Regenerative application of stromal vascular fraction cells enhanced fat graft maintenance: clinical assessment in face rejuvenation.

OBJECTIVES: The aim of this study was to evaluate the safety and efficacy of the use of FG-SVFs in face rejuvenation for esthetic improvement. METHODS: 33 female patients affected by face's soft-tissue defects with loss of volume, study group (SG), were treated with FG-SVFs, comparing results with a control group (CG) (n = 30) treated with fat graft not enhanced (FG). Clinical evaluation, a photographic assessment, magnetic resonance imaging (MRI), and ultrasound (US) were performed. Post-operative follow-up was performed at 1, 3, 7, 12, 24, 48, weeks, and then annually. RESULTS: SG patients showed 61% maintenance of the contour restoring and of volume after 3 years compared with the CG treated with FG, who showed 31% maintenance. 60.7% (n = 20) of SG patients, presented an increase of 6.6 mm in the soft tissue volume after 36 months, which was reported in only 33,3% (n = 10) of the CG. Volumetric persistence in the SG was higher than that in the CG (p <. 0001 vs. CG). MRI and US moreover confirmed the absence of important side effects, as fat necrosis, and cytosteatonecrotic areas. CONCLUSIONS: The use of FG-SVFs was safe and effective in this series of a case treated.

Experience of an Italian Hospital Claims Management Committee: A tool for extrajudicial litigations resolution.

Litigation related to medical liability has a great impact on Italian healthcare expenditure. Recently, many Italian Regions have adopted a "self-insurance system" and, in Sicilian Hospitals, were established the Claims Management Committees (CMC) to provide the direct management of claims. Here the experience of a Sicilian University Hospital CMC was described to analyze the claims features and their outcomes providing evidence on CMC usefulness. The analysis involved claims for compensation received during 4 years, using data obtained by a retrospective analysis of claims database created by Forensic Medicine Service. Claims data, obtained from the insurance broker, were used to perform the statistical comparison. During the examined period a total of 377 claims were received by CMC, respectively 63.6% for professional liability and 36.4% for other causes (damages not related to medical malpractice). The prevalence of complaints about malpractice regarded surgery. The CMC had expressed an opinion on 120 claims related to malpractice with the percentages of admission or rejection of liability respectively of 55% and 45%. The statistical analysis revealed a greater number of lawsuits in the Insurance system and, moreover, the CMC higher probability to reach the amicable settlement of litigations. CMC provides specific data on claims trend and economic expenditure, demonstrating its usefulness for analysis and monitoring the causes of patients/people damage. It is a tool for medical malpractice risk assessment and prevention. It can encourage the amicable settlement and prevention of civil action. It seems to be an efficient system to reduce the health liability costs.