Ligament Preservation in Open Rhinoplasty: Prospective Analysis.

BACKGROUND: In the open rhinoplasty technique, the soft tissue and ligaments are vulnerable to injury. Reconstruction of the ligaments is not performed routinely. The authors aimed to assess the effect of preservation of the nasal ligaments (ie, scroll, septocolumellar, and Pitanguy ligaments) in open-approach rhinoplasty. METHODS: In this prospective cohort study, 32 patients underwent open rhinoplasty with ligament preservation after receiving precise training on five cadavers. RESULTS: All patients had improved aesthetic and functional outcome in the early postoperative period with long-lasting preservation of tip projection and results. No patient needed secondary revision surgery for tip dropping or malrotation. The objective findings and subjective assessments were satisfying for the patients and surgeons. CONCLUSIONS: Refinements of nasal surgery have no limits. This study suggests that nasal ligament reconstruction, including of the scroll, septocolumellar, and Pitanguy ligaments, could maintain nasal tip projection and rotation for a long time. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Objective assessment of Platelet-Rich Plasma (PRP) potentiality in the treatment of Chronic leg Ulcer: RCT on 80 patients with Venous ulcer.

BACKGROUND: Chronic venous leg ulcer reduces the patients' activities and their overall quality of life. Platelet-rich plasma (PRP) was previously investigated as promising less invasive management for leg ulcers. THIS STUDY AIMS: To re-assess the efficacy and safety of PRP in the management of chronic leg ulcers due to venous factors. PATIENTS/METHODS: RCT enrolled 80 patients who clinically presented with chronic venous leg ulcers. Forty patients were allocated randomly for the treatment with autologous platelet-rich plasma (PRP). Intradermal and subdermal injection of PRP by 27guage syringe weekly, in all edges and in the granular floor of the ulcer for 4-6 sessions. Another 40 patients managed by conventional treatment by compression and dressing for the same period were allocated as Group B. Objective assessment achieved by the percentage of reduction of the size of the ulcer area, rate of healing, incidence of recurrence, and if side effects have been reported. RESULTS: PRP therapy showed better results and high p value significance when compared to conventional therapy. CONCLUSION: This study shows that PRP is effective and significant in promoting the wound healing process in chronic leg venous ulcers. PRP is simple, safe, and has a short learning curve technique.