In the diagnosis and treatment of plastic surgery,there are structural processing problems,such as positioning,moving,and reconstructing complex threedimensional structures.Doctors operate according to their own exper...In the diagnosis and treatment of plastic surgery,there are structural processing problems,such as positioning,moving,and reconstructing complex threedimensional structures.Doctors operate according to their own experience,and the inability to accurately locate these structures is an important problem in plastic surgery.Emerging digital technologies such as virtual reality,augmented reality,and three-dimensional printing are widely used in the medical field,particularly in plastic surgery.This article reviews the development of these three technical concepts,introduces the technical elements and specific applications required in plastic surgery,summarizes the application status of the three technologies in plastic surgery,and summarizes prospects for future development.展开更多
We present, for the first time, the repair by plastic surgery procedures of a large loss of perineal substance in a bonobo (hominin Pan paniscus). A 20-year-old male bonobo living in captivity in the Lola Ya Bonobo Sa...We present, for the first time, the repair by plastic surgery procedures of a large loss of perineal substance in a bonobo (hominin Pan paniscus). A 20-year-old male bonobo living in captivity in the Lola Ya Bonobo Sanctuary in Kinshasa in the Democratic Republic of the Congo was attacked by another bonobo. It was a large perineal wound through which urine flowed, located between the penis and the testicles, taking part of the anterior and posterior urethra, the bladder, as well as the elements of the spermatic duct. To repair the large loss of perineal substance, a pedicled flap of scrotal skin was removed, and then turned over, cutaneous surface on the trench of the loss of bladder substance and the urethral lumen. The postoperative course was satisfactory with healing by the first intention of the surgical wound, despite the wild postoperative behavior of the patient (removal of the vesicourethral catheter and protective plaster). We observed in the short term an urethro-cutaneous fistula, left in natural healing. The reconstructive surgery procedures applied in humans can also be applied with satisfactory results in bonobos, a species in the process of extension and whose members are our closest cousins. The bonobo is genetically close to humans. Based on this first successful experience, we advocate for reconstructive plastic surgery for all hominins (members of the human lineage), if indicated.展开更多
AIM:To investigate the diet of pouch patients compared to healthy controls,and to correlate pouch patients’diet with disease behavior.METHODS:Pouch patients were recruited and prospectively followed-up at the Compreh...AIM:To investigate the diet of pouch patients compared to healthy controls,and to correlate pouch patients’diet with disease behavior.METHODS:Pouch patients were recruited and prospectively followed-up at the Comprehensive Pouch Clinic at the Tel Aviv Sourasky Medical Center.Pouch behavior was determined based on clinical,endoscopic and histological criteria.Healthy age-and sex-matched volunteers were selected from the"MABAT"Israeli Nutrition and Public Health Governmental Study and served as the control group.All the participants completed a 106-item food frequency questionnaire categorized into food groups and nutritional values based on those used in the United States Department of Agriculture food pyramid and the Israeli food pyramid.Data on Dietary behavior,food avoidance,the use of nutritional supplements,physical activity,smoking habits,and body-mass index(BMI)were also obtained.Pouch patients who had familial adenomatous polyposis(n=3),irritable pouch syndrome(n=4),or patients whose pouch surgery took place less than one year previously(n=5)were excluded from analysis.RESULTS:The pouch patients(n=80)consumed significantly more from the bakery products food group(1.2±1.4 servings/d vs 0.6±1.1 servings/d,P<0.05)and as twice as many servings from the oils and fats(4.8±3.4 servings/d vs 2.4±2 servings/d,P<0.05),and the nuts and seeds food group(0.3±0.6 servings/d vs 0.1±0.4 servings/d,P<0.05)compared to the controls(n=80).The pouch patients consumed significantly more total fat(97.6±40.5 g/d vs 84.4±39 g/d,P<0.05)and fat components[monounsaturated fatty acids(38.4±16.4 g/d vs 30±14 g/d,P<0.001),and saturated fatty acids(30±15.5 g/d vs 28±14.1 g/d,P<0.00)]than the controls.In contrast,the pouch patients consumed significantly fewer carbohydrates(305.5±141.4 g/d vs 369±215.2 g/d,P=0.03),sugars(124±76.2 g/d vs 157.5±90.4 g/d,P=0.01),theobromine(77.8±100 mg/d vs 236.6±244.5 mg/d,P<0.00),retinol(474.4±337.1μg/d vs 832.4±609.6μg/d,P<0.001)and dietary fibers(26.2±15.4 g/d vs 30.7±14 g/d,P=0.05)than the controls.Comparisons of the food consumption of the patients without(n=23)and with pouchitis(n=45)showed that the former consumed twice as many fruit servings as the latter(3.6±4.1 servings/d vs 1.8±1.7 servings/d,respectively,P<0.05).In addition,the pouchitis patients consumed significantly fewer liposoluble antioxidants,such as cryptoxanthin(399±485μg/d vs 890.1±1296.8μg/d,P<0.05)and lycopene(6533.1±6065.7μg/d vs 10725.7±10065.9μg/d,P<0.05),and less vitamin A(893.3±516μg/d vs1237.5±728μg/d,P<0.05)and vitamin C(153.3±130 mg/d vs 285.3±326.3 mg/d,P<0.05)than the patients without pouchitis.The mean BMI of the pouchitis patients was significantly lower than the BMI of the patients with a normal pouch:22.6±3.2 vs 27±4.9(P<0.001).CONCLUSION:Decreased consumption of antioxidants by patients with pouchitis may expose them to the effects of inflammatory and oxidative stress and contribute to the development of pouchitis.展开更多
The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs diff...The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。展开更多
Longitudinal sleeve gastrectomy (LSG) has become an acceptable option in the management of morbidly obese patients. Complications in the form of pouch dilatation may occur in post-sleeve surgery. However, revision sle...Longitudinal sleeve gastrectomy (LSG) has become an acceptable option in the management of morbidly obese patients. Complications in the form of pouch dilatation may occur in post-sleeve surgery. However, revision sleeve gastrectomy procedures are effective in correcting such complications. The aim of this study was to systematically review all published cases that reported revision surgeries following the initial sleeve gastrectomy complicated by pouch dilatation. In addition, we are presenting two cases reported from our military/teaching hospital. A systematic literature search was conducted from English-language studies published from 2000 to 2014 from the following databases: PubMed, CINAHL, MEDLINE, EMBASE, Clinical evidence, Dara, Scopus, Web of Sciences, TRIP, Health Technology Database, Cochrane library, and Psych INFO. A total of 5340 articles were identified in the initial search and 5339 articles were excluded based on the exclusion criteria. Only one case study met the inclusion criteria for this systematic review, involving two patients. Also, we are reporting two cases with revision surgery performed for pouch dilatation post-sleeve surgery from our teaching hospital.?There was only one study that reported revision surgery as a management of gastric pouch dilatation post-sleeve surgery. Authors believe that the incidence of revision surgery for the management of pouch dilatation post-sleeve surgery is higher but underreported. This assumption may be valuable, especially because some surgeons consider pouch dilatation post-sleeve surgery a complication that arises due to surgical technique rather than the procedure itself;therefore, it is unreported.展开更多
Introduction: The amount of research on the relationship between plastic surgery and psychological features, such as personality disorders and indexes of body image dissatisfaction, has increased significantly in the ...Introduction: The amount of research on the relationship between plastic surgery and psychological features, such as personality disorders and indexes of body image dissatisfaction, has increased significantly in the last years. Aim: The aim of the present study was to examine these psychological features among Italian patients who underwent aesthetic plastic surgery, testing the mediating role of the mass media influence on the relationship between them and the choice of aesthetic plastic surgery. The Personality Diagnostic Questionnaire 4+ (PDQ-4+) and the Body Uneasiness Test (BUT) were administered to patients who underwent aesthetic plastic surgery (N = 111) and participants who had no history of aesthetic plastic surgical procedures (N = 149). Results: Results showed that aesthetic patients reported higher indexes of body image disturbance than controls. No significant differences between aesthetic participants and controls were found in all three cluster B personality disorders. Moreover, the effect of body image dissatisfaction on the choice to undergo aesthetic plastic surgery was partially mediated by the influence of mass media. Conclusions: In conclusion, the present study confirmed the importance of body dissatisfaction as a predictor of the choice to undergo aesthetic surgery and highlighted the influence of media messages regarding physical appearance.展开更多
Over the recent past few years, there is a huge innovation in plastic surgery and orthopedic surgery through implantation of new techniques, which enabled a great level of success in hand salvage. Conditions such as t...Over the recent past few years, there is a huge innovation in plastic surgery and orthopedic surgery through implantation of new techniques, which enabled a great level of success in hand salvage. Conditions such as trauma, tumor, sepsis, or vascular disease, may necessitate hand salvage. The most frequent argument among surgeon from different subspecialties (orthopedics, plastics, trauma, and vascular surgery) are characterized by in what way each one can do his own part of the salvage operation, be it bony fixation, revascularization, or soft-tissue coverage, but none of them is sure whether it should be endeavored. What is necessary in such clinical situations is an interdisciplinary team attitude led by individual or groups of clinicians who are conversant not only with their identifiable subspecialized skills but also with those of their coworkers and the consequences accompanying the joined efforts at hand salvage. The perception of orthoplastic surgery is based on such an indication, where the integrated skills and techniques of the orthopedic surgeon and reconstructive microsurgeon are performed in recital to direct efforts concerning hand salvage or choose against it when it is not designated. The current article reviews the roles of orthopedic and plastic surgery and how this team can deal with the existing techniques to improve outcomes in hand salvage surgery.展开更多
Before the 70s, in Brazil, each city had its morbidly obese, considered as the “excessive fats”, in very small numbers if we compare it with the current percentage. There was no classification of the degree of obesi...Before the 70s, in Brazil, each city had its morbidly obese, considered as the “excessive fats”, in very small numbers if we compare it with the current percentage. There was no classification of the degree of obesity by the body mass index (BMI) as we have today. By chance, on a Saturday in June 1975, at the Outpatient Clinic of the 23rd Infirmary of Santa Casa da Misericórdia Hospital in Rio de Janeiro, arrived the patient I. S., 41 years old, 1.70 m tall, supported by her two children, weighing 210 kg in weight body. Knowing that bariatric surgery only appeared in the 1980s, before that, patients with morbid obesity were left to their own devices, with hypertension and diabetes. The patient I. S. was hospitalized for 3 years in our Plastic Surgery Service, having received nutritional monitoring, had sporadic discharges and undergone 9 reparative plastic surgeries. She was discharged weighing 71 kg, with self-esteem recovered and happy to start a new life, without hypertension and diabetes.展开更多
Introduction: Surgical problems are of much disturbance to the world and should therefore be given serious attention. The prevalence of these surgical problems, has made plastic surgery become a broadly relevant and a...Introduction: Surgical problems are of much disturbance to the world and should therefore be given serious attention. The prevalence of these surgical problems, has made plastic surgery become a broadly relevant and acceptable way for addressing problems like injuries, congenital anomalies, surgical infections and malignancies among others. Aim: This study is to quantify and characterize surgical procedures done in the plastic surgery theatre located in the new Accident and Emergency (A & E) Building of KATH. Materials and Methods: Data were obtained from the Operation Register/Theatre Books in the plastic surgery theatre at the A & E Centre on cases operated on from October 1, 2009 to September 30, 2012. Data entry, presentation and analysis were done using Statistical Package for the Social Sciences (SPSS) 20.0 version. Results: Adults formed the majority of patients who sought for plastic surgery with a percentage of 70.3%. The male patients also outnumbered the females recording (61.5%) out of the total number of patients. Most of the cases recorded were acquired cases (93.2%). Reconstructive surgery was the commonest operation performed (30%);in 53.8% cases general anaesthesia was used. Conclusion: Among all the procedures used reconstructive surgery was the commonest surgery performed in the unit and general anaesthesia was the most type of anaesthesia used for the operations.展开更多
In this review article, various preferences in breast plastic surgery particularly after breast cancer will be discussed in view of the diverse indications for the different construction procedures. The various condit...In this review article, various preferences in breast plastic surgery particularly after breast cancer will be discussed in view of the diverse indications for the different construction procedures. The various conditions that necessitate the need for reconstruction are appraised, the important reconstructive procedures are discussed. The most important indications procedures discussed in this review include;Prophylactic subcutaneous mastectomy, Lumpectomy and Radiation, Modified Mastectomy with Axillary Sampling, Nipple reconstruction, and the contralateral breast. These procedures are discussed in view of plastic surgeon practice and patients acceptability in Saudi Arabia. Data from Saudi Arabia in particular was identified through searches of the EMBASE, and MEDLINE database, using the keywords: Saudi Arabia, breast plastic Surgery, breast reconstruction, autologous breast reconstruction, breast augmentation. Advances in prosthetic technologies and modifications in autologous flap techniques, and the development of novel tissue alternatives have allowed for sustained developments in breast reconstruction results. A variety of attitudes has been accessible for addressing the difficulties that endure after resection of breast cancer in Saudi Arabia. Patients should be educated to accept different process in this context.展开更多
Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient sa...Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient safety and quality of care. We aimed to deliver a one-day “hands-on” practical session on basic surgical skills and principles in plastic surgery, and to assess its effectiveness at improving confidence to the specialty among junior trainees. Methods: The one-day practical session covered knot tying, suturing, LA administration, skin lesion excision and local flaps, with short concurrent lectures on principles of plastic surgery. Self-assessment confidence scores were recorded before and after the course on seven domains: a) knowledge: wound assessment and management, suture selection, and concepts of flaps;b) practical skills: Handling of surgical instrument, suturing, LA administration, and skin lesion excision. Results: Thirty-five participants attended: Six core surgical trainees, fifteen foundation doctors, and fourteen medical students. The overall course satisfaction was 9.13/10. Self-assessment confidence scores in all domains significantly improved after the course (p < 0.0001). Suturing (58.6%) and skin lesion excision (74.5%) demonstrated the largest improvement. Qualitative feedback was extremely positive. Conclusions: The hands-on nature of the course offered participants great opportunities to acquire the necessary confidence and practical skills required for in-hospital placements. It is vital for students and doctors interested in a career in plastic surgery to prepare adequately for this diverse specialty, which is covered in limited depth in medical school. The need for more practical skills courses on plastic surgery for this demographic is intuitive.展开更多
At first glance, it may appear that martial arts and surgery do not relate to each other at all. However, martial arts and surgery are all one on the path of knowledge and self discovery. Innovations are constantly be...At first glance, it may appear that martial arts and surgery do not relate to each other at all. However, martial arts and surgery are all one on the path of knowledge and self discovery. Innovations are constantly being developed;some techniques stand the test of time while others are relegated to history. Martial arts and surgery have also branched out for example boxing, taekwondo, jujitsu and wrestling for martial arts whereas surgery has branched out to orthopaedics, paediatrics, cardiothoracic and neurosurgery to name a few. Some choose to specialize while others choose to be a generalist. Learning methodologies in martial arts and plastic surgery are similar. Martial arts students are the equivalent of surgical residents, and both have to enroll in a school that prepares them to be practitioners of their respective arts. In the last century, formal martial arts academies and surgical residency training programs have sprung up. The standards and entrance requirements vary from school to school as do training methodology and philosophical concepts. In this article, we seek to analyze Bruce Lee’s martial arts’ philosophy of Jeet Kune Do (JKD) and that how we can apply it to our personal path in Plastic & Reconstructive Surgery.展开更多
An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it...An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.展开更多
This research is an active pedagogical experience with surgeons who are specialized in reconstructive plastic surgery and nursing. The guiding questions were the statements of each Surgeon’s clients and what they thi...This research is an active pedagogical experience with surgeons who are specialized in reconstructive plastic surgery and nursing. The guiding questions were the statements of each Surgeon’s clients and what they think about them. Modeling the imaginary bodies of the patients and identify what they built in their minds, highlighting topics and the discussion about the practice made in clay modeling. Eight bodies were modeled, with six bodies with all the senses and two incomplete bodies with only the regions of the breasts and buttocks. It was concluded that there are diverse issues emerging such as gender, ethics, care, spirituality and dream as the fulfillment of the wishes of the patients. Where in the body can these surgeons act to improve the patients’ physical and quality of life? There is an important theme when we are generally welcoming women into an anamnesis that considers their body as a whole, but what is their expectation for each patient? This paper showed the importance of the preoperative evaluation of this whole, for the indication of repairs or contraindications of procedures that aim to improve the physical of the patients, with possible bodily surgical modifications as a form of modeling through liposuction, grafting or excision with lipectomy and withdrawal of excess skin to mitigate the effects of the transformations that deform the physical and end up harming the human relationship, especially women. This is a qualitative method showing the meanings of the bodies of the women represented in the modeling by the Surgeons. However, some surgeons stand out by the look of their practice, as greater sensitivity looking at the body as a whole, spiritual and emotional. They need to use their skills as surgical art and gift, to try to achieve a means, but not an end.展开更多
Objective:To explore the effect of combined application of expanded polytetrafluoroethylene and autologous ear cartilage in nasal plastic surgery.Methods:76 cases of nasal plastic surgery patients in our hospital from...Objective:To explore the effect of combined application of expanded polytetrafluoroethylene and autologous ear cartilage in nasal plastic surgery.Methods:76 cases of nasal plastic surgery patients in our hospital from September 2019 to September 2020 were selected as the research objects and divided into experimental group(38 cases,treated with expanded polytetrafluoroethylene+autologous ear cartilage surgery)and control group(38 cases,treated with autologous ear cartilage surgery).The treatment effect,appearance score and complications were compared.Results:The total effective rate of the experimental group(97.37%,37/38)was higher than that of the control group(78.95%,30/38),P<0.05;After treatment,the appearance score of the experimental group was(8.97±0.37),which was significantly higher than that of the control group(P<0.05);The total incidence of complications in the experimental group(5.26%,2/38)was significantly lower than that in the control group(21.05%,8/38),P<0.05.Conclusion:In the process of nasal plastic surgery,the combined application of autologous ear cartilage surgery and expanded polytetrafluoroethylene has obvious effect,improves the appearance of patients,and has less postoperative complications,which is worthy of promotion.展开更多
Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Vario...Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.展开更多
Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient sub...Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient subjective stress as well as objective physiological increase in heart rate and blood pressure. Aside from the improved experience, physiological stress is reduced which results in improved patient outcomes. Patients and methods: Eligible participants were all adults aged 18 or over who had non craniofacial lesions requiring minor surgery. A total of 99 adult patients who were capable of independent consent were randomized to receive a virtual reality experience (VR) or standard music distraction (no VR). Patients were recruited for the study during their office visit when scheduling minor procedure surgery. This was a single center, double-blind, controlled study conducted at Guthrie Clinic Robert Packer Hospital in Sayre, Pennsylvania between March 2019 to January 2020 (pre-pandemic). Ethics approval for this study was obtained from the Institutional Review Board of the Guthrie Clinic. Results: The change in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) significantly decreased from pre-procedure to mid-procedure in the VR group compared with standard. Herein our results are presented. Conclusions: Reductions in intraprocedural SBP, DBP and HR can be achieved when using VR. Although subjective reporting of pain and anxiety were not different between groups, VR significantly improves patient satisfaction compared with non VR standards.展开更多
209445 Fabrication and application of three-dimensional autogenous cartilage framwork in auricular reconstruction/Pan Bo(潘博,Plast Surg Hosp,Chin Acad Med Sci,Beijing 100144)…∥Chin J Plast Surg.-2009,25(3).-161～1...209445 Fabrication and application of three-dimensional autogenous cartilage framwork in auricular reconstruction/Pan Bo(潘博,Plast Surg Hosp,Chin Acad Med Sci,Beijing 100144)…∥Chin J Plast Surg.-2009,25(3).-161～164Objective To explore the fabrication and application of three-dimensional autogenous cartilage framwork in auricular reconstruction.Methods The process of fabrication of three-dimensional cartilage framework consisted of harvesting,carving and assembling the cartilage.The rib cartilage was harvested separately.The three-dimensional framework was composed of three main parts:the helix,the base and the pad,at different layer.The framework was fabricated according to the development of rib cartilage and contour and height of the reconstructed ear.Results From January 1992 to December 2006,5 248 patients of microtia were treated with 6 252 autogenous cartilage frameworks.Conclusion The three-dimensional framework is easily manipulated.The reconstructed ears look natural and had an erect contour.This method can effectively use the cartilage.10 refs,14 figs.展开更多
文摘In the diagnosis and treatment of plastic surgery,there are structural processing problems,such as positioning,moving,and reconstructing complex threedimensional structures.Doctors operate according to their own experience,and the inability to accurately locate these structures is an important problem in plastic surgery.Emerging digital technologies such as virtual reality,augmented reality,and three-dimensional printing are widely used in the medical field,particularly in plastic surgery.This article reviews the development of these three technical concepts,introduces the technical elements and specific applications required in plastic surgery,summarizes the application status of the three technologies in plastic surgery,and summarizes prospects for future development.
文摘We present, for the first time, the repair by plastic surgery procedures of a large loss of perineal substance in a bonobo (hominin Pan paniscus). A 20-year-old male bonobo living in captivity in the Lola Ya Bonobo Sanctuary in Kinshasa in the Democratic Republic of the Congo was attacked by another bonobo. It was a large perineal wound through which urine flowed, located between the penis and the testicles, taking part of the anterior and posterior urethra, the bladder, as well as the elements of the spermatic duct. To repair the large loss of perineal substance, a pedicled flap of scrotal skin was removed, and then turned over, cutaneous surface on the trench of the loss of bladder substance and the urethral lumen. The postoperative course was satisfactory with healing by the first intention of the surgical wound, despite the wild postoperative behavior of the patient (removal of the vesicourethral catheter and protective plaster). We observed in the short term an urethro-cutaneous fistula, left in natural healing. The reconstructive surgery procedures applied in humans can also be applied with satisfactory results in bonobos, a species in the process of extension and whose members are our closest cousins. The bonobo is genetically close to humans. Based on this first successful experience, we advocate for reconstructive plastic surgery for all hominins (members of the human lineage), if indicated.
基金Supported by A generous grant from the Leona M and Harry B Helmsley Charitable Trust(Partially)
文摘AIM:To investigate the diet of pouch patients compared to healthy controls,and to correlate pouch patients’diet with disease behavior.METHODS:Pouch patients were recruited and prospectively followed-up at the Comprehensive Pouch Clinic at the Tel Aviv Sourasky Medical Center.Pouch behavior was determined based on clinical,endoscopic and histological criteria.Healthy age-and sex-matched volunteers were selected from the"MABAT"Israeli Nutrition and Public Health Governmental Study and served as the control group.All the participants completed a 106-item food frequency questionnaire categorized into food groups and nutritional values based on those used in the United States Department of Agriculture food pyramid and the Israeli food pyramid.Data on Dietary behavior,food avoidance,the use of nutritional supplements,physical activity,smoking habits,and body-mass index(BMI)were also obtained.Pouch patients who had familial adenomatous polyposis(n=3),irritable pouch syndrome(n=4),or patients whose pouch surgery took place less than one year previously(n=5)were excluded from analysis.RESULTS:The pouch patients(n=80)consumed significantly more from the bakery products food group(1.2±1.4 servings/d vs 0.6±1.1 servings/d,P<0.05)and as twice as many servings from the oils and fats(4.8±3.4 servings/d vs 2.4±2 servings/d,P<0.05),and the nuts and seeds food group(0.3±0.6 servings/d vs 0.1±0.4 servings/d,P<0.05)compared to the controls(n=80).The pouch patients consumed significantly more total fat(97.6±40.5 g/d vs 84.4±39 g/d,P<0.05)and fat components[monounsaturated fatty acids(38.4±16.4 g/d vs 30±14 g/d,P<0.001),and saturated fatty acids(30±15.5 g/d vs 28±14.1 g/d,P<0.00)]than the controls.In contrast,the pouch patients consumed significantly fewer carbohydrates(305.5±141.4 g/d vs 369±215.2 g/d,P=0.03),sugars(124±76.2 g/d vs 157.5±90.4 g/d,P=0.01),theobromine(77.8±100 mg/d vs 236.6±244.5 mg/d,P<0.00),retinol(474.4±337.1μg/d vs 832.4±609.6μg/d,P<0.001)and dietary fibers(26.2±15.4 g/d vs 30.7±14 g/d,P=0.05)than the controls.Comparisons of the food consumption of the patients without(n=23)and with pouchitis(n=45)showed that the former consumed twice as many fruit servings as the latter(3.6±4.1 servings/d vs 1.8±1.7 servings/d,respectively,P<0.05).In addition,the pouchitis patients consumed significantly fewer liposoluble antioxidants,such as cryptoxanthin(399±485μg/d vs 890.1±1296.8μg/d,P<0.05)and lycopene(6533.1±6065.7μg/d vs 10725.7±10065.9μg/d,P<0.05),and less vitamin A(893.3±516μg/d vs1237.5±728μg/d,P<0.05)and vitamin C(153.3±130 mg/d vs 285.3±326.3 mg/d,P<0.05)than the patients without pouchitis.The mean BMI of the pouchitis patients was significantly lower than the BMI of the patients with a normal pouch:22.6±3.2 vs 27±4.9(P<0.001).CONCLUSION:Decreased consumption of antioxidants by patients with pouchitis may expose them to the effects of inflammatory and oxidative stress and contribute to the development of pouchitis.
基金supported by grants from the Youth Doctor Collaborative Innovation Team Project(QC201803)of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicinethe Project of Biobank(NO.YBKA201901)from Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine+1 种基金the Shanghai Youth Top-Notch Talent Program(201809004)“Chenguang Program”supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission(19CG18)and Science and Technology Commission of Shanghai Municipality(19JC1413),Shanghai Rising-Star Program(20QA1405600).
文摘The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。
文摘Longitudinal sleeve gastrectomy (LSG) has become an acceptable option in the management of morbidly obese patients. Complications in the form of pouch dilatation may occur in post-sleeve surgery. However, revision sleeve gastrectomy procedures are effective in correcting such complications. The aim of this study was to systematically review all published cases that reported revision surgeries following the initial sleeve gastrectomy complicated by pouch dilatation. In addition, we are presenting two cases reported from our military/teaching hospital. A systematic literature search was conducted from English-language studies published from 2000 to 2014 from the following databases: PubMed, CINAHL, MEDLINE, EMBASE, Clinical evidence, Dara, Scopus, Web of Sciences, TRIP, Health Technology Database, Cochrane library, and Psych INFO. A total of 5340 articles were identified in the initial search and 5339 articles were excluded based on the exclusion criteria. Only one case study met the inclusion criteria for this systematic review, involving two patients. Also, we are reporting two cases with revision surgery performed for pouch dilatation post-sleeve surgery from our teaching hospital.?There was only one study that reported revision surgery as a management of gastric pouch dilatation post-sleeve surgery. Authors believe that the incidence of revision surgery for the management of pouch dilatation post-sleeve surgery is higher but underreported. This assumption may be valuable, especially because some surgeons consider pouch dilatation post-sleeve surgery a complication that arises due to surgical technique rather than the procedure itself;therefore, it is unreported.
文摘Introduction: The amount of research on the relationship between plastic surgery and psychological features, such as personality disorders and indexes of body image dissatisfaction, has increased significantly in the last years. Aim: The aim of the present study was to examine these psychological features among Italian patients who underwent aesthetic plastic surgery, testing the mediating role of the mass media influence on the relationship between them and the choice of aesthetic plastic surgery. The Personality Diagnostic Questionnaire 4+ (PDQ-4+) and the Body Uneasiness Test (BUT) were administered to patients who underwent aesthetic plastic surgery (N = 111) and participants who had no history of aesthetic plastic surgical procedures (N = 149). Results: Results showed that aesthetic patients reported higher indexes of body image disturbance than controls. No significant differences between aesthetic participants and controls were found in all three cluster B personality disorders. Moreover, the effect of body image dissatisfaction on the choice to undergo aesthetic plastic surgery was partially mediated by the influence of mass media. Conclusions: In conclusion, the present study confirmed the importance of body dissatisfaction as a predictor of the choice to undergo aesthetic surgery and highlighted the influence of media messages regarding physical appearance.
文摘Over the recent past few years, there is a huge innovation in plastic surgery and orthopedic surgery through implantation of new techniques, which enabled a great level of success in hand salvage. Conditions such as trauma, tumor, sepsis, or vascular disease, may necessitate hand salvage. The most frequent argument among surgeon from different subspecialties (orthopedics, plastics, trauma, and vascular surgery) are characterized by in what way each one can do his own part of the salvage operation, be it bony fixation, revascularization, or soft-tissue coverage, but none of them is sure whether it should be endeavored. What is necessary in such clinical situations is an interdisciplinary team attitude led by individual or groups of clinicians who are conversant not only with their identifiable subspecialized skills but also with those of their coworkers and the consequences accompanying the joined efforts at hand salvage. The perception of orthoplastic surgery is based on such an indication, where the integrated skills and techniques of the orthopedic surgeon and reconstructive microsurgeon are performed in recital to direct efforts concerning hand salvage or choose against it when it is not designated. The current article reviews the roles of orthopedic and plastic surgery and how this team can deal with the existing techniques to improve outcomes in hand salvage surgery.
文摘Before the 70s, in Brazil, each city had its morbidly obese, considered as the “excessive fats”, in very small numbers if we compare it with the current percentage. There was no classification of the degree of obesity by the body mass index (BMI) as we have today. By chance, on a Saturday in June 1975, at the Outpatient Clinic of the 23rd Infirmary of Santa Casa da Misericórdia Hospital in Rio de Janeiro, arrived the patient I. S., 41 years old, 1.70 m tall, supported by her two children, weighing 210 kg in weight body. Knowing that bariatric surgery only appeared in the 1980s, before that, patients with morbid obesity were left to their own devices, with hypertension and diabetes. The patient I. S. was hospitalized for 3 years in our Plastic Surgery Service, having received nutritional monitoring, had sporadic discharges and undergone 9 reparative plastic surgeries. She was discharged weighing 71 kg, with self-esteem recovered and happy to start a new life, without hypertension and diabetes.
文摘Introduction: Surgical problems are of much disturbance to the world and should therefore be given serious attention. The prevalence of these surgical problems, has made plastic surgery become a broadly relevant and acceptable way for addressing problems like injuries, congenital anomalies, surgical infections and malignancies among others. Aim: This study is to quantify and characterize surgical procedures done in the plastic surgery theatre located in the new Accident and Emergency (A & E) Building of KATH. Materials and Methods: Data were obtained from the Operation Register/Theatre Books in the plastic surgery theatre at the A & E Centre on cases operated on from October 1, 2009 to September 30, 2012. Data entry, presentation and analysis were done using Statistical Package for the Social Sciences (SPSS) 20.0 version. Results: Adults formed the majority of patients who sought for plastic surgery with a percentage of 70.3%. The male patients also outnumbered the females recording (61.5%) out of the total number of patients. Most of the cases recorded were acquired cases (93.2%). Reconstructive surgery was the commonest operation performed (30%);in 53.8% cases general anaesthesia was used. Conclusion: Among all the procedures used reconstructive surgery was the commonest surgery performed in the unit and general anaesthesia was the most type of anaesthesia used for the operations.
文摘In this review article, various preferences in breast plastic surgery particularly after breast cancer will be discussed in view of the diverse indications for the different construction procedures. The various conditions that necessitate the need for reconstruction are appraised, the important reconstructive procedures are discussed. The most important indications procedures discussed in this review include;Prophylactic subcutaneous mastectomy, Lumpectomy and Radiation, Modified Mastectomy with Axillary Sampling, Nipple reconstruction, and the contralateral breast. These procedures are discussed in view of plastic surgeon practice and patients acceptability in Saudi Arabia. Data from Saudi Arabia in particular was identified through searches of the EMBASE, and MEDLINE database, using the keywords: Saudi Arabia, breast plastic Surgery, breast reconstruction, autologous breast reconstruction, breast augmentation. Advances in prosthetic technologies and modifications in autologous flap techniques, and the development of novel tissue alternatives have allowed for sustained developments in breast reconstruction results. A variety of attitudes has been accessible for addressing the difficulties that endure after resection of breast cancer in Saudi Arabia. Patients should be educated to accept different process in this context.
文摘Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient safety and quality of care. We aimed to deliver a one-day “hands-on” practical session on basic surgical skills and principles in plastic surgery, and to assess its effectiveness at improving confidence to the specialty among junior trainees. Methods: The one-day practical session covered knot tying, suturing, LA administration, skin lesion excision and local flaps, with short concurrent lectures on principles of plastic surgery. Self-assessment confidence scores were recorded before and after the course on seven domains: a) knowledge: wound assessment and management, suture selection, and concepts of flaps;b) practical skills: Handling of surgical instrument, suturing, LA administration, and skin lesion excision. Results: Thirty-five participants attended: Six core surgical trainees, fifteen foundation doctors, and fourteen medical students. The overall course satisfaction was 9.13/10. Self-assessment confidence scores in all domains significantly improved after the course (p < 0.0001). Suturing (58.6%) and skin lesion excision (74.5%) demonstrated the largest improvement. Qualitative feedback was extremely positive. Conclusions: The hands-on nature of the course offered participants great opportunities to acquire the necessary confidence and practical skills required for in-hospital placements. It is vital for students and doctors interested in a career in plastic surgery to prepare adequately for this diverse specialty, which is covered in limited depth in medical school. The need for more practical skills courses on plastic surgery for this demographic is intuitive.
文摘At first glance, it may appear that martial arts and surgery do not relate to each other at all. However, martial arts and surgery are all one on the path of knowledge and self discovery. Innovations are constantly being developed;some techniques stand the test of time while others are relegated to history. Martial arts and surgery have also branched out for example boxing, taekwondo, jujitsu and wrestling for martial arts whereas surgery has branched out to orthopaedics, paediatrics, cardiothoracic and neurosurgery to name a few. Some choose to specialize while others choose to be a generalist. Learning methodologies in martial arts and plastic surgery are similar. Martial arts students are the equivalent of surgical residents, and both have to enroll in a school that prepares them to be practitioners of their respective arts. In the last century, formal martial arts academies and surgical residency training programs have sprung up. The standards and entrance requirements vary from school to school as do training methodology and philosophical concepts. In this article, we seek to analyze Bruce Lee’s martial arts’ philosophy of Jeet Kune Do (JKD) and that how we can apply it to our personal path in Plastic & Reconstructive Surgery.
基金The study was supported by the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars of the Peking University Third Hospital(grant no.BYSYLXHG2019001).
文摘An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.
文摘This research is an active pedagogical experience with surgeons who are specialized in reconstructive plastic surgery and nursing. The guiding questions were the statements of each Surgeon’s clients and what they think about them. Modeling the imaginary bodies of the patients and identify what they built in their minds, highlighting topics and the discussion about the practice made in clay modeling. Eight bodies were modeled, with six bodies with all the senses and two incomplete bodies with only the regions of the breasts and buttocks. It was concluded that there are diverse issues emerging such as gender, ethics, care, spirituality and dream as the fulfillment of the wishes of the patients. Where in the body can these surgeons act to improve the patients’ physical and quality of life? There is an important theme when we are generally welcoming women into an anamnesis that considers their body as a whole, but what is their expectation for each patient? This paper showed the importance of the preoperative evaluation of this whole, for the indication of repairs or contraindications of procedures that aim to improve the physical of the patients, with possible bodily surgical modifications as a form of modeling through liposuction, grafting or excision with lipectomy and withdrawal of excess skin to mitigate the effects of the transformations that deform the physical and end up harming the human relationship, especially women. This is a qualitative method showing the meanings of the bodies of the women represented in the modeling by the Surgeons. However, some surgeons stand out by the look of their practice, as greater sensitivity looking at the body as a whole, spiritual and emotional. They need to use their skills as surgical art and gift, to try to achieve a means, but not an end.
文摘Objective:To explore the effect of combined application of expanded polytetrafluoroethylene and autologous ear cartilage in nasal plastic surgery.Methods:76 cases of nasal plastic surgery patients in our hospital from September 2019 to September 2020 were selected as the research objects and divided into experimental group(38 cases,treated with expanded polytetrafluoroethylene+autologous ear cartilage surgery)and control group(38 cases,treated with autologous ear cartilage surgery).The treatment effect,appearance score and complications were compared.Results:The total effective rate of the experimental group(97.37%,37/38)was higher than that of the control group(78.95%,30/38),P<0.05;After treatment,the appearance score of the experimental group was(8.97±0.37),which was significantly higher than that of the control group(P<0.05);The total incidence of complications in the experimental group(5.26%,2/38)was significantly lower than that in the control group(21.05%,8/38),P<0.05.Conclusion:In the process of nasal plastic surgery,the combined application of autologous ear cartilage surgery and expanded polytetrafluoroethylene has obvious effect,improves the appearance of patients,and has less postoperative complications,which is worthy of promotion.
文摘Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.
文摘Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient subjective stress as well as objective physiological increase in heart rate and blood pressure. Aside from the improved experience, physiological stress is reduced which results in improved patient outcomes. Patients and methods: Eligible participants were all adults aged 18 or over who had non craniofacial lesions requiring minor surgery. A total of 99 adult patients who were capable of independent consent were randomized to receive a virtual reality experience (VR) or standard music distraction (no VR). Patients were recruited for the study during their office visit when scheduling minor procedure surgery. This was a single center, double-blind, controlled study conducted at Guthrie Clinic Robert Packer Hospital in Sayre, Pennsylvania between March 2019 to January 2020 (pre-pandemic). Ethics approval for this study was obtained from the Institutional Review Board of the Guthrie Clinic. Results: The change in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) significantly decreased from pre-procedure to mid-procedure in the VR group compared with standard. Herein our results are presented. Conclusions: Reductions in intraprocedural SBP, DBP and HR can be achieved when using VR. Although subjective reporting of pain and anxiety were not different between groups, VR significantly improves patient satisfaction compared with non VR standards.
文摘209445 Fabrication and application of three-dimensional autogenous cartilage framwork in auricular reconstruction/Pan Bo(潘博,Plast Surg Hosp,Chin Acad Med Sci,Beijing 100144)…∥Chin J Plast Surg.-2009,25(3).-161～164Objective To explore the fabrication and application of three-dimensional autogenous cartilage framwork in auricular reconstruction.Methods The process of fabrication of three-dimensional cartilage framework consisted of harvesting,carving and assembling the cartilage.The rib cartilage was harvested separately.The three-dimensional framework was composed of three main parts:the helix,the base and the pad,at different layer.The framework was fabricated according to the development of rib cartilage and contour and height of the reconstructed ear.Results From January 1992 to December 2006,5 248 patients of microtia were treated with 6 252 autogenous cartilage frameworks.Conclusion The three-dimensional framework is easily manipulated.The reconstructed ears look natural and had an erect contour.This method can effectively use the cartilage.10 refs,14 figs.
