How Do Orthopaedic Patients Prefer to Be Contacted During a Pandemic?

Introduction Communication with patients is a vital part of the surgical pathway, and when done effectively, it can greatly improve patient outcomes and patient satisfaction and reduce canceled appointments. Different forms of communication work well for different patient demographics, and it is important to optimize communication techniques. We designed a study to review the communication preferences of orthopedic patients during the COVID-19 pandemic. Methods A cross-sectional study was performed by asking patients who were due to undergo orthopedic procedures to answer a questionnaire on their communication preferences, the reminder notice period for appointments, and safety and satisfaction ratings during the COVID-19 pandemic. Results Communication method preferences are influenced by patient factors such as gender and age. Phone calls were the most popular communication method throughout all patient groups, with 61% selecting it as their preference. Younger patients preferred multiple communication methods of phone calls, texts, and emails, whereas the older group had a stronger preference for letters. Letters were more popular among females (28% compared to 10% of males), whereas males had a stronger preference for other communication methods. The majority of patients said they would not have liked a letter prior to their clinic appointment (65%). Of those who indicated a preferred notice period, 73% would have liked five days or less notice prior to their clinic appointment, while 65% would have liked 10-14 days notice prior to their surgery. The average safety rating was 55%. The overall satisfaction rating with the communication process was 71.7%. Conclusion The COVID-19 pandemic has changed patient feelings towards healthcare and, as a result, changed the way healthcare is delivered. Communication method preferences among trauma and orthopedic patients vary and depend on factors such as gender and age. If healthcare departments can optimize their communication processes, they will improve their patient outcomes and enhance their resources.

Acceleration of textured saline breast implant deflation rate: results and analysis of 645 implants.

BACKGROUND: Although inflatable saline implants have been in use since 1965, few studies have examined their deflation rates over time. OBJECTIVE: We conducted a retrospective study to analyze the deflation rate for Mentor inflatable Siltex saline implants (Mentor Corp., Santa Barbara, CA) for a period of 5 years following implantation. METHODS: The study group included 645 Siltex inflatable implants placed in 324 patients for primary breast augmentation between 1992 and 1997. The implants were placed by a single surgeon using the same surgical technique. Implant data were obtained from the operative log and patient charts for a 6-year period from 1992 to 1997. All patients were followed for 5 years. RESULTS: The deflation rate of the implants was 0.3% within the first year of implantation, 2.2% within the first 3 years, and 5.3% over 5 years. The rate of spontaneous deflation per implant year was 0.3% at 1 year, 0.7% at 3 years, and 1.0% at 5 years. The deflation rate was lower than the expected deflation rate reported in the manufacturer's product insert data sheet. CONCLUSIONS: The rate of spontaneous implant deflation per year was demonstrated to increase with time. Further studies are needed to ascertain the long-term deflation rates for each type of breast implant.

An integrated approach to the repair of inverted nipples.

BACKGROUND: Many methods for the correction of the inverted nipple have been described, but no consensus has been reached as to which is the best approach. OBJECTIVE: We describe an integrated approach to the correction of nipple inversion that minimizes ductal disruption. METHODS: We performed initial nipple eversion using gentle traction with a skin hook. The nipple base was approached with the use of an inferior periareolar incision through the subcutaneous tissue. Blunt dissection parallel to the ducts restored varying degrees of projection. Selective ductal division was performed as necessary to obtain complete eversion with normal projection. To maintain the nipple in an overcorrected position, we placed a nylon traction suture through the center of the nipple and affixed to a stent consisting of a medicine cup and gauze padding. RESULTS: In a series of 21 patients, nipple eversion was maintained after at least 1 year's follow-up. CONCLUSIONS: The technique for correction of nipple inversion reported here is focused on blunt dissection through vertical spreading parallel to the lactiferous ducts, with selective division of only those ducts that restrict nipple projection. The use of traction stenting helps ensure eversion and protects the repair. The technique produces excellent results without recurrence of nipple inversion.