RESUMEN
Tracheostomy is one of the more commonly performed procedures in critically ill patients under mechanical ventilation. Postoperative scarring is one of the bothersome sequelae of tracheostomies. Scars distort physical appearance, especially when found on the head and neck, which could have a negative impact on quality of life. The aim of this study was to evaluate and assess the impact of post-tracheostomy scars on quality of life according to the tracheostomy method. A prospective, single-center, observational, case-control study was conducted. One hundred fifty-six persons with a post-tracheostomy surgical scar for more than four months were observed using the Patient and Observer Scar Assessment Scale and Dermatology Life Quality Index questionnaire. Persons were divided into two groups depending on the method of tracheostomy, and the duration of the cannulated period was considered in both groups. Statistical analyses were performed using SPSS ver. 16.0 (SPSS Inc., Chicago, IL, USA), and P values of <0.05 were considered significant. The patients who had a tracheostomic tube cannulation period of fewer than 15 days had better cosmetic results than those who had tracheostomic tubes for more than 15 days, regardless of the tracheostomy method: 6.64 ± 0.082 versus 16.15 ± 0.096 (P < 0.001) in the surgical tracheostomy group and 7.26 ± 0.211 versus 14.17 ± 0.379 (P < 0.05) in the percutaneous dilatational group. The Dermatology Life Quality Index scores had a mean value of 0.6 ± 0.01, which means that post-tracheostomy scarring in the present study had no effect on the person's quality of life. The aesthetic outcomes of post-tracheostomy scars after the open surgical tracheostomy technique did not significantly differ from those of the percutaneous dilatational technique in the present study. Persons with a long duration of tracheostomic tube ventilation showed worse aesthetic outcomes than those with short-term tracheostomic cannulation, which was not dependent on the tracheostomy technique. The Dermatology Life Quality Index showed that post-ttracheostomy scarring in the present study had no effect on the person's quality of life.
Asunto(s)
Cicatriz , Traqueostomía , Humanos , Traqueostomía/efectos adversos , Traqueostomía/métodos , Cicatriz/etiología , Estudios de Casos y Controles , Estudios Prospectivos , Calidad de VidaRESUMEN
BACKGROUND: The aim of this study was to perform a retrospective analysis of the prevalence, etiologies, types of maxillofacial injuries (MFIs), sites of maxillofacial fractures (MFFs) and their management in Yerevan, Armenia. METHODS: A retrospective cross-sectional study was conducted. The extracted data included age, sex, date of referral, mode of injury, etiology, radiology records and treatment methods. Study outcomes were measured using percentages, means, standard deviations and tests of proportions. P < .05 was considered significant. RESULTS: A total of 204 patients had a mean age of 36.26 ± 1.08 years (156 males and 48 females), and a total of 259 MFIs were recorded between 2017 and 2020. Interpersonal violence was found to be the most common etiology of MFFs in this study (42.1%), followed by road traffic accidents (RTAs) (27.9%) and falls (18.6%). The nasal bone was the most common injury site (47.5%), followed by the mandible (31.4%) and zygomatic complex (11.7%). The most common fracture site was the mandibular angle (37.9%), followed by the symphysis/parasymphysis (28.1%) and body (12.6%). Isolated soft tissue injuries were reported in 5.9% of the cases. The majority of MFFs were treated by open reduction and internal fixation. CONCLUSION: Interpersonal violence, followed by RTAs and falls, was the most common cause of MFIs. Males in the 21-30 years age group had the highest MFI incidence rate. The nasal bone was the most common injury site, followed by the mandible and zygomatic complex. Social education with the objective of reducing aggression and interpersonal conflict should be improved, and appropriate RTA prevention strategies should be strengthened and implemented.