Patient Satisfaction Rate Research Articles

Patient Satisfaction in the Inpatient Ward of Aceh Government Hospital: Case Study

Quality health services are services provided effectively and efficiently, focusing on the needs and expectations of patients and following a code of ethics. Patient satisfaction is an indicator of quality health service output. Patient satisfaction is a level of feeling from patients that arises from the performance of health services obtained after comparing it with what they expected. The quality of health services is directly proportional to patient satisfaction. However, patient satisfaction rates are still low, making it a problem for hospitals in low- and middle-income countries. This case study aims to determine patient satisfaction in the inpatient ward of Aceh Government Hospital. This case study is a quantitative study with a cross-sectional study design; the sampling technique uses a total sampling of 30 patients. The data collection tool uses the SERVQUAL Questionnaire, data analysis uses descriptive statistical tests and dimension by dimension gap score analysis. The research results for all dimensions of patient satisfaction have a negative gap score. The most dissatisfied dimension is empathy, with a gap score of -0.59, 87.70% suitability, while the lowest is the assurance dimension, with a gap score of -0.35, 92.70% suitability. Overall, the average reality value (x) is 4.29, the average expected value (y) is 4.80, the average gap score is -0.51, and the average conformity value is 89.37%. The results of the Cartesian diagram analysis show that the eight attributes included in quadrant A are the main priorities that must be immediately improved. The results of this case study show that, in general, all dimensions of satisfaction show a negative gap score, so hospital management is expected to balance expectations and reality regarding health services, especially those related to the eight main priority attributes of patient satisfaction in quadrant A.

The effect of virtual reality glasses applied during intrauterine device insertion on pain, anxiety and satisfaction: Randomized controlled study.

This study was carried out to determine the effect of the use of "virtual reality glasses," on anxiety, pain, and satisfaction level in order to reduce anxiety and pain during intrauterine device (IUD) insertion, which is a painful and stressful procedure for women and to divert attention to increase satisfaction. This randomized controlled study in the gynecology clinic of a state hospital with 80 women who were accepted to participate in the study. Data were collected using structured patient information form, numerical pain rating scale, state-trait anxiety inventory, patient satisfaction evaluation form, and virtual reality glasses. Post-procedural pain scores in the control group after IUD application were higher than post-procedural pain in the virtual reality group. Measurements of post-procedure anxiety in the control group were higher than measurements of post-procedural in the virtual reality group. Satisfaction levels of women with virtual reality glasses during IUD insertion were also found to be high. It was determined that the use of virtual reality glasses, one of the methods of distraction during IUD insertion, was effective in reducing pain and anxiety and increasing patient satisfaction.

Satisfaction with the Injection Experience of a New, Citrate-Free Formulation of Ixekizumab.

A new, citrate-free ixekizumab formulation, which is bioequivalent to the original formulation, was associated with significant reduction in injection site pain. This study evaluates patient satisfaction with the first injection experience of citrate-free ixekizumab in a real-world setting. A non-interventional, observational, web-based survey of adults (≥ 18years) with psoriasis, psoriatic arthritis, or axial spondyloarthritis was conducted between August 2022 and March 2023. Patients enrolled in the Taltz US Customer Support Program were identified as receiving either the original ixekizumab or initiating citrate-free ixekizumab. Patients receiving original ixekizumab completed one survey at baseline to assess satisfaction with the formulation and one survey after switching to assess satisfaction, willingness to continue using and recommending citrate-free ixekizumab, and formulation preference. Participants previously exposed to ixekizumab completed one survey to assess their satisfaction and willingness to continue using and recommending citrate-free ixekizumab. Descriptive and comparative statistics are reported for patients that switched from original to citrate-free ixekizumab (n = 361); and descriptive statistics are reported for patients not previously exposed to ixekizumab (n = 90). A total of 451 patients were included in the analysis. Significantly more patients were satisfied with their first injection with citrate-free ixekizumab compared to original ixekizumab (83.9% vs. 71.7% respectively; p = 0.0001). Almost all patients who switched from original ixekizumab were definitely or mostly willing to continue using and recommending citrate-free ixekizumab (93.9% and 93.4%, respectively). Additionally, 94.2% of patients who switched from original to citrate-free ixekizumab preferred citrate-free ixekizumab or had no preference. Three-fourths of patients not previously exposed to ixekizumab were satisfied with their first injection with citrate-free ixekizumab and 94.5% were definitely or mostly willing to continue using citrate-free ixekizumab. The citrate-free ixekizumab formulation was preferred and well accepted by most patients who switched from the original ixekizumab formulation. Similar findings were seen for those newly initiating citrate-free ixekizumab.

(219) Lengthening Phalloplasty: Combined Technique of a Urologist and a Plastic Surgeon

Abstract Introduction Lengthening phalloplasty is an operation that aims at increasing the length of the penile shaft. This procedure has been gaining popularity with different surgical techniques being described and possible suboptimal patient satisfaction rate that can be optimized. The most popular surgical method used for penile lengthening is release of the suspensory ligament. Our technique differs as it involves a combination of urological and plastic surgical steps to achieve the maximum length with the safest optimum outcome. Objective We are advocating the above unique modified surgical technique aiming to achieve the desired results with higher satisfaction rate. Methods A retrospective study including consecutive male patients presenting for penile lengthening over the last 6years. Patients underwent pre-operative andrology and psychological evaluation. All procedures were performed by the same urologist and plastic surgeon simultaneously. A successful surgical outcome is defined as: achieving a lengthening equal to or more than 2cm. Results A total of 82 married male patients were included. The age ranged from 26 to 40 years with a median of 33years. They had normal sexual activity with no psychiatric nor behavioural disturbance. The average pre-operative penile length was: 9.75 cm. the average additional penile lengthening achieved post-operatively was: 3.7 cm. with a range of 2.8 to 4.7 cm. There was no major complications or failure of the procedure observed. One patient suffered from partial wound dehiscence following return to sexual activity two week after surgery. Patients satisfaction with the outcome 6 months following surgery reached 31/32 with a single case of dissatisfaction owing to the residual scar (success rate of 97%). Conclusions We have concluded that using our multimodality technique that this type of phalloplasty is a safe procedure with 100% anatomical surgical success rate in achieving the desired length gain and overall patient satisfaction rate of 97% which has not been reported using the standard procedure. Disclosure No.

(156) Real World Penile Measurements Comparison Between Malleable and Three-Piece Inflatable Implants: An Objective Comparative Study

Abstract Introduction Despite the fact that malleable penile implants are easier and faster to implant surgically, yet inflatable penile implants (IPPs) have usually shown to have higher patient satisfaction rate and lower rates of distal erosion. It was felt, but never shown that IPPs simulated better erections that filled out the penis better. Nevertheless, this had never been objectively proven in the literature to our knowledge. Objective In this study, to achieve objective comparisons, we introduced the Penile Implant Intraoperative Measurements Planning (PIIMP) chart to find out whether IPPs were more likely to procure greater penile dimensions in comparison to malleable implants. Methods 193 men undergoing penile prosthesis implantation were included in the study. 153 had malleable implants, while 40 had an IPP. Penile length and circumference were measured both in a stretched and unstretched state, both before and after a PGE1 intracorporal injection (ICI). Postoperative penile dimensions were re-taken after implantation and documented together with cylinders/rods dimensions. Results In malleable implants, postoperative penile length ranged between pre and post ICI stretched length in 71.4% of times (n=110/153), fell below pre-ICI stretched length in 26.2% of cases (n=40/153) and reached beyond post-ICI stretched length in 1.96% of cases (n=3/153). In IPPs, postoperative penile length ranged between pre and post ICI stretched length in 60% of times (n= 24/40), fell below pre-ICI stretched length in 27.5% of cases (n=11/40) and reached beyond post-ICI stretched length in 12.5% of cases (n= 5/40). Using Fisher's exact test, it was found that postoperative penile length was 6.37 times more likely to rise above preoperative post-ICI stretched length in inflatable penile implants compared to malleable implant cases (12.5% vs 1.96%) (P value=0.0105) As for penile circumference, malleable implants showed a postoperative penile circumference ranging between pre and post-ICI relaxed girth in 69.9% of cases (n=10), reaching above post-ICI relaxed girth in 10.9% of cases (n=17), and falling below pre-ICI relaxed girth in 19.2% of cases (n=30). On the other hand, IPPs cases had a postoperative penile circumference ranging between pre and post ICI relaxed girth in 57.1% of cases (n=24), reaching above post-ICI relaxed girth in 27.2% of cases (n= 12), and falling below pre-ICI relaxed girth in only 9.1% (n= 4) of cases. (P <0.05) Thus IPPs were 2.5 times more likely to increase the girth of the penis (27.2% vs 10.9%) (P value <0.05) and 2.1 times less likely to cause a decrease in circumference in comparison to malleable implants (9.1% vs 19.2%) (P value <0.05) Conclusions Our study demonstrated that IPPs were superior to malleable implants in attaining greater postoperative penile lengths and girths. We introduced the PIIMP chart as an objective standardized and easily reproducible instrument for intraoperative documentation of penile dimensions. Disclosure No.

(107) Evaluating the Impact of Prior Prostate Cancer Hormonal Therapy on Satisfaction Rates in Post Implantation of Inflatable Penile Prosthesis

Abstract Introduction Androgen deprivation therapy (ADT), a vital treatment modality for prostate cancer, effectively reduces androgens (testosterone & dihydrotestosterone) through inhibiting its production or blocking its action, thereby impeding the growth and even causing shrinkage of prostate cancer cells. It has been utilized in the treatment of early-stage, recurrent, and metastatic cases of prostate cancer. Common side effects were hot flashes, fatigue, decreased bone density, mood changes, decrease libido and sexual dysfunction. Inflatable penile prosthesis (IPP) implantation has already emerged as a highly successful treatment option, garnering significant satisfaction rates among the general population with erectile dysfunction (ED) and specifically in prostate cancer patients who underwent radical prostatectomy (RP) or radiation therapy (XRT). Nevertheless, there remains a dearth of literature examining satisfaction rates specifically in patients with hormonal therapy history post-IPP implantation Objective Our study aims to comprehensively evaluate patient satisfaction rates post IPP implantation for ED, in relation to their ADT status for prostate cancer. Methods A retrospective chart review from our institutional database was conducted to identify 529 patients who underwent IPP at our institution by a single surgeon from 2017 to 2022. Eligible patients for inclusion included those with histological confirmation of prostate cancer treated by RP or XRT with or without hormonal therapy, followed by IPP implantation for ED, and had completed the 11-item Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) validated questionnaire with data available for review. All EDITS questionnaires were administered at least 6 months from operative date or later. Eligible patients were screened for placement into one of two groups depending on their ADT status. To prevent crossover confounding; patients with history of other types of hormonal therapy for non prostate cancer patients were excluded. Results A total of 96 patients were included and categorized into group 1 (ADT, n=30) and group 2 (No ADT, n=66). All patients' demographics were summarised in Table 1. The study revealed notable results regarding the impact of ADT on post IPP satisfaction rates which exhibited a significantly lower EDITS score compared to group 2 (P= 0.034) (Figure 1). Furthermore, group 1 showed no significant changes in post IPP satisfaction with relation to type of prostate cancer treatment offered. While group 2 demonstrated a significantly higher EDITS score post IPP in RP patients compared to XRT, which aligns with the reported literature. Conclusions Our initial findings suggest that despite IPP implantation for managing erectile dysfunction, which is expected to yield high satisfaction rates compared to other available treatment options, Yet the previous or ongoing history of androgen deprivation therapy continues to influence such patients' satisfaction. These observations provide valuable insights; however, further investigation on a larger scale is essential to validate these trends. Additionally, it is crucial to offer proper counseling to these patients regarding the expected outcomes to assist them in making informed decisions regarding the management of their ED. Lastly, the routine use of validated questionnaires has demonstrated significant value in quantifying device and sexual satisfaction following IPP implantation and should be considered as an integral evaluation tool Disclosure No.

(019) Penile Augmentation by Division of the Suspensory Ligament of the Penis and Autologous Fat Injection

Abstract Introduction Penile size dissatisfaction is a problem which is more prevalent than what is perceived, it is not taken seriously by healthcare professionals. It is reported that 45% of men are unhappy with their penile size. Most men are too ashamed to seek professional help so they go to online sites that promote fake pills, creams, lotions, or try to solve the problem themselves (DIY Penile enlargement) which causes significant complications or undergo high risk procedures without proper counselling. Objective The aim of this study was to evaluate the outcome of penile augmentation surgery by division of the suspensory ligament of the penis with insertion of silicon buffer for flaccid length enhancement plus liposuction and autologous fat injection for penile girth enhancement. Methods A retrospective audit of patient outcomes after surgical Penile Augmentation (PA) at one centre, over a 5.5 year period. 560 patients had division of the suspensory ligament of the penis with insertion of silicon buffer with liposuction and autologous fat injection. The following data was collected: - Pre and post-operative flaccid penile length and girth. - Patient reported satisfaction rates. - Complications. Results 560 patients were included in this study, the mean patient age was 38 (24–72). The Mean follow up duration was 6 (3-12) months. The mean increase in flaccid length was 3.8 (1.5-6) cm. The mean increase in girth was 4.2 (2.5-5.5) cm. The patient reported satisfaction rates were 85%. No serious adverse events were encountered; the following complications were recorded: partial fat absorption occurred in 120 patients (21.4%) and was managed by fat top up. Phimosis occurred in 20 patients (3.5%) and was manged conservatively in all but 2 patients who required a circumcision, hard fat lumps occurred 30 patients (5.3%) and was managed by in office needling. Migration of fat in the scrotum occurred in 40 patients (7.1%) and was managed conservatively in all but 5 patients who required surgical removal of the fat lumps, infection of the silicon buffer occurred in 6 patients (1.07%) and was managed by removal of the silicon buffer, discomfort from the silicon buffer occurred in 5 patients (0.89%) and was managed by removal of the silicon buffer. Conclusions Penile enlargement by division of the penile suspensory ligament and injection of autologous fat is a safe and effective procedure which is associated with high patient-satisfaction rates. Disclosure No.

Radiofrequency ablation versus stripping of great saphenous vein in the management of varicose veins

Background: Varicose veins are defined as dilated, tortuous subdermal veins >3 mm in diameter. It is a common entity affecting an estimated 10% of population. Aims and Objectives: The aim was to compare the efficacy of radiofrequency ablation (RFA) with great saphenous vein (GSV) stripping in patients with lower limb varicose veins in terms of disappearance of visible varicosities. Materials and Methods: It was a prospective randomized controlled study, conducted in a tertiary care medical college with the study population consisting of patients suffering from varicose veins. Totally 30 patients were enrolled and divided into 2 groups of 15 patients each. Group A underwent RFA while Group B underwent stripping of GSV with flush ligation of saphenofemoral junction. Results: The mean duration of the procedure in Group A was 53.67±6.6 min while in Group B it was 101.4±11.85 min which was statistically significant (P<0.0001). The mean duration of return to routine activities and work was 2.2±0.41 days in Group A and 3.07±1.16 days in Group B which was statistically significant (P=0.024). Post-operative analgesic requirement was similar in both groups (P=0.224). Complete remission was observed in all patients at 12 months visit and there was no recurrence identified even after a follow-up period of 4 years. Conclusion: RFA was found to be as effective as stripping of GSV in terms of obliteration of veins. The duration of procedure was found to be much less in RFA. Furthermore, cosmetic results, ulcer healing and patient satisfaction rate was better in RFA group. Patient return to normal activity was significantly earlier in RFA group.

The comparison of 1-year results for mini and wide-size cap grafts applied to nasal tips.

In the present study, we evaluated patient satisfaction with cap grafts by Rhinoplasty Outcomes Evaluation (ROE) scores. Mini cap and wide cap grafts were applied. A total of 80 patients who underwent a rhinoplasty operation with cap graft application to the tip region were included in the study. According to the cap graft size, there were two groups: Group 1 consisted of 40 patients with cap graft size ≤7 cm (mini cap group). Group 2 comprised 40 patients with cap grafts ≥8 cm (wide cap group). Patients in groups 1 and 2 underwent evaluations based on the following criteria at preoperative, postoperative-1st month, and postoperative-1st year intervals: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle. Postoperative 1st-month and 1st-year ROE scores of the wide cap group were significantly higher than those in the mini cap group (p<0.05). Preoperative tip projection ratio (Goode) values of the wide cap group were considerably higher than those in the mini cap group (p<0.05). There were no significant differences between tip projection, nasal dorsum length, nasofrontal angle, and nasolabial angle values of the mini cap and wide cap groups (p>0.05). Correlation tests showed that as preoperative ROE scores decreased, postoperative-1st month and 1st-year ROE scores increased (p<0.05). Postoperative 1st-month and postoperative 1st-year's ROE scores increased together (p<0.05). In the wide cap group, postoperative 1st-month and postoperative 1st-year's ROE scores increased compared to the mini cap group (p<0.05). As postoperative 1st-year nasolabial angle values increased, postoperative 1st-year ROE scores also increased (p<0.05). We found that patients who received wide-cap rhinoplasty had increased postoperative ROE scores and higher satisfaction rates during the first month and first year. Postoperative higher nasolabial angle values were related to higher ROE scores and patient satisfaction in the postoperative 1st year.

IDF23-0284 Evaluation of Patient Satisfaction by CGMS vs Self-Monitoring for Management of Diabetic Women on Insulin Therapy

IDF23-0284 Evaluation of Patient Satisfaction by CGMS vs Self-Monitoring for Management of Diabetic Women on Insulin Therapy

Improved Patient Outcomes with Electrocauterization Following Wedge Resection and Curettage for Ingrown Toenails: A Prospective Comparative Study.

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively ( p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively ( p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

Patient satisfaction and their determinants in outpatient department of a tertiary public hospital in Nepal: a cross-sectional study

BackgroundPatient satisfaction is a vital metric for assessing healthcare quality and delivering patient-centered care. It can predict service utilization patterns by determining healthcare users’ contentment with their providers. Consequently, evaluating patient satisfaction and its underlying factors is crucial to maintaining the quality of healthcare services. The present study aimed to assess patient satisfaction and its determinants in a tertiary care public hospital in Nepal. In this research, a cross-sectional design was employed to examine patient satisfaction within the Outpatient Department of Mental Hospital Lagankhel, Nepal. The study adopted a systematic random sampling approach for respondent selection, and stringent measures were implemented to uphold the validity and reliability of the collected data. To assess patient satisfaction comprehensively, the Patient Satisfaction Questionnaire-III (PSQ-III), developed by the RAND Corporation, was employed in conjunction with relevant sociodemographic variables. Utilizing mean scores and percentages, we calculated satisfaction levels across various dimensions. Additionally, a multinomial logistic regression analysis was conducted to investigate the relationships between patient satisfaction dimensions and sociodemographic characteristics.ResultsThis study encompassed perspective of 206 participants, with 57.3% representing patient relatives and 51% being male, median age of 32 years (standard deviation: 12.53). Notably, patients reported higher levels of satisfaction, particularly within the interpersonal relationship dimension, while the technical quality domain received comparatively lower satisfaction ratings. Multinomial logistic regression analysis underscored the significance of sociodemographic factors in shaping patient satisfaction, with age (p = 0.008), type of residence (p = 0.001), occupation (p = 0.0019), income status (p = 0.014), time to reach the healthcare facility (p = 0.013), and insurance enrollment status (p = 0.017) all demonstrating significant associations. These findings illuminate the intricate qualities of patient satisfaction within our healthcare context, offering actionable insights for enhancement and guiding the trajectory of future research endeavors.ConclusionsOverall patient expressed satisfaction with service provided by tertiary care hospital, however continuous improvement remains essential. Conducting large-scale, nationwide studies across hospital tiers is vital. This data-driven approach empowers policymakers to allocate resources effectively, inform decision-making, and enact policies that exceed patient expectations, fostering a healthcare system of unparalleled excellence.

Associated Factors in Patient Satisfaction among Older Persons Attending Primary Health Facilities in Sepang, Malaysia.

With Malaysia's ageing population, the utilisation of primary healthcare services by older individuals with comorbidities is expected to increase. Patient satisfaction serves as a key indicator for assessing the quality of healthcare services. Thus, the aim of this study is to evaluate patient satisfaction among older persons attending public primary healthcare facilities and to identify associated factors. A cross-sectional survey was conducted from October 2017 to January 2018, involving face-to-face interviews with older outpatients in primary health clinics. Minimum 300 participants were required and systematic random sampling were used. The measurement included sociodemographic variables, patient comorbidity and patient satisfaction using the Short-Form Patient Satisfaction Questionnaire (PSQ-18). A total of 317 participants enrolled in this study, resulting in a response rate of 95.6%. The findings indicated that 35.7% of participants reported high satisfaction, while 64.3% reported moderate satisfaction. Participants with at least secondary education (OR = 3.12) were more likely to experience satisfaction compared to those without formal education. Participants with monthly incomes above RM2,000 (OR = 0.40) and RM1,000-RM1,999 (OR = 0.53) were less likely to be satisfied compared to those earning less than RM999. Moreover, participants with two or more comorbidities were less likely to be satisfied compared to those with one comorbidity. Gender, marital status, employment status and living arrangements were not significant factors. This study highlights the need for healthcare authorities to examine factors such as patients' education level, income level and comorbidity status that are associated with healthcare satisfaction to enhance overall patient satisfaction.

Parenteral Versus Enteral Nutrition on Perioperative Cognitive Function in Anesthesia Patients

This study evaluated the impact of enteral nutrition versus parenteral nutrition on perioperative cognitive function and related outcomes in patients undergoing different surgeries. From April to December 2023, 240 patients in Shanghai, China, undergoing elective surgery were randomly assigned to receive either enteral or parenteral nutrition postoperatively. This cross-sectional study represented a wide range of clinical applications and surgical procedures. Outcomes, including longterm hospital stays, complication rates, dietary compliance, 30-day readmission rates, patient satisfaction, inflammatory markers, immunological response, stress response, and perioperative cognitive function, measured by Mini-Mental State Examination and Montreal Cognitive Assessment scores, were investigated in this study. Compared to patients in the parenteral nutrition group, those in the enteral nutrition group exhibited considerably shorter hospital stays (8.7 ± 1.9 days versus 9.4 ± 2.0 days, P &lt; 0.05), lower complication rates (22% versus 30%, P &lt; 0.05), and lower 30-day readmission rates (10% versus 15%, P &lt; 0.05). The enteral nutrition group exhibited higher patient satisfaction rates (9.1 ± 2.1 versus 8.2 ± 1.6, P &lt; 0.05). Additionally, enteral nutrition was linked to better immunological and inflammatory profiles and lower stress marker levels (cortisol, lymphocyte count, and C-reactive protein). After various surgical procedures, enteral nutrition recipients achieved higher scores on postoperative cognitive tests. Compared to parenteral nutrition, enteral nutrition provides better results regarding hospital stay, complication rate, readmission rate, patient satisfaction, and cognitive function. These results support the preferential use of enteral nutrition in postoperative treatment and contribute to the growing evidence demonstrating the physiological advantages of enteral nutrition and its beneficial effects on postoperative recovery and cognitive preservation.

Evaluation of expectations and satisfaction of the patient in the facial treatment with botulinic toxin in the upper third of the face

A study was conducted to survey the satisfaction of patients who underwent orofacial harmonization procedures using botulinum toxin to treat signs of aging in the upper third of the face. This is a retrospective observational study, with a sample population of 40 patients treated from November 2022 to June 2023, at the Ingá Institute, Marabá Polo, state of Pará, using data collection through a questionnaire that evaluated patient satisfaction, addressing sociodemographic aspects and questions related to patient satisfaction with the procedure performed. The data were analyzed using descriptive statistics, such as frequency, mean and deviations, and Pearson’s correlation. All analyses were performed in SPSS 21.0 software, with a significance level of 0.05. The results showed that the average satisfaction index of the patients was 95.73%, the minimum percentage was 4.27%. Pearson’s correlation of the groups shows a significant correlation for age for question P1 and P5, for phototype question P5 and for menopause for question P1 and P5, adapted from SROE. The P values for these parameters are considered statistically significant &lt;0.05.

Effectiveness of a novel consultant nurse-led breast pain clinic in secondary care.

Patients with breast pain are usually seen in 'one-stop clinic' (OSC) with breast imaging. In the absence of associated red flag features, the incidence of breast cancer is extremely low. With increase in referrals the OSC capacity is over-stretched. We developed a consultant nurse-led dedicated 'breast pain clinic' in September 2021 without routine breast imaging. After meticulous history and examination, patients obtained detailed counselling and advice regarding breast pain management. If any abnormality was noted then appointment was given for OSC. To assess the effectiveness of a consultant nurse-led dedicated 'breast pain clinic'. A prospective study of all consecutive patients seen in 'breast pain clinic' from September 2021 until September 2022. Feedback was sought from all patients. Altogether 429 patients were seen. The mean age was 48.7years (range 18-86). 87.6% (n = 376) patients required no breast imaging. Only 12.4% (n = 53) patients needed referral to OSC and subsequently 2 patients (0.46%) were diagnosed with breast cancer. Ninety-eight percent of patients felt reassured and 99.2% patients were extremely likely/likely to recommend this service to family and friends. Out of 376 patients who were discharged from breast pain clinic, 12 patients were referred again over a median follow-up period of 15months, and 2 out of them were diagnosed with breast cancer. A consultant nurse-led 'breast pain clinic' provides service improvement as it eases the pressure on the OSC. Most patients were managed without breast imaging with high level of patient satisfaction and low rereferral rate.

Reconstruction of Full-Thickness Eyelid Defects Following Tumor Resection: The Bucket Handle Modification.

To describe a modified approach for full-thickness lower eyelid defect reconstruction. This is a retrospective review of 5 patients with large full-thickness lower eyelid defects after tumor resection requiring reconstruction. For these lower eyelid defects, a lateral-based or superior-based tarsoconjunctival pedicle flap from the upper eyelid was used to rebuild the posterior lamella. In all cases, the anterior lamella was supplied from an adjacent myocutaneous flap in a bucket handle configuration. Data collection included tumor type and location, size of eyelid defect, presence of canalicular involvement, postoperative eyelid position, patient satisfaction, and complication rates. Five eyelids of 5 patients underwent Mohs micrographic excision of basal cell carcinoma followed by reconstruction with a bucket handle flap. Age range was 68 to 96 years old (mean of 81y). Five patients presented with lower eyelid involvement. The defect size ranged from 80% to 100% of the eyelid. Three patients had canalicular involvement and required bicanalicular nasolacrimal stent placement. After reconstruction, all patients showed good eyelid apposition to the globe with excellent esthetic outcome. No revision procedures were done. Average follow-up time was 13 months (range of 8 to 21mo). The bucket handle flap for full-thickness eyelid reconstruction is a simple technique that allows for preservation of all anatomical layers of the anterior lamella. This technique shows promising functional and esthetic outcomes.

A Natural Flat Volumized Lips Filler Technique: Retrospective Analysis of 920 Patients.

Traditionally, hyaluronidase (HYAL) is used after hyaluronic acid (HA) injection to dissolve the undesired migration of product. To describe a novel lip augmentation technique that uses HA and HYAL simultaneously in patients who previously had HA migration. Nine hundred twenty female patients were included. In the first group ( n = 793), HA injections were performed in subcutaneous plane of the lips. In the second group who had previous product migration ( n = 127), 7.5 units of HYAL is injected in 4 points in ergotrid area before proceeding with HA injection. The medicis lip fullness scale scores after 2 weeks improved in all patients, while 92% of patients perceived the results as "very much improved" with Global Aesthetic Improvement Scale ( p ˂ .001). There was no difference between 2 groups regarding the patient satisfaction rates ( p ˃.05), while filler migration was seen in 0.2% ( n : 15) of patients in the first group during the follow-up period. The new vertical injection approach provided an increased vertical height, optimal eversion, and an incisor display on the lips. The simultaneous use of HYAL before HA injection seems to be a safe and effective practice in 1-stage treatment of the previously injected lips with filler migration into ergotrid area.

Oncoplastic Reconstruction in the Setting of Prior Cosmetic Augmentation.

This study explores the surgical management and reconstruction options for augmented breasts in the context of breast conservation therapy (BCT) for breast cancer. We hypothesized that there would be no difference in the rates of complications, revisions, or patient satisfaction in patients who maintained their breast augmentation versus those that had their implants removed in the context of BCT. We conducted a retrospective review of 142 patients who underwent BCT at a single center from March 2016 to March 2022. The study included patients who had a preexistent cosmetic augmentation at the time of breast cancer diagnosis and BCT. Patient demographics, clinical and treatment characteristics, breast implant details, reconstructive technique, complications, and revisions were recorded. Patient-reported outcomes were assessed using the BREAST-Q Breast-Conserving Therapy module. Ninety-three (65.5%) patients chose to maintain their implants, while 49 (34.5%) elected to have them removed during BCT. Patients with submuscular implants were more likely to maintain their implants. Oncoplastic mastopexy was associated with higher complication rates, particularly in patients opting for implant downsizing. However, multivariate logistic regression did not identify implant management strategy as an independent predictor for complications or revisions. Surgical site infection was the only predictor of implant explantation. Patient-reported outcomes did not differ significantly between the different implant management cohorts. This study demonstrates that maintaining breast implants during BCT does not increase the risk of complications or revisions. Overall, BCT in augmented women was found to be a safe approach, with high patient satisfaction.

Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages.

This is a multicenter observational registry analysis of 1-year radiographic and clinical outcomes following anterior cervical discectomy and fusion (ACDF) using hydroxyapatite (HA)-infused polyetheretherketone (PEEK) intervertebral cages. Radiographic and clinical outcome data were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. To assess fusion, dynamic flexion-extension radiographs were independently evaluated with a validated method. Clinical outcomes were assessed using the following disease-specific measures: Neck Disability Index (NDI) and visual analog scale (VAS) for neck, left arm, and right arm pain. Patient satisfaction was also evaluated. A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m2) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (P < 0.01) preoperatively (46.3, n = 771) to postoperatively (12 months: 25.2, n = 281). Consistently, mean VAS neck (preoperative: 64.2, n = 770; 12 months: 28.6, n = 278), VAS right arm (preoperative: 42.6, n = 766; 12 months: 20.4, n = 277), and VAS left arm (preoperative: 41.1, n = 768; 12 months: 20.8, n = 277) decreased significantly (P < 0.01). Patients reported high satisfaction rates after surgery with no significant changes in postoperative patient satisfaction between 6 weeks and 12 months (95.1%, n = 273). ACDF with HA-infused PEEK cages demonstrates promising radiographic and clinical outcomes, supporting the potential benefits of incorporating HA into PEEK cages to enhance fusion rates and improve patient outcomes. This study demonstrates a >90% fusion rate by level with reliable improvements in patient reported outcomes, along with a high rate of patient satisfaction, in a large patient cohort undergoing ACDF with HA-infused PEEK cages. 2 .