Infections

All Conditions

Neoplasms

Skin and Connective Tissue Diseases

Symptoms and General Pathology

Wounds and Injuries

Immune System Diseases

Eye Diseases

Skin Neoplasms

Communicable Diseases

Surgical Wound Infection

Hypersensitivity

Facies

Surgical Wound

Wound Infection

Eyelid Diseases

Disease Attributes

Postoperative Complications

Anti-Infective Agents

All Drugs and Chemicals

Gastrointestinal Agents

Pharmaceutical Solutions

Dermatologic Agents

Anti-Bacterial Agents

Antibiotics, Antitubercular

Erythromycin

Erythromycin Estolate

Erythromycin Ethylsuccinate

Erythromycin stearate

Lubricant Eye Drops

Petrolatum

Mineral Oil

Polymyxins

Bacitracin

Enzyme Inhibitors

Anti-Infective Agents, Local

Intervention: 200 patients in the antibiotic arm will receive either erythromycin or bacitracin, based on allergies, surgeon preference, and antibiotic availability. If neither antibiotic is obtainable by the patient, bacitracin polymyxin will be prescribed instead. Antibiotic ointment is to be applied to the surgical incision(s) 4 times daily for 1 week.

Intervention: 200 patients in the placebo group will receive mineral oil/petrolatum-based artificial tear ointment to be applied to the surgical incision(s) 4 times daily for 1 week.

Topical antibiotic ointment will be erythromycin or bacitracin. If the patient cannot obtain either (e.g. lack of availability at the pharmacy), bacitracin polymyxin will be prescribed. Allergy to all 3 study drugs means that a patient will be excluded from the study.

Topical Antibiotic Product

Mineral oil/petrolatum-based artificial tear ointment.

Topical Non-Antibiotic Ointment

Robert Kersten, MD

The investigators propose a prospective randomized control trial testing the hypothesis that routine topical antibiotic prophylaxis does not significantly reduce the rate of infection after eyelid surgery.

The use of prophylactic topical antibiotic therapy after eyelid surgery is widespread. Due to increasing antibiotic resistance, antibiotic-related complications, and healthcare costs, the investigators wish to determine whether prophylactic post-operative antibiotic ointment is truly necessary. After all, existing dermatology literature currently recommends against the routine use of antibiotic ointment after various surgical procedures (e.g. Mohs surgery). The investigators aim to perform a prospective randomized control trial at the University of California, San Francisco. The investigators aim to recruit a total of 400 oculoplastics patients undergoing eyelid surgery or surgery involving peri-orbital incisions from 2017 through 2019.

Patients will be randomized to one of two intervention arms (i.e. antibiotic ointment vs. placebo artificial tear ointment) and will not at any point cross over to the other arm.

Randomization to one of two intervention arms (i.e. antibiotic ointment vs. placebo artificial tear ointment) will be performed prior to study recruitment by REDCap software. Patients' randomization assignments will be revealed at the initial pre-operative visit or at time that procedure consent is obtained; the study team will not be aware of a subject's randomization assignment prior to that time.

Topical Antibiotic Prophylaxis for Eyelids

The Role of Topical Antibiotic Prophylaxis in Eyelid Surgery

The rate of superficial incisional or deep incisional surgical site infection (SSI) of clean and clean-contaminated wounds.

A secondary outcome is the rate of superficial or deep SSI in participants considered high risk for infection due to comorbidities such as smoking, exogenous immunosuppressive agent use, or medical conditions causing immunosuppression such as diabetes mellitus.

A secondary outcome recording the rate of wound dehiscence after surgery.

A secondary outcome recording the rate of allergic contact dermatitis due to post-operative ointment.

University of California, San Francisco

Among participants who did not proceed with surgery or who had no post-operative follow-up, adverse event data for events specific to the post-operative period (i.e. allergic contact dermatitis or wound dehiscence) were not collected. These participants were excluded from the denominator in determining frequency of these adverse events.

The antibiotic arm received either erythromycin or a bacitracin containing ointment, depending on allergies, surgeon preference, and pharmacy availability. Patients were instructed to apply the ointment to the surgical incision(s) 4 times daily for 1 week.

Topical Antibiotic Ointment

The non-antibiotic ointment arm received mineral oil/petrolatum-based artificial tear ointment with instructions to apply it to the surgical incision(s) 4 times daily for 1 week.

Total

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Smoking status

Participants were considered high risk for infection if they had a history of smoking or a medical history of a condition associated with immune suppression, such as diabetes mellitus, infection with human immunodeficiency virus, or autoimmune disease requiring immunosuppressive agents.

High risk for infection

Asplenia

Autoimmune disease

Diabetes mellitus

Human immunodeficiency virus infection

Malignancy

Organ transplantation

Blepharoplasty

Browplasty

Dacryocystorhinostomy

Ectropion/Entropion repair

Eyelid lesion removal and/or biopsy

Ptosis repair

Reconstruction after Mohs surgery

Orbitotomy

Tarsorrhaphy

Wedge excision

Data not available for 3 participants who did not proceed with surgery.

Davin Ashraf MD

Number of Participants With Surgical Site Infections

Number of High Risk Participants With Surgical Site Infections

Number of Participants With Wound Dehiscence

Number of Participants With Allergic Contact Dermatitis

Overall Study

Behaviors and Mental Disorders

Skin Diseases

Quality of Life

patient's psychological experience the anxiety level

Self-administered questionnaires by the patient will be given during visits in the following order:the self-administered questionnaires concerning the announcement consultation will be completed by the patient after consultation waiting room; self-questionnaires will be given in just before the operation waiting room (D0) just before the suture removal points (J10) and just before the follow-up visit (M3).

Self-administered questionnaires

Marie BEYLOT-BARRY, MD, PhD

Surgery is the first-line treatment of localized skin cancers. Knowledge on the patient's psychological experience is limited. Therefore, the psychological impact on patients before, during and after surgery can be underestimated. Moreover, the diagnosis of cancer disturbs the patient's entire life and the onset of anxiety disorders is frequent following this announcement.

The main objective of the study is to explore patients' experience assessing anxiety before, during and away from surgery. The investigators will distinguish the anxiety related to the surgical act itself and the anxiety related to the announcement of the disease.

The secondary objective is to assess the impact of surgery on quality of life, self-image and aesthetic satisfaction.

Exploratory Prospective of Experienced by Patients in the Surgery of Skin Cancers of the Face in Interventional Dermatology Department

Self-assessment questionnaires will be given to the patient

University Hospital, Bordeaux

Musculoskeletal Diseases

Nervous System Diseases

Contracture

Dupuytren Contracture

Fibroma

Neoplasms, Fibrous Tissue

Neoplasms, Connective Tissue

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Muscular Diseases

Connective Tissue Diseases

Surgical intervention as second-line surgery for the treatment of Dupuytren's disease.

Surgical treatment of Dupuytren's disease. Average from 2 to 4 joints per hand operated on simultaneously

Surgical treatment

JEANFRANCOIS OUDET

MH barba

Marie Barba

As part of a graduated medical-surgical strategy, and in our practice, surgery for Dupuytren's disease appears as a second-line treatment indicated in a situation of failure after treatment with percutaneous needle aponeurotomy.The results of second-line surgery in terms of safety and efficacy have not been specifically evaluated in patients who underwent failed percutaneous needle aponeurotomy. This evaluation nevertheless appears necessary for the validation of a medical-surgical strategy during Dupuytren's disease.

Dupuytren's disease is characterised by retractile fibrosis of the superficial palmar aponeurosis that can result in irreversible flexing of the fingers and long-term disability. The treatment of Dupuytren's disease, whether medical or surgical, remains symptomatic. It is based in Europe on percutaneous needle aponeurotomy and surgical aponeurectomy. Its objectives are the reduction of the deformity of the fingers in flexum, and that of the incapacity that generates the illness. Percutaneous needle aponeurotomy for Dupuytren's disease was developed by Jean-Luc Lermusiaux in 1972 in the Rheumatology Department of the Lariboisière Hospital in Paris. Its efficiency, its tolerance, its simplicity, its low cost and the possibility of repeating it make it a benchmark treatment. Percutaneous needle aponeurotomy is, for many, if the existence of this technique is known and understood, the first-line treatment of Dupuytren's disease.

As part of a graduated medical-surgical strategy, and in our practice, surgery for Dupuytren's disease appears as a second-line treatment indicated in a situation of failure after treatment with percutaneous needle aponeurotomy. The safety and efficacy of the surgery was evaluated in the context of a first-line treatment of Dupuytren's disease. The results of second-line surgery in terms of safety and efficacy have not been specifically evaluated in patients who underwent failed percutaneous needle aponeurotomy. This evaluation nevertheless appears necessary for the validation of a medical-surgical strategy during Dupuytren's disease.

Tolerance and Efficacy Study of Second-line Surgery After Percutaneous Needle Aponeurotomy for Dupuytren's Disease.

Tolerance and Efficacy Study of Second-line Surgery After Percutaneous Needle Aponeurotomy for Dupuytren's Disease. URAM 3

Primary end point: joint deformity of each treated joint at 3 months.• The development of the degree of joint extension malalignment at 3 months will be described both by the relative difference and by the absolute difference between the measurements at V0 and V3, overall and for each modality of the known prognostic factors: joint types (MCP versus PIP), age at onset of disease (\<50 years versus \>= 50 years), initial severity of disease.

Dr ROULOT

Ramsay Générale de Santé

Cicatrix

Fibrosis

Emollients

After informed consent and closing the wound with the sutures, the scar will be covered by a hydrocolloid dressing, which will be left in place for 7 days (Experimental)

and the other group of patients (control), after closing the wound with the sutures, the scar will be covered with petrolatum jelly during this time period, which has to be re-applied daily.

A single hydrocolloid dressing will be applied to the surgical site for 7 days following dermatologic surgery

Hydrocolloid dressing

The patient with the control wound will be covered with petrolatum jelly during this time period, which has to be re-applied daily.

Petrolatum jelly dressing

Patients will be randomized either to receive standard daily dressing or hydrocolloid dressing using a randomization generator. After closing the wound with the sutures,the scar will be covered by a hydrocolloid dressing, which will be left in place for 7 days(Experimental) or the standard dressing (Control) that will be covered with petrolatum jelly and bandaging during this time period, which has to be re-applied daily. Patients and dermatologic surgeons will then complete surveys 7 days, 30 days, and 90 days after surgery to evaluate the cosmetic appearance of these scars.

Each patient will have the surgical scar treated with either type of intervention

Scar Appearance After Postoperative Hydrocolloid Dressing Versus Standard Petrolatum Ointment

Scar Appearance After Postoperative Hydrocolloid Dressing Versus Standard Petrolatum Ointment: A Randomized Controlled Trial

Patient and surgeon assessment of cosmetic outcome using modified visual analogue scar scale. The minimum value is 1 and the maximum value is 10. 1 is the worst possible scar appearance and 10, is the best possible scar appearance.

Complication rate including hematoma, seroma, wound infection requiring antibiotics, opening and drainage of wound, dehiscence. Complications will be assessed by physicians other than operating surgeon

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Topical Antibiotic Prophylaxis for Eyelids	NCT03199911	Antibiotic Side... Eyelid; Wound Eyelid Diseases Surgical Wound ... Surgical Wound,... Surgical Incisi... Skin Cancer Fac... Antibiotic Alle... Surgical Site I...	Topical Antibio... Topical Non-Ant...	18 Years -	University of California, San Francisco
Exploratory Prospective of Experienced by Patients in the Surgery of Skin Cancers of the Face in Interventional Dermatology Department	NCT04336371	Skin Cancer Fac... Surgical Incisi...	Self-administer...	18 Years -	University Hospital, Bordeaux
Tolerance and Efficacy Study of Second-line Surgery After Percutaneous Needle Aponeurotomy for Dupuytren's Disease.	NCT04164953	Dupuytren's Dis... Surgical Incisi...	Surgical treatm...	18 Years -	Ramsay Générale de Santé
Tolerance and Efficacy Study of Second-line Surgery After Percutaneous Needle Aponeurotomy for Dupuytren's Disease.	NCT04164953	Dupuytren's Dis... Surgical Incisi...	Surgical treatm...	18 Years -	Ramsay Générale de Santé
Scar Appearance After Postoperative Hydrocolloid Dressing Versus Standard Petrolatum Ointment	NCT05618912	Scar Skin Scarring Skin Cancer Wound Heal Wound of Skin Surgical Wound Patient Satisfa... Patient Prefere... Surgical Incisi...	Hydrocolloid dr... Petrolatum jell...	18 Years -	Indiana University
Exploratory Prospective of Experienced by Patients in the Surgery of Skin Cancers of the Face in Interventional Dermatology Department	NCT04336371	Skin Cancer Fac... Surgical Incisi...	Self-administer...	18 Years -	University Hospital, Bordeaux

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