• Title/Summary/Keyword: Pediatric plastic surgery

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The Changing Patterns of Antibiotic Susceptibility for Acinetobacter baumannii in Pediatric Burn Patients (소아 화상환자에서 배양된 Acinetobacter baumannii에 대한 항생제 감수성 양상의 변화)

  • Lee, Sang-Min;Lee, So-Yeon;Kim, Young-Ho;Lee, Kyu-Man;Jang, Young-Chul;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.146-151
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    • 2008
  • Purpose : Multidrug-resistant Acinetobacter baumannii (A. baumannii) is recognized to be the most difficult pathogen to control and treat in pediatric burn centers. We analyzed the antibiotic susceptibility pattern of A. baumannii in our pediatric burn intensive care unit during the past 7 years. Methods : We retrospectively evaluated 56 patients (105 samples) under the age 15 years and who were infected with A. baumannii between January 1999 and December 2005. Results : Fot the 56 patients, the ratio of males to females was 1.15:1 and the median age was 48.3 months. The sites of 105 isolates were wounds (65%), sputum (20%), blood (6 %), cutdown tips (5%), endo-tip tubes (2%) and urine (2%). A. baumannii presented yearround. The annual antimicrobial resistance rate increased and the multidrug resistant rate for two or more antibiotics was 93.33%. For 3 patients in whom resistance emerged, the interval period between the susceptible and resistant strains after antibiotic use was a mean of 10 days. The A. baumannii isolated from blood were all multi-drug resistant pathogens. Conclusion : Multidrug resistance of A. baumannii is increasing. Strict infection control guidelines and active surveillance are needed for the prevention and treatment of A. baumannii in hospitals.

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Evidence-based management of isolated dentoalveolar fractures: a systematic review

  • Samriddhi Burman;Babu Lal;Ragavi Alagarsamy;Jitendra Kumar;Ankush Ankush;Anshul J. Rai;Md Yunus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.123-133
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    • 2024
  • Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults. Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.

The maxillary incisor labial face tangent: clinical evaluation of maxillary incisor inclination in profile smiling view and idealized aesthetics

  • Naini, Farhad B.;Manouchehri, Shaadi;Al-Bitar, Zaid B.;Gill, Daljit S.;Garagiola, Umberto;Wertheim, David
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.31.1-31.7
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    • 2019
  • Background: To test the hypothesis that in profile smiling view, for ideal aesthetics, a tangent to the labial face of the maxillary central incisor crowns should be approximately parallel to the true vertical line and thereby perpendicular to the true horizontal line. Methods: An idealized female image was created with computer software and manipulated using the same software to construct an "ideal" female profile image with proportions, and linear and angular soft tissue measurements, based on currently accepted criteria for idealized Caucasian profiles. The maxillary incisor labial face tangent was altered in 5° increments from 70 to 120°, creating a range of images, shown in random order to 70 observers (56 lay people and 14 clinicians), who ranked the images from the most to the least attractive. The main outcome was the preference ranks of image attractiveness given by the observers. Results: The most attractive inclination of a tangent to the labial face of the maxillary incisor crowns in profile view in relation to the true horizontal line was 85°, i.e. 5° retroclined from a perpendicular 90° inclination. The most attractive range appears to be between 80 and 90°. Excessive proclination appeared to be less desirable than retroclination. Beyond 105° most observers recommend treatment. Conclusion: In natural head position, the ideal inclination of the maxillary incisor crown labial face tangent in profile view will be approximately parallel to the true vertical line and thereby approximately perpendicular to the true horizontal line.

The Bacterial Colonization of Burn Wound and the Changes of Antibiotic Susceptibility in Childhood Burn (January, 1999~December, 2002) (소아 화상의 화상부위 세균 집락화와 항균제 감수성 변화(1999년 1월~2002년 12월))

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam;Lee, Kyu-Man;Oh, Suk-Joon
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.157-165
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    • 2005
  • Purpose : Children occupy a large proportion of burn victims. So we want to aid to pediatric burn care through the understanding of the bacterial distribution in burn wounds and antibiotic susceptibility against isolated microorganisms from burn wounds. Methods : We analysed the medical records of 213 pediatric burn patients(0~15 years), 406 samples that grew bacteria in burn wound sites. Results : Of the total 213 patients, male were 59.6% and female were 40.4%. Scalding burn was the most common(78.4%), flame burn was the second(16.4%). Pathogens were isolated in 406 samples. The most common was Pseudomonas aeruginosa(58.1%). Next were Enterococcus species, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus species, Acinetobacter species. P. aeruginosa was resistant to trimethoprim-sulfamethoxazole in 100%, cephalothin in 98.1%, ampicillin-sulbactam in 96.2%, ampicillin in 95.3%, ceftriaxone in 95.2%, tobramycin in 93.7%, cefoperazone in 68.9%, ceftazidime in 67.7%. Enterococcus species were resistant to tetracycline in 63.9%, streptomycin in 45.5%, gentamicin in 36.1%, penicillin G in 13.7%. S. aureus was resistant to gentamicin in 89.7%, tetracycline in 86.2%, ciprofloxacin in 86.2%, penicillin G in 84.3%, oxacillin in 78.4%, erythromycin in 76.5%. Acinetobacter species were resistant to ampicillin-sulbactam in 100%, gentamicin in 85.7%, ampicillin in 83.3%, piperacillin in 61.5%. Conclusion : P. aeruginosa was highly resistant to drugs like cefoperazone in 68.9%, ceftazidime 67.7%. S. aureus was highly resistant to penicillin G in 84.3%, oxacillin in 25.9 %, but none to vancomycin in 0%, teicoplanin in 2.2%. According to the study, Acinetobacter species turned out to be multi-resistant strains, so careful attention must be paid to the choice of antibiotics.

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