RESUMO
Introduction: At present, lots of studies have discussed the effects and outcomes of cranioplasty using polyetheretherketone (PEEK). However, interventions or management for PEEK cranioplasty got less attention. This article presented a perioperative paradigm for preventing postoperative complications. Materials and Methods: Modified PEEK plates with certified safety were implanted in patients who received evolving perioperative paradigm. Serial perioperative managements were developed as a comprehensive paradigm to prevent correlated risk factors of postoperative complications, which mainly included managements of epidural collections and wound healing. The preparation of the surgical area and systemic state were essential before surgery. During the operation, the blood supply of the incision and the handling of dura and temporalis were highlighted in our paradigm. After cranioplasty, management of subcutaneous drainage and wound healing were stressed. Patients received conventional management from February 2017 to August 2018 in our center. After the evolving paradigm developed, patients received comprehensive perioperative management from September 2018 to August 2020. Results: A total of 104 patients who underwent PEEK cranioplasty were consecutively enrolled; 38 (36.5%) received conventional perioperative management, and 66 (63.5%) received evolving perioperative paradigm. The general information of the two groups was comparable. Notably, patients who received the evolving paradigm presented a significantly decreased incidence of postoperative complications from 47.4 to 18.2% (P < 0.01), among which the incidences of subcutaneous effusion, epidural hematoma, and subcutaneous infection decreased significantly. Conclusion: The evolving perioperative paradigm could effectively prevent risk factors and reduce related complications. It was valuable to promote these comprehensive managements and inspire more clinical practice on improving patients' outcomes after PEEK cranioplasty.
RESUMO
Objective To investigate the preventive effect of specially-designed clothing on dressing the wound of panents after breast cancer surgery. Methods Using random number table, we divided 400 patients having undergone breast cancer surgery into the observation group and control group in equal number. In the control group, the patients wore ordinary patient clothing after dressing the chest wound with compression bandage,and in the observation group the patients wore the specially-designed clothing after the same treatment of the chest wound as that in the control.The two groups were compared in terms of the incidence of subcutaneous effusion,incidence of skin flap necrosis and the difference of patients'comfort. Results The incidences of subcutaneous effusion and skin flap necrosis were significantly lower than those in the control group.The patient was more comfortable than that the control group, with statistically significant differences (P<0.05,P<0.01). Conclusion After breast cancer surgery,the specially-designed clothing for the patients can effectively reduce the incidences of subcutaneous effusion and incidence of skin flap necrosis and improve the patient's comfort,and deserve clinical promotion.
RESUMO
Objective To compare the clinical effects of vacuum sealing drainage and traditional method on subcutaneous effusion after spinal operation .Methods From June 2009 to June 2011 ,52 cases were randomly divided into 2 groups:group A(treat with vacuum sealing drainage) and group B(treat with traditional method ) .Comparing the cure rate ,wound healing time ,infection rete and satisfaction rate between two groups .Results All cured cases were followed up for 3 months ,all wounds achieved primary healing postoperatively ,and without recurrence .The cure rate was 92 .31% (24/26)in group A ,there was statistically significant difference compared with group B[69 .23% (18/26)](χ2 =4 .457 ,P<0 .05) .The wound healing time was(12 .13 ± 1 .39) d in group A ,and(17 .72 ± 1 .78) d in group B ,which showed statistically significant difference between two groups (t=11 .455 ,P<0 .05) . The satisfaction rate was 84 .62% (22/26)in group A ,and 61 .54% (15/26)in group B ,which showed statistically significant differ-ence between two groups(χ2 =4 .457 ,P<0 .05) .Conclusion The clinical effects of vacuum sealing drainage on subcutaneous effu-sion after spinal operation was obviously superior to traditional method ,and vacuum sealing drainage has advantages such as less pain ,more satisfaction in patients and less workload in medical staff .
