolo desenvolvido pode auxiliar na eficácia de agentes antioxidantes, em estudos que visam elucidar o nível de peroxidação lipídica causada por medicamentos e cosméticos e, até mesmo, na realização de estudos de base, caracterizando etnias e gêneros. Ademais, um ensaio anti-inflamatório in vivo com equipamento de fluxometria Laser Doppler foi utilizado para comparar a formulação fotoprotetora com ou sem ácido ferúlico. Os dados indicaram que o antioxidante reduziu o coeficiente angular das unidades de perfusão, mitigando os efeitos inflamatórios. Ainda, foi identificada diferença entre os gêneros, sugerindo reação inflamatória mais pronunciada em mulheres. O ácido ferúlico provou ser um recurso valioso, além de ser seguro e elevar o FPS dos fotoprotetores, também atenuando os efeitos da inflamação

Evaluation of a 3D printed female anatomical model for the hands on training of trans-obturator tape (TOT) and tension free vaginal tape (TVT) sling procedures / Evaluación de un modelo anatómico femenino impreso en 3D para el entrenamiento práctico de los procedimientos de cinta trans-obturadora (TOT) y cinta vaginal sin tensión (TVT)

Trans-obturator tape (TOT) and tension free vaginal tape (TVT) procedures are efficient treatment options, which reduce the surgical complications and provide adequate support to urethra in case of increased abdominal pressure to prevent stress urinary incontinence (SUI). The aim of this study is to evaluate the effect and efficacy of 3D printed female anatomical model on the training of TOT and TVT procedures. A 3D printed female anatomical model was produced for MedTRain3DModSim, Erasmus+ European Union project led by Turkey with the participation of Greece, Italy, Czech Republic and South Korea. Face and content validities of the model evaluated by the participants and the experts respectively. During two learning & teaching & training activities and a multiplier event of the project between 2016 and 2018; 41 medical students, 30 residents and 19 specialists of urology and gynecology were educated and performed TOT and TVT procedures with this model under the mentorship of 3 experts. All participants were assessed and scored for their achievement on both procedures with model according to 7 parameters by the experts. There was no statistical difference between the students and residents for each parameter. All the parameters of the students and specialists were statistically different. 3D anatomical models produced from real data and mimicking different types of tissues are suitable for basic anatomy education of students and residents, hands on training for junior surgeons before cadaveric courses in hybrid education system, surgical planning of the surgeons and informing the patients before the operation.

Los procedimientos de cinta transobturadora (TOT) y cinta vaginal sin tensión (TVT) son opciones de tratamiento eficientes, que reducen las complicaciones quirúrgicas y proporcionan un soporte adecuado a la uretra en caso de aumento de la presión abdominal para prevenir la incontinencia urinaria de esfuerzo (IUE). El objetivo de este estudio fue evaluar el efecto y la eficacia del modelo anatómico femenino impreso en 3D en el entrenamiento de los procedimientos TOT y TVT. Se produjo un modelo anatómico femenino impreso en 3D para MedTRain3DModSim, proyecto Erasmus + de la Unión Europea dirigido por Turquía con la participación de Grecia, Italia, la República Checa y Corea del Sur. Validez facial y de contenido del modelo fueron evaluados por los participantes y los expertos respectivamente. Durante dos actividades de aprendizaje, enseñanza y capacitación y un evento multiplicador del proyecto entre 2016 y 2018; 41 estudiantes de medicina, 30 residentes y 19 especialistas en urología y ginecología fueron capacitados y realizaron procedimientos TOT y TVT de este modelo bajo la tutoría de 3 expertos. Todos los participantes fueron evaluados y calificados por los expertos, por su logro en ambos procedimientos con el modelo de acuerdo con 7 parámetros. No hubo diferencia estadística entre los estudiantes y los residentes para cada parámetro. Todos los parámetros de los estudiantes y especialistas fueron estadísticamente diferentes. Los modelos anatómicos en 3D producidos a partir de datos reales e imitando diferentes tipos de tejidos son adecuados para la educación básica de anatomía de estudiantes y residentes. Además de ofrecer una capacitación práctica para los cirujanos antes de los cursos cadavéricos en el sistema educativo, y una planificación quirúrgica de los cirujanos e información para los pacientes antes de la cirugía.

Comparison of Two Specimen-Collection and Microscopy Methods for the Rapid Laboratory Diagnosis of Seborrheic Dermatitis- A Pilot Study

Malassezia spp. causes seborrheic dermatitis. For laboratory diagnosis, skin scrapings are collected and mounted in potassium hydroxide (KOH) for microscopy and processed for culture. Obtaining scrapings has disadvantages and KOH lacks colour contrast making interpretation difficult. This pilot study compared the results of specimen collection by cellophane tape method with scraping method. It also compared microscopy using Chicago Sky Blue 6B (CSB) stain plus KOH with the conventional method using KOH alone.METHODSSkin specimens were collected from the affected sites of 80 patients by scraping and cellophane tape. Specimens were subjected to KOH examination, KOH plus CSB stain, and culture for the presence of Malassezia spp.RESULTSA total of 160 specimens were collected from 80 patients for microscopy. Of 160 specimens, each was subjected to KOH and CSB plus KOH, 145 (91%) demonstrated Malassezia spp. by CSB plus KOH and 124 (77.5%) by KOH alone (p= 0.001). Cellophane tape method yielded 141 (88%) positive results compared to 128 (80%) by skin scraping (p=0.047). The odds of detecting Malassezia spp. was 4.4 times greater when the specimen was collected by cellophane tape and subjected to microscopy with CSB and KOH than when it was collected by scraping and examined microscopically with KOH alone (p= 0.002).CONCLUSIONSCellophane tape is a convenient method for specimen collection. CSB stain provides colour contrast and enables easy identification of fungal elements.

Transobturator suburethral tape versus suburethral tape placement in female stress urinary incontinence / Cinta suburetral versus cinta transobsturatriz en el tratamiento de la incontinencia urinaria de esfuerzo femenina

ABSTRACT Introduction : The surgical management of stress urinary incontinence uses the transobturator tape (TOT) technique since 2006. We present a study applying the suburethral tape as a better alternative that does not require the TOT needle. Objective : To demonstrate the advantages of the suburethral tape placement technique over the transobturator tape technique in the surgical treatment of stress urinary incontinence. Methods : Observational comparative study using the non- invasive suburethral tape placement versus the transobturator tape technique. Results : Fifty patients were treated with TOT for stress urinary incontinence and other 50 patients were managed with suburethral tape placement (UTP) in the previous shift the same day or the preceding day. The TOT patients were 56 years old on average, and time of the procedure was 18 minutes on average. Complications included pain in the inguinal area (13 cases), mesh extrusion (2 cases), and suture dehiscence of anterior colporrhaphy, presence of left inguinoperineal granuloma due to mesh reaction and bruising in the left obturator area (one case of each). The 50 patients treated with UTP were 56 years old on average, operating time was 7 minutes on average, and there were no complications. The cost of the TOT kit was about US$ 1 000.00, and the suburethral tape cost was US$ 50.00. Conclusions : In this study of stress urinary incontinence treatment, the suburethral tape technique was safer than the transobturator tape technique and had a lower cost.

RESUMEN Introducción . Entre los tratamientos quirúrgicos de la incontinencia urinaria de esfuerzo se emplea la técnica de la cinta transobturatriz (TOT, por sus siglas en inglés) desde el 2006 hasta la actualidad. Se presenta un estudio con la aplicación de la cinta uretral (UTP, por sus siglas en inglés) como mejor alternativa al no usar la aguja del TOT. Objetivo . Demostrar las ventajas de la aplicación de la cinta suburetral versus la cinta transobturatriz en el tratamiento quirúrgico de la incontinencia urinaria de esfuerzo. Métodos . Estudio observacional, comparativo con la técnica no invasiva empleando cinta suburetral versus la técnica de la cinta transobturatriz. Resultados . Se evaluó 50 pacientes intervenidas con TOT, quienes precedieron un turno el mismo día o el día precedente a las pacientes operadas con la cinta uretral. El promedio de edad fue 56 años y el tiempo promedio del procedimiento fue 18 minutos. Las complicaciones consistieron en dolor en la zona inguinal (13 casos), extrusión de malla (2 casos) y, una de cada caso, dehiscencia de sutura de la colpoporrafia anterior, presencia de granuloma inguinoperineal izquierdo por reacción a la malla, hematoma en zona obturatriz izquierda. En los 50 casos tratados con cinta suburetral, el promedio de edad fue 56 años, el tiempo operatorio 7 minutos y no existió complicación alguna. El costo del kit de la TOT fue alrededor de US$ 1 000.00; la cinta suburetral costó US$ 50.00. Conclusiones . En la presente serie de manejo de la incontinencia urinaria de esfuerzo, la técnica de la cinta suburetral resultó más segura que la técnica de la cinta transobturatriz y fue de menor costo.

Effect of Kinesio Taping at Knee on Position Sense and Lower-limb Function / 中国康复理论与实践

Objective:To observe the effects of Kinesio Taping and kneepad on position sense of knee in healthy young adult male. Methods:In September, 2019, 20 healthy adult male aged 21 to 27 were selected. They were measured the joint angle error in angle reproduction test, and tested with functional reach test (FRT), 10-meter walking time (10MWT), and Timed "Up and Go" Test (TUGT) under follow four conditions: non-intervention, simple Kinesio Taping, simple kneepad, and both Kinesio Taping and kneepad. Results:For the angle error, it was the most under non-intervention, and the least under simple Kinesio Taping (F = 61.260, P < 0.001). For FRT, there was no significant difference among all the conditions (F = 1.793, P = 0.988). For 10MWT, it was the least under simple Kinesio Taping (F = 23.817, P < 0.001). For TUGT, it was the most under non-intervention (F = 19.865, P < 0.001). Conclusion:Kinesio Taping can improve position sense of knee, as well as walking, without further benefit along with kneepad.

Treatment of skin and soft tissue defect with Nice combination with elastic dressing and stretch / 中华骨科杂志

Objective To explore the clinical effects of Nice knot combined with elastic compress and stretch in treating skin and soft tissue defect.Methods From August 2017 to April 2019,a total of 23 patients,10 males and 13 females,aged 36.5±5.3 years (range 26-76 years),were retrospectively analyzed.The defect size was 60±5.3 cm2 (28-96 cm2).Under local anesthesia,the wound was debrided thoroughly,sutured and fixed by Nice knot.The wound was fixed by elastic dressing and traction.The wound was retracted every 3 days during dressing change.The wound healing grade,healing rate,healing time,and postoperative Vancouver Scar Scale (VSS) were observed and recorded.Results All operations were performed successfully in the debridement room.The operation time was 42±10.5 min (range 30-50 min),intraoperative bleeding 30±2.5 ml (range 20-60 ml),and the operation cost 180±11.5 RMB (range 160-240 RMB).Twenty patients were followed up for 4±2.5 months (range 3-6 months).The wound healing rate of 23 patients was 50％±3.5％ (range 40％-56％).For the 20 patients,the wound healing rate was 65％±4.3％ (range 53％-75％),74％±4.5％ (range 65％-80％),83％±1.8％ (range 76％-85％),90％±1.6％ (range 84％-95％) and 95％±3.5％ (range 94％-98％) at 3,6,9,12 and 15 days,respectively.The wound healing rate of 20 patients was 100％ at the 42nd days of follow-up.Wound healing rate of Grade A and grade B was 95％ (19/20) with scar VSS score 4(3,6).The excellent and good rate of grade B was 80％ (16/20).Two cases were sutured and fixed with Nice knot after 10 days because of the partial loss of the sutures.One case was treated with vacuum sealing drainage (VSD) on-line junction because infection was not completely controlled.Local infection was controlled and the wound was contracted by Nice junction at 1 week.Conclusion The treatment of skin and soft tissue defect with Nice combination with elastic dressing and traction has the advantages of simple operation,low operation condition,short operation time,less bleeding,low cost,high wound healing grade and healing rate,suitable for basic level hospital application and promotion.