Raysa Cabrejo

Does Fat Grafting Influence Postoperative Edema in Orthognathic Surgery

Purpose: Autologous fat grafting is a useful adjunctive procedure to orthognathic surgery and may also confer anti-inflammatory properties. The purpose of this study is to answer the clinical question: among patients undergoing orthognathic operations, what are the effects of fat grafting on facial edema (magnitude, duration, and rate of decrease)? Methods: A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from preoperative and a series of postprocedure time-points were analyzed. The data set was divided into a fat-grafted cohort and a non-fat-grafted cohort and later analyzed using paired and unpaired t tests and linear regressions to determine significant correlations. Results: One hundred sixteen pre- and postoperative three-dimensional photo data sets were included. The sample included 29 subjects. The facial volume was analyzed both overall and comparing each subgroup (orthognathic vs. orthognathic + fat grafting group). Postoperative facial volume increase averaged 23.7% for the entire cohort (FG and nFG). By week 12, the swelling decreased about 62% from baseline. In all patients, there was a statistically significant decrease in facial volume with time. In the fat-grafted group, despite adding volume, the facial volume was equal to the non-fat-grafted group at week 1, yet the rate of decrease was faster through week 12. Conclusion: The majority of postoperative facial edema decreases by 12 weeks following orthognathic surgery. In this cohort of patients, despite the addition of volume, concurrent fat grafting lessened postoperative edema, and led to a greater magnitude and speed of resolution.

Abstract 64: Deterioration of Sensory Perception or Friction & Shear in Low Risk Braden Scores is Associated with Accelerated Development of Hospital Acquired Pressure Ulcers

PURPOSE: The Braden Scale is a risk stratification tool currently used by nurses to identify patients at risk of developing hospital acquired pressure ulcers (HAPUs). The tool operates on a 23-point system comprised of 6 components (Sensory Perception, Moisture, Activity, Mobility, Nutrition, Friction & Shear) where a threshold value of 18 distinguishes those with “low risk” (19–23 points) from those considered “high risk” (≤18 points). A Braden score is calculated on day of admission and updated throughout the hospital stay. Only patients deemed “high risk” are placed under special nursing protocols aimed at preventing pressure ulcer formation. Using linear regressions analysis, this study sought to better understand factors affecting the timing of HAPU development between high and low risk patients.

Abstract: Cost Analysis of Trigger Finger Treatment

Additionally, costs of both OR time and instruments were significantly less in the procedure room as compared to the main OR. The cost of the instrument tray utilized for trigger finger release was calculated as

Abstract: Functional Network Development in Sagittal Craniosynostosis Treated with Whole Vault Cranioplasty

3,304.25 in the main OR and

Facial Malformation in Crouzon’s Syndrome Is Consistent with Cranial Base Development in Time and Space

993.79 in the procedure room. Cost per minute for all personal services in the operating room, including anesthesia and nursing services, was calculated to be

Abstract QS02: A National Longitudinal Comparison of Strip Craniectomy and Whole Vault Cranioplasty

44/ minute, a cost that was virtually absent in the procedure room. Lastly, there was no difference in complication rates between the two groups.