Antiseptic Techniques in Breast Implant Surgery: Insights From Plastic Surgeons in Saudi Arabia.

Background: Breast implant surgery is a popular procedure worldwide, and the same holds true for Saudi Arabia. Ensuring a sterile surgical environment is crucial to avert postoperative infections. This study explores the various antiseptic techniques adopted by Saudi plastic surgeons during breast implant procedures. Objectives: This study aims to assess Saudi plastic surgeons' adherence to antiseptic measures in breast implant surgery, and determine what types of antiseptic measures are most commonly used among Saudi plastic surgeons. Methods: The authors conducted a cross-sectional survey among board-certified plastic surgeons in Saudi Arabia, collecting data through a self-administered online questionnaire. This questionnaire, which covered their demographic information and their antiseptic practices during breast implant surgery, was disseminated via a WhatsApp (Menlo Park, CA) broadcast message from May 15 to June 27, 2023. Results: Of the 52 Saudi plastic surgeons who completed the questionnaire, all reported employing preoperative antibiotics and skin disinfection. Other measures included pocket irrigation (86.5%), implant irrigation (92.3%), sleeve/funnel usage (65.4%), nipple shield usage (51.9%), and glove change during the procedure (96.2%). Nearly, all respondents used only a surgical cap for head cover (96.2%) and postoperative antibiotics as prophylaxis (98.1%). However, more than half of them did not minimize door movement during the procedure (51.9%). Conclusions: This study offers a valuable insight into the antiseptic practices during breast implant surgery in Saudi Arabia. The findings underline the need for further research to establish evidence-based guidelines for antiseptic practices in this field.

Demographic characteristics and outcome of burn patients requiring skin grafts: a tertiary hospital experience.

Split thickness skin graft (STSG) and full thickness skin graft (FTSG) are the integral part of burn wound management. However the impact of these graft types on the outcome still remain a matter of controversy. The purpose of this study was to determine the demographic characteristics and outcome of graft surgery of the patients undergone STSG and FTSG at Plastic Surgery Department of Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia. This retrospective study included 85 burn patients who received STSG (56 cases) and FTSG (29 cases) at PSMMC during 2010-2015. Demographic characteristics (age, gender, etiology of burn, and area of burn) and outcome (graft loss, graft contraction, skin pigmentation, altered sensation, infection rate and duration of hospital stay) were recorded among the patients who received STSG or FTSG. Out of 85 patients 50 patients were male and 35 female with a ratio of 1.42:1. The patients under the age of 10 years comprised the largest burn group with 28 cases (32.9%) out of total 85 patients. The number of patients above the age of 30 years was relatively smaller. Flame (49.3%) and scald (27%) burns constituted the majority of burn cases. The incidence of contraction among STSG (12.5%) and in FTSG (17.2%) cases was similar. Altered sensation was observed in 7.05% of STSG patients and 13.7% of FTSG cases. Loss of graft was observed in 16% of STSG and 20.6% of FTSG patients. The pigmentation was quite similar in STSG (21.4%) and FTSG (24. 1%). The hospitalization time in FTSG (28 days) patients was also comparable with STSG (26.9 days) group. This study showed that majority of the skin graft cases at PSMMC were male under the age of 30 years mostly affected by flame or scald burns. The outcome following STSG and FTSG surgery was comparable with no significant advantage of one over the other. It may be deduced that both STSG and FTSG have relative merits and demerits and either of these grafting procedure may be considered depending on depth and extent of injury, location and surface area of burn.

Total quality management in plastic surgery.

BACKGROUND: Quality management in plastic surgery has been limited to audit reports of individual clinical conditions, procedures and their outcomes, mortality rates, or other individual aspects of the field. METHODS: This work was done as a part of the mission assigned to us from the Military Medical Directorate to work on and develop the policies and standards of the practice of plastic surgery in the Saudi military hospitals. It is an overview of auditing in plastic surgery with a new expansion vision of the concept of total quality management in plastic surgery including the executable component (new data collection forms) that leads to the complete quality cycle. In addition, a pilot study over one of the main referral units of the military hospitals, Riyadh Armed Forces Hospital, is included. RESULTS: The various suggested audit and the monthly report forms are presented. The study of the unit revealed that the most frequently operated region was the head and neck, followed by the hand. Major operations constituted 31.3% of the surgeries done, and there was an overall negative correlation between age and hospital stay. CONCLUSIONS: A general approach and unifying the auditing process facilitates comparisons between departments in the same country and between different countries in the globe.

Surgical correction of primary cutis vertices gyrata.

Primary cutis vertices gyrata is a rare condition of the scalp characterized by the formation of furrows and folds resembling the convolutions of the brain. A review of the English literature did not reveal any surgically treated cases. The authors report three cases treated by simple excision of the deepest furrows with a satisfactory result.