1,720,971 research outputs found
Body contouring following bariatric surgery and massive weight loss: Post-Bariatric body contouring
No full textMorbid obesity is a chronic condition that is extremely difficult to treat. Unfortunately it is growing at an alarming rate in all age groups and is becoming a real epidemic in Europe and North America. Bariatric surgery is becoming the current standard treatment for severe obesity and its overall safety and effectiveness continues to improve. Even though success of bariatric surgery can be expressed by net reduction of BMI (Body Mass Index) global patient satisfaction does not usually exceed 6.2 on a visual analogue scale (VAS) of 10. Hand in hand with massive weight loss obtained with bariatric procedures comes the need to effectively and aesthetically manage the excess skin that remains as more patients are at present seeking the help of plastic surgeons to address the resulting aesthetic concerns. © 2013 Bentham Science Publishers. All Rights Reserved
Post-bariatric body contouring surgery and patient safety
No full textMassive Weight Loss (MWL) patients differ from other patients in several parameters. They are at an increased risk for complications secondary to potential nutritional deficiencies, persistent obesity, venous varicosities, poor quality and inelastic tissue. As the numbers of patients who seek body contouring after extreme weight loss increase, surgeons must be able to inform patients of the risks and complications of body-contouring surgery as they relate to the specific co-morbidities of the particular patient. Likewise, surgeons will need to alter the aggressiveness of the procedure according to the risk versus benefit in patients who fall into higher-risk groups. The foundation for a safe body contouring practice involves a combination of good patient selection and managing patient expectations. Appropriate pre-operative assessment intra- and post-operative care as well as selection of the appropriate timing, type, and magnitude of surgery are all essential. © 2012 Bentham Science Publishers. All rights reserved
Back contouring after massive weight loss
No full textManagement of excessive laxity of the abdomen, breasts, arms, thighs and buttocks following massive weight loss has received much attention, however little has been written about the surgical approach to the back rolls and folds. Back rolls can range in a number from one to four on either sides of the midline. In post-bariatric patients, the excess tissue must be excised. Liposuction is rarely indicated because the skin and subcutaneous tissue remains in excess in these patients. In addition, back tissue is dense and fibrous, making it less amenable to liposuction. Post-bariatric contouring of back-roll deformities requires an approach that allows for direct excision of the two lower folds (lower thoracic and hip rolls) during the circumferential lower body lift procedure and of the two upper folds. © 2012 Bentham Science Publishers. All rights reserved
Cultured epithelial autograft (CEA) in burn treatment: Three decades later
No full textMethods for handling burn wounds have changed in recent decades and increasingly aggressive surgical approach with early tangential excision and wound closure is being applied. Split-thickness skin (STSG) autografts are the gold standard for burn wound closure and remain the mainstay of treatment to provide permanent wound coverage and achieve healing. In some massively burned patients, however, the burns are so extensive that donor site availability is limited. Fortunately, considerable progress has been made in the culture of human keratinocytes and it is now possible to obtain large amounts of cultured epithelium from a small skin biopsy within 3-4 weeks. Questions related to optimal cell type for culture, culture techniques, transplantation of confluent sheets or non-confluent cells, immediate and late final take, carrier and transfer modality, as well as final outcome, ability to generate an epithelium after transplantation, and scar quality are still not fully answered. Progress accomplished since Reinwald and Green first described their keratinocyte culture technique is reviewed. © 2006 Elsevier Ltd and ISBI.Atiyeh BS, 2005, BURNS, V31, P944, DOI 10.1016-j.burns.2005.08.023; Barlow Y, 1992, J TISSUE VIABILITY, V2, P33; BARRANDON Y, 1985, P NATL ACAD SCI USA, V82, P5390, DOI 10.1073-pnas.82.16.5390; Barret JP, 2003, PLAST RECONSTR SURG, V111, P744, DOI 10.1097-01.PRS.0000041445.76730.23; BELL E, 1979, P NATL ACAD SCI USA, V76, P1274, DOI 10.1073-pnas.76.3.1274; BOYCE ST, 1995, ANN SURG, V222, P743, DOI 10.1097-00000658-199512000-00008; BUTLER CE, 2003, ADV FREE TRANSFER TI, V17, P107; Carsin H, 2000, BURNS, V26, P379, DOI 10.1016-S0305-4179(99)00143-6; Chalumeau M, 1999, J PEDIATR SURG, V34, P602, DOI 10.1016-S0022-3468(99)90083-0; Chester AL, 2004, J BURN CARE REHABIL, V25, P266, DOI 10.1097-01.BCR.0000124749.85552.CD; COMPTON CC, 1989, LAB INVEST, V60, P600; Coruh A, 2005, J BURN CARE REHABIL, V26, P471, DOI 10.1087-01.br.0000185114.59640.b4; COULOMB B, 1989, J INVEST DERMATOL, V92, P122, DOI 10.1111-1523-1747.ep13071335; 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Pressure sores with associated spasticity: A clinical challenge
No full textParaplegic and quadriplegic patients particularly those suffering from spinal cord injuries are at a high risk of developing pressure ulcrations. Unlike pressure ulcers in geriatric patients, which usually can be controlled with pressure relieving devices and local wound care, pressure ulceration complicating spinal cord injuries should be viewed from another perspective. Clinical management is also more complex because of the associated spasticity. Although it is now recognised that spasticity control is critical for management of patients with cerebral or spinal cord diseases or injuries, published risk assessment studies and risk assessment pressure sore scales fail to recognise spacticity as a major risk factor. Identification of spasticity should heighten the awareness of medical and paramedical personnel and have a positive impact on prevention as well as on treatment of pressure sores in this particularly difficult group of patients. We present our experience with a young quadriplegic patient with severe spasticity presenting with a large infected ischial pressure sore. All surgical as well as conservative attempts to achieve healing failed because of our failure to recognise the importance of spasticity control in the overall treatment scheme. Spasticity control should be included as a prerequisite for any treatment protocol of such patients. © Blackwell Publishing Ltd and Medicalhelplines.com Inc 2005.
Thigh lift
No full textThigh lifting for excess soft tissue and skin laxity became an essential part of the lower body contouring after massive weight loss. Since early 1950's, thigh deformity and different techniques of thigh lift have been addressed. In this chapter, we address and review the anatomical considerations of the different procedures of medial thigh lift and lateral thigh lift as well as the combined techniques. © 2012 Bentham Science Publishers. All rights reserved
THE SAFETY AND EFFICACY OF DRESSINGS WITH SILVER – ADDRESSING CLINICAL CONCERNS
No full text[No abstract available]
Nipple or areolar reduction with simultaneous breast augmentation [8] (multiple letters)
No full text[No abstract available]10
An innovative procedure for the treatment of primary and recurrent capsular contracture (CC) following breast augmentation
No full textBackground: Capsular contracture (CC) is the most frequently reported complication following alloplastic breast augmentation. At present, none of the available preventive measures are effective, and various treatment modalities have been advocated. Reduction of the inflammatory process is critical for successful treatment. Late intracapsular glucocorticosteroid (GC) injections have been somewhat effective for the treatment, but the fine balance between the effectiveness of therapeutic GC dosages and their potential serious side effects is of utmost importance. Objectives: The authors investigate whether instillation of a rapid-acting water-soluble GC in the implant pocket during the early proliferative phase of wound healing is more effective than delayed instillation during the remodeling phase. Methods: Between 2003 and 2009, 33 consecutive patients presenting with CC (Baker grades III and IV) were managed by capsulectomy with implant replacement and corticosteroid therapy immediately as well as 2 to 3 days later through an indwelling catheter left in place for that period. This delayed but early administration is a novel technique for GC injection. Results: Complete correction of the contracture with no recurrence was achieved in all patients with a follow-up range of 2 to 10 years. Conclusions: This GC administration technique avoids the potential complications of long-term, slow corticosteroid release. 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