RESUMEN
Background: The aim of the study was to evaluate the efficacy of hyaluronic acid application after tendon repair in prevention of postoperative adhesions, and to clarify the best circumstances that must be fulfilled to obtain this goal. Tissue adhesion usually happens due to injury, foreign-body reaction, bleeding, or infection but is considered an important factor for wound healing. As a result, tendons repair after injury is usually complicated due to limited postoperative movement. Several methods were used to try to prevent postoperative adhesions but most of them did not give satisfactory results as the mechanism of adhesion formation is still unclear.Methods: Fifty patients were included in this prospective study performed at department of plastic, reconstruction and burn surgery, faculty of medicine, Menoufia University over the period of approximately two years (January 2016 to November 2017).Results: Close follow up of the function of the repaired tendons was evaluated repeatedly over the period of 6 months. 40 patients showed excellent progress in regaining function with less possibility of performing adhesions, these patients also expressed satisfaction and comfort toward the regained function. 10 patients showed reasonable progress and were mildly satisfied.Conclusions: Application of hyaluronic acid in addition to a well-planned rehabilitation plan is a good and reliable method against adhesions when performing primary tendon repair.
RESUMEN
Background: The aim of the study is to facilitate choosing the surgical technique that will be suitable for improving both function and aesthetics of each patient through this suggested algorithm system. Any post burn neck contracture usually causes severe impairment of function and aesthetics, which causes serous psychological and social problems. That’s why it is very important to sub-categorize this type of deformity by anatomical location and cause of burn to allow choosing the ideal method of surgical management.Methods: This is a prospective study which was performed in Plastic Surgery Department, Menoufia University Hospitals over the period from March 2017 to March 2019. The study included 30 patients suffering post burn neck contracture deformities.Results: Patients were carefully examined, and the post burn neck deformities were analyzed according to age, condition of skin at the contracture site, the range of sternomastoid muscles movement at both sides of the neck and patient's general condition. Patients were given scores and categorized into 4 grades. And according to each patient's grade, the suitable surgical technique was chosen and fulfilled. 25 patients showed great satisfaction to their post operative’s outcomes and the rest were poorly satisfied.Conclusions: Application of patients with post burn neck contractures to this algorithm system will make it easy to choose the ideal method of management and gain the best surgical results possible when performing surgical correction.