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Introduction: There has been an exponential increase in the number of young adults seeking tattoo removal in recentyears. The main reason is a prohibition of any form of tattoo in recruitment of army, paramilitary force, police, and otherjobs. Most studies done on tattoo removal are either on laser removal or have established results of only one particularsurgical method of tattoo removal. However, almost all known surgical methods of tattoo removal have been performed inthe present study.Aims and Objectives: The aim is to study the clinical outcome of various surgical methods of tattoo removal to search for anideal one.Materials and Methods: A study was conducted in 350 patients. Tattoo removal was done with surgical methods. The varioussurgical techniques used were excision and primary closure, serial excision, tangential split thickness excision, tangentialexcision with dermal over grafting, and excision with grafting. The factors which determined the choice of procedure weresize, site, shape, depth of tattoo, skin laxity, and presence of complication of tattooing or previously attempted tattoo removal.Patients were followed for 3 months.Results: Excision and primary closure were done in 26 tattoos. Serial excision in 9, split thickness tangential excision in 2,tangential excision with dermal over grafting in 179, and excision with grafting in 134 tattoos were done. Scar stretching, minimalcolor changes, and hypertrophy were seen after tattoo removal. Post-operative marginal hypertrophy was seen lesser in tangentialexcision with dermal over grafting (60%) than in excision with grafting (75%) though it could be managed conservatively. Patientsatisfaction levels were well achieved.Conclusion: All procedures resulted in complete tattoo removal, and each had its own application and limitations. It was difficultto label one procedure superior to the other.
RESUMO
Background: Priming is one of those techniques in which a small dose of non-depolarizing muscle relaxants is administeredfollowed by a large intubating dose. Cisatracurium is the newly introduced drug with Hoffman elimination. The problem with itsuse is delayed onset of action. The present study was conducted to compare the onset of cisatracurium for tracheal intubationwith and without priming dose of rocuronium.Materials and Methods: A total of 60 American Society of Anesthesiologist physical Status Ι and ΙΙ patients undergoing surgeryunder general anesthesia were included in the study. Patients were divided into two groups of 30 each. Patients in Group Rreceived priming dose of rocuronium 0.06 mg/kg before intubating dose of cisatracurium (0.14 mg/kg). Group C patients didnot get any priming, only normal saline was given before intubating dose of cisatracurium (0.15 mg/kg).Results: Time gap between administration of the cisatracurium and complete loss of T1 was recorded as intubation time.The intubation time was significantly less in Group R, i.e., 130 ± 11.02 s as compared to Group C, i.e., 230.33 ± 12.82 s. Theintubating conditions were similar in both the groups. The hemodynamic changes were statistically insignificant. The time to25% recovery of the T1 response is defined as the clinically effective duration of neuromuscular block. The rate of recovery isdescribed by the recovery index, which is defined as the time from 25% to 75% T1 recovery.Conclusion: Priming with rocuronium decreased the onset time without increasing the clinical duration of action or recovery index.