Topaz M.,Plastic Surgery Unit |
Carmel N.N.,Bar - Ilan University |
Carmel N.N.,aron Medical Center |
Topaz G.,Bar - Ilan University |
And 3 more authors.
Medicine (United States) | Year: 2014
Stress-relaxation is a well-established mechanism for laboratory skin stretching, with limited clinical application in conventional suturing techniques due to the inherent, concomitant induction of ischemia, necrosis and subsequent suture failure. Skin defects that cannot be primarily closed are a common difficulty during reconstructive surgery. The TopClosure® tension-relief system (TRS) is a novel device for wound closure closure, providing secured attachment to the skin through a wide area of attachment, in an adjustable manner, enabling primary closure of medium to large skin defects.The aim of this study was to evaluate the efficiency of the TopClosure TRS as a substitute for skin grafting and flaps for primary closure of large soft tissue defects by stress-relaxation.We present three demonstrative cases requiring resection of large to huge tumors customarily requiring closure by skin graft or flaps. TRS was applied during surgery serving as a tension-relief platform for tension sutures, to enable primary skin-defect closure by cycling of stress-relaxation, and following surgery as skin-secure system until complete wound closure.All skin defects ranging from 7 to 26 cm in width were manipulated by the TRS through stress-relaxation, without undermining of skin, enabling primary skin closure and eliminating the need for skin grafts and flaps. Immediate wound closure ranged 26 to 135 min. TRS was applied for 3 to 4 weeks. Complications were minimal and donor site morbidity was eliminated. Surgical time, hospital stay and costs were reduced and wound aesthetics were improved.In this case series we present a novel technology that enables the utilization of the viscoelastic properties of the skin to an extreme level, extending the limits of primary wound closure by the stress-relaxation principle. This is achieved via a simple device application that may aid immediate primary wound closure and downgrade the complexity of surgical procedures for a wide range of applications on a global scale. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source
Pan X.-F.,University of Sichuan |
Zhao Z.-M.,University of Sichuan |
Sun J.,Chengdu Medical College |
Chen F.,Deyang Peoples Hospital |
And 7 more authors.
PLoS ONE | Year: 2014
Objectives: To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. Methods: We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. Results: We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). Conclusions: The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university. © 2014 Pan et al. Source
Liu P.,Deyang Peoples Hospital |
Jiang L.-H.,University of Sichuan |
Yang L.,Beijing Forestry University |
Wang L.,CAS Institute of Psychology |
And 4 more authors.
Chinese Journal of Evidence-Based Medicine | Year: 2010
Objective: To perform a cross-sectional study on mental situations of parents of student victims in Wenchuan earthquake and analysis the data to produce best evidences for the government on their decision-making. Methods: By the use of questionnaires, interviewer, and observation, we performed field study on 225 student victims' parents selected by simple random sampling to collect their demographic characteristics, economic and mental status. Results: (1) Of the 123 student victims the only child of the family account for 91.87%, female account for 50.41%, the pupil and below, the middle school student, and the college account for 48.78%, 50.41%, 0.81% respectively. (2) Mental and behavior differences between fathers and mothers were significant. (3) The parents declining to accept the death of their children are not in a good social support. (4) The parents with good family economics and high education are more likely to accept the death of children. Conclusion: (1) We should build a 'Mutual Aid' organization to help those parents construct a good social support net. (2) To take the advantage of rural hospitals to build the long-acting mechanism of the psychological intervention. (3) To perform the psychological intervention corresponding to right period and right aimed group. © 2010 Editorial Board of Chin J Evid-based Med. Source
Wen J.,University of Sichuan |
Sun X.,University of Sichuan |
Sun X.,McMaster University |
Shi Y.K.,University of Sichuan |
And 4 more authors.
European Journal of Trauma and Emergency Surgery | Year: 2012
Purpose: To better understand the differences of patient influx and types of trauma between front-line and referral hospitals after the Wenchuan earthquake, so as to improve the efficiency of injury management. Methods: A retrospective and comparative study was performed in Deyang People's Hospital (a front-line hospital) and West China Hospital (a secondary referral hospital). Results: A total of 1,106 patients were admitted to the front-line hospital, and 1,775 to the secondary referral hospital. The patient flow peaked within 24 h after the quake, and decreased dramatically thereafter in the front-line hospital, while it peaked 2 days after the disaster in the referral one. Extremities were the most frequent location of all identified injuries (48. 4% in the front-line hospital and 49. 5% in the second-line hospital). Head and trunk injuries were more frequent in the front-line hospital than the referral hospital. Most of the deaths in the front-line hospital occurred within 24 h (6/8), whilst most in the referral hospital died more than 7 days (29/30) after the earthquake. While the total mortality in the front-line hospital was less than that in the referral hospital (0. 7 vs 1. 7%), the critical mortality in the former was higher (22. 8 vs 9. 4%). Conclusions: There were dramatically different features in terms of quake-related patient influx and types of injury between the epicenter and less-affected hospitals. © 2011 Springer-Verlag. Source
Zhao C.,Deyang Peoples Hospital |
Tan C.,Deyang Peoples Hospital |
Sun X.,Deyang Peoples Hospital |
Guo X.,Deyang Peoples Hospital |
And 3 more authors.
Chinese Journal of Clinical Oncology | Year: 2012
Objective: To analyze the prognosis of thoracic tumor patients with leukemoid reaction. Methods: Seventeen thoracic tumor cases with leukemoid reaction were perioperatively observed. Results: Of the 17 patients, 12 underwent surgery. Of the 12 patients treated with surgery, one died of serious complications, 9 received chemotherapy and radiotherapy, and two did not receive the aforementioned treatments. Nine patients died 4 months to 15 months after surgery, and the other two cases were not followed up. Four patients who received chemotherapy and radiotherapy without surgery died after 3 months to 11 months. One patient left the hospital without the doctor's permission and sought treatment from Chinese medicine but died after three months. Conclusion: The prognosis of thoracic tumor patients with leukemoid reaction is bad. However, surgery, chemotherapy, and radiotherapy may help improve the prognosis. Source