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Article ; Online: The use of lidocaine gel to optimize pedicle condition during microsurgery.

Sleiwah, Aseel / Din, Asmat H / See, Marlene

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2021 Volume 74, Issue 9, Page(s) 2392–2442

MeSH term(s)	Anesthetics, Local/administration & dosage ; Gels ; Humans ; Lidocaine/administration & dosage ; Microsurgery ; Reconstructive Surgical Procedures ; Surgical Flaps
Chemical Substances	Anesthetics, Local ; Gels ; Lidocaine (98PI200987)
Language	English
Publishing date	2021-04-18
Publishing country	Netherlands
Document type	Letter
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2021.03.095
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Article ; Online: Is a lecture-free curriculum ideal?

Abhee, Stasha Sonia / Phillips, Richard / Sleiwah, Aseel

Medical teacher

2020 Volume 43, Issue 4, Page(s) 480

MeSH term(s)	Curriculum ; Learning
Language	English
Publishing date	2020-08-27
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.1080/0142159X.2020.1809641
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Article ; Online: Balancing Training Opportunities and Patient Outcomes: A Single Surgeon's Experience.

Mughal, Maleeha / Sleiwah, Aseel / Townley, William

Annals of plastic surgery

2021 Volume 87, Issue 4, Page(s) 440–445

Abstract: Abstract: Microvascular free tissue transfer is the criterion standard of reconstruction post-oncological resections of the head and neck region. We present a consultant's first 200 consecutive microvascular head and neck reconstructions in independent ... ...

Abstract	Abstract: Microvascular free tissue transfer is the criterion standard of reconstruction post-oncological resections of the head and neck region. We present a consultant's first 200 consecutive microvascular head and neck reconstructions in independent practice. A retrospective analysis of a prospectively collected database of all head and neck reconstructions performed in the first 3 years of practice was performed. These included 200 consecutive microvascular head and neck reconstructions performed by a single surgeon at a tertiary referral center. We review the results and complications in this series and discuss factors significant for successful outcomes in head and neck reconstruction. We also highlight that different parts of the surgery in the majority of cases were performed by a trainee under the supervision of the senior surgeon and thus discuss the need for training future plastic surgeons with an interest in head and neck reconstruction.
MeSH term(s)	Head and Neck Neoplasms/surgery ; Humans ; Neck/surgery ; Plastic Surgery Procedures ; Retrospective Studies ; Surgeons
Language	English
Publishing date	2021-09-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000002727
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Article ; Online: Is Routine Imaging Necessary for the Management of Pediatric Hand Fractures Postoperatively?

Sleiwah, Aseel / Al-Jabir, Ahmed / Mughal, Maleeha / Syed, Mobinulla

Annals of plastic surgery

2022 Volume 88, Issue 6, Page(s) 622–624

Abstract: Background: Pediatric hand fractures heal remarkedly well, and clinically significant displacement after operative fixation is rare. Radiation exposure in medical practice is regulated by the Ionizing Radiation Medical Exposure Regulations 2017, and ... ...

Abstract	Background: Pediatric hand fractures heal remarkedly well, and clinically significant displacement after operative fixation is rare. Radiation exposure in medical practice is regulated by the Ionizing Radiation Medical Exposure Regulations 2017, and unnecessary radiation should be avoided. In the literature, there is paucity of information regarding the number of radiographs required in the postoperative period and guidelines are lacking. Methods: This study aims to examine whether routine imaging or the lack of it influences functional outcome and time to discharge from the clinic. A retrospective data of pediatric hand fractures requiring intervention between 2014 and 2018 at our institution were conducted before and after elimination of routine postoperative imaging. A total of 230 patients were included in the study. Results: Two cohorts of patients were identified. The first had routine postoperative radiographs, whereas the second did not have routine radiographs. There was no change in management and difference in the range of motion at discharge between the 2 groups (P = 0.74). Patients without routine imaging were discharged earlier from clinic (74.4 vs 108.2 days, P = 0.012). Conclusions: This study shows that clinically significant fracture displacement is rare after operative reduction and fixation in pediatric age group. It demonstrates our experience in refraining from routine postoperative radiographs. The overall benefit is to avoid unnecessary radiation and subsequent costs implicated.
MeSH term(s)	Child ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Hand ; Humans ; Postoperative Period ; Radiography ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003151
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Article ; Online: Dermatofibrosarcoma Protuberans in Children.

Sleiwah, Aseel / Wright, Thomas C / Chapman, Thomas / Dangoor, Adam / Maggiani, Francesca / Clancy, Rachel

Current treatment options in oncology

2022 Volume 23, Issue 6, Page(s) 843–854

Abstract: Opinion statement: Paediatric dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue malignant tumour which displays aggressive local behaviour and has low metastatic potential. The diagnosis is often delayed as DFSP is usually mistaken for other ... ...

Abstract	Opinion statement: Paediatric dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue malignant tumour which displays aggressive local behaviour and has low metastatic potential. The diagnosis is often delayed as DFSP is usually mistaken for other skin conditions, particularly in the early stages of disease. DFSP tends to follow an indolent course after the initial presentation with what is often described as a "rubbery lump". As the disease progresses, the lump tends to enlarge, change colour, and exhibit a more nodular consistency. In rare cases, DFSP can present as an ulcerated exophytic lesion or a depressed area of skin, making diagnosis even more challenging. A high index of suspicion is warranted for early diagnosis, and referral to a specialist unit with expertise in both oncologic resection and reconstruction. DFSP tumours arise from the dermis and grow with finger-like projections. Therefore, in cosmetically sensitive or functionally important locations, an excision and analysis technique that assesses all excision margins is the gold standard of care. Slow Mohs technique performed with en bloc excision is a well-tolerated option for oncologic resection of the tumour. Mohs technique can also be considered but can be challenging in children for reasons explained below. As an alternative, depending on the anatomical location, tumours can be excised with a wide local excision. While an excision technique that incorporates the deep fascia with a 3-cm peripheral margin is acceptable in adults, planning of the excision margin in children should involve consideration of preoperative imaging with MRI, site of the tumour, age, and physical built of the child. Patients should be offered all treatment options considering the local outcomes, available expertise, and cost. A multidisciplinary approach and good communication between team members is crucial. Close collaboration with a pathologist who is familiar with sectioning technique that allows margin control is of paramount importance. Soft tissue reconstruction should be performed immediately after oncologic clearance, although a staged approach may be required. Adjuvant radiotherapy should be avoided in children due to the long-term risk of secondary malignancies and potential for growth disruption.
MeSH term(s)	Adult ; Child ; Dermatofibrosarcoma/diagnosis ; Dermatofibrosarcoma/surgery ; Humans ; Margins of Excision ; Mohs Surgery/methods ; Neoplasm Recurrence, Local/pathology ; Skin Neoplasms/diagnosis ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery
Language	English
Publishing date	2022-04-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-022-00979-9
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Zs.A 5523: Show issues

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Article: Perioral pressure ulcers in patients with COVID-19 requiring invasive mechanical ventilation.

Sleiwah, Aseel / Nair, Ganeshkrishna / Mughal, Maleeha / Lancaster, Katie / Ahmad, Imran

European journal of plastic surgery

2020 Volume 43, Issue 6, Page(s) 727–732

Abstract: Background: Facial pressure ulcers are a rare yet significant complication. National Institute for Health and Care Excellence (NICE) guidelines recommend that patients should be risk-assessed for pressure ulcers and measures instated to prevent such ... ...

Abstract	Background: Facial pressure ulcers are a rare yet significant complication. National Institute for Health and Care Excellence (NICE) guidelines recommend that patients should be risk-assessed for pressure ulcers and measures instated to prevent such complication. In this study, we report case series of perioral pressure ulcers developed following the use of two devices to secure endotracheal tubes in COVID-19 positive patients managed in the intensive care setting. Methods: A retrospective analysis was conducted on sixteen patients identified to have perioral pressure ulcers by using the institutional risk management system. Data parameters included patient demographics (age, gender, comorbidities, smoking history and body mass index (BMI)). Data collection included the indication of admission to ITU, duration of intubation, types of medical devices utilised to secure the endotracheal tube, requirement of vasopressor agents and renal replacement therapy, presence of other associated ulcers, duration of proning and mortality. Results: Sixteen patients developed different patterns of perioral pressure ulcers related to the use of two medical devices (Insight, AnchorFast). The mean age was 58.6 years. The average length of intubation was 18.8 days. Fourteen patients required proning, with an average duration of 5.2 days. Conclusions: The two devices utilised to secure endotracheal tubes are associated with unique patterns of facial pressure ulcers. Measures should be taken to assess the skin regularly and avoid utilising devices that are associated with a high risk of facial pressure ulcers. Awareness and training should be provided to prevent such significant complication.Level of evidence: Level IV, risk/prognostic study.
Keywords	covid19
Language	English
Publishing date	2020-09-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632906-8
ISSN	1435-0130 ; 0930-343X
ISSN (online)	1435-0130
ISSN	0930-343X
DOI	10.1007/s00238-020-01737-6
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Article ; Online: Locally Advanced Scalp Tumors: Clinical and Survival Outcomes of a Tertiary Unit.

Sleiwah, Aseel / Mughal, Maleeha / Thomas, Nicholas / Roblin, Paul / Townley, William / Jeannon, Jean-Pierre

Annals of plastic surgery

2021 Volume 87, Issue 3, Page(s) 271–277

Abstract: Introduction: Locally advanced nonmelanoma skin cancers of the head and neck are well described in the current literature. However, data about clinical and survival outcomes are lacking. We present survival data from a tertiary head and neck cancer unit ...

Abstract	Introduction: Locally advanced nonmelanoma skin cancers of the head and neck are well described in the current literature. However, data about clinical and survival outcomes are lacking. We present survival data from a tertiary head and neck cancer unit in London. Methods: A retrospective analysis of data collected from a single institution was conducted. All patients with locally advanced cutaneous scalp carcinomas invading the skull between 2011 and 2019 were included. Data included patient demographics, tumor, comorbidities, interventions, flap survival, and metal work exposure. Survival outcomes were examined using Kaplan-Meier analysis. Results: Twenty-three patients were identified. The mean age was 72 years. Eighteen patients were male, and 5 were female. Five patients were immunosuppressed. Nineteen patients underwent outer cortex drill-down/full-thickness calvarial resection, followed by reconstruction with free tissue transfer. Six patients had titanium mesh reconstruction after segmental skull resections. Three patients underwent further surgery because of exposed metalwork. Disease-free survival at 3 years after surgery was 60%. Conclusions: Locally advanced nonmelanoma skin cancers invading the bone are sporadic. There are little published data on clinical and survival outcomes in this group. Despite the nature of these skin lesions, a high degree of local control can be obtained by extensive surgical resection, outer table drill-down, and calvarial resection. We conclude that aggressive management of the bony invasion improves disease-free survival and improves local control.
MeSH term(s)	Aged ; Female ; Head and Neck Neoplasms/surgery ; Humans ; Male ; Retrospective Studies ; Scalp ; Skin Neoplasms/surgery ; Skull
Language	English
Publishing date	2021-08-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000002673
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Article ; Online: Delayed diagnosis of dermal leiomyosarcoma mimicking keloid scar.

Sleiwah, Aseel / Clinton, Aoibhinn / Herbert, Kevin

BMJ case reports

2018 Volume 2018

Abstract: A 43-year-old man developed an abnormal scar 6 months following excision of a leiomyoma from his left shoulder. The scar was elevated, irregular in shape, pink-red in colour, hard in consistency and it was extending beyond the margins of the original ... ...

Abstract	A 43-year-old man developed an abnormal scar 6 months following excision of a leiomyoma from his left shoulder. The scar was elevated, irregular in shape, pink-red in colour, hard in consistency and it was extending beyond the margins of the original wound. A diagnosis of a keloid scar was considered and the patient was managed as such. He underwent a planned procedure for intralesional excision of the keloid scar. The histopathological examination showed a diagnosis of leiomyosarcoma. This case report presents a delayed diagnosis of dermal leiomyosarcoma mimicking a keloid scar. The patient subsequently underwent wider excision of the tumour with curative intention.
MeSH term(s)	Adult ; Cicatrix/diagnosis ; Delayed Diagnosis ; Diagnosis, Differential ; Humans ; Keloid/diagnosis ; Leiomyoma/surgery ; Leiomyosarcoma/diagnosis ; Leiomyosarcoma/surgery ; Male ; Shoulder/surgery ; Skin Neoplasms/diagnosis ; Skin Neoplasms/surgery ; Surgical Wound/complications
Language	English
Publishing date	2018-01-26
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2017-222616
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Article ; Online: Perioral pressure ulcers in patients with COVID-19 requiring invasive mechanical ventilation

Sleiwah, Aseel / Nair, Ganeshkrishna / Mughal, Maleeha / Lancaster, Katie / Ahmad, Imran

European Journal of Plastic Surgery ; ISSN 0930-343X 1435-0130

2020

Keywords	Surgery ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
DOI	10.1007/s00238-020-01737-6
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Article ; Online: Euglycaemic ketoacidosis: a potential new hazard to plastic surgery day case and inpatient procedures.

Sleiwah, Aseel / McBride, Michael / Black, Claire E

BMJ case reports

2017 Volume 2017

Abstract: A woman aged 44 underwent elective standard abdominoplasty and bilateral mastopexy (superiorly based pedicle with vertical scar) following weight loss of 8.5 stone (53.9 kg) over a 5-year period. She had type 2 diabetes and her antidiabetic medications ... ...

Abstract	A woman aged 44 underwent elective standard abdominoplasty and bilateral mastopexy (superiorly based pedicle with vertical scar) following weight loss of 8.5 stone (53.9 kg) over a 5-year period. She had type 2 diabetes and her antidiabetic medications included metformin, liraglutide and empagliflozin. Towards the end of the first postoperative day, she reported gradual onset of nausea, vomiting and abdominal pain. Her condition continued to deteriorate overnight, becoming tachycardic and tachypnoeic. Urgent investigations showed severe diabetic ketoacidosis with euglycaemia. She was managed with fluid resuscitation, insulin infusion and intravenous sodium bicarbonate in the high dependency unit. She made a complete clinical and biochemical recovery and was discharged on day 9 postoperatively. This case illustrates a diagnostic challenge of a serious life-threatening complication of diabetes in the postoperative period associated with a novel class of antidiabetic medications, sodium-glucose cotransporter 2 inhibitors.
MeSH term(s)	Abdominoplasty/adverse effects ; Adult ; Diabetes Mellitus, Type 2 ; Diagnosis, Differential ; Female ; Humans ; Infusions, Intravenous ; Inpatients ; Insulin/administration & dosage ; Insulin/therapeutic use ; Ketosis/diagnosis ; Ketosis/drug therapy ; Postoperative Complications/diagnosis ; Sodium Bicarbonate/administration & dosage ; Sodium Bicarbonate/therapeutic use
Chemical Substances	Insulin ; Sodium Bicarbonate (8MDF5V39QO)
Language	English
Publishing date	2017-08-09
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2017-220253
Database	MEDical Literature Analysis and Retrieval System OnLINE

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