Components separation technique with limited subcutaneous undermining: a cadaver study.

The purpose of this study is to evaluate the influence of the undermining of the subcutaneous tissue on the tension of the abdominal wall, after the components separation of the abdominal muscles. Twenty adult cadavers were studied. The resistance of the medial advancement of both anterior and posterior recti sheaths was represented by the traction index and measured in 2 levels-3 cm above and 2 cm below the umbilicus. Traction indices were compared in the following 3 consecutive dissection situations: (1) after the subcutaneous tissue undermining laterally to the semilunaris line; (2) after the dissection of the rectus muscle from its posterior sheath associated with the release of the external oblique muscle; (3) after the subcutaneous tissue undermining laterally to the anterior axillary line. Friedman and Spearman tests were used to compare the results. There was no statistical significant difference between the subcutaneous tissue undermining laterally to the semilunaris line and that laterally to the anterior axillary line, when associated with the musculoaponeurotic dissections. In conclusion, limited subcutaneous undermining does not influence the tension of closure of the musculoaponeurotic layer after the components separation technique in cadavers.

Seroma em lipoabdominoplastia e abdominoplastia: estudo ultrassonográfico comparativo / Seroma in lipoabdominoplasty and abdominoplasty: ultrasonographic

Introdução: O seroma é uma das complicações mais frequentes nas abdominoplastias. Objetivo: Comparar a incidência de seroma em pacientes submetidos à abdominoplastia convencional e à lipoabdominoplastia. Método: Foram estudadas 41 pacientes, divididas em dois grupos: Grupo A (21 pacientes submetidas à abdominoplastia convencional e Grupo B (20 pacientes submetidas à lipoabdominoplastia). Para a investigação da formação de seroma foi realizado ultrassonografia de cinco regiões da parede abdominal (epigástrio(EPI), umbilical (UMB), hipogástrio (HIPO), fossa ilíaca direita (FID) e fossa ilíaca esquerda(FIE)) em dois momentos: entre o 11º e o 14º dia de pós-operatório (DPO) (P1) e entre o 18º e 21º DPO (P2). Resultados: A incidência de seroma tanto em P1 quanto em P2 foi significativamente maior no grupo A que no grupo B. Observou-se que no grupo A, no P1, as regiões FID e FIE apresentaram maior incidência de coleções fluidas. No grupo B, houve uma maior incidência de coleções fluidas na região HIPO em P1 e nas regiões UMB e HIPO em P2. Conclusão: Houve menor incidência de seroma nos pacientes submetidos à lipoabdominoplastia em relação à abdominoplastia convencional nos momentos estudados.

Background: Seroma is one of the most common complications in abdominoplasty. Objective: To compare the rate of seroma formation in patients who underwent either abdominoplastyand lipoabdominoplasty. Methods: The sample consisted of 41 female patients, who were divided into three groups and underwent one of the following procedures: groupA (n=21), abdominoplasty and group B (n=20), lipoabdominoplasty. In order to investigate seroma formation, abdominal ultrasound was performed in 5 regions of the abdominal wall [epigastrium (EPI), umbilical (UMB), hypogastrium (HYPO), right iliac fossa (RIF) and left iliac fossa (LIF)], at two postoperative periods: (P1), between postoperative days 11 and 14, and (P2), between postoperative days 18 and 21. Results: The rate of seroma formation at both P1 and P2 was significantly higher in group A than in group B. It was observed that, in group A at P1, the regions RIF and LIF developed larger fluid collections. In group B, there were significantly larger fluid collections in the HYPO region at P1, and in the UMB and HYPO regions at P2. Conclusion: Lipoabdominoplasty is effective technique for the prevention of seroma compared with abdominoplasty.

Seroma in lipoabdominoplasty and abdominoplasty: a comparative study using ultrasound.

BACKGROUND: Abdominoplasty is one of the most frequently performed cosmetic procedures, and its combination with liposuction has become more common. Seroma is one of the most common complications in abdominoplasty. The aim of this study was to compare the rate of seroma formation in patients who underwent either abdominoplasty with or without the use of quilting sutures or lipoabdominoplasty. METHODS: Fifty-eight female patients were divided into three groups and underwent one of the following procedures: group A (n=21), abdominoplasty without quilting sutures; group B (n=17), abdominoplasty with quilting sutures; and group C (n=20), lipoabdominoplasty. To investigate seroma formation, abdominal ultrasound was performed in five regions of the abdominal wall (epigastrium, umbilical, hypogastrium, right iliac fossa, and left iliac fossa) at two postoperative periods (P1, between postoperative days 11 and 14; and P2, between postoperative days 18 and 21). RESULTS: The rate of seroma formation at both P1 and P2 was significantly higher in group A. It was observed that in group A at P1, the regions of right iliac fossa and left iliac fossa developed larger fluid collections. In group B, there were no significant differences with respect to fluid collections among the five study regions at both P1 and P2. In group C, there were significantly larger fluid collections in the hypogastrium region at P1 and in the umbilical and hypogastrium regions at P2. CONCLUSION: Abdominoplasty with quilting sutures and lipoabdominoplasty are effective techniques for the prevention of seromas compared with abdominoplasty without quilting sutures.

Abdominoplasty and its effect on body image, self-esteem, and mental health.

The impact of abdominoplasty on the quality of life of abdominoplasty patients was assessed 1- and 6-months postoperatively. Forty women aged 25 to 60 years were divided into study group (25 patients who underwent abdominoplasty) and waiting-list control group (15 patients). Three questionnaires (Body Shape Questionnaire [BSQ], Rosenberg Self-Esteem Scale [RSE/UNIFESP], and Short Form 36 Health Survey Questionnaire [SF-36]) were administered to the study group (preoperatively, 1- and 6-months postoperatively) and control group (on 2 occasions 6 months apart). A significant positive impact on body image, self-esteem, and mental health was found 1- and 6-months postoperatively. Significant differences were observed in role physical, role emotional, and vitality 1-month postoperatively. In the control group, significant differences were found for vitality. There was a significant improvement in Comparative perception of body image (6-month assessment) in the study group compared with controls. Abdominoplasty improved body image, self-esteem, and mental health.

O problema da aquisiçäo de medicamentos na rede pública de saúde de Londrina / The problem of the drugs aquisition in the health public net-Londrina

A partir da vivência da realidade do Centro de Saúde do Jardim Leonor, localizado na Regiäo Oeste da cidade de Londrina e da populaçäo que procurava os seus serviços, os alunos do 1§ ano dos cursos do Centro de Ciências da Saúde da UEL, identificaram a falta de medicamentos como o problema a ser estudado no seviço. Foram realizadas entrevistas com uma amostra de pacientes que aguardavam na sala de espera, algumas visitasno bairro, além dos profissionais do próprio serviço e uma visita ao Centro de Fornecimento de Medicamentos para toda a rede de saúde do município(CENTROFARMA). Os principais resultados encontrados demonstram que 74,2 por cento das pessoas procuram o Centro de Saúde para satisfazer suas necessidades de assistência a saúde; no entanto apenas 38,8 por cento das pessoas entrevistadas conseguiam encontrar no seviço os medicamentos requeridos. Embora näo se trate de uma amostra aleatória, estatisticamente controlada, os resultados apontam que é evidente a ausência de alguns medicamentos no Centro de Saùde como consequência do caótico quadro de sua distribuiçäo, falta de uma produçäo mais ampla e de verbas destinadas à saùde