Seyed Reza Mousavi

The SCARE Statement: Consensus-based surgical case report guidelines

INTRODUCTION Case reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines. METHODS The CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group. RESULTS In round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7-9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist. CONCLUSION We present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports.

Evaluating tamoxifen effect in the prevention of hypertrophic scars following surgical incisions.

OBJECTIVES To evaluate the clinical utility of tamoxifen in the prevention of hypertrophic scars (HTSs). MATERIAL AND METHODS In a double‐blind randomized clinical trial, 300 patients with a history of HTSs who underwent surgery with different skin incisions were assigned randomly to two groups. The first received tamoxifen tablets postoperatively according to a standard protocol, and the control group received placebo. After 2 months, the two groups were compared according to the development of HTSs, and the results were analyzed. RESULTS The studied population comprised 235 men (78.7%) and 65 women (21.7%) who developed HTSs after surgical incision, 138 of whom (92%) were in the study group and 78 (52%) in the control group. CONCLUSION Tamoxifen seems to be an effective agent in the prevention of HTSs after surgery.

Flexor tendon repair in children with zone 2 injuries: an innovative technique using autogenous vein ☆

OBJECTIVES This is a new technique for tendon repair that may improve the results of existing methods. METHODS The study is a nonrandomized retrospective study using historical (nonconcurrent) controls. From May 1994 to March 2004, 53 children aged 5 to 15 years requiring tendon repair (test group) were compared to 53 children conventionally repaired (control group). All patients had flexor tendon injuries, involving zone 2. In the test group (53 patients), a modified Kessler repairing of tendons with 4-0 prolene was used, followed by a core suture of running 7-0 nylon or prolene epitendinous suture. After the tendon repair, a segment of vein through which the tendon had been passed before or a vein patch used as a tendon sheath substitute was used to repair the sheath defects. The results during 6 months of follow-up were compared with those of the control group that were operated using the conventional technique (modified Kessler method). RESULTS We assessed the results by measuring the range of motion of the metacarpophalangeal, distal interphalangeal, and proximal interphalangeal joints in the follow-up period and graded them as excellent, good, fair, and poor. In the test group, 86% were graded as excellent, 11% good, 3% fair, and 0% poor results; and in the control group, 0% were excellent, 12% good, 38% fair, and 50% poor results. The differences were significant (P < .005). CONCLUSIONS Our preliminary results appeared encouraging when compared with the outcomes achieved by the conventional tendon repair technique. As the new technique decreases the need for intensive physiotherapy, it may serve as a substitute method for the conventional tendon repair and eventually become a standard technique in the future.

Quality-of-Life Outcomes in Patients with Gynecologic Cancer with Colostomy and Effectiveness of Psychologist Consultation

Treatment of gynecologic malignancies often involves a multimodality approach and is associated with high morbidity and changes in bowel, bladder, hormonal, sexual, and reproductive function, many of which can cause emotional and psychosocial in addition to physical distress [7,8]. In such circumstances, it is worthwhile to assess quality of life in the evaluation of the outcomes of various therapeutic procedures along with their final impact on patients’ lives [1]. Quality of life for gynecologic cancer patients tends to be at its worst between time of diagnosis and completion of radiotherapy, especially when they have colostomy [7]. Therefore, it is important to consultant with the psychotherapist during the chemotherapy and follow for long time under psychotherapy for the emotional and functional components of quality of life in gynecologic cancer and rectum involvement patients while on active treatment, a critical window for additional clinician support. Previous studies suggest that psychosocial interventions for cancer patients in the acute setting improve patients’ psychological well-being [9,10]. Palliative care is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications [11]. Because radiation and chemotherapy and surgery for these patients has been associated with risk of poor adjustment, our objective was to identify the trajectory of patients’ quality of life during and after treatment, particularly the role of psychosocial interactions on patient quality of life. We believe that it is consulting with a psychologist during and after treatment significant impact on quality of life.

Innovative procedure in surgical management of chronic lymphoedema

Background:  Lymphoedema is the result of impaired lymphatic drainage from the affected organ. This abnormality can be primary or secondary. Different non‐operative and operative approaches have been introduced to treat chronic lymphoedema. In the present study, we describe a new surgical technique and compare its results with other more commonplace methods.