Liposuction Assisted Abdominoplasty:An Enhanced Abdominoplasty Technique

Background: Combining liposuction with abdominoplasties was considered risky during the 1980s and 1990s due to reports of increased complications rates and the belief that liposuction posed a danger to flap circulation. However, the corresponding author's intraoperative observations at that time, that liposuction preserved all but the smallest blood vessels, negated the prevailing opinions that liposuction increased the risk to flap circulation, and in October 1996, liposuction assisted abdominoplasty (LAA) was first performed. Thereafter, LAA was honed to become a lipoabdominoplasty techniquenot merely a combination of liposuction and abdominoplasty, a technique that utilizes liposuction as a dissection toolhydro- and lipo-dissection, to dissect free and separate the abdominal flap from the deep fascia. Enhanced flap excursion could be demonstrated intraoperatively by selectively transecting the skin retaining ligaments and limiting liposuction to the flap's undersurface, created a vascular lining layer rich in anastomosing blood vessels that provided a rich blood supply to the flap, enabling increased flap excursion. Methods: Five ninety-three consecutive ambulatory LAAs with circumferential torso liposuction and other area liposuction are presented and the surgical technique is illustrated and discussed. Results: There were no serious adverse events, anesthesia complications, hospital transfers, no venous thromboembolism or postoperative respiratory complications in the 593 cases. Patient satisfaction was high, and the results compared favorably with abdominoplasty results published in the scientific literature. Conclusions: LAA is a safe and effective abdominoplasty technique. Extensive clinical experience with LAA suggests longer flap excursion and improved perfusion. It routinely incorporates circumferential torso and other areas liposuction and has commonly included buttock fat grafting

Humanitarian Action and Military Intervention: Temptations and Possibilities.

Although the war in Liberia in July 2003 claimed hundreds of lives, the international community was reluctant to intervene. In this article, the author debates the question: does international military intervention equal protection of populations? The role of humanitarian organisations in military intervention is considered. Aid organisations cannot call for deployment of a protection force without renouncing their autonomy or appealing to references outside their own practices. Such organisations provide victims with vital assistance and contribute to ensuring that their fate becomes a stake in political debate by exposing the violence that engulfs them, without substituting their own voices for those of the victims. The political content of humanitarian action is also outlined and military intervention in the context of genocide is discussed. The author concludes that the latter is one of the rare situations in which humanitarian actors can consider calling for an armed intervention without renouncing their own logic

Carbon monoxide binding to iron porphyrins

The carbon monoxide affinities of iron complexes of meso-tetra (α,α,α,α-o-pivalamidophenyl)porphyrin (the "picket fence" porphyrin) and of a "picket fence" porphyrin derivative with an appended axial base have been measured in solution and compared with the CO affinities of various hemoproteins. The model complexes bind CO with much greater affinity than normal hemoproteins; the role of the steric bulk of distal residues in lowering the CO affinities of the hemoproteins is discussed. The significance of this lowered CO affinity is described with regard to endogenous CO. A discussion of mutant hemoglobins lacking distal residues that sterically inhibit the binding of CO is presented. The use of pressure units versus concentration units in equilibrium expressions is analyzed

Letting it go: a transformative session of massage therapy

This personal essay the role of skilled touch, in this case massage therapy, in healing from loss