Day 2 :
Council Member of Association of Oral & Maxillofacial Surgeons, India
Keynote: TO EVALUATE THE EFFICACY AND EFFECTIVENESS OF N-BUTYL 2-CYANOACRYLATE GLUE (TRU SEAL) IN CLOSURE OF ORAL & MAXILLOFACIAL LACERATION & SURGICAL INCISIONS
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Dr. Praveen Kumar Singh has completed his BDS from Purvanchal Institute of Dental Sciences, Gorakhpur in the year 2012. In his BDS, he achieved certificate of honor from Colgate Palmolive India Limited and a merit certificate from ISP, for securing highest marks in the subject of Periodontology. Later on, he completed his Masters training in Oral & Maxillofacial Surgery from JSS Dental College & Hospital, Mysore. Currently, he stand as Vice President of Indian Association of Dental Students an official member nation of International Association of Dental Students,Switzerland. In addition, he is also Official Student Council Member of Association of Oral & Maxillofacial Surgeons of India. He is Scientific Editor of Dental Deluge and has formerly been the Editor of the Indian Section of Dental Students Research, Switzerland.
INTRODUCTION; Effective wound closure is critical for minimizing wound complications and preventing wound dehiscence. The various wound closure techniques include staples, traditional nylon and skin sutures, subcuticular sutures and skin adhesives. Currently topical skin adhesives are frequently being used. Most of the adhesives used are cyanoacrylates short and long chain (butyl and isobutyl cyanoacrylates) derivatives. Cyanoacrylates (CAC) are tissue adhesives exhibiting the objectives of achieving coaptation of surgical wound borders, and thus eliciting healing. This material is bacteriostatic and biodegradable, and exhibits suitable tensile strength.
Cyanoacrylates glue results in cutaneous closure in less than 5 minutes. It should not be used for deep wound closure or in any patient sensitive to cyanoacrylates. Wound closure using tissue adhesives require careful attention to be given to closure of subcutaneous layer to ensure optimal approximation and tension on the edges of the wound.Cyanoacrylates glue polymerise rapidly within seconds following contact with proteinaceous surfaces to form strong and flexible bonds. This chemical property makes them extensively used in different surgical application. Prior to application of cyanoacrylates, the tissue surface should be cleaned and dried as much as possible. Protection of the surrounding tissues from accidental contact with cyanoacrylates can be done by covering them by gauze, or chloramphenicol 1% ointment.
SURGICAL TECHNIQUE; Under nasoendotracheal intubation, skin preparation was done with povidine iodine. Skin incision for each procedure was placed in the standard location. Then reduction of fracture and plating was done. In 80% of the patients subcutaneous sutures were placed. Skin closure was done with N-butyl 2 cyanoacrylate glue. Pressure dressing was placed in the usual manner for 24hrs postoperatively.
RESULTS; In this study, REEDA Scale was used to assess healing. Redness, edema, Ecchymosis was seen in all 10 patients, which subsided by 2nd week post operatively. None of the patients had discharge from surgical site on 1st post operative day but was noted in 2 patients 1st week post operatively. There was evidence of wound gaping in 1 patient on 1st post operative day and 2 patients at end of 1st week post operatively. Stony Brook Scar evaluation was used to evaluate post operative cosmesis in this study. No significant cosmetic impairment was found in all patients at the end of the study. Patients were highly satisfied with the excellent cosmetic results. In this study, no adverse inflammatory reactions were encountered and it is relevant to a study conducted by Ahmed Habib et al. The Surgical glue has the characteristic of being rapidly transferred from a liquid to a solid state that occurs at room temperature without the need of catalysts, solvents or application of pressure.
CONCLUSION; The study reflects qualitative assessment of cyanoacrylates which is simple to use & with proper application resulted in uniform and everted closure of the wound. It is cost efficient as compared to other wound closure materials. The properties of cyanoacrylate glue were appreciated clinically as it showed excellent results with respect to the closure time, post operative healing and patient comfort.
The quantitative data as reiterated from results make us conclude that cyanoacrylate glue performed excellently and showed similar cosmetic results when scarring evaluation was done. It is noteworthy that within the limitations of this study, which includes, less sample size and short duration for evaluation, this material showed excellent results and future studies in larger sample size can overcome the above stated limitations.
Seinäjoki University of Applied Sciences, FINLAND
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Dr. Mari Salminen-Tuomaala, PhD in Health Sciences, is Senior Lecturer in Seinäjoki University of Applied Sciences, School of Health Care and Social Work. She is Project Manager in simulation based education research and development project. She has worked over 20 years as registered nurse at medical departments, cardiac care unit and emergency department before teaching career. Her main research and expertise areas concern acute care (intensive care, out-of-hospital emergency care, care and counseling at the emergency department), simulation based education, psychosocial coping of myocardial infarction patients and their spouses, families as clients in health care and families in challenging life situations. She has about 40 conference presentations and over 50 scientific publications.
Statement of the Problem: The development of multiprofessional simulation-based learning is important in acute nursing, where the sometimes rapid fluctuations in patients’ condition call for effective and competent action from those contributing to the care. Familiarity with the competence areas and responsibilities of the other professional groups helps promote optimal action. Multiprofessional collaboration does not emergence naturally. It is a combination of many factors and requires constant and conscious development.
The purpose of the research; was to describe nursing and medical staff’s experiences of the usefulness of multiprofessional simulation-based education in one hospital district in Finland. The research aimed at producing user-oriented knowledge to be used in the development of multiprofessional simulation pedagogical continuing education. The study is part of a larger research project, whose purpose is to build up a multiprofessional simulated learning environment for a network of partners. They involve a university of applied sciences, a vocational education centre, a health technology development center and a hospital district.
Methodology; Data were collected using a Web-based survey tool. The questionnaire contained both quantitative and qualitative items. Quantitative data was analysed using SPSS Statistics for Windows 23 and qualitative data was analysed using inductive content analysis
Findinds; Both nursing and medical staff experience that simulation education is useful for the development of multiprofessional teamwork. Members of a well-functioning multiprofessional team accept their mutual differences in competence, but work for a common goal. The collaboration can be hindered by lacking information about the other team members’ work and by different professional practices, concepts and ways of thinking.
Conclusion & Significance: Learning multiprofessional collaboration occurs both individually and in communities. Its basis lies in respecting diversity, in the potential of collaborative learning, motivation, facilitation and evaluation and in acquiring multiprofessional competence.