23 research outputs found
Lower energy and pulse stacking. a safer alternative for skin tightening using fractional co2 laser
To evaluate the effect of different energies and stacking in skin shrinkage. Three decreasing settings of a fractional CO2 laser were applied to the abdomen of Twenty five Wistar rats divided into three groups. Group I (n=5) was histologically evaluated for microthermal zones dimensions. Groups II and III (n=10 each) were macroscopic evaluated with freeware ImageJ for area contraction immediately and after 30 and 60 days. No statistical significance was found within microthermal zone histological dimensions (Group I) in all settings studied. (Ablation depth: 76.90 to 97.18µm; Coagulation depth: 186.01 to 219.84 µm). In Group II, macroscopic evaluation showed that all settings cause significant immediate skin contraction. The highest setting cause significant more intense tightening effect initially, contracting skin area from 258.65 to 179.09 mm2. The same pattern was observed in Group III. At 30 and 60 days, the lowest setting significantly sustained contraction. Lower fractional CO2 laser energies associated to pulse stacking could cause consistent and long lasting tissue contraction in rats.To evaluate the effect of different energies and stacking in skin shrinkage. Methods: Three decreasing settings of a fractional CO2 laser were applied to the abdomen of Twenty five Wistar rats divided into three groups. Group I (n=5) was histologically ev3112835sem informaçãosem informaçã
Review of 1,447 Breast Augmentation Patients Using PERTHESE Silicone Implants
Introduction A survey of surgeons in Brazil on their experience with PERTHESE silicone breast implants was performed. Materials and methods Surgeons that used PERTHESE implants between 2002 and 2008 were surveyed on the shape and volume of the implants used, surgical incision site, surgical plane of insertion, key postoperative complications, and surgeon and patient satisfaction. Results The survey had a response rate of 20%, with ten surgeons reporting data on 1447 patients. The majority of the implants used were 200-300 cc, round, and high profile. Preference for the traditional inframammary incision site (47% of patients) was favored over transaxillary (33%) and periareolar (19%), and both subglandular (55%) and submuscular (44%) planes of insertion were used. Over 97% of surgeons and patients were satisfied with the results and surgeons indicated that the implants were easy to use. Conclusions This review demonstrates that these implants are safe, maybe easier to introduce than other implants, and result in a high level of surgeon and patient satisfaction.341111
Thoraco-omphalopagus Asymmetric Conjoined Twins: Report Of A Case And Complete Review Of The Literature
Thoraco-omphalopagus asymmetric conjoined twinning is a rare condition in which a grossly defective foetus (the parasite) is attached to the thorax and upper abdomen of the main foetus (the autosite). We describe a case of thoraco-omphalopagus asymmetric conjoined twins in which the autosite had an associated large-diameter omphalocoele that was successfully separated at our institution. Reconstruction of the resulting abdominal-wall defect was performed using a flap from the gluteal region and the proximal portion of the inferior limb of the parasite, which is demonstrated. In addition, a review of all previously published cases is presented, showing that overall positive results can be obtained in treating this condition and that the presence and degree of cardiac involvement have a major influence on the prognosis. © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.671e18e21Edmonds, L.D., Layde, P.M., Conjoined twins in the United States, 1970-1977 (1982) Teratology, 25, pp. 301-308Martínez-Frías, M.L., Bermejo, E., Mendioroz, J., Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain (2009) J Pediatr Surg, 44, pp. 811-820Spencer, R., Parasitic conjoined twins: External, internal (fetuses in fetu and teratomas), and detached (acardiacs) (2001) Clin Anat, 14, pp. 428-444Sharma, G., Mobin, S.S., Lypka, M., Urata, M., Heteropagus (parasitic) twins: A review (2010) J Pediatr Surg, 45, pp. 2454-2463Chen, P.L., Choe, K.A., Prenatal MRI of heteropagus twins (2003) AJR Am J Roentgenol, 181, pp. 1676-1678Petit, T., Raynal, P., Ravasse, P., Herlicoviez, M., Delmas, P., Prenatal sonographic diagnosis of a twinning epigastric heteropagus (2001) Ultrasound Obstet Gynecol, 17, pp. 534-535Fujimori, K., Shiroto, T., Kuretake, S., Gunji, H., Sato, A., An omphalopagus parasitic twin after intracytoplasmic sperm injection (2004) Fertil Steril, 82, pp. 1430-1432Mackenzie, A.P., Stephenson, C.D., Funai, E.F., Lee, M.J., Timor-Tritsch, I., Three-dimensional ultrasound to differentiate epigastric heteropagus conjoined twins from a TRAP sequence (2004) Am J Obstet Gynecol, 191, pp. 1736-1739De Ugarte, D.A., Boechat, M.I., Shaw, W.W., Laks, H., Williams, H., Atkinson, J.B., Parasitic omphalopagus complicated by omphalocele and congenital heart disease (2002) J Pediatr Surg, 37, pp. 1357-1358Bhansali, M., Sharma, D.B., Raina, V.K., Epigastric heteropagus twins: 3 case reports with review of literature (2005) J Pediatr Surg, 40, pp. 1204-120
Successful Calvarial Bone Salvage Using Multiple Outer Table Perforation Technique On Total Scalp Avulsion Injury
For centuries, cranial outer table perforations were used to treat scalp avulsions that compromised the underlying periosteum. However, its use declined with the development of newer alternatives such as free-flap transpositions and scalp replantation. We report a case of extensive scalp avulsion with a large area of bone devoid of its periosteum. Outer calvarial plate perforations were drilled to promote granulation tissue growth. Skin grafts were used as a temporary coverage. The remaining scalp was then expanded, and the flaps obtained allowed a satisfactory coverage of the area of alopecia. The objective of this report is to bring this treatment method again into the set of possibilities to be considered when planning scalp reconstruction, as it is a feasible alternative and enables good results. © 2012 Springer-Verlag.3614953Mitchell, G.F., Total avulsion of the scalp: A new method of restoration (1933) Br Med J, 1, pp. 13-15. , 20777279 10.1136/bmj.1.3757.13 1:STN:280:DC%2BC3MzmtlGlug%3D%3DRobinson, F., Complete avulsion of the scalp (1952) Br J Plast Surg, 5, pp. 37-50. , 14944771 10.1016/S0007-1226(52)80005-0 1:STN:280:DyaG38%2FnsVyrsw%3D%3DYin, J.W., Matsuo, J.M., Hsieh, C.H., Yeh, M.C., Liao, W.C., Jeng, S.F., Replantation of total avulsed scalp with microsurgery: Experience of eight cases and literature review (2008) J Trauma, 64, pp. 796-802. , 18332826 10.1097/TA.0b013e3180341fdbDucic, Y., Reconstruction of the scalp (2009) Facial Plast Surg Clin N Am, 17, pp. 177-187. , 10.1016/j.fsc.2009.01.001Flaherty, F., Complete avulsion of the scalp: With a report of a case (1914) Ann Surg, 59, pp. 186-190. , 17863140 10.1097/00000658-191402000-00004 1:STN:280: DC%2BD2srkvVWrtA%3D%3DOsborne, M.P., Complete scalp avulsion: Rational treatmentReport of cases: Experimental basis for production of free, hair bearing grafts from avulsed scalp itself (1950) Ann Surg, 132, pp. 198-213. , 15433188 1:STN:280:DyaG3c%2Fkt1yhsg%3D%3DJeong, S.H., Koo, S.H., Han, S.K., Kim, W.K., An algorithmic approach for reconstruction of burn alopecia (2010) Ann Plast Surg, 65, pp. 330-337. , 20733370 10.1097/SAP.0b013e3181d2487a 1:CAS:528:DC%2BC3cXhtVGgtrzKNewman, M.I., Hanasono, M.M., Disa, J.J., Cordeiro, P.G., Mehrara, B.J., Scalp reconstruction: A 15-year experience (2004) Ann Plast Surg, 52, pp. 501-506. , 15096938 10.1097/01.sap.0000123346.58418.e6Simon, E., Sellal, S., Chassagne, J.F., Stricker, M., Duroure, F., Total, nonreplantable scalp avulsion: Utility of artificial dermis (2008) Eur J Plast Surg, 30, pp. 233-237. , 10.1007/s00238-007-0176-0Molnar, J.A., Defranzo, A.J., Marks, M.W., Single-stage approach to skin grafting the exposed skull (2000) Plast Reconstr Surg, 105, pp. 174-177. , 10626988 10.1097/00006534-200001000-00030 1:STN:280: DC%2BD3c%2FptVCitg%3D%3DTerzioǧlu, A., Aslan, G., Saydam, M., Trephination in the treatment of scalp avulsion: Successful application of a historical method (1999) J Oral Maxillofac Surg, 57, pp. 204-206. , 9973134 10.1016/S0278-2391(99)90242-2Furlanetti, L.L., De Oliveira, R.S., Santos, M.V., Farina Jr., J.A., MacHado, H.R., Multiple cranial burr holes as an alternative treatment for total scalp avulsion (2010) Childs Nerv Syst, 26, pp. 745-749. , 20390420 10.1007/s00381-010-1145-7Milcheski, D.A., Cheroto-Filho, A., Goldenberg, D., Farias, J.C., Ferreira, M.C., Reimplante microcirúrgico das avulsões de couro cabeludo - Experiência de 7 anos (2003) Rev Bras Cir Plast, 18, pp. 47-54Barry, R.B., Langtry, J.A., Lawrence, C.M., The role of cortical bone fenestration in the management of Mohs surgical scalp wounds devoid of periosteum (2009) Br J Dermatol, 160, pp. 1110-1112. , 19434794 10.1111/j.1365-2133.2009.09117.x 1:STN:280: DC%2BD1MzjvVaitw%3D%3DBecker, G.D., Adams, L.A., Levin, B.C., Secondary intention healing of exposed scalp and forehead bone after Mohs surgery (1999) Otolaryngol Head Neck Surg, 121, pp. 751-754. , 10580232 10.1053/hn.1999.v121.a98216 1:STN:280:DC%2BD3c%2FkvVSksg%3D%3
Occurrence Of Fat Embolism After Liposuction Surgery With Or Without Lipografting: An Experimental Study
Background: Liposuction in plastic surgery consists of the removal of excess fatty tissue in healthy individuals. In recent decades, this procedure has become more common worldwide. Associated with liposuction, lipografting has also been used for improving body contours, and has become known as liposculpture. Liposuction sometimes causes complications, including fat embolism, as described in the medical literature. The present study aims at ascertaining whether there is intravascular mobilization of fat after mechanical liposuction surgery and/or fat graft when carried out using one of the most common specific procedures used for liposuction, the superwet technique. Methods: A total of 30 Wistar rats were included in this study. Before the surgery, the animals were placed in the supine position and anesthetized with thiopental for 50 to 60 minutes, as it is generally performed in clinical practice. The animals were divided in the following 3 groups. Group A, consisting of 10 rats, served as controls, and were only anesthetized. Group B consisted of 10 rats, which underwent only liposuction. Group C also comprised 10 rats, which were liposuctioned and then lipografted in the dorsal region. Blood was collected just before and again, 48 hours after the procedure. After 48 hours, the animals were killed, and the lungs, kidneys, liver, and brain were histologically examined. Results: All the collected samples were analyzed microscopically with 2 different stains, namely, hematoxylin and eosin, and Sudan black. Fat particles were found in the lungs of 3 animals in group B (those that underwent only liposuction) and in 6 animals of group C (liposuction and lipografting). No fat particles were found in any organ of the control group. Conclusions: With this experiment, the authors showed that there is a risk of systemic mobilization of fat after liposuction surgery and that this risk is even higher when fat grafts are also carried out. Copyright © 2011 by Lippincott Williams & Wilkins.672101105(2009) Plastic Surgery Statistics, , www.plasticsurgery.org/Documents/Media/2006-Top-Five-Surgical-Cosmetic- Procedures.pdf, American Society of Plastic Surgeons. Available at(2006), www.cirurgiaplastica.org.br, Brazilian Society of Plastic Surgery-Institute DATAFOLHA Available atSouto, A.M., Freitas, L.F., Merheb, G.M., (2005) Book of Brazilian Society of Plastic Surgery, pp. 757-765. , In: Carreirão S, Cardin V, Goldenberg D. (SBCP) São Paulo, Brazil: AtheneuKenkel, J.M., Brown, S.A., Love, E.J., Waddle, J.P., Krueger, J.E., Noble, D., Robinson Jr., J.B., Rohrich, R.J., Hemodynamics, electrolytes, and organ histology of larger-volume liposuction in a porcine model (2004) Plastic and Reconstructive Surgery, 113 (5), pp. 1391-1399. , DOI 10.1097/01.PRS.0000112748.48243.62Ross, R.M., Johnson, G.W., Fat embolism after liposuction (1988) Chest., 93, pp. 1294-1295El-Ali, K.M., Gourlay, T., Assessment of the risk of systemic fat mobilization and fat embolism as a consequence of liposuction: Ex vivo study (2006) Plastic and Reconstructive Surgery, 117 (7), pp. 2269-2276. , DOI 10.1097/01.prs.0000218715.58016.71, PII 0000653420060600000026Grazer, F.M., De Jong, R.H., Fatal outcomes from liposuction: Census survey of cosmetic surgeons (2000) Plastic and Reconstructive Surgery, 105 (1), pp. 436-446Laub Jr., D.R., Laub, D.R., Fat embolism syndrome after liposuction: A case report and review of the literature (1990) Annals of Plastic Surgery, 25 (1), pp. 48-52. , DOI 10.1097/00000637-199007000-00011Costa, A.N., Mendes, D.M., Toufen, C., Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting (2008) J Bras Pneumol., 34, pp. 622-625Dillerud, E., Re: Fat embolism after liposuction (1991) Ann Plast Surg., 26, p. 293Senen, D., Atakul, D., Erten, G., Evaluation of the risk of systemic fat mobilization and fat embolus following liposuction with dry and tumescent technique: An experimental study on rats (2009) Aesthetic Plast Surg., 33, pp. 730-737Toledo, L.S., Syringe liposculpture: A two-year experience (1991) Aesthetic Plast Surg., 15, pp. 321-326Flecknell, P., Local and regional anaesthesia in laboratory animals (1996) Laboratory Animal Anaesthesia, pp. 69-70. , 2nd ed. London, UK: Academic PressWixson, S.K., Smiler, K.L., Anesthesia and analgesia in rodents (1997) Anesthesia and Analgesia in Laboratory Animals, pp. 165-203. , In: Kohn DF, ed. London, UK: Academic PressBallaux, P.K.E.W., Gourlay, T., Ratnatunga, C.P., Taylor, K.M., A literature review of cardiopulmonary bypass models for rats (1999) Perfusion, 14 (6), pp. 411-41
Seven-year institutional experience in the surgical treatment of orbito-zygomatic fractures
Introduction: Facial trauma is a common injury in the urban setting. Many studies have been published on the epidemiology of facial fractures, but few of them conducted in Brazil. The purpose of this study was to analyze the epidemiological characteristics of patients treated for orbito-zygomatic fractures at our institution. Methods: Retrospective analysis of 141 patients with orbito-zygomatic complex fractures who underwent surgical treatment between May 2001 and May 2008. Results: The population studied consisted mostly of males (86.5% of patients), with a male:female ratio of 6.4:1. A marked predominance of patients aged 21-30 years was observed (34.3%). Traffic-related causes were the most common, with motorcycle accidents as the most frequent aetiology (24.8% of patients), followed by car accidents (19.2%) and interpersonal violence (15.2%). Associated injuries accounted for 88 lesions in 65 patients, and their occurrence was statistically associated with traffic-related causes. All patients enrolled in the study were managed with operative treatment. The most utilized method for treatment was internal fixation with miniplates and screws (83.7% of the cases). The complication rate was 24.8%. Conclusion: Orbito-zygomatic fractures can cause significant morbidity and impairment in patients' quality of life. Despite recent improvements in legislation and educational campaigns, traffic remains the main cause of these injuries. More intensive efforts should be made in order to reduce its impact ill the aetiology of facial trauma. (C) 2010 European Association for Cranio-Maxillo-Facial Surgery.39859359
Occurrence of Fat Embolism After Liposuction Surgery With or Without Lipografting An Experimental Study
Background: Liposuction in plastic surgery consists of the removal of excess fatty tissue in healthy individuals. In recent decades, this procedure has become more common worldwide. Associated with liposuction, lipografting has also been used for improving body contours, and has become known as liposculpture. Liposuction sometimes causes complications, including fat embolism, as described in the medical literature. The present study aims at ascertaining whether there is intravascular mobilization of fat after mechanical liposuction surgery and/or fat graft when carried out using one of the most common specific procedures used for liposuction, the superwet technique. Methods: A total of 30 Wistar rats were included in this study. Before the surgery, the animals were placed in the supine position and anesthetized with thiopental for 50 to 60 minutes, as it is generally performed in clinical practice. The animals were divided in the following 3 groups. Group A, consisting of 10 rats, served as controls, and were only anesthetized. Group B consisted of 10 rats, which underwent only liposuction. Group C also comprised 10 rats, which were liposuctioned and then lipografted in the dorsal region. Blood was collected just before and again, 48 hours after the procedure. After 48 hours, the animals were killed, and the lungs, kidneys, liver, and brain were histologically examined. Results: All the collected samples were analyzed microscopically with 2 different stains, namely, hematoxylin and eosin, and Sudan black. Fat particles were found in the lungs of 3 animals in group B (those that underwent only liposuction) and in 6 animals of group C (liposuction and lipografting). No fat particles were found in any organ of the control group. Conclusions: With this experiment, the authors showed that there is a risk of systemic mobilization of fat after liposuction surgery and that this risk is even higher when fat grafts are also carried out.67210110
Surgical Management Of Phenotypic Alterations Related To The Dunnigan Variety Of Familial Partial Lipodystrophy
[No abstract available]64912481250Hegele, R.A., Joy, T.R., Al-Attar, S.A., Rutt, B.K., Lipodystrophies: Windows on adipose biology and metabolism (2007) J Lipid Res, 48, pp. 1433-1444Garg, A., Acquired and Inherited Lipodystrophies (2004) New England Journal of Medicine, 350 (12), pp. 1220-1234. , DOI 10.1056/NEJMra025261Garg, A., Peshock, R.M., Fleckenstein, J.L., Adipose tissue distribution pattern in patients with familial partial lipodystrophy (Dunnigan variety) (1999) Journal of Clinical Endocrinology and Metabolism, 84 (1), pp. 170-174. , DOI 10.1210/jc.84.1.170Jackson, S.N.J., Howlett, T.A., Mcnally, P.G., O'Rahilly, S., Trembath, R.C., Dunnigan-Kobberling syndrome: An autosomal dominant form of partial lipodystrophy (1997) QJM - Monthly Journal of the Association of Physicians, 90 (1), pp. 27-36Keller, J., Subramanyam, L., Simha, V., Gustofson, R., Minjarez, D., Garg, A., Lipodystrophy: An unusual diagnosis in a case of oligomenorrhea and hirsutism (2009) Obstet Gynecol, 114, pp. 427-43
Mesenchymal stromal cells from adipose tissue attached to suture material enhance the closure of enterocutaneous fistulas in a rat model
Surgical treatment for enterocutaneous fistulas (EF) frequently fails. Cell therapy may represent a new approach to treatment. Mesenchymal stromal cells (MSCs) have high proliferative and differentiation capacity. This study aimed to investigate whether M161217091719sem informaçãosem informaçã
Paired Evaluation Of Calvarial Reconstruction With Prototyped Titanium Implants With And Without Ceramic Coating
PURPOSE: To investigate the osseointegration properties of prototyped implants with tridimensionally interconnected pores made of the Ti6Al4V alloy and the influence of a thin calcium phosphate coating.METHODS: Bilateral critical size calvarial defects were created in thirty Wistar rats and filled with coated and uncoated implants in a randomized fashion. The animals were kept for 15, 45 and 90 days. Implant mechanical integration was evaluated with a push-out test. Bone-implant interface was analyzed using scanning electron microscopy.RESULTS: The maximum force to produce initial displacement of the implants increased during the study period, reaching values around 100N for both types of implants. Intimate contact between bone and implant was present, with progressive bone growth into the pores. No significant differences were seen between coated and uncoated implants.CONCLUSION: Adequate osseointegration can be achieved in calvarial reconstructions using prototyped Ti6Al4V Implants with the described characteristics of surface and porosity.299579587Sanan, A., Haines, S.J., Repairing holes in the head: A history of cranioplasty (1997) Neurosurgery, 40 (3), pp. 588-603. , Mar, PMID: 9055300Bandyopadhyay, A., Espana, F., Balla, V.K., Bose, S., Ohgami, Y., Davies, N.M., Influence of porosity on mechanical properties and in vivo response of Ti6Al4V implants (2010) Acta Biomater, 6 (4), pp. 1640-1648. , MayVehof, J.W.M., Haus, M.T.U., De Ruijter, A.E., Spauwen, P.H.M., Jansen, J.A., Bone formation in transforming growth factor beta-I-loaded titanium fiber mesh implants (2002) Clin Oral Implants Res, 13 (1), pp. 94-102. , MarPonader, S., Von Wilmowsky, C., Widenmayer, M., Lutz, R., Heinl, P., Körner, C., Singer, R.F., Schlegel, K.A., In vivo performance of selective electron beam-melted Ti-6Al-4V structures (2010) J Biomed Mater Res A, 92 (1), pp. 56-62. , JanWarnke, P.H., Douglas, T., Wollny, P., Sherry, E., Steiner, M., Galonska, S., Becker, S.T., Sivananthan, S., Rapid prototyping: Porous titanium alloy scaffolds produced by selective laser melting for bone tissue engineering (2009) Tissue Eng Part C Methods, 15 (2), pp. 115-124. , JulNeovius, E., Engstrand, T., Craniofacial reconstruction with bone and biomaterials: Review over the last 11 years (2010) J Plast Reconstr Aesthet Surg, 63 (10), pp. 1615-1623. , OctCabraja, M., Klein, M., Lehmann, T.-N., Long-term results following titanium cranioplasty of large skull defects (2009) Neurosurg Focus, 26 (6), p. 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