Canniesburn Plastic Surgery Unit

Glasgow, United Kingdom

Canniesburn Plastic Surgery Unit

Glasgow, United Kingdom
SEARCH FILTERS
Time filter
Source Type

Ul Hassan M.S.,NHS England | Chatterjee J.S.,Canniesburn Plastic Surgery Unit
European Journal of Plastic Surgery | Year: 2012

Surgical drains are commonly used in plastic surgery. Drains are subsequently removed at arbitrary volumes depending on local protocols. The rational for when to remove a drain has not been scientifically determined. We compared removal of drains at ≤30 ml/24 h vs. ≤50 ml/24 h for 158 wounds, in 90 patients. Postoperative complications, length of hospital stay and resulting cost-benefit were considered. Prospective data were collected for two consecutive similar cohorts of patients undergoing abdominoplasty, bilateral breast reduction and breast augmentation. In the first cohort, drains were removed when drainage was ≤30 ml/24 h and the second cohort when ≤50 ml/24 h. Demographics, days of drainage, surgeon grade and duration of postoperative hospital stay were recorded. Patient records were then analysed and complications recorded, including haematoma, infection, seroma, wound breakdown and fat necrosis. The median postoperative stay for all three operations for both drainage cohorts was similar with no statistically significant difference; however, the drainage time in breast augmentation was significantly less in the <50 ml/24 h group. There were no significant differences in outcome measures between the patients undergoing abdominoplasty, breast reduction or breast augmentation. Drain removal at ≤50 vs. ≤30 ml/24 h did not result in an increase in postoperative morbidity or adverse outcome in any of the three different operation types. © 2011 Springer-Verlag.


PubMed | Royal Infirmary, University of Glasgow and Canniesburn Plastic Surgery Unit
Type: Journal Article | Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS | Year: 2014

The pre-malignant skin lesion lentigo maligna (LM) presents a particular challenge. Pathologists demonstrate poor diagnostic concordance and often struggle to assess whether excision margins are truly negative. This can lead to equivocal histology reports and a lack of clear guidance with which surgeons may rationalise their surgical management plans. Based upon the biological principle that tumour burden increases the chance of recurrence, we propose a shift in diagnostic paradigm, using melanocyte count (MC) at an excision margin to predict LM recurrence.This retrospective study reviewed all cases of LM from a regional UK melanoma centre (1996-2011), to include 167 excisions, from 99 patients. Pathology slides were assessed for MC (blinded) at the most affected margin. Seven secondary markers of neoplasia were additionally evaluated. Logistic regression analysis was used to model the relationship between MC and recurrence.MC is a strong predictor of LM recurrence (p<0.0001). A regression curve predicts risk for individual MCs, which may also be divided into three risk strata; low (0-11% [MC 0-20]), intermediate (15-89% [MC 21-30]), and high risk (92-100% [MC31]). MC misclassified 0.6% of cases in the low and high risk groups compared with 21% for pathologists, who were also equivocal for 18% of excisions. MCs inter-rater concordance was high (>0.9). The secondary factors were all independently associated with recurrence, but failed to improve predictive ability supplementary to MC.MC confidently predicts LM recurrence and is more accurate and reliable, whilst also reducing the uncertainty of current pathology assessment. Risk estimates for any given MC can be easily charted using the regression curve graph, where confidence interval and risk group boundaries demonstrate the degree of certainty associated with any given prediction. This change in approach is congruent with tumour behaviour. A recurrence tipping point corresponds to the sharp risk increase across the intermediate groups narrow band of MC.


PubMed | Royal Devon and Exeter Hospital, Castle Hill Plastic Surgery Unit and Canniesburn Plastic Surgery Unit
Type: | Journal: Plastic surgery international | Year: 2015

Introduction. See and treat one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service.


Foong D.P.S.,Wythenshawe Hospital | Bryson A.V.,Canniesburn Plastic Surgery Unit | Banks L.N.,Stepping Hill Hospital | Shah M.,Royal Manchester Childrens Hospital
International Journal of Injury Control and Safety Promotion | Year: 2010

The incidence of contact burns from heated hair straighteners is increasing. The aim of this paper is to assess the safety features of hair straighteners, the mechanism of contact burns and the resultant morbidity in children. This study involves retrospective analyses of patients' case notes and examination of hair straighteners during heating and cooling. Grabbing and stepping onto heated devices were the common mechanisms of injury involving mainly hands and feet. Healing time ranged from 2 to 79 days. Nineteen percent required extensive therapy to maintain good function. Most devices had locking mechanisms to keep the internal surfaces closed; however the external surfaces reached 72.8°C and took 8.6 min to cool below 50°C. Contact with heated hair straighteners causes significant morbidity. The devices, including the external surfaces remain dangerously hot for a prolonged period after being switched off. These findings call for appropriate safety measures to be redressed by manufacturers and awareness amongst users to avoid these preventable injuries. © 2010 Taylor & Francis.


Lo S.,Canniesburn Plastic Surgery Unit | Lo S.,Chang Gung University | Lin Y.-T.,Chang Gung University | Lin C.-H.,Chang Gung University | Wei F.C.,Chang Gung University
Injury | Year: 2013

Difficulties in management of major degloving injuries of the upper limb are compounded by their relative rarity and a lack of clarity in decision-making regarding surgical treatment strategies. Management options include salvaging the degloved segment through revascularization techniques such as direct arterial anastamosis or arterio-venous (AV) shunting, and reconstructing the unsalvageable degloving injury with microsurgical or non-microsurgical techniques. This article focuses on the use of revascularization techniques as a means to salvaging a major degloved segment. We propose a new classification to aid decision-making in strategies to salvage the degloved skin. This is based on assessment of the degloved segment regarding its suitability for revascularization, the choice of revascularization technique, and its anatomical expendability. Major degloving injuries involving the palm but not the digits is a strong indication for AV shunting in isolation (Group 1). Major degloving injuries that include the digits as well require both AV shunting and digital artery revascularization (Group 2). Major deglovings involving the dorsum of hand or forearm are only relative indications for AV shunting and traditional management with flap reconstruction or skin grafting is equally appropriate. This new classification and its application are discussed in a number of case examples. © 2013 Elsevier Ltd.


Robertson B.F.,Canniesburn Plastic Surgery Unit | Robertson G.A.,Canniesburn Plastic Surgery Unit | Shoaib T.,Canniesburn Plastic Surgery Unit | Soutar D.S.,Canniesburn Plastic Surgery Unit | And 2 more authors.
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2014

Background: Current standard treatment of Pleomorphic Salivary Adenoma (PSA) of the Parotid Gland is by surgical excision. The management of incomplete excision remains undecided with post-operative radiotherapy advocated by some and observation by others. Methods: 190 patients who underwent resection of PSA of the parotid gland within the West of Scotland region from 1981 to 2008 were identified and data collected. Results: 78/190 patients had a primary incomplete excision. 25/78 received post-operative radiotherapy and 53 were observed. Recurrences occurred in 11/53 in those observed and in 1/25 of those who received radiotherapy. 21/25 complained of significant side effects from the radiotherapy. 38 surgeons performed 190 procedures, with a range of experience from 1 to28 procedures. Conclusions: Radiotherapy does appear to reduce recurrence with incomplete excision, however it is associated with significant side effects. We therefore feel radiotherapy should not be routinely recommended. Subspecialisation should be adopted to increase the operating surgeon's experience. © 2014 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.


PubMed | Beatson Oncology Center and Canniesburn Plastic Surgery Unit
Type: Journal Article | Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS | Year: 2014

Current standard treatment of Pleomorphic Salivary Adenoma (PSA) of the Parotid Gland is by surgical excision. The management of incomplete excision remains undecided with post-operative radiotherapy advocated by some and observation by others.190 patients who underwent resection of PSA of the parotid gland within the West of Scotland region from 1981 to 2008 were identified and data collected.78/190 patients had a primary incomplete excision. 25/78 received post-operative radiotherapy and 53 were observed. Recurrences occurred in 11/53 in those observed and in 1/25 of those who received radiotherapy. 21/25 complained of significant side effects from the radiotherapy. 38 surgeons performed 190 procedures, with a range of experience from 1 to28 procedures.Radiotherapy does appear to reduce recurrence with incomplete excision, however it is associated with significant side effects. We therefore feel radiotherapy should not be routinely recommended. Subspecialisation should be adopted to increase the operating surgeons experience.


Abdelhalim M.A.,University of Glasgow | Chatterjee J.S.,Canniesburn Plastic Surgery Unit
European Journal of Plastic Surgery | Year: 2012

The trauma workload in plastic surgery is not well documented in the literature. The authors wished to investigate the operative trauma caseload in a tertiary referral plastic surgery centre to determine the demographics, mechanisms of injury, sites of injury and procedures performed. This study was conducted using a prospectively tabulated comprehensive database in which details of every trauma operation performed at the Canniesburn Plastic Surgery Unit (Glasgow, Scotland) are logged. The data from an 8-year study period (2003-2010) were collected for patient demographics, site of injury and operative procedures performed. The data from a shorter study period (April 2006-December 2010) were collected separately to investigate the mechanisms of injury. Data analysis was undertaken using Mintab 15 Statistical Software English. Analysis of 21,929 operative procedures on 8,880 patients was undertaken. There was a predominance of young male patients. More than 75% of trauma affected the limbs. The mechanism of injury was predominantly accidents (31%) including RTAs. The second most common mechanism was violent crime (17%), of which more than a quarter involved a knife. Notably, alcohol was a contributing factor in 3.4% of all trauma cases. Plastic surgery trauma involves injury to all sites of the body and the mechanisms are variable. However, certain mechanisms are arguably preventable through public health initiatives and legislative change in order to reduce the unnecessary economic burden on the health service. There is a significant operative caseload with a requirement for a varying complexity of reconstruction, ranging from debridements to microvascular free tissue transfer. Arguably, the plastic surgeon must be an integral part of any trauma centre. © Springer-Verlag 2012.


Leaver H.,Ninewells Hospital and Medical School | Chatterjee J.S.,Canniesburn Plastic Surgery Unit
European Journal of Plastic Surgery | Year: 2013

The authors present an extremely rare finding of a duplicated extensor pollicus longus (EPL) muscle belly and tendon of the thumb, in a patient undergoing extensor synovectomy for rheumatoid disease. The previous reported cases are briefly reviewed, and the specific anatomical findings are presented. The case history of duplicated EPL muscle and tendon is reported alongwith the interoperative findings. Intraoperative photographs are used to display the anomaly clearly. A literature review was conducted to determine the reported frequency of such an apparently rare anatomical anomaly. © 2012 Springer-Verlag.


PubMed | Canniesburn Plastic Surgery Unit
Type: Journal Article | Journal: Journal of surgical case reports | Year: 2015

Spontaneous umbilical endometriosis is a rare extrapelvic manifestation of endometriosis. Very few such cases have been previously reported, almost always associated with a variety of symptoms, usually during menstruation. We present a case of asymptomatic umbilical endometriosis treated with skin-sparing excision. Differential diagnoses relevant to the clinician, as well as treatment options, are also presented. Surgeons should always consider umbilical endometriosis in their diagnostic approach when confronted with atypical umbilical nodules, regardless of whether they are symptomatic or not.

Loading Canniesburn Plastic Surgery Unit collaborators
Loading Canniesburn Plastic Surgery Unit collaborators