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1.
Plast Reconstr Surg ; 111(1): 425-9; discussion 430-1, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12496615

RESUMEN

The surgical technique of ultrasound-assisted liposuction has become a standard procedure for the treatment of lipodystrophy. However, little is known about the impact of this therapy on fatty tissue on the molecular level. There are concerns about possible adverse effects related to the high-intensity ultrasound energy, because in vitro studies have shown a substantial generation of free radicals. In this study, the authors investigated whether ultrasound waves can create an excessive free radical production in vivo by measuring lipid peroxidation products in the form of malondialdehyde equivalents. For this purpose, the thiobarbituric acid-reactive substances (TBARS) assay was chosen. In this test, malondialdehyde, a major product of lipid peroxidation, reacts with thiobarbituric acid to produce a pink adduct that can be measured spectrophotometrically. The authors determined oxidation products in 28 aspirates of 17 treated patients before ultrasound-assisted liposuction (0 minutes) to establish a baseline concentration and at 2, 5, and 10 minutes after the treatment was begun. Median malondialdehyde concentration of the control group (conventional liposuction, 0 minutes) was 3.40 nmol of malondialdehyde per gram of adipose tissue. Median concentrations after 2, 5, and 10 minutes of ultrasound-assisted liposuction were 7.45 (n = 28), 8.84 (n = 21), and 4.07 (n = 8) nmol malondialdehyde per gram adipose tissue, respectively. The differences were not statistically significant. The data suggest that there is no excessive formation of lipid oxidation products in response to free radicals. The antioxidative capacity of adipose tissue does not seem to be overwhelmed by the standard application regimen of ultrasound-assisted liposuction.


Asunto(s)
Tejido Adiposo/metabolismo , Radicales Libres/metabolismo , Lipectomía/efectos adversos , Ultrasonido/efectos adversos , Femenino , Humanos , Lipectomía/métodos , Peroxidación de Lípido , Masculino , Malondialdehído/análisis , Persona de Mediana Edad , Sustancias Reactivas al Ácido Tiobarbitúrico/análisis
3.
Plast Reconstr Surg ; 115(6): 1715-21; discussion 1722, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15861079

RESUMEN

BACKGROUND: The safety and efficiency of liposuction have been proven in several studies, but little attention has been paid to postoperative pain. The present study was designed to determine the demand for analgesic agents used postoperatively after liposuction. METHODS: A total of 303 patients underwent ultrasound-assisted liposuction between January 1, 1999, and February 1, 2002, in the Department of Plastic Surgery at the Florence Nightingale Hospital, in Düsseldorf, Germany. The study is partly retrospective of the postoperative demand for analgesic agents. RESULTS: The study group of 244 female and 59 male patients was 42.2 +/- 13.6 years of age (range, 12 to 78 years). The average total suction volume removed was 2404.6 +/- 1704.2 cc (range, 90 to 9100 cc). Of 303 patients, 146 (48.2 percent) did not require any additional analgesic agents on the day of the operation, with 157 (51.8 percent) asking for pain relief on the operation day. On the first postoperative day, 88 (29.0 percent) of all liposuction patients asked for pain medication. That number of patients decreased to 28 (9.2 percent) on postoperative day 2, 21 (6.9 percent) on postoperative day 3, 11 (3.6 percent) on postoperative day 4, five (1.7 percent) on postoperative day 5, four (1.3 percent) on postoperative day 6, and zero on postoperative day 7. The data were further specified concerning details on analgesic agents. Of 303 patients, 146 (48.2 percent) did not require any form of pain medication. For 61 patients (20.1 percent), light analgesic agents were sufficient. Eighty-three patients (27.4 percent) asked for stronger medication, such as tramadol. Only 13 patients (4.3 percent) needed strong opioids for adequate pain management. No statistically significant difference concerning postoperative pain was observed between patients who were operated on under local anesthesia and those who received general anesthesia. CONCLUSIONS: This study gives clear proof that liposuction is a relatively painless procedure, and 48.2 percent off all liposuction patients do not need any pain medication at all. If they do need analgesic agents postoperatively, in most cases, analgesic therapy is sufficient with oral pain medication such as paracetamol or tramadol. In addition, patients can be reassured that merely 1 week after the operation very few patients complain of pain, and they can return to normal life without any complications concerning pain.


Asunto(s)
Lipectomía , Dolor Postoperatorio/prevención & control , Adolescente , Adulto , Anciano , Analgésicos , Analgésicos Opioides , Anestesia General , Anestesia Local , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
4.
Plast Reconstr Surg ; 114(5): 1025-31, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15457009

RESUMEN

The osmotic tissue expander is a new device made of a hydrogel expanding skin that does not require external fillings. Once implanted, it absorbs body fluids, which leads to a gradual swelling of the device. The swelling phase is completed in 6 to 8 weeks and results in skin gain. Different shapes and sizes are available, and the devices can be used in almost every area of the body. Over a 4-year period, the osmotic tissue expander was used in 58 patients in different areas of the body. A round osmotic tissue expander was mainly used in breast reconstruction, and a rectangular expander was used for defect coverage after excision (i.e., of scars and tumors). The mean age of the patients was 49.34 years (range, 4 to 76 years). During the expansion phase, the patients noted only a little discomfort and pain for the first few days. Without a silicone membrane in the first-generation expander, the rate of successful explantation and good final result was 81.5 percent. In a few cases, rapid swelling of the device led to the introduction of a silicone membrane that encloses the expander and leads to a slower, more gradual, and consistent swelling. After introduction of the silicone envelope, the success rate improved to 91 percent. The expander is now used with a silicone membrane in every case. The osmotic tissue expander has many advantages compared with the conventional expander: there is no need for painful external fillings and the risk of external infections is avoided. The expander is 10 percent of its final volume and only requires a short incision and a small pocket. An operation can easily be performed under local anesthesia, with minimal tissue mobilization in older children and compliant patients.


Asunto(s)
Procedimientos de Cirugía Plástica/instrumentación , Dispositivos de Expansión Tisular , Adolescente , Adulto , Anciano , Implantación de Mama/métodos , Implantes de Mama , Niño , Preescolar , Diseño de Equipo , Humanos , Hidrogel de Polietilenoglicol-Dimetacrilato , Persona de Mediana Edad , Siliconas , Expansión de Tejido/instrumentación
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