the use of poly lactic acid to improve projection of reconstructed nipple

Abstract Purpose Nipple-areola reconstruction represents an important step for final mammary reconstruction. Many techniques have been described. The drawback is the progressive nipple projection loss with time from 50% to over 70% of the initial projection. In this report, we evaluated the effect of injectable poly-lactic acid (PLLA) to improve projection of reconstructed nipples. Results We selected 12 patients with a residual nipple projection between 0.1 and 2 mm. The patients were injected locally inside the nipple with 0.5 ml of PLLA (dilution 1:4) every 4 weeks for 4 times. At the study end, patients were satisfied with results. No adverse effects were observed. After one year, an increase of nipple projection ranging from 0.5 to 3.5 mm was obtained with an average increase of 2.3 mm (282%) and this variation was statistically significant ( p Conclusion The use of injectable PLLA is a simple and effective procedure to improve projection of reconstructed nipple

Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion

Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion

Studio clinico caso-controllo sul trattamento di cicatrici post-chirurgiche con Activ Skin C e Activ Skin K

Materiali e metodi. Vengono di seguito presentati i risultati di uno studio preliminare, condotto su 30 pazienti (18 femmine e 12 maschi), volto a valutare l’efficacia di due prodotti ad uso topico, una crema (Activ skin C) ed un gel (Activ skin K), per il miglioramento delle cicatrici postchirugiche e la prevenzione delle cicatrici patologiche. I pazienti selezionati possedevano 2 cicatrici chirurgiche, simili per sede e qualità del tessuto cutaneo di riferimento. Delle due cicatrici, una sola è stata trattata con i prodotti in studio mentre l’altra è stata utilizzata come controllo e non trattata con alcun prodotto topico. Il trattamento è iniziato 3 giorni dopo la rimozione dei punti di sutura ed ha visto alternarsi i due prodotti topici: la crema nei primi 15 giorni ed il gel nei successivi 30, con controlli a 0, 15, 30, 45 giorni e 3 mesi, in cui sono state effettuate valutazioni cliniche e documentazione fotografica delle sedi interessate. Risultati. Alla fine dello studio la quasi totalità dei pazienti mostrava un sensibile miglioramento della cicatrice trattata rispetto al controllo. Discussione. L’utilizzo dei prodotti topici in studio ha migliorato in modo significativo il processo di riepitelizzazione e maturazione della cicatrice chirurgica. È quindi possibile affermare che essi sono un valido supporto, nella fase post-chirurgica, per migliorare il processo di cicatrizzazione e nel prevenire la formazione di cicatrici patologiche

Extracorporeal Shock Wave Therapy for Management of Chronic Ulcers in the Lower Extremities. Ultrasound Med Biol. 2008 Apr 2;

Management of chronic ulcers in the lower extremities is still a challenge for patients and health providers. Recent studies showed extracorporeal shock waves (ESW) as effective in stimulating growth factors, inducing angiogenesis and healing of fractures and injuries. This study was planned to investigate the opportunity of introducing the ESW in the treatment of chronic wounds. Thirty consecutive patients with chronic posttraumatic, venous and diabetic ulcers, unresponsive to conservative or advanced dressing treatments, were counseled about the use of ESW as alternative treatment for their wounds. Thirty-two wounds were treated and 16 wounds healed completely within six sessions of ESW. In all of the nonhealed wounds, decrease of the amount of exudates, increased percentage of granulation tissue compared with fibrin/necrotic tissue and decrease of wounds' size were statistically significant after four to six sessions of ESW (p < 0.01). Significant decrease of pain was reported (p < 0.001). Comparison with a control group of 10 patients with chronic ulcer treated on the basis of regular dressings confirmed the statistical significant improvement in the healing process (p < 0.01). ESW therapy seems to be a safe, feasible and cost-effective treatment for chronic ulcers in the lower extremities. Further research and clinical trials are necessary to evaluate dose and time intervals of sessions to standardize a protocol of treatment in the management of chronic wounds

The Outcome of Primary Subglandular Breast Augmentation Using Tumescent Local Anesthesia.

BACKGROUND: Tumescent local anesthesia (TLA) technique to obtain regional anesthesia and vasoconstriction of the skin and subcutaneous tissues is routinely adopted for several plastic surgery procedures. Here, we describe the use of TLA in primary subglandular breast augmentation. This series evaluates advantages and disadvantages of TLA in elective augmentation breast surgery as well as patients' response to this procedure. METHODS: Between December 2008 and November 2011, 150 patients underwent bilateral primary subglandular breast augmentation under TLA and conscious sedation in the presence of a board-certified anesthesiologist. Midazolam 0.05 mg/kg IV and ranitidine 100 mg IV were given as premedication. Tumescent local anesthesia was composed of 25 mL of lidocaine 2%, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) in 1000 mL of 0.9% NS. The solution was delivered between the pectoral fascia and the mammary gland via a spinal needle. After infiltration, 45 minutes were allowed before surgery for local anesthetic effects to take place. RESULTS: The mean age of the patients was 34.3 years. The average amount of tumescent solution infiltrated was 1150 mL, with a maximal dose of 17 mg/kg of lidocaine used. Operating time was 45 minutes and recovery room time averaged 125 minutes. Minor complications were found in a total of 9 (5.3%) patients, with no main surgery-related complications such as hematoma or seroma formation. CONCLUSIONS: Breast augmentation under TLA and conscious sedation proved to be safe in the presence of a board-certified anesthesiologist and when performed with meticulous surgical technique