A clinical retrospective study comparing two short-scar face lifts: Minimal access cranial suspension versus lateral SMASectomy

BACKGROUND: The purpose of this study was to retrospectively compare the short- and long-term cosmetic outcomes of two minimal incision rhytidectomies and analyze their advantages and disadvantages. METHODS: The results of minimal access cranial suspension face lift versus minimal incision rhytidectomy with lateral SMASectomy were evaluated after 1 and 24 months. Statistical analysis considered surgeon/patient satisfaction, time used in the procedures, pain, and learning curves. Photographs were sent to the patients and two plastic surgeons, unfamiliar with the cases, for evaluation of results that were assessed by an objective grading system described by Strasser. RESULTS: Eighty-two patients completed 1 and 24 months' follow-up. Complications were two hematomas, two retroauricular-lobule dog-ears, and one hypertrophic preauricular scar. Surgical time was longer for the SMASectomy. Postoperative pain was worse for minimal access cranial suspension face lift. There were no difference

Ultra HD Liposuction: Enhancing abdominal etching using Ultrasound-Guided Rectus Abdominis Fat Transfer (UGRAFT)

Background: High-definition (HD) liposuction has allowed surgeons to sculpt the abdomen, enhancing abdominal etching. To create a more athletic abdomen, fat grafting has been used subcutaneously, and rectus abdominis fat grafting has been performed in patients undergoing lipoabdominoplasty. With the objective of increasing muscle volume to obtain a natural-looking abdomen in patients who are not suitable for abdominoplasty, we propose the use of ultrasound-guided rectus abdominis fat grafting (UGRAFT) in association with HD liposuction. Patients: A prospective study with 10 consecutive patients undergoing UGRAFT was conducted. After HD liposuction, UGRAFT was performed from an incision in the umbilical region, using a blunt 2.5-mm cannula assisted by ultrasound. Fat injection was done closer to the anterior rectus sheath in the lower and middle muscle bellies. Results: UGRAFT was performed in 10 patients. The mean age was 34.8 years (range, 24-51 years). The mean body mass index was 23.83 kg/m(2)(range, 20.58-28.39 kg/m(2)). The mean volume of fat injected per "pack" was 34 cm(3)(range, 20-40 cm(3)). UGRAFT added a mean time of 20 minutes (range, 15-30 minutes) to HD liposuction. Comparing the rectus abdominis muscle thickness pre-UGRAFT and post-UGRAFT, average muscle thickness increase was 5.1 mm (55.7% +/- 37%), withP< 0.0001. Conclusion: UGRAFT showed to be helpful for obtaining muscle expansion and a more natural abdominal contour, avoiding that unnatural appearance that HD liposuction may provide in patients who gain weight or have skin laxity

Characterization of the orbital volume in normal population

Introduction: The aim of the study was to describe the normal orbital volume and its most important relationships with other clinical variables. Methods: We designed a correlation study and consecutive normal CTs scans were included. Orbital volume and facial anthropometrics were measured and correlated between them. Two independent and blind observers made all the measurements. Uni and multivariate statistical analysis were performed in order to create a predicting model for orbital volume. Results: A total of 199 consecutive patients were included in the study (398 orbits). The mean Orbital Volume (OV) was 24.5 ± 3.08 cc. Adequate intra and interobserver reliability was observed. There were no differences between the right and left orbit (p¼0.73). The male average OV was 24.9 ± 3.03 cc, the female OV was 23.9 ± 3.08 cc. Age group analysis demonstrated a slow increase in OV beyond thirty years, but these differences were not significant (p¼0.98). Only the age, total facial height, facial width and the interorbital distance were significant and were included in the predictive model of OV. Conclusion: We have characterized the normal orbital volume,variations and associations. In order to further advance in the understanding of the clinical implications the abnormal orbital volume must be fully studied.AO foundatio

Postoperative pain in suction assited lipoplasty versus laser lipolisis. Comparative prospective study Comparación del dolor secundario a lipoaspiración tradicional versus lipolisis láser. Estudio prospectivo

The traditional suction-assisted lipoplasty, is a well established and commonly performed technique used for the treatment of lipodystrophias, which has undergone improvements with advances in anesthetics, pharmacology and introduction of new instruments. New techniques have appeared, promising advantages in recovery periods, symptomathology and aesthetic results when compared to the traditional suction- assisted lipoplasty. One of these newly introduced techniques is the laser-assisted lipoplasty (laserlipolysis), which claims less pain, less bruising and faster postoperative recovery. No evidence has been published to support these advantages when comparing laser-assisted lipoplasty to the traditional method, specifically when refering to pain, an important symptom to be taken into consideration in the postoperative period. For this reason we designed a prospective, randomized clinical study comprising 60 patients to which the two techniques were applied to different body areas. Pai

Frequency and use of pain assessment tools implemented in randomized controlled trials in the adult burns population: A systematic review

Introduction: Pain continues to be an ongoing issue of concern in adult burn patients. Inadequate pain assessment hinders meaningful research, and prevents the optimal management of burn pain. The objective of this study was to examine the content of existing research in burn pain with the frequency and context of pain assessment tool use in randomized clinical trials in order to further inform their use for future researchers and clinicians. Methods: Electronic searches of MEDLINE, CINAHL, EMBASE and The Cochrane Library databases from 1966 onwards were used to identify English articles related to clinical trials utilising pain assessment in adult burns patients. Results: The systematic literature search identified 25 randomized clinical trials utilising pain assessment tools. Unidimensional pain assessment tools were most frequently used pain assessment tools, with multidimensional tools used less often, despite the multifaceted and complex nature of burn pain. Conclusion: The review highlights the lack of consistency of pain assessment tool use in randomized clinical trials with respect to managing burn pain. We recommend a broader but consistent use of multidimensional pain assessment tools for researchers undertaking clinical trials in this field. The review supports the need for an international expert consensus to identify the necessary critical outcomes and domains for clinicians and researchers undertaking further research into burn pain

The accuracy of different methods for diagnosing septal deviation in patients undergoing septorhinoplasty: A prospective study

Objective: This study aimed to determine the diagnostic accuracy of different diagnostic tests in predicting nasal septum deformities during preoperative planning for septorhinoplasty. Methods: Consecutive patients who underwent septorhinoplasty between June 2011 and August 2012 were included (n = 30) and underwent a protocol of diagnostic tests, including nasal speculoscopy, craniofacial computed tomography (CT), three-dimensional (3D) reconstruction of the nasal septum by CT and nasal endoscopy. A modified Guyuron classification of septal deformities was used for classifying the septal deviations. Direct surgical assessment of the nasal septum during open septorhinoplasty was the reference standard with which each of the diagnostic tests was compared. Sensitivity, specificity and predictive values of each test were calculated. Results: The preoperative diagnosis was nasal bone fracture in 11 patients, nasal septal fracture in 15 and post-traumatic nasal deformity in four. For type A deviations (localised), craniofacial CT showed the highest performance with a sensitivity of 100%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 99%. For type B septal deformations (C shape), nasal endoscopy (sensitivity, 100%; specificity, 87.5%; PPV, 87.7%; and NPV, 100%) showed the highest performance. For type C deformities (S shape), nasal endoscopy (sensitivity, 70%; specificity, 100%; PPV, 100%; and NPV, 87%) showed the highest performance. The accuracy for nasal endoscopy was 27/30 (90%), 26/30 (87%) for craniofacial CT, 22/30 (73%) for 3D reconstruction and 10/28 (36%) for speculoscopy. Conclusions: Nasal endoscopy and craniofacial CT were more accurate and precise than nasal speculoscopy and 3D reconstruction for preoperative evaluation of the nasal septum, thus enabling more appropriate surgical planning for septorhinoplasty. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved

Work-related traumatic spinal cord lesions in Chile, a 20-year epidemiological analysis

Study design:Retrospective cohort study.Objective:To describe the characteristics of patients with work-related traumatic spinal cord injuries (TSCI) in Chile.Setting:Hospital del Trabajador in Santiago, Santiago, Chile.Methods:Patients suffering from TSCI incurred at the workplace from 1986 to 2005 were identified through records of the Asociación Chilena de Seguridad (ACHS, Chilean Safety Association).Results:The medical records of 173 patients, 172 men and 1 woman, were analyzed. The yearly average incidence was 7.8 per million workers. Age at TSCI onset was 38.212.1 years. The principal external causes for TSCI incurred at the workplace were falls from a height in 86 cases (49.7%) and trauma blows to the vertebral spine in 61 cases (35.3 %). More falls occurred in the field construction, and other traumas occurred as a result of traumatic blows caused by tree trunks and stones in forestry and mining sectors. Mortality in this series was 8.7%, and the worst prognosis was for older

Acute compartment syndrome as a complication of cutaneous loxoscelism mainly edematous

El síndrome compartimental agudo (SCA) es el aumento de la presión en un espacio osteofascial cerrado. Esto reduce la presión capilar bajo el nivel necesario para la viabilidad de los tejidos del compartimento. El SCA de mano como complicación de un loxoscelismo cutáneo (LC) de predominio edematoso es muy poco frecuente. Presentamos el caso de una mujer de 22 años que presentó un SCA de la mano secundario a un LC y que requirió tratamiento quirúrgico de urgencia mediante una fasciotomía dorsal y palmar. Palabras clave: Loxoscelismo cutáneo; síndrome compartimental; Loxosceles spp.; araña del rincón; mordedura araña.Acute compartment syndrome (ACS) is the increase of pressure in a closed osteofascial space. This reduces capillary perfusion below the level necessary for tissue viability. Injury could be irreversible if proper treatment is not performed. Hand ACS secondary to cutaneous loxoscelism with edematous predominance is extremely infrequent. We present a clinical case of a 22-year-old patient who started a hand compartment syndrome secondary to cutaneous loxoscelism (CL), requiring emergency surgical treatment with dorsal and palmar fasciotomy. Keywords: cutaneous loxoscelism; compartment syndrome; Loxosceles spp; brown recluse spider; spider bite