Prospective comparison of primary wound closure with tissue- adhesive versus suture materials

Background and Objectives: Nowadays the final outcome of wound closure using tissue adhesives and suture material is making a real competition for better results. Cosmetic outcome is regarded as the first demand for the patients. The aim of this study was to make a comparison between the two closure methods in terms of cosmetic outcome, complication and patients' satisfaction

Method: A prospective comparative study was conducted at Rizgary Teaching Hospital and West Erbil Emergency Hospital in Erbil city from March 2012 to March 2013. A total of 105 patients were included in the study. The method of closure was selected alternatively between tissue adhesive [octylcyanoacrylate] and suture material. Analysis for cosmetic outcome, complications and patients' satisfaction were done using the statistical package for the social sciences [version 19]

Results: The complications were 25% [13 patients] in the tissue adhesive group and 18% [9 patients] in the sutured group. Of the 44 patients in the tissue adhesive group, 86.4% [38 patients] were satisfied; while of the 61 patients in the sutured group, 88% [54 patients] were satisfied with the end result. Excellent cosmetic outcome achieved in 77.3% in the tissue adhesive group and 80.3% in the sutured group

Conclusion: Tissue adhesive [octylcyanoacrylate] is effective and reliable in primary skin closure, yielding similar cosmetic results to standard suturing method. Tissue adhesive is faster and offers several practical advantages over suture repair

Evaluation of cleft lip and palate management in Erbil

Background and Objectives: Cleft lip and palate are congenital deformities that affect the primary and secondary palates during embryogenesis. The objectives of this study was to record the pattern of presentation of cleft lip and palate in Erbil, the types of surgical procedures, the outcome and complications, hence making recommendations to ensure improved care

Methods: This is a prospective study conducted in Erbil city, in the Department of Plastic Surgery at Rezgary Teaching Hospital and Rapareen Pediatric Hospital from March 2009 to May 2013. A total of 164 patients with cleft lip/palate were included in this study. Statistical package for the social sciences [version 18] was used for data entry and analysis

Results: The age ranged from birth to 24 years. The ratio of male to female was 1.4: 1. The combined cleft lip and palate was the commonest type [87 cases, 53%]. The commonest risk factor was poor family [105 cases, 64%], followed by consanguinity [97 cases, 59%]. The commonest procedure for cleft lip repair was Millard [67 cases] and that for cleft palate repair was Furlow palatoplasty [57 cases]. The commonest complication of cleft lip repair was wide scar [9 cases, 7.5%] mostly below one year of age. Ninety-one percent of the parents were satisfied with the children's appearance of the lip and 86% of parents were satisfied with palatoplasty result

Conclusion: The high degree of association of consanguinity with the cleft lip and palate emphasizes the importance of education about discouraging consanguineous marriage. Millard repair is still the commonest procedure for cleft lip repair

Postburn head and neck reconstruction using tissue expanders

Tissue expanders are useful adjuvant in reconstruction after burn. The technique provides tissue of similar texture and color to the defect to be covered and has the added advantage of minimal donor site morbidity. The study aimed to assess the outcome and complications of using tissue expansion for head and neck postburn reconstruction. Thirty patients with head and neck burn scar, treated with thirty eight tissue expanders, were included in this prospective study at the Plastic Surgery Department in Rizgari Teaching Hospital in Erbil from April 2009 to November 2012, with the mean age of 14 years. Statistical package for social sciences [SPSS version 18] was used for data entry and analysis. The commonest use of tissue expander was for treating postburn scar alopecia [18 patients, 60%], followed by postburn cheek scar [six patients 20%]. The scar size ranged from 4x10cm to 16x24cm. Complete burn scar excision was possible in 80% of cases with single or multiple sessions of expansion. Early exposure of the expander followed by infection occurred in three cases [10%], which led to interruption of the expansion and expander removal. Satisfactory results were achieved after reconstruction in 90% of cases. Tissue expansion, if carefully planned and conducted, is one of the treatments of choice for post-burn reconstruction of the head and neck, allowing an expanded flap suitable for versatile coverage

Evaluation of hemangioma management in Erbil city

The term hemangioma refers to the common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. Hemangioma has a perinatal incidence of 1%-3% and affecting 10% of infants by one year of age. The aim of this study was to evaluate treatment outcomes following various managements of hemangiomas. One hundred four patients were included in this prospective study. Based on clinical management, each patient was assigned to different treatment groups: steroid, surgical, and combined therapy. Treatment outcomes were evaluated based on improvement in size and color, by a blinded panel of three raters including two doctors and one patient or patient's parents. Finally, comparison of outcomes between groups was analyzed statistically. A p value

Incidence of facial soft tissue injuries among patients attending Surgical Casualty Reception in Rojh-halat Emergency Hospital

Facial soft-tissue injuries are the most common injuries presenting to surgical causality reception. The present study aimed to provide a preliminary data base about the distribution, type, pattern and etiology of facial soft tissue injuries. In a prospective clinical study all patients with facial injury were enrolled in this study, over a ten months period [from 1[st] October 2010- 1[st] July 2011], who attended Surgical Casualty Reception in Rojh-halat Emergency Hospital. A questionnaire was used to collect patients' database and relevant information. The wound configuration was divided as laceration, abrasion and contusion as well as the site of facial soft tissue injuries were recorded using the modified MCFONTZL system. A total of 168 patients with facial soft tissue injuries were received and managed at Surgical Casualty Reception in Rojh-halat Emergency Hospital. The age of the patients were ranged from 1-80 years old. Most of the patients were within the age range of 1-10. Male patients constitute 62.5% of the cases. The most common etiology of facial soft tissue injury was falls. Regarding type of the injury, laceration was the most common type. The lips and chin region were mostly involved. Fall is the most common cause of facial injury. Lower third of the face is mostly involved. road traffic legislations have a role in decreasing road traffic accidents