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Background: Post-burn facial hyperpigmentation is a common consequence of burn injuries, especially in dark skin types, frequently results in severe psychological suffering. Despite the abundance of treatment modalities, most of the outcomes are disappointing and unsatisfactory. We aimed to investigate the therapeutic effect of ablative fractional CO2 laser-assisted delivery of tranexamic acid (TXA) for the treatment of facial post-burn hyperpigmentation. Methods: From January 2021 to January 2023, 30 patients (22 male, 8 female) at a mean age of 26.45 years, skin types (18 type III, 12 type IV), with facial post-burn hyperpigmentation were included in this prospective study. The patients received (4–8) twice-weekly laser sessions with topical TXA. At baseline and 1 month after the final treatment session, clinical evaluation using Investigator's Global Assessment (IGA) six-point scale and biopsy specimens from hyperpigmented areas were stained with Masson fontana (MF) stain and immunostaining procedures for melanin and monoclonal mouse anti-melanoma antigen recognized by T cells-1 (MART-1). The possible adverse effects and patients' satisfaction were recorded. Results: One month after the final treatment session, IGA score was significantly reduced (P < 0.001). Histopathologically, evident reduction of melanin density and significant decrease in the number of MART-1-positive cells (P <.001) were observed. None of our cases experienced serious adverse events, apart from mild and transient degrees of erythema, burning, and edema. After a mean follow-up period of 7.1 months, 26 patients (86.7%) were satisfied with the cosmetic results of the treatment. Conclusions: Laser-assisted delivery of tranexamic acid is safe, well-tolerated, and effective treatment strategy for facial post-burn hyperpigmentation especially in patients with skin of color. Level of evidence: Level IV, therapeutic study [ABSTRACT FROM AUTHOR]

Background: Fracture acetabulum is a challenging, difficult to treat orthopedic injury due to its location and associated concomitant injuries. The modified Stoppa approach for reduction of fracture acetabulum improves access to quadrilateral surface and posterior column and is considered to be advantageous in many facets of the surgery. Methods: A randomized controlled clinical study was conducted to provide an update on our experience with modified Stoppa as a favorable surgical approach in acetabular fractures. In the period between 2015 and 2017; 18 patients with acetabular fractures operated by the classical ilioinguinal approach were retrospectively reviewed through their medical records as a controlled group and selected 20 patients with acetabular fractures were operated in the period between 2017 and 2019 using the modified Stoppa approach, as a clinical case group. The two groups were compared regarding operative data and postoperative clinical data, complications, and follow up. Cases were operated in Al Zahraa University Hospital and Nasr City Insurance Hospital by the same surgeon and one of the co-authors. Results: (Group A) those operated by ilioinguinal approach and (Group B) those operated using Stoppa approach. The whole study included 25 males (66%); mean age was 41.8 ± 8.42 (range 18-65) years. The mean follow-up period was 18.5 months with 5 patients lost to follow-up. Both column fractures were observed in most of the patients (45%). We observed anatomical reduction, excellent clinical outcome scores in 75% of patients of group B (p = 0.030), and less complications. Conclusion: Our findings indicated that the modified Stoppa approach is the most convenient approach when surgery is required and achieved favorable results in the treatment of anterior acetabular fractures because it improves visualization in lateral compression injuries and allows treatment of both column fractures with single incision. Hence, it is recommended as an alternative to ilioinguinal approach in developing countries. Further, larger-scale comparative studies of the two surgical modalities for different acetabular fracture types and long-term complications are recommended. Trial registration: A retrospective registration is proceeding through Clinicaltrials.gov. Level of evidence: Level III, therapeutic clinical study [ABSTRACT FROM AUTHOR]