Validation of orthopedic allograft preparation process: a new application of media fill test.

Musculoskeletal allografts represent an important practice in orthopedic surgeries and the demand for them has been growing. For this reason, in order to reduce clinical risk and to more efficiently manage the increase of allograft usage and also to optimize timing of the surgeries, the thawing and washing processes with aseptic technique were centralized in the department of Hospital Pharmacy. This study describe the design and execution of an adapted Media Fill Test (MFT) to demonstrate aseptic thawing and washing of allografts. For this specific and innovative setting, to better simulate the actual processing steps, a surrogate system was developed to simulate the tendon allograft. The aseptic technique of four operators was assessed and an initial performance validation and the first revalidation were described. All MFT were completed successfully, with no observation of turbidity. The readapted MFT shown in this study can provide insight into this innovative and growing field to other health professionals who want to implement this service.

Conservative Neck Rejuvenation.

In the field of facial rejuvenation, among the recurrent topics, one of the most discussed is the return to less invasive techniques. Lower face rejuvenation is best achieved acting on the platysma muscle. Many techniques are used and usually include platysma section, redundancy reduction, and redraping. Platysma plication is also used especially in secondary cases because of the increased risk of nerve injury due to possible anatomical damage caused by previous operations. A technique that preserves the deep planes based on a new plication method is proposed (conservative neck rejuvenation). In this technique, the dissection plane is only subcutaneous to reduce the risk of nerve injuries. An effective neck contouring is possible using a simpler technique with very good results and a lower rate of morbidity.

Otoplasty for prominent ears: a versatile combined technique to master the shape of the ear.

OBJECTIVE: We present our experience with an otoplasty technique that combines "closed" anterior scoring using the Stenström otoabrader with mattress sutures to the posterior cartilage. STUDY DESIGN AND SETTING: In a retrospective study, we report our experience with 135 patients operated on in the last 12 years. Some surgical principles make our procedure different from previous combination techniques: the posterior access incision is linear without skin excision; anterior scoring is performed along the entire antihelix and scapha, with care to score toward the concha at the tail of the antihelix to bring the ear lobe nearer to the mastoid; Mustarde's mattress sutures are used to stabilize the result. RESULTS: There were no major complications and few minor complications. The aesthetic results were graded as very good or good in 95% of the cases; the rest were graded as satisfactory. CONCLUSIONS: Our technique is versatile, gives pleasant, natural-looking results, and has a low complication rate. It is a simple, reliable, reproducible, and easily mastered method.

Subdermal liposuction: long-term experience.

This article discusses the technique of subdermal liposuction treating superficial subdermal fat. Advantages include the treatment of small adiposities, removal to favor skin accommodation, improvement of the cullulitic aspect of skin, and more progressive suction with better control of the evolution of the procedure.

A personal technique: mammaplasty with J scar.

Mastopexy and reduction mammaplasty techniques have evolved with time, pursuing the aim of an effective and reliable technique that produces a well-shaped breast and reduces the amount of scarring. The authors believe that the L mammaplasty achieves the best results in terms of a short scar and a good, stable shape. They present their technique of a modified L mammaplasty with a resulting scar in the shape of a J, which implies a central breast resection with the nipple-areola complex transposed on a superior pedicle. The correct execution of the preoperative markings and the shaping of the gland tissue are mandatory to obtaining the desired result. The technique has been used during the past 7 years on 326 patients, providing satisfactory results with short scars and virtually no complications.

A new alar demarcator to facilitate the intracartilagineous approach to tip plasty

The alar demarcator is a useful device to make an accurate alar resection when a intracarilagineous approach to the tip is used in rhinoplasty. The demarcator is easy to use following a careful drawing on the skin of the tip of the nose of the anatomy of the cartilages and of their planned resection

Subperiosteal temporal lift

Ptosisi of the lateral extension of the brows transmits sadness, Blepharocalasis is often associated and may be corrected at the same time. The procedure may be performed on an outpatient basis. An incision in the temporal scalp with a lightning shape minimizes the evidence of the scar even with wet hair. The undermining is begun under the galea, then is carried out under the periosteum of the frontal bone, just medial to the temporal fossa a few centimeters before the orbital ridge. The subperiosteal undermining is extended downwards and laterally until the outer canthal area is reached. The excision of a strip of skin and galea permits an effective traction of all the soft tissues of the lateral extension of the brow

Suction-assisted lipectomy of the subdermal fat layer: a new way of performing liposuction

Suction-assisted lipectomy has amazingly envolved since its first step in 1977. The subdermal liposuction is a new technique that widens the indications of liposuction. Very slight adiposities may now be easily treated. This method allows to obtain a better result particularly in areas where the fat layer is thin as in the ankles or calves, and is of great value in the treatment of secondary deformities due to irregular residual fat left during the first procedure. The treatment of the superficial adipose tissue allows a better skin retraction. In fact, if the subdermal fat layer is firm it acts like and arch opposing to the force of skin retraction just like the arch of a vault prevents roof collapse. Very thin Grazer-Grams Mercedes cannulas are used to treat the superficial fat layer. The deeper adipose tissue is suctioned with thin cannulas first and their gauge is, increased along the procedure. This way the fat is removed gradually and evenly. This new way of performing the suction minimizes the evenience of skin irregularities, a too frequent sequela of the classic procedure