Postoperative Swelling Research Articles

Comparison of intraosseous and submucosal dexamethasone injection in mandibular third molar surgery: a split-mouth randomized clinical trial

The objective of this study was to compare the effect of intraosseous dexamethasone injection and submucosal dexamethasone injection on postoperative sequelae after mandibular third molar surgery. This was a randomized, triple-blind, split-mouth clinical trial. Fifty-four mandibular third molars (27 patients) were subdivided according to the side (right and left); intraosseous injection of dexamethasone (4mg) was randomly assigned to one side and submucosal injection to the other. All surgeries were performed by one surgeon. Postoperative pain was evaluated by visual analogue scale score immediately after surgery and on postoperative days 1, 3, and 7. Postoperative swelling (determined using two linear measurements) and mouth opening (determined by measurement of the inter-incisal distance) were assessed on postoperative days 3 and 7. The number of analgesics consumed was recorded. No significant difference in pain or swelling was found between the two injection techniques. However, there was significant difference in trismus on postoperative day 3, with submucosal injection showing a better outcome (P<0.001). Both techniques of dexamethasone injection were effective in controlling pain and swelling after mandibular third molar surgery, but submucosal injection was superior for the control of trismus.

Distal hypospadias repair using the needle point bipolar cutting–coagulation forceps

To determine the outcome of distal hypospadias repairs performed using bipolar diathermy (BD) for all the dissection. Retrospective review of 310 patients undergoing distal hypospadias (264 subcoronal/distal penile and 46 coronal/glanular) over a 11-year period. Median age at surgery was 2.0 years (range 9 months-15 years). Caudal anesthesia was performed in all patients. All children underwent an in situ tubularization of the urethral plate, which was combined with midline incision of the plate in 30 (10%). Preputial reconstruction was performed in 303 (98%) patients. BD forceps was used for coagulation and for all the dissection including skin incision, elevation of glans wings, separation of the corpus spongiosum from the corpora cavernosa, and urethral plate incision, when deemed appropriate. The authors assessed surgical complications and cosmetic results. The latter using the hypospadias objective score (HOSE), with a score≥14 considered as acceptable. The average operative time was 70min. There was no postoperative bleeding or hematomas that required surgical intervention. There were no wound infections or necrosis. Complications occurred in 37 patients (11.9%). Urethral fistula formation was the commonest (n=18). Postoperative persistent preputial swelling occurred in 3.5% of cases. Two hundred twelve patients (90.6%) had a HOSE score≥14, and no patient required revision surgery for skin problems after a median follow-up of 8.1 (range 1.2-13.1) years. The study is limited by its retrospective nature and by the fact that a number of other pre-operative, intra-operative, and postoperative variables can affect outcome. Bipolar diathermy can be safely used for distal hypospadias repairs. It allowed careful control of intra-operative bleeding and also clear visualization of tissue planes. Complication rate overall compares favorably with the literature, and cosmetic results were satisfactory.

Effect of triangular flap design and healing procedure on the sequelae after extraction of impacted lower third molars

OBJECTIVE To evaluate the effect of different triangular flap design and healing procedure on the sequelae after extraction of impacted lower third molars. METHODS In this prospective, split-mouth study, 60 healthy patients with bilateral, symmetrically fully impacted lower third molars (LM3) were included, of whom 30 patients with totally bony impacted LM3 were allocated into group A, while the other patients with partially bony impacted LM3 were allocated into group B. All the teeth were extracted by the same surgeon. Triangular flap was used on one side, and the wound was primarily closed with two sutures (TF-P). On the other side, modified triangular flap was used with a triangular region of mucosa posterior to LM2 removed during operation, and a triangular soft tissue defect was left for drainage after suture (MTF-S). The patients were followed up on postoperative days 1, 3 and 7. Clinical parameters included postoperative pain, swelling, and trismus. Distal probing depth of adjacent second molar was assessed 6 months after extraction. Doctors responsible for the evaluation did not know the group and flap design. Paired sample t test was used to analyze the differences of postoperative sequelae between the two strategies. RESULTS In group A, MTF-S strategy could reduce postoperative pain, ibuprofen consumption, and swelling significantly compared with TF-P strategy on the postoperative 1st and 3rd days (P<0.05). Besides, the trismus in the patients with TF-P strategy was more serious than that with MTF-S strategy on the postoperative 1st, 3rd and 7th days (P<0.05). However, statistic difference between the two strategies in pain, swelling and trismus was not detected in group B. Additionally, the VAS score in the patients with MTF-S strategy in group B increased slightly on the postoperative 4th day. The probing depth of the adjacent second molar was evaluated 6 months after extraction. Statistic difference was not detected between MTF-S strategy and TF-P strategy in the both groups. CONCLUSION Modified triangular flap with secondary healing procedure could effectively reduce the postoperative complications of totally bony impacted LM3. However, the difference between the two strategies in the probing depth of the adjacent second molar was not statically significant 6 months after extraction.

Arm sling after carpal tunnel surgery: myth or evidence based?

Arm sling elevation is widely used after hand surgery to prevent swelling and pain. This prospective cohort study investigated whether arm sling elevation has any value after carpal tunnel release surgery. Patients were assigned to one of two groups after carpal tunnel release: with or without arm sling elevation. The primary outcome was postoperative swelling. Secondary outcomes were pain and symptom relief and functional outcome. Volumetric analysis showed no significant difference between the sling and non-sling group. Pain scores and improvement of symptom severity and functional status scores were similar for both groups. Thirty-eight per cent found the sling uncomfortable. These results do not support routine use of arm sling elevation after carpal tunnel release. Level of evidence: III.

Postoperative discomfort after implant placement according to the All-on-4 concept with or without Zygoma implants: A prospective clinical study.

The purpose of the study was to assess patients' postoperative discomfort after implantations according to the All-on-4 concept with and without using Zygoma implants. Three treatment groups were formed for this prospective study: All-on-4 rehabilitation in the maxilla (group 1, N=25), All-on-4 rehabilitation in the maxilla using at least two Zygoma implants (group 2, N=25), and All-on-4 rehabilitation in the mandible (group 3, N=20). Principal outcome parameters were postoperative pain (100mm VAS) and perceived swelling (100mm VAS). Also, the use of analgesics was documented. The worst postoperative pain of 21.3 (SD 18.9) VAS was observed in group 2, but there was no statistically significant difference between the groups (mixed ANOVA p=.791). The postoperative total intake of painkillers was significantly higher in group 2 than in the other groups (p<.001). On postoperative day 28, the mean pain scores in all groups declined to values below 5 VAS. Postoperative perceived swelling in group 2 was significantly more severe than it was in group 1 and 3 (p<.001). The use of Zygoma implants in All-on-4 surgical interventions had an essential effect on postoperative swelling, but less so on postoperative pain. The slightly increased, but statistically not significantly different postoperative pain in group 2 was compensated by an overall higher postoperative intake of painkillers compared to the other groups.

Evaluation of Dexamethasone Injection into the Pterygomandibular Space in Impacted Lower Third Molar Surgery

Aim: It was to evaluate the efficacy of dexamethasone (Dx) of a single dose of 8 mg dexamethasone injected pre-operatively into the pterygomandibular space in reducing post-operative pain, swelling, and limited mouth opening following lower third molar surgery. Subjects and Methods: A prospective, randomized, split mouth study involving 62 surgical extractions of lower third molars in 31 patients. range (20 – 35 years) with similar bilaterally impacted lower third molars. Sites from the study group (SG) received single dose of 2ml of 4mg Dx preoperatively, while those in the control group (CG) received a placebo (the same volume of sterile saline solution). Previous history of significant medical condition, drug allergy, or infection that may contraindicates the use of Dx was excluded. Results: Significant reduction in swelling, pain and total postoperative analgesic consumption was observed in SG than CG on the 2nd day. Also, there were differences between both groups regarding to the interincisal distance (IID) measurements on the 7th day. Conclusion: Both groups showed acceptable results, however, Dx injection seems to be the appropriate treatment for rapid recovery of range of IID, reduction of swelling, and relief of pain following impacted lower 3rd molar extraction.

Clinical Outcomes and PROMIS Scores with the Use of Synthetic Cartilage Implant (CARTIVA) in Hallux Rigidus at a Non-Industry Sponsored, Multi-Surgeon, Academic Institution

Category:Midfoot/ForefootIntroduction/Purpose:Hallux rigidus is a common arthritic condition seen by foot and ankle specialists. Historically, surgical treatment options have varied from an isolated cheilectomy to first metatarsophalangeal joint fusion. More recently, first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) has become a popular surgical option. A randomized clinical trial sponsored by the manufacturers of the implant showed equivalent pain relief and functional outcome scores at 2 year follow-up when compared to patients undergoing first MTP fusion. In addition, the study reported no bone loss, implant wear or loosening. We retrospectively reviewed 1 year PROMIS score outcomes, clinical outcomes and implant survivorship of patients treated with first MTP hemiarthroplasty with the Cartiva implant at an academic, multi-surgeon center.Methods:We retrospectively reviewed 54 consecutive patients that underwent first MTP hemiarthroplasty with Cartiva for hallux rigidus between January 1, 2017 and December 1, 2017. Minimum follow-up criteria was 1 year, with the average being 1.37 years and maximum follow-up of 1.9 years. The Coughlin radiographic grading of disease severity averaged 2.18 at the time of implantation on a scale of 0 to 4. Surgery was performed by 8 fellowship-trained orthopedic foot and ankle surgeons at an academic institution. Baseline PROMIS scores (physical function, pain interference, global function, global mental, depression) and PROMIS scores acquired at 1 year postoperative were compared and evaluated using the Wilcoxon signed t-test. Clinical outcomes and postoperative complications/events were documented through review of electronic medical records. At the time of the study, 49 patients had reached 1 year follow-up with an average age of 56 (range, 33 - 74) years at the time of implantation.Results:Physical function, pain interference, global function and depression scores all demonstrated clinically and statistically significant improvement at 1 year postoperative. Global mental score did not show significant improvement at the one year follow-up.One patient underwent revision surgery to a 1st MTP fusion for persistent pain. Three patients had postoperative soft tissue swelling requiring prolonged retained sutures. Five patients underwent therapeutic injection with steroid between 2 - 11 months postoperative for persistent discomfort which improved. Five patients were prescribed orthotics between 3 - 6 months follow-up. One patient sustained a metatarsal fracture during the application of the implant requiring ORIF but retained the implant. Implant retention at 1 year was 98% (48/49). No correlation between preoperative radiographic grading and the incidence of poor clinical outcomes.Conclusion:To our knowledge, this is the first study that demonstrates the outcomes of synthetic cartilage implants using a large series of surgeons without affiliation or consultation for the implant company. One year following first MTP hemiarthroplasty with PVA hydrogel implant (Cartiva), functional and pain scores improved significantly, but did not show significant improvement with global mental scores. The implant displayed excellent survivorship at the 1 year time point, with only one patient undergoing surgical revision. Treatment of hallux rigidus with the PVA hydrogel implant - Cartiva, shows improved patient outcomes and has reassuring results at one year.

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation.

Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). Prospective, randomized, double-masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end-tidal isoflurane concentration (EtISOIns), and expired end-tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre- and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). A significant (P=.0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n=11) compared with pRB bupivacaine patients (n=11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near-significant increase in intraoperative bleeding (P=.0519), and a significant increase in bruising (P=.0382) and swelling (P=.0223) was noted in the iSB bupivacaine group. Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.

Relationship between Operative Time and Complications for Impacted Mandibular Third Molar Removal

OBJECTIVE: To identify relationship between operative time and surgical complications encountered during and soon after removal of impacted 3rdMolar teeth.METHODOLOGY: This cross-sectional study was conducted at the department of Oral &amp; Maxillofacial Surgery, Faculty of Dentistry, Liaquat University of Medical &amp; Health Sciences, Jamshoro from February 2017 to July 2017. Total ninety two surgical removals were done after pre-operative assessment of impaction. Operative time was recorded. Any intra-operative complication was noted during surgery and postoperative complications were recorded on 3rd, 5th and 7thday. The Data was analysed by statistical software package SPSS version 20.0 Qualitative variables were expressed as absolute frequencies and percentages. The variables were presented as mean, frequencies/percentages.RESULTS: The results of this study showed that surgical removal of third molar was more common in females (58%) with the highest percent of mesioangular (39%).The pre-operative pain was more in females and older patients. In intraoperative complication, injury to soft tissue was more common than other complications. In postoperative complications, swelling and trismus were more on the 3rdday.CONCLUSION: The inflammatory complications that can be considered (pain, swelling and trismus) after third molar surgery remain an important factor at the early postoperative periods. The intraoperative and postoperative complication also depends on surgeons experience and duration of procedure which may increase or decrease the sequela of removal impacted teeth. KEY WORDS: Operative Time, Impaction, Impacted mandibular, Third molar.

THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.

Tranexamic acid may benefit patients undergoing total hip/knee arthroplasty because of haemophilia

BackgroundThe lower limb joints, including hip and knee, are the most commonly involved joints in haemophilic arthropathy. With a higher risk of transfusion, total hip and knee arthroplasty (THA and TKA) are still the first choice after failure of conservative treatment. In the present study, we aimed to analyze clinical outcomes and complications rate after total joint arthroplasty of the lower limbs using tranexamic acid (TXA) or not.MethodsThirty-four patients with haemophilia A undergoing 24 TKA and 18 THA were evaluated in this retrospective study (No. 201302009). Based on using TXA or not, they were divided into either TXA (12 knees and 10 hips) or Non-TXA groups (12 knees and 8 hips). Total blood loss, intraoperative blood loss, total amount of FVIII usage, range of motion, inflammatory biomarkers, joint function, pain status, complication rate and patient satisfaction were assessed and compared at a mean follow-up of 68 months.ResultsUsage of TXA can decrease not only the perioperative blood loss (p = 0.001), transfusion rate (p = 0.017) and supplemental amount of FVIII (p < 0.001) but also swelling ratio, surgical joint pain. Moreover, compared with non-TXA group, the patients in TXA group had a lower level of inflammatory biomarkers and better joint function.ConclusionThe hemophiliacs treated with TXA had less perioperative blood loss, hidden blood loss, transfusion rate, a lower ratio of postoperative knee swelling, less postoperative joint pain, lower levels of inflammatory biomarkers and better joint function. Further studies need performing to assess the long-term effects of TXA in these patients.

The efficacy of homeopathic Arnica montana 200 CH on dental surgical treatments: a double-blind, placebo-controlled study

Objectives: The aim of this placebo-controlled study was to assess the efficacy of single dose homeopathic Arnica montana 200 CH in dental surgeries. Methods: The study included 79 patients undergoing wisdom teeth extractions, implant placements, cystectomies, augmentation procedures, alveoloplasties, lefort-1 osteotomies at Istanbul Medipol University’s Department of Oral and Maxillofacial Surgery. The patients were randomly divided into two groups using a computer program. Three globulesof Arnica montana 200 CH were administered in the sublingual area in the patients group 1, and glucose globules were administered in the sublingual area in the patients into group 2. After each patient’s surgical operation, the surgeoncompleted a survey about operation time and scope. In addition,a self-assessment survey was completed by the patients the day after their operationsto evaluate their post-operational swelling and pain. Results: Arnica montana did not appear to significantly prevent post-operative swelling and pain when compared to the placebo (p &amp;lt; 0.05). Conclusions: This study showed that the use of Arnica montana before a physically traumatic procedure is not more effective than the use of a placebo. However, the results should be evaluated in other studies, including the administration of Arnica montana after a physically traumatic procedure to clearly demonstrate its homeopathic efficiency.

Comparison of two different flap designs for bilateral impacted mandibular third molar surgery

ObjectiveWe compared the effect of lingual-based triangular flap with buccal-based triangular flap on postoperative complications in impacted third molar surgery. Material and methodsThirty patients aged between 18 and 36 (mean age 19.65±2.14) were included. They all had bilateral impacted third molars. We used buccal-based triangular flap on a randomly selected side (Group 1) and lingual-based triangular flap on the other side (Group 2). We evaluated pain during 7 days after the surgery; swelling and trismus on postoperative 2., 7. and 14. days; wound dehiscence and alveolar osteitis incidence on postoperative 7. and 14. days. ResultsPain was significantly higher in Group 2 during 7 days postoperatively (P<.05). Trismus and swelling were also more prominent in Group 2 on postoperative days 2 and 7. In Group 2, the duration of the surgery in was longer than Group 1 (P<.05). In Group 1, 17 patients (56.7%) had wound dehiscence and 6 patients (20%) in Group 2 (P<.05). No alveolar osteitis developed in either groups. ConclusionThe buccal-based triangular flap seems better with regard to postoperative pain, swelling and trismus. On the other hand, the lingual-based triangular flap had a lesser incidence for wound dehiscence.

Versatile midfacial degloving approach in oral and maxillofacial surgery.

ObjectivesOral and maxillofacial surgeons must gain mastery of various approaches to the midface due to the increasing incidence, complexity, and severity of presenting midfacial fractures. Unlike in the case of other body parts, the need to preserve facial aesthetics makes it more difficult for the surgeon to select an approach for managing the facial injuries. The midfacial degloving (MFD) approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. The aim of the present study was to evaluate the efficacy of MFD in maxillofacial surgery and to assess its advantages and complications.Materials and MethodsThe MFD approach was used in five cases, with three cases treated with open reduction and internal fixation and two cases operated on for posttraumatic deformity. Nasal dorsum augmentation was completed in three cases and nasal osteotomy was performed in one case. The bicoronal flap technique was combined with MFD for frontal bone augmentation in one case. The intraoperative time required for flap completion and the ease of performing the planned procedures were noted. Postoperative evaluation was done for reduction, aesthetics, function, and complications.ResultsAccess was excellent for performing all planned procedures. Average time spent for flap elevation and exposure of the midface was 63 minutes. Complications like postoperative swelling, infraorbital nerve paresthesia, and intranasal crusting were all transient. No long-term complications like stenosis of the nose, sneer deformity, or weakness of the facial muscles were noticed. Additionally, no complications were noted when MFD was combined with bicoronal flap.ConclusionThough the MFD approach is technically demanding and takes more time than other facial approaches, it should be learned and applied by maxillofacial surgeons in selective cases, as it provides complete exposure of the midface without facial scarring.

Hemostatic and Anti-Inflammatory Effects of Carbazochrome Sodium Sulfonate in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial

BackgroundPostoperative recovery after total knee arthroplasty (TKA) is associated with postoperative anemia, allogeneic transfusion, and stress immune responses to surgery. Carbazochrome sodium sulfonate (CSS) reduces bleeding through several mechanisms. We assessed the effect of CSS combined with tranexamic acid (TXA) on postoperative anemia, blood transfusion, and inflammatory responses. MethodsThis study was designed as a randomized, placebo-controlled trial of 200 patients undergoing unilateral primary TKA. Patients were divided into 4 groups: group A received TXA plus topical and intravenous CSS; group B received TXA plus topical CSS only; group C received TXA plus intravenous CSS only; group D received TXA only. ResultsTotal blood loss in groups A (609.92 ± 221.24 mL), B (753.16 ± 247.67 mL), and C (829.23 ± 297.45 mL) was lower than in group D (1158.26 ± 334.13 mL, P < .05). There was no difference in total blood loss between groups B and C. We also found that compared with group D, the postoperative swelling rate, biomarker level of inflammation, visual analog scale pain score, and range of motion at discharge in groups A, B, and C were significantly improved (P < .05). No thromboembolic complications occurred. There were no differences in transfusion rate, intraoperative blood loss, platelet count, or average length of stay among the 4 groups (P > .05). ConclusionCSS combined with TXA was more effective than TXA alone in reducing perioperative blood loss and inflammatory response and did not increase the incidence of thromboembolism complications.

Effects of concentrated growth factors on relieving postoperative reaction of guided bone regeneration in the esthetic zone

To explore the effect of concentrated growth factors (CGF) on postoperative pain and swelling in patients with complex dental implants. A total of 28 patients with single maxillary anterior teeth loss and labial orbital bone defect were recruited randomly and divided into two groups. Each group included 14 patients. The experimental group was applied with CGF membrane to guide bone regeneration, whereas the control group was treated with collagen membrane to guide bone regeneration. The postoperative pain degree and swelling degree were compared, and data were analyzed with SPSS 23.0 software. Postoperative pain was measured by visual analogue scale (VAS), and the degree of swelling was divided into four grades according to swelling range. VAS scores of patients in experimental and control groups reached 35.1±22.5 and 47.0±20.3, respectively. The duration of postoperative pain in experimental and control groups totaled (2.1±1.5) and (2.8±1.0) days, respectively. No statistically significant difference was observed between the two groups (P>0.05). Percentages of non-swelling, mild swelling, moderate swelling, and severe swelling in experimental group reached 21.4%, 57.1%, 21.4%, and 0, respectively, and those in control group were 7.1%, 35.7%, 35.7%, and 21.4%. Swelling duration reached (2.4±1.4) and (4.2±2.2) days in the experimental and control groups, respectively. A statistically significant difference was observed in the swelling degree of experimental and control groups (P<0.05). The use of CGF can significantly reduce the degree of postoperative swelling and shorten swelling time but cause no significant effect on pain.

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Does Tranexamic Acid Reduce Knee Swelling and Improve Early Function Following Arthroscopic Meniscectomy? A Double-Blind Randomized Controlled Trial

Background:Arthroscopic meniscectomy often results in rapid recovery and return to preinjury activities; however, postoperative hemarthrosis and swelling can lead to pain, decreased range of motion, and delayed return to work and leisure activities. Tranexamic acid (TXA) is a lysine-based inhibitor of plasminogen to plasmin that has gained popularity in arthroplasty surgery for reducing blood loss and, more recently, in anterior cruciate ligament reconstruction by reducing postoperative hemarthrosis, swelling, and pain while increasing function in the short term.Purpose:To determine whether there is a role for TXA in improving the short-term results of swelling, pain, and function following arthroscopic meniscectomy.Study Design:Randomized controlled trial; Level of evidence, 2.Methods:We performed a prospective double-blinded randomized controlled trial in 41 patients undergoing arthroscopic meniscectomy by comparing patients treated with intravenous TXA with those treated with a placebo (normal saline). A single surgeon treated all patients. Following randomization, a dose of 1 g of TXA in 100 mL of normal saline (treatment group) or 100 mL of normal saline (placebo group) was given intravenously at induction prior to tourniquet inflation by the anesthetist. The anesthetist administering the TXA or placebo was not blinded, but all other clinicians involved were. Patients were evaluated by a blinded observer at postoperative days 3, 14, and 30, with the range of motion, swelling, pain levels (visual analog scale), and Lysholm and Tegner knee scores recorded.Results:Patient demographics were similar in both groups. In the treatment group, there was a nonsignificant improvement in range of motion (P = .056) and swelling (P = .384) at 14 days; however, there was a significant improvement in the Tegner score at 3 days (P = .0064). The complication profile was similar between the groups.Conclusion:The administration of 1 g of intravenous TXA in routine arthroscopic meniscectomy may improve early functional recovery without increased risk. A larger study is required to confirm these results and further evaluate any potential benefit.Registration:ACTRN12618001600235 (Australian New Zealand Clinical Trials Registry).

Discovering the True Resolution of Postoperative Swelling After Rhinoplasty Using 3-dimensional Photographic Assessment

Discovering the True Resolution of Postoperative Swelling After Rhinoplasty Using 3-dimensional Photographic Assessment

Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

BackgroundThe present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis.MethodsThe PubMed, Embase, and Cochrane library databases were retrieved, and the effect of PRF on the healing process of the alveolar socket after surgical extraction of the mandibular third molars was evaluated by meta-analysis. The postoperative pain, swelling, trismus, osteoblastic activity, and soft tissue healing were assessed, and the incidence of alveolar osteitis, weighted mean difference (WMD)/standard mean difference (SMD), the risk ratio (RR), and the 95% confidence interval (CI) were calculated.ResultsThe current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications. Subsequently, the pain (SMD = − 0.53, 95% CI: − 1.02–-0.05, Pheterogeneity = 0.001, I2 = 75.7%) and swelling (WMD = − 0.55, 95% CI: − 1.08–-0.01, Pheterogeneity = 0.573, I2 = 0) were relieved and the incidence of alveolar osteitis was reduced (RR = 0.35, 95% CI: 0.16–0.75, Pheterogeneity = 0.597, I2 = 0%). However, no significant difference was observed in trismus, osteoblastic activity, and soft tissue healing between the PRF and non-PRF groups.ConclusionThe current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications. PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar.