Dataset Information

Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?

ABSTRACT:

Purpose

To bring to the attention of the orthopaedic fraternity that adolescent children smoke and this has an adverse effect on the bone regenerate during limb deformity corrective surgery.

Methods

Retrospective review of patients undergoing limb deformity corrective surgery with a prolonged frame time and bone-healing index. Patients operated on between 1993 and 2005 in a single regional specialist paediatric orthopaedic hospital.

Results

Seventeen smoking patients (16 adolescent, one aged 9 years), with prolonged bone regenerate consolidation time of more than double the standard time. Bone-healing index (BHI) was increased in both active smokers and passive smokers.

Conclusions

In the older child/adolescent we should consider smoking (active or passive) as a detrimental factor in prolonging their frame times. We should council these patients and their carers to stop smoking at least during the period of their treatment.

SUBMITTER: Rajan RA

PROVIDER: S-EPMC2656748 | biostudies-literature | 2007 Dec

REPOSITORIES: biostudies-literature

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Publications

Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?

Rajan Rohan Ananda RA Ong Ming M Jones Stanley S Fernandes James J

Journal of children's orthopaedics 20071113 6

<h4>Purpose</h4>To bring to the attention of the orthopaedic fraternity that adolescent children smoke and this has an adverse effect on the bone regenerate during limb deformity corrective surgery.<h4>Methods</h4>Retrospective review of patients undergoing limb deformity corrective surgery with a prolonged frame time and bone-healing index. Patients operated on between 1993 and 2005 in a single regional specialist paediatric orthopaedic hospital.<h4>Results</h4>Seventeen smoking patients (16 ad ...[more]

PMID: 19308533

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Project description:Introduction:Severe hand trauma, leading to extensive skeletal and tissue defects, requires plastic surgical reconstruction of the highest level aiming at maximizing function and aesthetics. The intention of this study was to investigate clinical parameters and resource consumption connected with severe hand injuries, with specific emphasis on a follow-up evaluation of quality of life after the reconstruction process. Materials and methods:In this retrospective study, we evaluated patients with severe hand injuries from 2013 to 2016 who had completed surgical and non-surgical treatment. Measures included total period of therapy (TPT) in days, total duration of operations including anesthesia (TOA), total duration of all operations (TO), and total number of operations (TNO). We also determined total inpatient stay (TIS), total number of clinic presentations with interventions (TNPI), initial hand injury severity score (iHISS), and inpatient proceeds (IPP) in Euros (€). Correlation was assessed between iHISS and TOA, TNO, and TIS. Finally, these patients were reexamined in a follow-up inquiry and the life quality was assessed with the five-level version of the EuroQol five-dimensional (EQ-5D) descriptive system (EQ-5D-5L). Results:We analyzed 12 patients with an average age of 44 years (min. 24 years, max. 75 years). Patients receiving reconstructive surgery experienced median ( x˜ ) TPT of 175 days [interquartile range (IQR), 51-499], TOA of 13 h (IQR, 6-37), TO of 9 h (IQR, 4-25), and TNO of 5 (IQR, 3-11). Further, the patients' median TIS was 22 days (IQR, 9-86), TNPI was 4 (IQR, 2-8), and iHISS was 77 (IQR, 44-162). The median IPP was 14.595 € (IQR, 5.541-33.709 €). IHISS was positively correlated with Pearson's r for TIS (0.817), TOA (0.857), and TNO (0.871). The EQ-5D-5L index value resulted in a high level of life quality with a median of 0.898 (min. 0.8, max. 1). Conclusion:Severe hand injuries are related to high efforts for surgical and functional reconstructions, which result in high quality of life measured with the EQ-5D-5L assessment. However, for a defined collective of patients, myoelectric prosthetic functional replacement should be considered. Further studies are necessary to examine functional outcomes and quality of life after bionic prosthetic replacement. Also, a bionic reconstruction score to define hard criteria for taking an acute treatment decision is necessary.

Project description:IntroductionLower limb conditions requiring reconstructive surgery can be either congenital or acquired from trauma, infection or other medical conditions. Patient-reported outcome measures (PROMs) are often used by healthcare professionals to assess the impact of a patient's condition (and treatment) on quality of life. However, we are not aware of any measures developed specifically for people requiring lower limb reconstructive surgery. Consequently, it is not clear the extent to which current PROMs accurately and specifically measure the outcomes that are important to these patients.Methods and analysisThe 'PROLLIT' (Patient-Reported Outcome Measure for Lower Limb Reconstruction) involves three phases: to explore what is important to patients with regard to quality of life (phase 1), ascertain whether current measures adequately capture these experiences (phase 2) and if not begin, the development of a new PROM (phase 3). The population of interest is people requiring, undergoing or after undergoing reconstructive surgery for a lower limb condition. In this paper, we describe phase 1, which aims to develop a conceptual framework to identify and map what is important to this group with regard to social interactions, employment, perceived health and quality of life after condition onset/injury and throughout recovery. The conceptual framework will be developed through three steps: (step A) a qualitative evidence synthesis, (step B) a qualitative study with patients and staff to explore patient's views and experiences of lower limb reconstructive surgery and (step C) a round table discussion with key stakeholders where findings from step A and step B will be brought together and used to finalise the conceptual framework.Ethics consideration and disseminationEthical approval has been granted for the qualitative data collection (step B) from South Central Berkshire Research Ethics committee (REF:20/SC/0114). Findings from steps A and B will be submitted for peer-reviewed publication in academic journals, and presented at academic conferences.Prospero registration numberCRD42019139587.Isrctn registration numberISRCTN75201623.

Dataset Information

Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?

Purpose

Methods

Results

Conclusions

Publications

Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?

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