Patient Satisfaction Rate Research Articles

An Innovation Technique in East Asia Rhinoplasty.

To investigate the application and therapeutic efficacy of a novel cartilage framework: the external septa framework in East Asian rhinoplasty. From November 2021 to April 2023, Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital, Central South University, treated 41 patients with autologous costal cartilage rhinoplasty using an innovation external septal framework. The surgical open approach used an inverted V-shaped trans-columellar incision and marginal incision. The sixth or seventh costal cartilage was harvested to form the nasal columella support grafts (strut), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft are connected in a way of tongue in groove to form a external septum framework to support and lengthen the tip. A cap graft is used to shape the tip of the nose, the rectus abdominis fascia is used to cover the tip of the nose, and the shield grafts are used to augment the inferior lobules. ePTFE was sculpted according to the degree of augment of the nasal dorsum and implanted on the dorsal to augment the nasal dorsum. Clinical outcomes were assessed through standard facial photographs taken during the preoperative and follow-up periods, and a postoperative satisfaction survey was completed with regular follow-up using the rhinoplasty outcome evaluation scale (ROE) and visual analogue scale (VAS). Results of objective and subjective measurements before and after surgery were compared utilizing paired-sample t tests. Values of P < 0.05 were considered significant. Nasal framework's objective evaluation outcomes were assessed by measuring the patients' preoperative and postoperative nasolabial angle, nasal length, and nasal tip projection. (The distance between the pronasale and the alar-cheek junction was calculated as the tip projection.) The comparison of preoperative and postoperative nasolabial angle and nasal length was performed using the paired-sample t test, and the comparison of nasal tip projection was performed using the Wilcoxon signed rank-sum test for the comparison of paired samples. Values of P < 0 .05 were considered significant. A total of 41 patients were treated, including 9 males and 32 females, ranging in age from 17 to 48 years(32.8 ± 1.5 years old), In the study, an average follow-up period of 19.85 ± 4.88 months was observed (range 12-29 months). There was no long-term or short-term complication observed. The aesthetic outcome of all cases such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and bulbous tip was satisfactory. Patient satisfaction evaluation: The ROE scale was (11.85 ± 2.46) preoperatively and (17.43 ± 2.15) postoperatively. The VAS scores were (4.86 ± 1.60) preoperatively and (8.48 ± 1.25) postoperatively. The difference of ROE scale and VAS scores among the patients was statistically significant (P < 0. 05), and 88.9% of patients were satisfied following those procedures. In terms of nasolabial angle, preoperative and postoperative measurements of 41 patients were (86.11 ± 2.25)° and (98.66 ± 1.90)°, respectively, and the difference of nasolabial angle was statistically significant (P < 0.05); nasal length measurements were 39.43 ± 1.55mm (37.95-43.51mm) preoperatively and 42.17 ± 1.46mm (40.23-45.62mm) postoperatively; in terms of nasal tip projection, preoperative and postoperative measurements of median values were 1.84(1.73,2.01)cm and 2.15(2.02,2.32)cm, respectively; and the difference between preoperative and postoperative values was statistically significant (P < 0.05). The innovative cartilage framework-external septal framework, avoids the dissection of septa and absorption of septal cartilage with compression of ESG, it is easy to be performed, and it is also stable and strong to achieve in good aesthetic result. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Application of 3D-printed individualized porous tantalum buttress in shelf acetabuloplasty for developmental dysplasia of the hip

Shelf acetabuloplasty is a viable treatment for developmental dysplasia of the hip (DDH), yet autologous bone grafts have faced challenges such as morphological mismatch, imprecise placement, and long-term graft resorption. The rapid advancement of three-dimensional (3D) printing technology in orthopedics has enabled the acquisition of digital image correlation method (DICM) data from patient pelvic to bilateral femoral proximal regions through computed tomography (CT) scans. This data is then utilized by software to create 3D models and design individualized metal implants. Using tantalum-based TA1 type I spherical powder as the raw material, a porous tantalum buttress with a pore size of 600 microns and a porosity of 75% was fabricated employing the selective electron beam melting (SEBM) technology. Our Center has applied this 3D-printed individualized porous tantalum buttress in shelf acetabuloplasty for 21 DDH patients (25 hips), including 6 males and 15 females, with a mean age of (21.38&amp;plusmn;7.39) years. The follow-up period ranged from 12 to 47 months, averaging (22.64&amp;plusmn;10.86) months. At the final follow-up, patient-reported outcomes (PROs) were used to assess patient&amp;rsquo;s subjective feelings. Significant improvements were observed in the Non-Arthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), Hip Outcome Score-Sports Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and Visual Analog Scale (VAS) compared with preoperative levels (P&lt;0.01). Radiographic assessments showed that postoperative lateral center edge (LCE) angle, Tonnis angle, acetabular angle (Sharp&amp;rsquo;s angle), and femoral head coverage all trended towards normal, with statistically significant differences (P&lt;0.01). There was no implant displacement or bone resorption in any case, and no progression in Tonnis grading for hip osteoarthritis (OA) was noted postoperatively, with an 84% patient satisfaction rate. The early follow-up results of 3D-printed individualized porous tantalum buttress in shelf acetabuloplasty are satisfactory, indicating a reliable application prospect for the treatment of DDH patients.

Effectiveness of Aerobic Training for Adverse Symptoms Related to Chemotherapy During Treatment: Protocol for a Randomized Controlled Trial With Cost-Effectiveness Assessment.

One strategy to prevent adverse effects resulting from chemotherapy treatment is to perform physical exercises during treatment. However, there is still no consensus on the best type and intensity of exercise, nor when it should be started. Most studies have been carried out in patients with breast cancer, usually a few weeks after starting chemotherapy, on an outpatient basis 2 to 3 times a week. The main differences in our study are that we carried out physical training in hospitalized patients undergoing a cycle of chemotherapy for cancer treatment and that this training was carried out 5 times a week and was not restricted to a specific type of cancer. We aimed to evaluate the effects of aerobic training on symptoms related to chemotherapy (nausea, vomiting, asthenia, and sensation of weakness), fatigue, mobility, clinical complications, and length of hospital stay of patients during the drug treatment cycle. We also evaluated patient satisfaction with the proposed intervention, the adverse effects of aerobics training, and the cost-effectiveness of this intervention. This is a controlled and randomized trial with blinded evaluation that will include 94 hospitalized patients with cancer for 1 or more cycles of chemotherapy. The intervention group will perform aerobic training during a cycle of chemotherapy. The control group will receive a booklet with guidelines for staying active during the hospitalization period. The groups will be compared using a linear mixed model for fatigue, mobility, and chemotherapy-related symptoms before and after the intervention. The length of hospital stay will also be compared between groups using Kaplan-Meier survival analysis. The incidence of complications will be compared using the χ2 test. Cost-effectiveness and cost-utility analyses will be performed for the impact of exercise and quality-adjusted life years with the EQ-5D-3L-21 quality of life trials. The implementation variables (acceptability, suitability, and feasibility) will be evaluated by frequencies. The clinical trial registration was approved in March 2023. Recruitment and data collection for the trial are ongoing, and the results of this study are likely to be published in late 2025. Chemotherapy has side effects that negatively impact the quality of life of patients with cancer. Aerobic exercise can reduce these side effects in a simple and inexpensive way. The field of work of physical therapists could be expanded to oncology if the intervention works. Registro Brasileiro de Ensaios Clínicos RBR-6b4zwx3; https://tinyurl.com/39c4c7wz. DERR1-10.2196/60828.

The effect of absorbable collagen suture for oral implant repair on wound healing and inflammation factors of gingival crevicular fluid

Background: To investigate the clinical value of absorbable collagen suture in the treatment of oral implant restoration. Methods: A prospective, randomized, single-blind trial was conducted in patients undergoing dental implant restoration in our hospital. The patients were divided into an absorbable group (incision closure with absorbable collagen suture) and a conventional group (incision closure with conventional suture). The incision healing time, postoperative pain degree, incision healing grade, patient satisfaction, and the levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and interleukin-6 (IL-6) in gingival crevicular fluid were compared between the two groups. Results: The absorbable group had faster incision healing times and lower postoperative pain scores on days 1 and 2, all with significant differences (P&lt;0.05). Wound healing in the absorbable group was notably better, with a Grade A healing rate of 96.88% and a Grade B healing rate of 3.13%. In contrast, the conventional group had a Grade A healing rate of 81.25%, a Grade B healing rate of 17.19%, and a Grade C healing rate of 1.56%. These differences favored the absorbable group significantly (P&lt;0.05).Before surgery, there were no statistically significant differences in the levels of TNF-α, IL-6, and IL-8 in gingival crevicular fluid between the absorbable and conventional groups (P&gt;0.05). However, 3 days after surgery, the absorbable group showed significantly lower levels of TNF-α, IL-6, and IL-8 compared to the conventional group (P&lt;0.05).Patient satisfaction rates for stability, aesthetics, chewing function, and pronunciation were similar between the two groups (P&gt;0.05). However, patients in the absorbable group reported significantly higher comfort levels compared to those in the conventional group (P&lt;0.05). Moreover, the complication rate in the absorbable group was significantly lower at 6.25% compared to 18.75% in the conventional group (P&lt;0.05). Conclusion: Absorbable collagen suture for oral implant prosthesis after suture, beneficial to wound healing and reduce postoperative pain and inflammation.

Validation of a Questionnaire to Assess Patient Satisfaction with an Automated Drug Dispensing System.

Automated drug dispensing systems (ADDs) have been introduced to improve the efficiency of dispensing and patient safety. The available questionnaires measure patient satisfaction with particular aspects of ADDs. Also, the level of patient satisfaction with ADDs is not widely established. This study aimed to develop and validate a novel questionnaire to assess patient satisfaction with ADDs. Content and construct validity procedures were used to validate the 20-item questionnaire with four domains, including pharmacy administration, dispensing practice, patient education, and the dispensing system. Two hundred consenting participants took part in this study, from those who visited the outpatient pharmacy in a government hospital. The internal consistency of all four scale items shows acceptable reliability (>0.7). In the exploratory factor analysis, three items were removed due to poor factor loading and cross-loading. In the confirmatory factor analysis, the model has acceptable fit indices, including the comparative fit index (0.937), Tucker-Lewis's index (0.924), standardized root mean square residual (0.051), root mean square error of approximation (0.057), and χ2/df (1.67). The convergent and discriminant validity were established, since the average variance extracted (AVE) was ≥0.5 and the squared correlation (SC) values of one construct with other constructs were less than the AVE of the specific construct. This study offered a reliable and valid 17-item questionnaire incorporating a multi-dimensional four-factor model to evaluate patient satisfaction with ADDs. The validated questionnaire can be utilized to explore patients' perspectives on ADDs.

Explore the safety and efficiency of mild myopia retention in patients with myopia and presbyopia

Objective: To explore the corrective effects of a personalized corneal refractive surgery design that retains mild myopia in patients over 40 years old with refractive errors and presbyopia. Methods: A retrospective case series study was conducted, including 60 patients (120 eyes) over 40 years old who underwent corneal refractive surgery at Peking Union Medical College Hospital l from January 2023 to December 2023. The patients were divided into two groups based on their preference: Group A (retained mild myopia) and Group B (fully corrected), with 30 patients (60 eyes) in each group. Preoperative and postoperative visual acuity, subjective refraction, slit-lamp examination, corneal topography, and intraocular pressure were assessed at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery. The effectiveness and safety indices were calculated based on visual acuity before and after surgery. The National Eye Institute Refractive Quality of Life questionnaire was used to evaluate patient satisfaction and postoperative visual symptoms. Results: There were no significant differences in preoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), corneal thickness, and intraocular pressure between the two groups (all P>0.05). At the final follow-up, the proportions of eyes with UDVA≥0.8 and≥1.0 were 93.3% (56/60) and 60.0% (36/60) in Group A, and 100% (60/60) and 83.3% (50/60) in Group B, respectively. The SE was significantly different between Group A [(-0.35±0.52) D] and Group B [(-0.07±0.55) D] (P<0.05). Near visual acuity was better in Group A than in Group B (P<0.05). The effectiveness indices were 0.96±0.23 and 0.99±0.12, and the safety indices were 1.02±0.11 and 1.02±0.07 for Groups A and B, respectively. Both groups had high overall satisfaction, but Group A had higher scores for near vision, reading, and computer screen viewing. Conclusion: The personalized corneal refractive surgery design that retains mild myopia provides good corrective effects for patients over 40 years old with refractive errors, improving patient satisfaction and quality of life.

Validation of a tagalog version of the EORTC PATSAT-C33 and EORTC OUT-PATSAT7 patient satisfaction questionnaires for patients with cancer undergoing outpatient radiotherapy.

190 Background: The satisfaction of cancer patients with their care significantly impacts their quality of life. Beyond specific cancer treatments, the delivery of care plays a vital role. Evaluating patient satisfaction with care is increasingly important in oncology due to the prolonged and intensive nature of cancer management. Discussions often focus on medical aspects, neglecting administrative and psychosocial concerns. Patient-centered care involves assessing satisfaction, which reflects perceived quality. Patient satisfaction is now recognized as a key indicator of care quality. Methods: The EORTC developed tools like PATSAT-C33 and OUT-PATSAT7 to assess satisfaction with cancer care. These instruments, translated into Tagalog using a “forward-backward” translation procedure in accordance with the EORTC QOL Study Group guidelines, were validated among Filipino cancer patients undergoing radiotherapy. The tools encompass dimensions like doctors' skills, information exchange, nurses' responsiveness, and care organization. They showed reliability and validity comparable to the original versions. Results: Construct, criterion, and factorial validity were assessed, indicating the tools measure intended constructs effectively. The multi-item scales of EORTC PATSAT-C33 and EORTC OUT-PATSAT7 have good to excellent internal consistency. A value between 0.8 - 0.9 represents good reliability, whereas a Cronbach alpha of≥0.9 represents excellent reliability. Criterion validity was confirmed by comparing them with a validated Filipino satisfaction scale. Each dimension identified in the original study applies to Filipino cancer patients, suggesting the tools' applicability across populations. Conclusions: Despite some demographic biases in the study sample, the translations proved valid and reliable. These Tagalog versions are recommended for use with native Tagalog-speaking Filipino cancer patients. Further studies with larger sample sizes may enhance reliability. [Table: see text]

Case–Control and Cohort Studies in Homeopathy: Part 4 of the Research Method Series

AbstractCase–control and cohort studies are fundamental epidemiological research designs utilized to investigate the relationship between exposures and outcomes in medical research. This paper provides a comparative analysis of these two study designs, focusing on their respective strengths, applications, and implications for understanding disease etiology, progression, and intervention effectiveness. Case–control studies offer a retrospective lens, enabling researchers to assess the impact of exposures on disease development by comparing individuals with a particular outcome (cases) to those without (controls). Through meticulous selection and analysis, case–control studies unveil potential risk factors and causal relationships, particularly beneficial for investigating rare diseases or long latency periods. Conversely, cohort studies adopt a prospective approach, following a group of individuals over time to evaluate the incidence of outcomes in relation to exposures. This design facilitates the assessment of cumulative exposure effects, disease progression, and intervention efficacy, providing valuable insights into the natural history of diseases. In the context of homeopathy, both the study designs may be utilized for the evaluation of long-term treatment effects, disease progression, and patient satisfaction, shedding light on the holistic nature of homeopathic care. By embracing rigorous methodologies and leveraging the strengths of both study designs, researchers in homeopathy can advance evidence-based practice, enhancing our understanding of homeopathic principles and their practical implications in clinical settings.

Surgical Treatment for Provoked Vulvodynia: A Systematic Review.

Provoked vulvodynia (PV), characterized by vulvar pain upon touch or pressure, is the leading cause of pain during sexual intercourse. It causes a significant decline in overall quality of life, including sexual dysfunction and mental distress. Surgical interventions, such as perineoplasty and vestibulectomy, are considered a last resort for PV cases unresponsive to less invasive therapies. This systematic review evaluates the efficacy of surgery for PV and suggests areas for future research. The literature search encompassed PubMed, Scopus, Web of Science, and Cochrane Library, identifying relevant peer-reviewed studies up to August 21, 2023. Out of 1102 records retrieved, 29 met the eligibility criteria. Surgery was typically considered after failed conservative treatments. In 15 of the 29 studies defining surgical success as a significant reduction in dyspareunia, success rates ranged from 52% to 93%. Six studies using validated scales for pain assessment noted a significant reduction in vulvar pain following surgery (p < .001). Two studies reported enhancements in sexual function ranging from 57% to 87%, while 3 studies found 89%-97% of women regained the ability to engage in sexual intercourse after surgery. Patient satisfaction rates ranged from 79% to 93%. Bartholin cysts occurred in up to 9% of cases, the most common complication reported. Surgery seems to be an effective and safe PV treatment option with success rates ranging from 52% to 97%, depending on the variation of outcome measures. Randomized clinical trials with established outcome measures are needed to determine the best surgical approach with minimal operative risk and optimal long-term outcomes.

Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) in treatment of degenerative diseases of lumbosacral spine compared to modified open TLIF: a prospective randomised controlled study.

The aim of this study was to determine the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) compared to modified open TLIF via the Wiltse approach for treatment of degenerative diseases of the lumbosacral region. The results were evaluated over a post-operative period of 48 months. Radiological data and medical records of patients who underwent MIS TLIF and modified open TLIF between May 2017 and May 2021 were reviewed. Parameters monitored to evaluate the surgical results were: clinical status, operation time, blood loss, radiation dose to patient, day of discharge, analgesic consumption, fusion, and complications rate. For functional assessment, the Visual Analogue Scale for back pain (VAS-BP), VAS for leg pain (VAS-LP), Oswestry Disability Index (ODI), Patient Satisfaction Rate (PSR), and the complication rate were used. This study included 57 patients randomly divided into two groups: 30 operated on using the MIS TLIF technique, and 27 operated on using the modified open TLIF technique via the Wiltse approach. 48-month follow-up rates were similar for the two cohorts. Patients did not differ significantly at baseline in terms of ODI, VAS-BP, or VAS-LP. Perioperatively, MIS TLIF was associated with significantly less blood loss (167.3 ± 80.0 vs. 297.9 ± 81.5 ml, p = 1.1E-05), slightly longer procedures (185.7 ± 45.2 vs. 183.1 ± 66.4 minutes, p = 0.76), a lower radiation dose (MIS 16.9 ± 7.1 vs. 22.0 ± 9.7 mGy OPEN p = 0.012), and shorter hospitalisations (MIS 5.9 ± 1.8 vs. 7.7 ± 1.6 days OPEN). The most common complication was radiculitis, which accounted for 33% and 37% in the MIS and the TLIF groups, respectively. The second most common complication was malposition of the fixation material, which accounted for 18.5% in the TLIF group and 20% in the MIS group. The level of fusion achieved was 92.6% in the MIS group versus 92.3% in the TLIF group. There was lower consumption of analgesics in MIS. Patient Satisfaction Rate (PSR) was 90%. Clinical and radiological outcomes after MIS TLIF in patients with degenerative disease of the lumbosacral region are generally favourable. MIS TLIF was associated with decreased blood loss perioperatively, a lower radiation dose and an earlier discharge, but there was no difference between MIS TLIF and modified open TLIF in 48-month outcomes in terms of disability, back pain, leg pain, quality of life, or patient satisfaction rate or complication rate. Although the differences taper off over time, MIS TLIF has undeniable advantages in the perioperative and early postoperative periods.

Upper blepharoplasty in Asian population: A novel technique based on functional zoning and dynamic reconstruction with anatomical structure.

Double eyelid blepharoplasty is the most popular cosmetic operation in Asian population. Various surgical techniques have been developed in order to create dynamic eyelid folds with natural-looking in recent years, but postoperative complications like so-called sausage-like appearance have not been resolved completely. To create natural-looking dynamic folds, we propose a new method imitating the original anatomical structure of congenital double-eyelid. Eighty-six patients who underwent the double-eyelid surgery from June 1st, 2018 to October 31st, 2020 were included in this retrospective study, including 10 males and 76 females, aged 18-39 years (mean 27.4 ± 5.6 years). All the included patients received double eyelid surgery performed by the same senior doctor, using the pretarsal orbicularis oculi muscle-releasing technique. Patient Reported Outcome Measures questionnaires were administrated to assess the severity of scarring, pain, and asymmetry, as well as functional and appearance issues. Surgical outcome was assessed through objective and subjective evaluation forms (PROM and patient satisfaction rate). Among the 86 patients, 5 were lost during the follow-up period. The absolute number of enrolled patients is 81. 91.36% of the enrolled patients reported minimal or non-visible scarring at the double eyelid incision. As to functional and appearance issues, the main problem were asymmetry (12.35%) and the narrowing of the supratarsal crease width (8.64%). No supratarsal depression and "sausage-like" appearance occurred in this study. 95.1% of patients reported either good or excellent outcome (mean score: 108 of 120) based on analysis of PROM results, and 96.3% of patients reported either high or very high satisfaction (mean score: 96 of 120) for the patient satisfaction assessment. This new surgical method of double-eyelid blepharoplasty provides comparatively safe and effective results.

Evaluation of Diagnostic Accuracy and Patient Satisfaction in Telemedicine VS. IN-Person Examinations: A Non-Inferiority Study in Adult Ophthalmology

Evaluation of Diagnostic Accuracy and Patient Satisfaction in Telemedicine VS. IN-Person Examinations: A Non-Inferiority Study in Adult Ophthalmology

Quality Improvement Project to Develop a Pictorial Chronic Obstructive Pulmonary Disease (COPD) Action Plan.

Introduction Chronic obstructive pulmonary disease (COPD) is a global health concern and a leading cause of morbidity and mortality worldwide. COPD action plans help patients manage exacerbations by recognizing symptoms early and taking necessary steps. We found our COPD written action plan difficult to understand, potentially affecting the patient's ability to self-manage their COPD. Aims We aim to design a new COPD action plan to increase the knowledge scores of our patients during competency checks by 20%. Methods We employed the quality improvement methodology of needs analysisand root cause analysis and used a Pareto chart to identify the top four contributory factors to an ineffective COPD action plan. These include being too wordy, lacking pictorial illustrations, being only available in a single language (English), and too much medical jargon. Using the prioritization matrix to assess possible solutions, the team decided to implement a pictorial COPD action plan. After two cycles of Plan-Do-Study-Act, the final pictorial COPD plan was compared with the original written action plan. Results Ten English-speaking COPD patients from our outpatient respiratory clinics were surveyed with the original action plan while 11 more were surveyed after the introduction of the pictorial action plan. There was an improvement in mean knowledge scoresby 92.8%(t(19) = 6.67, p < 0.01, at 95% CI). Patient satisfaction rates also increased from 44% to 100%. Sixty-three percent (63.6%) of patients surveyed said they referred back to the pictorial action plan 3 months after being introduced to it. Conclusion Pictorially enhanced COPD action plans have been shown to improve our patients' knowledge of COPD self-management.

Evaluating patient satisfaction with WALANT for hand surgery: a comprehensive questionnaire-based study.

There has been an increase in the popularity of the wide-awake local anesthesia no-tourniquet (WALANT) procedure for various upper limb surgeries. The present study aims to conduct a comprehensive analysis of the satisfaction levels of 106 patients, considering factors such as age, gender, comorbidities, and the specific procedures they underwent. The present study was a retrospective cohort study conducted to analyze the overall satisfaction of a cohort of 106 patients who underwent various surgical procedures of the hand between 2018 and 2023. The satisfaction was assessed with a questionnaire comprising 13 questions/statements adjusted to a standard Swiss grading system (from 1 = I strongly agree to 6 = I strongly disagree). Overall satisfaction with WALANT was high, with most patients expressing positive experiences. Patients with hypertension reported similar satisfaction levels compared to those without, while diabetic patients experienced significantly higher anxiety levels during the procedure (p > 0.05). WALANT exhibits versatility as an anesthesia choice, demonstrating efficacy in both routine and complex hand surgeries. Our survey-based study reveals a high satisfaction level across diverse procedures. When assessing the correlation between WALANT satisfaction and patient comorbidities, hypertension displayed no significant impact, while diabetic patients reported heightened anxiety. Importantly, patient satisfaction remained consistently high even within the subgroup with comorbidities. Our results underscore WALANT's reliability in upper limb surgery, showcasing its usefulness and positive outcomes across a broad range of patients and surgical procedures.

Predictors of patient satisfaction in the surgical treatment of cervical spondylotic myelopathy.

Patients with cervical spondylotic myelopathy (CSM) experience progressive neurological impairment. Surgical intervention is often pursued to halt neurological symptom progression and allow for recovery of function. In this paper, the authors explore predictors of patient satisfaction following surgical intervention for CSM. This is a retrospective review of prospectively collected data from the multicenter Quality Outcomes Database. Patients who underwent surgical intervention for CSM with a minimum follow-up of 2 years were included. Patient-reported satisfaction was defined as a North American Spine Society (NASS) satisfaction score of 1 or 2. Patient demographics, surgical parameters, and outcomes were assessed as related to patient satisfaction. Patient quality of life scores were measured at baseline and 24-month time points. Univariate regression analyses were performed using the chi-square test or Student t-test to assess patient satisfaction measures. Multivariate logistic regression analysis was conducted to assess for factors predictive of postoperative satisfaction at 24 months. A total of 1140 patients at 14 institutions with CSM who underwent surgical intervention were included, and 944 completed a patient satisfaction survey at 24 months postoperatively. The baseline modified Japanese Orthopaedic Association (mJOA) score was 12.0 ± 2.8. A total of 793 (84.0%) patients reported satisfaction (NASS score 1 or 2) after 2 years. Male and female patients reported similar satisfaction rates (female sex: 47.0% not satisfied vs 48.5% satisfied, p = 0.73). Black race was associated with less satisfaction (26.5% not satisfied vs 13.2% satisfied, p < 0.01). Baseline psychiatric comorbidities, obesity, and length of stay did not correlate with 24-month satisfaction. Crossing the cervicothoracic junction did not affect satisfactory scores (p = 0.19), and minimally invasive approaches were not associated with increased patient satisfaction (p = 0.14). Lower baseline numeric rating scale neck pain scores (5.03 vs 5.61, p = 0.04) and higher baseline mJOA scores (12.28 vs 11.66, p = 0.01) were associated with higher satisfaction rates. Surgical treatment of CSM results in a high rate of patient satisfaction (84.0%) at the 2-year follow-up. Patients with milder myelopathy report higher satisfaction rates, suggesting that intervention earlier in the disease process may result in greater long-term satisfaction.

The Current Evidence and How-To on Combined Sacrocolpopexy and Rectopexy.

Multicompartment prolapse is a complex pelvic floor condition that can involve coordination of both urogynecologists and colorectal surgeons. Concomitant sacrocolpopexy and ventral rectopexy is a safe and effective approach to treating this condition. The combined procedure has high rates of patient satisfaction and symptom improvement, including defecatory dysfunction, sexual health, and overall increased quality of life. Concomitant sacrocolpopexy with ventral rectopexy is safe and improves overall outcomes.

A new technique of monsplasty as an adjunctive procedure in cases of abdominoplasty: A prospective clinical trial

BackgroundNo standard monsplasty technique has existed until now. Although various monsplasty methods have been described, they exhibit high complication rates with sparse postoperative data. Studies that used pubic suspension techniques did not describe exact anatomical landmarks for the mons pexy. This study aimed to improve the aesthetic and functional appearance of the pubic region with long-term results for all grades of pubic ptosis or bulging with abdominoplasty and provide exact anatomical points to anchor the mons to the rectus sheath. MethodsThis non-randomized prospective clinical trial included 30 patients with various degrees of abdominal wall laxity between December 2017 and September 2019. The surgical procedure was performed for female patients with pendulous abdomen, pubic ptosis or bulging, body mass index ≤35 ​kg/m2, and age 18–60 years. All patients were followed for up to one year; patient satisfaction was assessed before and after surgery regarding aesthetic results and impact on outfits, hygiene, and sexual activity. ResultsThe marginal homogeneity test revealed a statistically significant patient satisfaction rate regarding outfits, sexual function, hygiene, and aesthetics. Regarding postoperative complications, seroma (one case) was managed by aspiration, and one case of wound dehiscence was managed conservatively with dressings. ConclusionThis study recommends a quick and reproducible monsplasty technique with a low complication rate, a technique that helps determine specific anatomical landmarks for anchoring the mons to the rectus sheath. Combining this technique with abdominal contouring is advisable for optimal aesthetic results and maintained lymphatic drainage in the pubic region. Trial registrationPan African Clinical Trial Registry, PACTR202407819592984. Registered December 22, 2017. Prospective registration, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=30636.

Prophylactic Antibiotics are Unnecessary for Routine CO2 Laser Burn Scar Treatment.

CO2 ablative fractional laser (CO2 AFL) therapy is a safe and effective procedure when used in the treatment of hypertrophic scars for burn patients. It has a high patient satisfaction rate and a minimal side effect profile, typically consisting of postoperative pain, irritation, surgical site inflammation, and, in rare cases, infection. Although prophylactic antibiotics have historically been recommended, there is a paucity of literature on the topic and recent studies indicate that they may be unnecessary in routine cases. In this retrospective, single center descriptive study, 230 cases in patients with hypertrophic burn scars treated with CO2 AFL therapy were compared. 28 cases were with the use of prophylactic antibiotics and 201 cases were without the use of prophylactic antibiotics. We found that there was no significant association between the use of antibiotics and the prevention of topical skin infection in cases treated with CO2 AFL therapy (p=1). Therefore, we conclude that the omission of prophylactic antibiotics is not associated with an increased risk of infection and recommend that prophylactic antibiotics should not be indicated in the setting of routine CO2 AFL therapy for patients with hypertrophic burn scars.

Clinical study on anterolateral femoral interregional flap with turbocharge technique in the repair of large limb wounds.

To compare the clinical outcomes of anterolateral femoral interregional flap with turbocharge technique and traditional anterolateral femoral flap in repair of large limb wounds. Clinical data of 38 patients with large limb surface wound (11 cm×39 cm-16 cm×65 cm) admitted to the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from May 2018 to May 2022 were retrospectively analyzed. Eighteen patients were treated by anterolateral thigh perforator flap combined with superficial circumflex iliac artery flap (ALTP-SCIAP) with turbocharge technique (interregional flap group); while 20 patients were treated with unilateral or bilateral anterolateral femoral flaps, combined with skin grafting if necessary (traditional anterolateral femoral flap group). The survival of skin flap, repair of donor area, complications and patient satisfaction were compared between the two groups. In interregional flap group, 18 flaps were harvested and transplanted, the flap width, length and the viable area were (9.9±2.0) cm, (44.2±3.5) cm and (343.2±79.9) cm2, respectively. In traditional anterolateral femoral flap group, 29 flaps were harvested and transplanted, the flap width, length and the viable area were (11.0±2.8) cm, (21.7±3.2) cm and (186.4±49.2) cm2, respectively. There were significant differences in the flap length and the viable area between the two groups (t=22.365 and 8.345, both P<0.05). In the interregional flap group, the donor site of flap was closed by direct suture in 11 flaps, by skin retractor assisted suture in 6 flaps, and by skin grafting in one flap. In traditional anterolateral femoral flap group, the donor site of flap was closed by direct suture in 12 flaps, by skin retractor assisted suture in 11 flaps, and by skin grafting in 6 flaps. The skin graft rates of the two groups were 5.6% (1/18) and 20.7% (6/29), respectively (χ2=2.007, P>0.05). The interregional flap group had lower postoperative complications rate (5.6% vs. 35.0%, χ2=4.942, P<0.05) and higher patient satisfaction rate (94.4% vs. 70.0%, χ2=4.448, P<0.05) than traditional anterolateral femoral flap group. Compared with the traditional anterolateral femoral flap, the anterolateral femoral interregional flap with turbocharge technique has a larger flap area, most of the donor areas of the flap can be sutured directly without skin grafting and with less complications and a higher patient satisfaction rate.

The Patient's Perspective: Does It Align with Dialysis Adequacy?

The concept of patient-centered care puts the individual's health needs and desired health outcomes as the driving forces behind medical decision-making and quality assessment in the healthcare system. Patients with end-stage kidney disease (ESKD) treated by hemodialysis require frequent encounters with the dialysis facility in order to survive. Therefore, their satisfaction with care and perceived patient experience are important aspects that might impact their adherence to the care regimen. The aim of this study was to evaluate patient satisfaction and its association with perceived patient experience and objective clinical quality parameters, across three hemodialysis clinics. A prospective cohort study analyzed the data of 126 patients with ESKD receiving chronic hemodialysis over 9 months in 3 different care facilities. Sociodemographic characteristics, medical history, treatment details, and dialysis adequacy (measures as STDKt/V) were collected. Perceived quality of care, patient satisfaction and clinical outcomes were assessed. Patients differed significantly between sites by age, diabetes status and biochemical parameters. Satisfaction scores varied significantly for 12/14 survey questions and at the site-level, with Site 2 scoring highest. Overall satisfaction did not correlate with Kt/V. At Site 1, a moderate negative correlation was found between satisfaction and Kt/V. Kt/V correlated positively with age but inversely with satisfaction. Hospitalization rates were similar regardless of satisfaction. Mortality trended lower in the highest Kt/V quartile. Achieving clinical quality while optimizing patient satisfaction requires multifactorial approaches tailored to the unique population of the hemodialysis facility. Further research is needed to fully understand factors influencing satisfaction and perceived quality.