Suture Marks Research Articles

Vascular anomalies of the limb and trunk in children: a retrospective comparative study of endoscopic surgery and open surgery.

Endoscopic resection has been reported for vascular anomalies (VA) previously. However, there is no study comparing endoscopic resection surgery (ERS) with open resection surgery (ORS) in children. We aimed to compare clinical and cosmetic outcomes between two approaches in pediatric VA. Between June 2018 and June 2023, 138 pediatric VA patients undergoing ERS or ORS were retrospectively reviewed. Propensity score matching (PSM) was performed to minimize selection bias. The Scar Cosmesis Assessment and Rating (SCAR) Scale and numerical rating scale (NRS) based on patient satisfaction were used for cosmetic assessment. After PSM for age, depth of lesion, size of lesion, and site of surgery, 72 patients (ERS = 24, ORS = 48) were analyzed. Patients undergoing ERS had longer operative time (164.25 ± 18.46 vs. 112.85 ± 14.26min; P < 0.001), less estimated blood loss (5.42 ± 2.15 vs. 18.04 ± 1.62ml; P < 0.001), and shorter median hospital stay (4.50 [3.00-5.00] vs. 6.00 [5.00-6.00] days; P < 0.001). The follow-up time was 8.04 ± 1.23month for ERS group and 8.56 ± 1.57month for ORS group. For aesthetic results, the median overall SCAR score in ERS was lower than that in ORS (2 [1-3] vs. 5 [4-5]; P < 0.001), and the subscales of "scar spread," "dyspigmentation," "track marks or suture marks," and "overall impression" were better. The median NRS score was higher (8 [7-8] vs. 6 [5-6]; P < 0.001) and length of scars was shorter (2.18 ± 0.30 vs. 8.75 ± 1.98cm; P < 0.001) in ERS group than those in ORS group. The incidences of total complications and recurrence showed no significant difference between two groups. Endoscopic surgery can be a safe and effective option for pediatric VA in the limbs and trunk. It offers the advantages of improving aesthetic outcomes and reducing postoperative wound healing time.

A Novel Surgical Approach For Upper Eyelid Blepharoplasty

Purpose: To report the surgical results of the patients with dermatochalasis (DC) who underwent upper eyelid blepharoplasty (UEB) with the cautery method was aimed. Materials and Methods: UEB surgery was performed by cautery method in 36 eyes of 18 patients due to DC. Pencil-tipped cautery was used to cut to sagging and marked skin area and was removed. Patients were examined preoperatively and postoperatively on the 1st day, 3rd day, 2nd week, 3rd month and 6th month. Results: The mean age was 54.6±7.9 years (range, 46 to 67 years) and 10 of were female and 8 were male. Mean operation time (1 session for 2 upper eyelid (UE)) was 36.7 ± 5.8 minutes (range, 28 to 46 minutes). Mean wound healing time was 7.7 ± 1.6 days (range, 5 to 12 days). Skin ecchymosis persisted for approximately 24.8±3.7 days (range, 19 to 38 days). Suture marks did not appear in 34 patients (%94), they were present in 2 patients 6 months after surgery. Statistically significant change was detected in the 6-month period in terms of skin ecchymosis and suture scar disappearance (p

An innovative microcoring technology: A novel approach to acne scar treatment.

Acne scars present a complex challenge in dermatology and cosmetics, despite advancements in technological interventions such as fractional lasers, microneedling, and surgical procedures. Effective treatment remains elusive for many individuals. This study aims to evaluate the efficacy of rotational fractional resection using 1 mm diameter rotating scalpels as a primary treatment for icepick and boxcar scars on the cheeks and glabella region. Three patients with acne scars underwent a single treatment session of rotational fractional resection. Evaluation occurred at the 2-month post-treatment mark to assess improvements in scar appearance and potential skin-related side effects. Following the treatment, significant improvements were observed in the targeted acne scars. Notable enhancements were noted without major skin-related adverse effects, except for minor suture marks. The outcomes of this study underscore the potential of rotational fractional resection as an innovative and effective approach in treating acne scars. This single-session cosmetic procedure shows promise in yielding lasting and quantifiable results, offering a hopeful solution for individuals seeking comprehensive acne scar treatment.

Timing of suture removal to reduce scarringin skin surgery: a randomized assessor-blinded feasibility trial.

Timing of suture removal after excision skin surgery varies, with few studies analysing the factors that contribute to poor wound healing and cosmesis. Here, we performed a pilot study to compare suture removal at 7 days or 10 days and its effect on healing and overall appearances of scars including the presence of suture marks.

Limb-sparing resection of axillary soft tissue sarcomas

For patients with soft tissue sarcoma, surgical resection is akey element of curative therapy. Surgery is performed as awide resection with microscopically negative margins (R0resection) and as limb-sparing procedure whenever possible to preserve maximum function. Soft tissue sarcoma, metastases. Extensive disease with major neurovascular involvement, placement of biopsy tract necessitates extensive resection, palliative care. Extended deltopectoral approach. Release of pectoralis major and minor tendons. Vascular and neurologic exploration, identification of the axillary vessels and brachial plexus, placing of loops around major structures. Mobilization of these structures to achieve adequate exposure. Clipping of vessels entering the tumor. Tumor resection, suture marking for histological analysis. Soft tissue reconstruction by transosseous reinsertion of the pectoralis minor to the coracoid process. Drill channel placement, transosseous refixation of the pectoralis major to the humerus. Shoulder abduction brace for 6weeks, passive mobilization for 6-12weeks followed by active mobilization. Compression sleeve. Oncological follow-up. Between 2017 and 2022, wide resection was performed in 6consecutive cases including 4 primary soft tissue sarcomas and 2metastases. Primary R0 resection was achieved in 100%. Mean follow-up was 22.5months (3-60months). There were no local recurrences. Mean active shoulder abduction was 135.0 ± 41.4° (90-180°). Neurological deficits were not observed. Mean subjective shoulder function was 80.0 ± 21.0% (50-100%). The mean Musculoskeletal Tumor Society (MSTS) score was 89.5% (32-100%), indicating good functional outcome in the study cohort.

Evaluation of Facial Trauma Scars After Treating by Refining Plastic Surgery Techniques: A Follow-Up Study.

Although early debridement and refining plastic surgery techniques have been shown to be effective in the treatment of facial scars after trauma, their postoperative outcomes have not been quantitatively evaluated by the relevant Scar Cosmesis Assessment and Rating (SCAR) Scale. This study was designed to provide a fair assessment of the appearance and local symptoms of scars after treatment by refining plastic surgery techniques and to share the operational skills of surgical repairs. Patients who received refining plastic surgery techniques were followed up, and facial scars were taken as high-definition photos, which were presented to 6 professional observers, 6 lay observers, and patients themselves to score the facial scars, including: scar spread, erythema, dyspigmentation, track marks or suture marks, hypertrophy/atrophy, itch and pain according to the SCAR. There were 56 patients who met the inclusion criteria and 25 agreed to participate in the study. No hypertrophic scar was found, and all patients were satisfied with the scar control effect. The scores showed that the treatment was achieved good results in scar spread (pro group: 0.85±0.55, lay group: 0.96±0.68, patients: 0.92±0.64), erythema (pro group: 0.34±0.26, lay group: 0.45±0.37, patients: 0.32±0.48), hypertrophy/atrophy (pro group: 0.21±0.27, lay group: 0.21±0.31, patients: 0.32±0.48), and there was no significant difference in the scores of the 3 observation groups ( P >0.05). However, it is difficult to eliminate dyspigmentation (pro group: 0.29±0.26, lay group: 0.30±0.30, patients: 0.40±0.50), track marks or suture marks (pro group: 0.45±0.33, lay group: 0.59±0.30, patients: 0.36±0.49). Two (8%) patients complained of itch and 1 (4%) patient complained of both itch and pain in the past 24 hours. The appearance of facial scars is satisfactory, the local symptoms are mild, and the evaluation among different aesthetics is affirmative after receiving refining plastic surgery techniques, which is just in line with the purpose of seeking beauty for the patients, and meanwhile can provide a good foundation for the comprehensive treatment of late scars, so that the treatment plan should be promoted.

Breasteeding Self Efficacy And Behavior Of Sexio Post Mothers For Breast Milk In Source Living Hospital Ambon

Abstract&#x0D; Caesarean section is an act of delivery assistance through a surgical process that results in changes in tissue continuity and causes pain. The impact that occurs in post-cesarean section patients includes infection in the suture marks, uterine infections, keloids, blood vessel injuries, and amniotic fluid entering the blood vessels. In addition, the discomfort felt by post-sectional patients can cause mother's dependence on nurses and families in meeting the needs of activities and the relationship between mother and baby is disrupted because the mother is more focused on the pain of the surgical wound. In addition, the process of physical and psychological adaptation of the mother will be more severe when the mother undergoes a surgical delivery process. The pain felt by the mother after childbirth and the physical limitations in carrying out activities tend to have the potential to affect the mother's ability to care for her baby and breastfeed her baby. Mother's Milk (ASI) is the best nutrition for babies because it provides adequate nutrition and is in accordance with the baby's needs. The mother's lack of confidence in her ability to breastfeed her baby can be caused by the mother not making initial contact with her baby. This can affect the welfare of the baby in the future. This research is quantitative research. The design used is cross sectional or cross sectional. The sampling technique was done by consecutive sampling. This study aims to analyze the effect of breastfeeding self-efficacy on breastfeeding behavior of post-cesarean mothers. The results of statistical analysis using chy-square showed that breastfeeding self-efficacy for post-cesarean mothers affected poor breastfeeding behavior by 80.9%. On the other hand, mothers who had poor BSE only 31% had good breastfeeding behavior. These results indicate that there is an effect of BSE on the breastfeeding behavior of post-cesarean mothers at the source of life hospital in Ambon (p value = 0.012). There is an influence between breastfeeding self efficacy on the behavior of breastfeeding mothers after cesarean section at Sumber Hidup Hospital in Ambon.

Surgical seaming in dentistry

Sutures provide a temporary means of approximating defect edges to promote wound healing. The ideal suture technique should approximate and evert wound edges, provide prolonged support, leave no suture marks, and be easy to place. Sutures are used in an attempt to improve the speed of healing and different types of materials can be used to close wound, which range from special glue to wire staples and from animal protein to synthetic materials.

Endoscopic Forehead Lift Using Pretrichial Vertical Incisions and Solid Suture Technique: Effective Fixation and Lesser Scar Formation.

Endoscopic forehead lift with frontal incisions behind anterior hairline has been used conventionally not to exposure scar on the forehead. Accordingly, patients with convex forehead, high hairline, and redundant forehead skin are regarded as not good candidates for endoscopic forehead lift. However, we introduce the advantages of pretrichial vertical incision on the forehead using techniques that minimize the risk of scar formation. Between December 2019 and April 2021, 73 patients who underwent endoscopic forehead lift using pretrichial vertical incision and cortical bone tunnel fixation method were enrolled in this study. One plastic surgeon independently assessed postoperative 6 months scar using Scar Cosmesis Assessment and Rating scale, which include clinician questions and patient questions. Seventy-three patients (67 women and 6 men) with a mean age of 54.5 years (range, 19- 76 years) were included in this study. Skin sutures were stitched out 7.15 days after surgery (range, 7-8 days). All patients were followed up over 6 months. ''Overall impression" and ''patient question'' scored zero in all patients. In 14 patients, pencil-thin line was shown, and the other 1 patient showed a little hyperpigmentation in 1 scar out of 3 frontal scars. Erythema, track marks or suture marks, and hypertrophy/atrophy were scored zero in all patients. The worst total score was 1 in 15 patients. Pretrichial vertical incision with cortical bone tunnel fixation using nonabsorbable suture provides several advantages comparing to conventional incision behind anterior hairline. Scar, which is the only potential concern, was not substantive problem and can be overcome with our techniques.

Two new species of Myxobolus Bütschli, 1882 (Cnidaria: Bivalvulida: Myxobolidae) infecting the gill of the black redhorse, Moxostoma duquesnei (Lesueur) (Cypriniformes: Catostomidae) in the Little Tennessee River Basin, North Carolina.

Two new species of Myxobolus Bütschli, 1882 (Bivalvulida: Myxobolidae) are described from the gill of the black redhorse (Moxostoma duquesnei [Leueur][Cypriniformes: Catostomidae]) from the Little Tennessee River Basin, North Carolina, United States. Myxobolus branchiofilum n. sp. infects lumen of the lamellar arterioles and Myxobolus branchiopecten n. sp. infects the bone and cartilage at the tip of the gill rakers. They differ from all congeners by a combination of myxospore dimensions and the presence or absence of an iodinophilic vacuole in the sporoplasm, mucous envelope, intercapsular process, and sutural markings. A phylogenetic analysis of the small subunit ribosomal DNA recovered M. branchiopectin sister to Myxobolus sp. (AF378343) in a clade composed of 6 species of Myxobolus, which infect predominately cypriniform intermediate hosts. Myxobolus branchiofilum was recovered sister to Myxobolus ictiobus Rosser, Griffin, Quiniou, Alberson, Woodyard, Mischker, Greenway, Wise & Pote, 2016 in a clade composed of 8 species of Myxobolus, which predominately infect catostomid intermediate hosts. Histological sections of infected gill revealed intra-lamellar plasmodia of M. branchiofilum in the lumen of the lamellar arterioles and foci of M. branchiopecten developing in the bone and cartilage of the gill raker tip. These are the first myxozoans reported from the black redhorse. Given that these two new species are morphologically congeneric but recovered in distantly related clades, we discuss the persistent issue of myxobolid genera paraphyly/polyphyly.

A new species of Myxobolus Bütschli, 1882 (Bivalvulida: Myxobolidae) infecting stratum spongiosum of the imperiled sicklefin redhorse, Moxostoma sp. (Cypriniformes: Catostomidae) from the Little Tennessee River, North Carolina, USA.

The sicklefin redhorse, Moxostoma sp. (Cypriniformes: Catostomidae), is an innominate imperiled catostomid endemic to the Hiwassee and Little Tennessee river basins, which has been restricted to a few tributaries of these systems by impoundments. During collections to propagate sicklefin redhorse for reintroduction, a myxozoan, described herein, was observed infecting sicklefin redhorse in the Little Tennessee River Basin, North Carolina. Myxobolus naylori Ksepka et Bullard sp. n. infects the stratum spongiosum covering the scales of sicklefin redhorse. Myxospores of the new species differ from all congeners by the combination of having a mucous envelope, intercapsular process, and sutural markings as well as lacking an iodinophilic vacuole in the sporoplasm. A phylogenetic analysis of the 18S rDNA gene recovered the new species in a polytomy with Myxobolus marumotoi Li et Sato, 2014 and a clade comprised of species of Myxobolus Bütschli, 1882; Thelohanellus Kudo, 1933, and Dicauda Hoffman et Walker, 1973. Histological sections of infected sicklefin redhorse skin revealed myxospores within a plasmodium in the stratum spongiosum dorsal to scales, encapsulated in collagen fibres, and associated with focal erosion of scales directly beneath the plasmodium; in some instances, the scale was perforated by the plasmodium. The specificity of the new species to sicklefin redhorse may make it a useful biological tag to differentiate sicklefin redhorse from morphologically similar species. The new species is the first parasite reported from sicklefin redhorse, a species of concern to the United States Fish and Wildlife Service. No species of Myxobolus has been reported from species of Moxostoma in the Southeast United States. As it was observed that Myxobolus minutus Rosser, Griffin, Quiniou, Alberson, Woodyard, Mischker, Greenway, Wise et Pote, 2016 is a primary junior homonym of Myxobolus minutus Nemeczek, 1911, we propose the replacement name Myxobolus diminutus (Rosser, Griffin, Quiniou, Alberson, Woodyard, Mischker, Greenway, Wise et Pote, 2016).

Nasal Reconstruction in Darker Skin: Is the Subunit Principle Valid?!

The Subunit principle of Aesthetic Nasal Reconstruction is well known among Reconstructive surgeons and it is considered to be the excellence of care. It advocates to reconstruct a nasal defect as per the specific subunit, placing the suture line at a border of one subunit and its adjacent within the nasal surface. Individuals with skin types III to V are prone to hyperpigmentation, hypertrophic scars, keloids and obvious suture marks. Applying the Subunit principle in these darker complexion patients would not be sufficient. In fact, it would result in a scarred nose with a patch. With our frequent experience in such cases, it was very important to revisit the mentioned principle. In darker complexion individuals requiring significant part of their nose to be reconstructed, a consideration should be given to entire nasal unit reconstruction. This would allow placing the seams at junction with adjacent regions (cheek, lip) rather than within the nose and much acceptable aesthetic outcome.

Nasal reconstruction in darker skin: is the subunit principle valid?

&lt;p&gt;The subunit principle of aesthetic nasal reconstruction is well known among reconstructive surgeons and it is considered to be the excellence of care. It advocates to reconstruct a nasal defect as per the specific subunit, placing the suture line at a border of one subunit and its adjacent within the nasal surface. Individuals with skin types III to V are prone to hyperpigmentation, hypertrophic scars, keloids and obvious suture marks. Applying the subunit principle in these darker complexion patients would not be sufficient. In fact, it would result in a scarred nose with a patch. With our frequent experience in such cases, it was very important to revisit the mentioned principle. In darker complexion individuals requiring significant part of their nose to be reconstructed, a consideration should be given to entire nasal unit reconstruction. This would allow placing the seams at junction with adjacent regions (cheek and lip) rather than within the nose and much acceptable aesthetic outcome.&lt;/p&gt;

A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish buccal convexity: One-year aesthetic and patient-reported outcomes.

To compare guided bone regeneration (GBR) with connective tissue graft (CTG) in terms of aesthetic and patient-reported outcomes (PROMs). Patients with a single tooth gap in the anterior maxilla and horizontal alveolar defect were enrolled in a single-blind RCT. All sites had a buccopalatal bone dimension of at least 6mm, received a single implant and were randomly allocated to the control (GBR) or test group (CTG) to re-establish buccal soft tissue convexity. Primary outcomes were Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI) assessed after 1year. Secondary outcomes included PROMs registered during the early stages of healing and after 1year. Twenty-one patients were included per group (control: 11 females, mean age 51; test: nine females, mean age 48). Although there was no significant difference in the PES between the groups (control: 10.11; test: 10.48; p=.577), the MSI was significantly lower in the test (1.10) than in the control group (2.53) (p=.017). Based on descriptive statistics, the latter demonstrated wider scars, more colour mismatch and slightly more suture marks. However, these were not considered disturbing by the patients given similar VAS on soft tissue aesthetics (control: 84; test: 87). Oedema and haematoma were rated twice as high in the control group on at least two postoperative time points, and patients took more painkillers (7.10 vs. 4.86). OHIP-14 decreased in both groups between baseline and 1-year follow-up, indicative of less discomfort in daily life. Differences in MSI and PROMs between the groups may be explained by the need of a vertical releasing incision in order to achieve sufficient access for GBR, periosteal incisions and the use of biomaterials that may induce inflammation. GBR and CTG resulted in favourable aesthetic outcomes as assessed by professionals and patients. However, given additional vertical and periosteal incisions, GBR resulted in more scarring, postoperative discomfort and a higher need for painkillers.

Donor Site Morbidity in Submental Flap: Emphasizing on Facial Hairs Direction.

Introduction:Donor site morbidity is an important factor for selecting a flap for reconstruction. Submental flap using submentum skin for reconstruction has low donor site morbidity. Up to now, donor site morbidity of submental flap in Caucasians has not been evaluated.Materials and Methods:In a retrospective study, donor site morbidity of the submental flap including changes in hair direction, hypertrophic scars, and suture marks was evaluated.Results:Forty patients with at least 2 years of follow-up were evaluated. Female patients indicated better esthetic results. Abrupt beard hair direction change occurred in five male patients. Two hypertrophic scars and one suture mark were recorded.Conclusion:The direction of beard hairs in submentum may be changed after submental flap harvest. Accordingly, this is important in some ethnic and religious groups.

Multiple Z-plasty for Suture Marks

Multiple Z-plasty for Suture Marks

A new species of Myxobolus (Myxozoa: Bivalvulida) infecting the medulla oblongata and nerve cord of brook trout Salvelinus fontinalis in southern Appalachia (New River, NC, USA).

Myxobolus neurofontinalis n. sp. infects the brain and medulla oblongata of brook trout (Salvelinus fontinalis [Mitchill, 1814]) in the New River, western NC. It is the first species of Myxobolus described from the brook trout and resembles another congener (Myxobolus arcticus Pugachev and Khokhlov, 1979) that infects nerve tissue of chars (Salvelinus spp.). The new species differs from M. arcticus and all congeners by myxospore dimensions and by having a mucous envelope and distinctive sutural markings. A phylogenetic analysis of the small subunit rDNA (18S) suggests that the new species shares a recent common ancestor with some isolates identified as M. arcticus and that the new species and its close relatives (except Myxobolus insidiosus Wyatt and Pratt, 1973) comprise a clade of salmonid nerve-infecting myxobolids. The phylogenetic analysis indicates that several isolates of "M. arcticus" (sensu lato) in GenBank are misidentified and distantly related to other isolates taken from the type host (Oncorhynchus nerka [Walbaum, 1792]) and from nearby the type locality (Kamchatka Peninsula, Russia). Serial histological sections of infected brook trout confirmed that myxospores of the new species are intercellular and infect nerve cord and medulla oblongata only. A single infected brook trout showed an inflammatory response characterized by focal lymphocytic infiltrates and eosinophilic granulocytes; however, the remaining 4 brook trout lacked evidence of a histopathological change or demonstrable host response. These results do not support the notion that this infection is pathogenic among brook trout.

Intraoperative inking is superior to suture marking for specimen orientation in breast cancer.

Margin status is an important indicator of residual disease after breast-conserving surgery (BCS). Intraoperatively, surgeons orient specimens to aid assessment of margins and guide re-excision of positive margins. We performed a retrospective review of BCS cases from 2013 to 2017 to compare the two specimen orientation methods: suture marking and intraoperative inking. Patients with ductal carcinoma in situ, T1/T2 invasive cancer treated with BCS were included. Rates of positive margins and residual disease at re-excision were evaluated. 189 patients underwent BCS; 83 had suture marking, 103 had intraoperative inking and 3 had un-oriented specimens. The incidence of positive margins was 29% (24 patients) in the suture marked group and 20% (21 patients) in the intraoperative inked group (P=.18). Among the 45 patients with positive margins, 60% of tumors were stage T1, 76% were node negative, 36% were palpable with median tumor size of 1.5cm. Residual disease was identified on re-excision in 21% of the suture marked specimens and 57% of intraoperative inked specimens (P=.028). The incidence of residual cancer at re-excision for positive margins was higher for intraoperatively inked versus suture marked specimens. This finding suggests that intraoperative inking is more effective at guiding re-excision of positive margins.

Evaluation of mucosal scar characteristics after periodontal plastic surgery

Introduction Gingival recession is the most common mucogingival anomaly, as well as the most frequent periodontal plastic surgery indication. The surgical procedure and healing of the wound result in scar formation, which impacts oral soft tissue aesthetics. The aim of this study was to evaluate the characteristics of a postsurgical scar after gingival recession treatment using the mucosal scarring index (MSI). Material and methods In accordance with the MSI, ten standardized and calibrated photographs of the postsurgical site, taken 3-6 months following the surgical procedure, were analyzed. That included the evaluation of six parameters: scar appearance, scar length, suture marks, contour, color, and overall appearance. 30 professionals divided into the three groups conducted the scar analysis: 10 dental students (S), 10 periodontology and oral medicine residents (SS) and 10 periodontal specialists (SP). Results the average MSI values showed the following results: S: 3.63 ± 2.71, SS: 3.63 ± 2.83 and SP: 3.12 ± 2.75. There was no difference between the MSI values obtained in the three groups (p=0.544). Conclusion Due to the similar MSI values among all the groups, a conclusion may be drawn that by the application of this index, the aesthetic evaluation of the postsurgical scar after the gingival recession treatment can be done in a fast and simple way. Further research based on a larger sample and various surgical procedures is necessary in order to confirm these statements.

Suture Self: Constructing Femininity in Edmond de Goncourt's Chérie

This study evaluates the role of the ellipsis in Edmond de Goncourt's novel Chérie (1884), a text he calls a purely analytic account of French girlhood and adolescence. The ellipsis exemplifies the paradoxical poetics of Goncourt's project: the punctuation mark of omission and elision, ellipses also act as suture marks, typographically and metaphorically, where female-authored documents have been incorporated into Chérie. The ellipsis makes Goncourt's bricolage possible while also showing the limits of his attempt to create a transparent study of la jeune fille. What is produced in Chérie is not a documentary of female development, but a construct that conforms to Goncourt's own notion of femininity.