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1.
J Plast Reconstr Aesthet Surg ; 74(2): 364-369, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32888861

RESUMO

INTRODUCTION: With the emergence of blunt-tipped microcannulas, there is a hypothesis that these could cause less damage and reduce pain as compared to conventional sharp needles in eyelid surgery. The purpose is to determine whether an 18G blunt-tipped cannula can be better than a 26G needle. METHODS: This prospective, observer-blinded, randomized clinical trial was conducted from June 2017 to December 2018. Sixty-eight patients were randomized to receive local anesthesia injections for upper blepharoplasty. Infiltration was performed by using a 26-gauge sharp needle on one side and on the other side, infiltration was performed by using an 18-gauge stainless-steel blunt-tipped microcannula. A numeric rating scale (NRS) from 0 to 10 was used to blindly assess pain in patients receiving anesthesia injections with both needle types. Photographs of the eyelids of each patient were taken in five different periods and used by three blinded observers to identify bruise or ecchymoses. RESULTS: A total of 136 eyelid operations were performed. There was no statistically significant difference when both groups were compared; however, the average score of pain was higher in patients taking the infiltration through the needle (2.85 versus 2.50). Regarding the evaluation of bruising and ecchymoses, the results showed that, in the five periods evaluated, there was no statistical difference in bruising and ecchymosis in the eyelids when taking the infiltration through a sharp needle when compared with that of the eyelids taking infiltration through a (blunt-tipped) microcannula. CONCLUSION: The evaluation of the blunt-tipped microcannula showed a lower pain score mean than that obtained for the sharp needle (2.5 versus 2.85) (p > 0.05). There was no statistically significant difference in the bruising and ecchymosis courses.


Assuntos
Anestesia Local/instrumentação , Blefaroplastia , Cânula/efeitos adversos , Contusões/prevenção & controle , Equimose/prevenção & controle , Agulhas/efeitos adversos , Dor Processual/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Local/métodos , Contusões/diagnóstico , Contusões/epidemiologia , Contusões/etiologia , Método Duplo-Cego , Equimose/diagnóstico , Equimose/epidemiologia , Equimose/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/diagnóstico , Dor Processual/epidemiologia , Dor Processual/etiologia , Estudos Prospectivos
3.
Plast Reconstr Surg ; 104(6): 1748-50, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10541179

RESUMO

Sensory reconstruction has recently been stressed in breast reconstruction. However, there are no reports concerning the reconstruction of a sensitive areola. The bilateral reconstruction of a sensitive areola using a neurocutaneous flap based on the medial antebrachial cutaneous nerve is reported. The flap was harvested from the distal third of the forearm as an island flap and tunneled to reach the apex of the new breast, which was previously reconstructed using a 135-cc, gel-filled, silicone prosthesis covered by a latissimus dorsi myocutaneous flap. Six months later, fine sensibility in the reconstructed areola was demonstrated. The patient could perceive light touch, pain, and 14 mm two-point discrimination. At 2 months after surgery, 50 percent of cutaneous faulty stimulus location was observed. However, at 4 and 6 months after surgery, faulty location disappeared. Six months after harvesting the medial antebrachial cutaneous nerve, the sensory deficit was minimal; it included a hypoesthesic zone of 4 to 7 cm and an anesthesic zone of 2.5 to 5 cm on the middle third of the forearm. Fifteen months after the procedure, no hypoesthesic zone was observed; only a 2 to 3 cm anesthesic zone on the proximal medial side of the forearm existed. This sensory deficit passed unnoticed by the patient. The technique developed here is a refinement in breast reconstruction, and we think it should be used in selected patients.


Assuntos
Mamoplastia/métodos , Microcirurgia/métodos , Mamilos/cirurgia , Retalhos Cirúrgicos/inervação , Adulto , Feminino , Humanos , Mastectomia Radical Modificada , Reoperação , Pele/inervação , Técnicas de Sutura
5.
Rev. AMRIGS ; 27(4): 454-61, 1983.
Artigo em Português | LILACS | ID: lil-18268

RESUMO

Os autores apresentam neste trabalho, um estudo experimental onde sao comparados quatro tipos de anastomoses nervosas: a sutura epineural, a sutura interfascicular (intrafascicular), a sutura perineural e o envelope venoso. Este ultimo e uma contribuicao original dos autores. Em cada um destes tipos de anastomoses foram tambem comparados os resultados obtidos em dois diferentes intervalos de tempo: tres semanas e tres meses. Um intervalo e aqui compreendido a partir da data de execucao da anastomose (pos-seccao) ate o momento da resseccao para o preparo e visualizacao do material no microscopio eletronico de rastreamento de eletrons (SEM - Scanning Electron Microscope). O envelope venoso e apresentado em detalhes


Assuntos
Microcirurgia , Regeneração Nervosa , Neurocirurgia , Nervos Periféricos
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