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1.
Zhonghua Yan Ke Za Zhi ; 56(11): 805-810, 2020 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-33152838

RESUMO

Oculoplastic and orbital surgery is concerned with the occurrence, manifestation, diagnosis, treatment and prevention of the eyelid, orbit and lacrimal diseases, as well as the repair and reconstruction of the related deformities and defects. Since the beginning of the new century, the number of patients with eyelid and orbital diseases has increased continuously, and the team of specialists has expanded rapidly. The development of oculoplastic and orbital surgery in China has entered an all-round new stage, especially with the establishment of Chinese Society of Oculoplastic Surgery and Orbital Disease in 2013. Oculoplastic and orbital surgery in China has made outstanding achievements in strengthening the training of professional talents, promoting interdisciplinary and international exchanges, improving the academic level of basic research, and emphasizing on the research of translational medicine. The technique of ocular plastic surgery has been progressing continuously. Cosmetic surgery of the eye has gained widespread popularity and standardization. Orbital surgery has recorded an innovative, interdisciplinary and rapid growth. International exchanges have helped to expand the international influence and competitiveness. This article is written to celebrate the 70th anniversary of Chinese Journal of Ophthalmology. (Chin J Ophthalmol, 2020, 56: 805-810).


Assuntos
Procedimentos Cirúrgicos Oftalmológicos , Oftalmologia , Cirurgia Plástica , China , Humanos , Órbita/cirurgia
2.
Artigo em Russo | MEDLINE | ID: mdl-33161681

RESUMO

Nikolai Olegovich Milanov, the academician of the Russian Academy of Medical Sciences, leading Russian surgeon, Merited Scientist of the Russian Federation, is one of the pioneers of development of reconstructive microsurgery in our country. He made immense contribution to development of modern plastic and reconstructive microsurgery. He is the author of unique developments that inputted significantly into successive achievements in treatment of traumatic and iatrogenic tissue defects and congenital pathology. The priority areas of his research were replantation of fingers, hands and larger segments of limbs in adults and lower extremities in children, abjuncted because of wheeled traumas, auto-transplantation of revasculized tissue complexes in post-traumatic, congenital and acquired pathologies in adults and children, in oncologic diseases, in extensive tracheal defects, reconstructive microsurgery of blood and lymph vessels and peripheral nerves, reconstructive microsurgery in male and female infertility. He introduced to clinical practice great number of new surgical interventions based on micro-surgical auto-transplantation of various tissue complexes. He achieved brilliant successes in scientific and practical activities during 39 years of work. He was the first in the world who underwent a successful re-implantation of lower limb, amputated at the level of upper third of leg by train wheel in 2.5-year-old child. He also was the first surgeon who performed unique operation of simultaneous replantation of two limbs, amputated at the level of middle third of leg in 7-year-old child. N. O. Milanov used the micro-surgical technique of applying direct lymphatic venous anastomoses in lymphatic edema. He developed innovative methods of multiple transplantation of toes to hand and transplantation of omentum, for example, to close defects of the scalp in basal cell carcinoma. This brilliant surgeon can be called the founder of clinical auto-transplantology. He actively participated in resolving problem of "prefabrication" of various tissue complexes with desired properties for their subsequent auto-transplantation. Under the direction of N. O. Milanov, the new scientific school was formed that included such well-known surgeons as R. T. Adamyan, A. I. Nerobeev, I. V. Reshetov and many others.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Aniversários e Eventos Especiais , Masculino , Microcirurgia , Federação Russa
3.
Vestn Otorinolaringol ; 85(5): 74-77, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140939

RESUMO

The object of the clinical research was 367 patients after rhinoplasty. All patients before the operation fill in a special questionnaire, allowing to evaluate quantify the signs of dysmorphophobia. Patients with low index of dysmorphophobia (within 5-6 points) adequately estimated the result of the operation because their opinion coincided with the opinion of the doctor and in some cases they didn't notice even insignificant defects the doctor saw. The total number of these results satisfying the patient and the doctor composed 93% (341 patients). The patients who attaches great importance to insignificant defect of their appearance the index of desmorphophobia was high (16 patients - the average index of dysmorphophobia - 15). Questionnaires containing questions that allows to expose the signs of dysmorphophobia may be useful in the time of selection of patients for plastic surgery, in particular rhinoplasty. According to the questionnaire worked out by us, the index of dysmorphophobia of 5 points and below allows to count up on an adequate evaluation. The importance of index from 6 to 10 points may require psychological support of the patient who will much evaluate the result.


Assuntos
Médicos , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Cirurgia Plástica , Humanos , Satisfação do Paciente , Inquéritos e Questionários
4.
Can J Surg ; 63(5): E454-E459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33107817

RESUMO

SUMMARY: Small surgical residency programs like plastic surgery can be challenging environments to accommodate parental leave. This study aimed to report the experiences, attitudes and perceived support of Canadian plastic surgery residents, recent graduates and staff surgeons with respect to pregnancy and parenting during training. Residents and staff surgeons were invited via email to participate in an online survey. The results presented here explore experiences of pregnancy and parental leave of current plastic surgery residents and staff surgeons. Residents' and staff surgeons' perceptions of program director support, policies, negative comments and the impact of parental leave on the workload of others were also explored. Although the findings suggest that there may be improvements in the support of program directors, there continues to be a negative attitude in surgical culture toward pregnancy during residency. The perceived confusion of respondents with respect to programspecific policies emphasizes the need for open conversations and standardization of parental leave.


Assuntos
Atitude do Pessoal de Saúde , Internato e Residência/estatística & dados numéricos , Licença Parental/estatística & dados numéricos , Gravidez/psicologia , Cirurgia Plástica/educação , Adulto , Canadá , Feminino , Humanos , Internato e Residência/organização & administração , Masculino , Pessoa de Meia-Idade , Diretores Médicos/psicologia , Políticas , Gravidez/estatística & dados numéricos , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/psicologia , Cirurgia Plástica/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
5.
FP Essent ; 497: 11-17, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33021773

RESUMO

Nonsurgical cosmetic procedures, including injection procedures, are among the fastest growing medical procedures. In 2018, botulinum toxin and hyaluronic acid injections were the two most common nonsurgical cosmetic procedures performed in the United States. Botulinum toxin is a neuromodulator with seven serotypes, but only serotypes A and B are in clinical use. The facial areas in which botulinum toxin is used most commonly include the forehead, glabella, and lateral canthal lines (ie, crow's feet). Adverse effects are transient. Several types of injectable dermal fillers are available. Hyaluronic acid is the most commonly used filler and is hypoallergenic. Others include calcium hydroxylapatite, poly L-lactic acid, and polymethylmethacrylate. The characteristics of fillers, including their elasticity and viscosity, are used to determine which should be used for specific applications. Potential serious complications include vascular occlusion leading to tissue necrosis or blindness. Immediate recognition and management of complications are needed to prevent long-term sequelae. With appropriate training, physicians and other clinicians can perform these injections safely in the office setting.


Assuntos
Técnicas Cosméticas , Envelhecimento da Pele , Cirurgia Plástica , Face , Humanos , Ácido Hialurônico , Estados Unidos
6.
FP Essent ; 497: 18-22, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33021774

RESUMO

Facial plastic surgery deals with improving the form, function, and appearance of the face. Blepharoplasty (ie, eyelid surgery) is the most commonly performed surgical procedure in men and women 65 years and older. It has been shown to be effective for improving attractiveness and eyelid function (eg, improved visual field). Indications for upper and lower eyelid surgery include aesthetic concerns, ptosis, and peripheral field vision impairment. Facelift procedures resuspend, reposition, and release underlying facial structures and excise excess skin to improve the appearance of the face. Facelifts mainly involve manipulation of the superficial musculo-aponeurotic system (SMAS), a group of muscles in the lateral face. Types of facelifts include subcutaneous facelift with SMAS manipulation to allow for facial shaping of the deep soft tissue. Such manipulation can include SMAS-ectomy, SMAS plication, and SMAS flap creation. Deep plane facelift involves the SMAS and release of the facial and cervical retaining ligaments. Hematoma is a common serious complication of facelifts. Less common complications include skin flap necrosis, nerve damage, and scarring. Rhinoplasty is another commonly performed facial surgery. The two main forms are open rhinoplasty and closed rhinoplasty.


Assuntos
Ritidoplastia , Cirurgia Plástica , Feminino , Humanos , Masculino
7.
FP Essent ; 497: 23-26, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33021775

RESUMO

Liposuction and nonsurgical fat reduction modalities (ie, body contouring) are among the most commonly performed cosmetic procedures in the United States. Liposuction is an invasive surgical procedure in which adipose tissue is dislodged and suction is used to remove it. The procedure originally was performed with a regional nerve block or general anesthesia; a tumescent technique for local anesthesia now is used. There are several types of liposuction, each uses application of energy to allow for removal of fat. These methods include laser-assisted, power-assisted, and ultrasound-assisted liposuction. Abdominoplasty can be performed in combination with liposuction for management of loose skin. Nonsurgical fat reduction modalities include cryolipolysis, use of radiofrequency lipolysis devices, and ultrasonographic modalities. Cryolipolysis uses cold temperatures to achieve lipolysis, whereas radiofrequency lipolysis devices use heat to destroy adipose tissue. Nonthermal low-intensity, low-frequency ultrasonography uses mechanical methods to destroy fat cells. High-intensity focused ultrasound uses thermal methods. Body contouring procedures can be performed alone or in combination with other procedures.


Assuntos
Lipectomia , Cirurgia Plástica , Humanos , Estados Unidos
8.
FP Essent ; 497: 27-36, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33021776

RESUMO

In 2018, breast augmentation was the most common cosmetic surgical procedure performed in the United States. It was the most commonly performed cosmetic surgical procedure in women ages 18 to 34 years. Silicone gel-filled implants are the most commonly used in the United States, followed by saline-filled implants. The most common approach to placement of implants is through an incision in the inframammary fold. The majority of implants are placed subglandularly, under the breast tissue but on top of the pectoralis muscle. Postoperative complications include lumps, asymmetry, leakage or deflation, capsular contracture, changes or loss of nipple and areolar sensation, seroma, hematoma, changes in breast shape, and infection. Long-term complications include infection, implant rupture, capsular contracture, and breast implant-associated anaplastic large cell lymphoma. Any patient who has undergone breast augmentation who presents with a breast lump or mass should be referred to a breast unit for evaluation. Lumps can indicate implant rupture, capsular contracture, seroma, hematoma, breast cancer, or infection. Studies have shown no association between silicone-filled breast implants and connective tissue disorders. Breast reconstruction after mastectomy frequently involves placement of implants. Autologous reconstruction remains another option. Various implants are approved by the Food and Drug Administration for buttock and calf augmentation.


Assuntos
Implantes de Mama , Neoplasias da Mama , Cirurgia Plástica , Adolescente , Adulto , Implantes de Mama/efeitos adversos , Feminino , Humanos , Mastectomia , Géis de Silicone , Estados Unidos , Adulto Jovem
9.
Acta Biomed ; 91(3): ahead of print, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32921744

RESUMO

During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown. Nevertheless, we have experienced different difficulties. We have not had the possibility to use a secure teleconferencing software. In our unit we had not technological devices. Surgeons in our department were not able to use remote video technology for patient management. Guidelines for an appropriate selection of patients which could be served via telemedicine had to be created. Telemedicine must be regulated by healthcare organizations for legal, ethical, medico-legal and risk management aspects. Even if we have experienced an important need to use telematic solutions during the COVID-19 lockdown, liability and risk management issues has greatly limited this possibility in our unit. The need of telemedicine in the time of COVID-19 pandemic has encouraged us to implement future virtual encounters in order to reduce unnecessary in-person visits by taking into consideration all legal, ethical and medico-legal aspects.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Gestão de Riscos/métodos , Cirurgia Plástica/organização & administração , Telemedicina/métodos , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão
10.
Harefuah ; 159(9): 694-696, 2020 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-32955814

RESUMO

INTRODUCTION: The breast as an organ has much more importance than its physiological role and is considered a symbol of fertility and femininity for thousands of years. The history of plastic surgery operations of the breast developed parallel to the oncological breast surgery started for the late 19th century. In a number of issues of IMAJ and "Harefuah", some of the challenges and complexities are presented and discussed: breast implants associated lymphoma, mycobacterial infections, and galactorrhea. There are challenges in breast reconstruction post-chemotherapy, using autologous fat with a negative pressure to enhance vascularity and fat take. Modification of the surgical technique is presented to prevent the use of acellular dermal matrix in immediate direct to implant breast reconstruction. The Israeli innovation of creating a lighter implant manipulating the silicone is also described and the experience of one center in transgender breast reductions.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Mamoplastia , Cirurgia Plástica , Feminino , Humanos , Mastectomia , Complicações Pós-Operatórias
11.
Unfallchirurg ; 123(10): 807-815, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32968833

RESUMO

Necrotizing fasciitis is a fulminant and potentially life-threatening infection of the skin and soft tissue. It is usually caused by a combination of different bacteria and is often due to assumed minor trauma. Clinically, only relatively insignificant skin changes are initially present, such as blistering or erythema. They are often accompanied by excessive pain. In the further course, the massive systemic reaction becomes predominant. The diagnosis of necrotizing fasciitis is primarily clinical, which can be supported by laboratory parameters (LRINEC score) and computed tomography imaging. Decisive for the prognosis is the immediate initiation of surgical treatment by radical debridement. Additionally, the calculated administration of a combination of different antibiotics should be initiated. As part of the further complex intensive care treatment, a regular reevaluation of the wounds is carried out. Multiple débridements are always necessary until plastic surgery for defect coverage can be carried out.


Assuntos
Fasciite Necrosante/cirurgia , Cirurgia Plástica , Desbridamento , Serviço Hospitalar de Emergência , Humanos , Prognóstico , Pele
12.
Praxis (Bern 1994) ; 109(12): 961-966, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32933387

RESUMO

Dealing with Acute Complications of Aesthetic Surgery Procedures Performed Abroad: Cost Analysis for the Swiss Health System Abstract. Aesthetic surgery tourism is a growing phenomenon, with a steady increase of people travelling abroad for surgical procedures. In our hospital, a relevant number of patients consulted the emergency department for complications after cosmetic surgery performed in foreign countries. This progressively increasing trend leads to multiple outpatient clinic consultations and surgical re-operations. We investigated this phenomenon at Lausanne University Hospital from May 2015 to December 2018, with the aim to give a review of the surgical and hospital care costs, finally affecting the Swiss insurance system.


Assuntos
Turismo Médico , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Humanos , Complicações Pós-Operatórias , Suíça
13.
Plast Reconstr Surg ; 146(4): 464e-473e, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32970014

RESUMO

BACKGROUND: Physician burnout is a well-known problem and widespread issue in the field of medicine. Recently, more attention has been given to the significance of burnout among plastic surgeons. The cause of burnout is multifactorial, with emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment all playing a role. The objective of this article is to provide practical measures to help plastic surgeons in identifying the signs of burnout, thereby mitigating its consequences. METHODS: A literature review was performed to determine the comprehensive findings of previous research conducted on burnout among plastic surgeons. Particular interest was given to successful tactics used in managing work-related stress. Wellness strategies and resources from both academic and private medical settings were also obtained to further review methods for burnout management. RESULTS: There is a wide range of causes and risk factors for burnout among plastic surgeons. The majority of cases correlate with increased workload, loss of physician autonomy, and, in the context of trainees, lack of mentorship. Managing burnout can be supported by identification through survey tools. Establishing a wellness committee is also useful to develop institution-specific interventions. Equally as important, individuals must take steps to manage and minimize their burnout. CONCLUSIONS: This article provides practical strategies for institutions to identify and manage burnout among plastic surgeons. It is obvious that causes of burnout vary in different settings such as academic and community hospitals; therefore, it is critical for institutions to individualize their approach to burnout.


Assuntos
Esgotamento Profissional/diagnóstico , Esgotamento Profissional/terapia , Cirurgia Plástica/psicologia , Esgotamento Profissional/etiologia , Humanos , Fatores de Risco
14.
Plast Reconstr Surg ; 146(5): 680e-683e, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32732794

RESUMO

Telemedicine holds vast amounts of potential in changing the way outpatient plastic and reconstructive surgery is practiced. Before the coronavirus disease 2019 (COVID-19) pandemic, video conferencing was used by a small fraction of medical specialties. However, since the start of the pandemic, the Centers for Medicare and Medicaid Services and the largest private health insurance companies have relaxed regulations to allow the majority of specialties to use video conferencing in lieu of in-person visits. Most importantly, video conferencing minimizes patient and physician exposure in situations such as these, and decreases risk in the immunocompromised population. Video conferencing, which has been shown to be just as safe and efficacious in treating patients, offers the ability to follow up with physicians while saving travel time and travel-related expenses. This in turn correlates with increased patient satisfaction. Video conferencing also allows physicians to expand their reach to patients in rural areas seeking advanced professional advice. Incorporating video conferencing into existing practices will make for a more efficient practice, improve patient satisfaction, and decrease cost to patients and the health care system.


Assuntos
Procedimentos Cirúrgicos Ambulatórios , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Telemedicina/métodos , Comunicação por Videoconferência , Infecções por Coronavirus/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Humanos , Pandemias/prevenção & controle , Satisfação do Paciente , Pneumonia Viral/prevenção & controle , Cirurgia Plástica/métodos , Cirurgia Plástica/organização & administração , Telemedicina/organização & administração , Estados Unidos , Comunicação por Videoconferência/organização & administração
17.
Plast Reconstr Surg ; 146(2): 371-379, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740590

RESUMO

BACKGROUND: As a component of the Maintenance of Certification process from 2003 to 2019, the American Board of Plastic Surgery tracked 20 common plastic surgery operations. By evaluating the data collected over 16 years, the authors are able to examine the practice patterns of pediatric/craniofacial surgeons in the United States. METHODS: Cumulative tracer data for cleft palate repair was reviewed as of April of 2014 and September of 2019. Evidence-based medicine articles were reviewed. Results were tabulated in three categories: pearls, or topics that were covered in both the tracer data and evidence-based medicine articles; topics that were covered by evidence-based medicine articles but not collected in the tracer data; and topics that were covered in tracer data but not addressed in evidence-based medicine articles. RESULTS: Two thousand eight hundred fifty cases had been entered as of September of 2019. With respect to pearls, pushback, von Langenbeck, and Furlow repairs all declined in use, whereas intravelar veloplasty increased. For items not in the tracer, the quality of studies relating to analgesia is among the highest of all areas of study regarding cleft palate repair. In terms of variables collected by the tracer but not studied, in 2019, 41 percent of patients received more than 1 day of antibiotics. CONCLUSIONS: This article provides a review of cleft palate tracer data and summarizes the research in the field. Review of the tracer data enables cleft surgeons to compare their outcomes to national norms and provides an opportunity for them to consider modifications that may enhance their practice.


Assuntos
Fissura Palatina/cirurgia , Medicina Baseada em Evidências/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Medicina Baseada em Evidências/métodos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Cirurgiões/legislação & jurisprudência , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/legislação & jurisprudência , Cirurgia Plástica/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos , Adulto Jovem
18.
Plast Reconstr Surg ; 146(2): 217e-220e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740601

RESUMO

BACKGROUND: The gender disparity between the number of female and male chairs and program directors has been previously established. The aim of this study was to determine whether any differences in objective credentials existed between male and female plastic surgery department chairs/division chiefs and program directors. METHODS: Information about each plastic surgery program director and chair/chief was extracted from the websites of all institutions affiliated with a plastic surgery residency program. For each individual, information about the length of their career, number of fellowships completed, and number of publications was recorded. The two-tailed t test was used to compare differences between male and female chairs and program directors. RESULTS: A total of 99 chairs were recorded, of which nine (9.1 percent) were female. Of the 99 program directors, 13 (13.1 percent) were female. There was no difference in the number of years in practice or number of fellowships between men and women for either position. On average, male chairs had significantly fewer publications than female chairs (71.9 versus 128; p < 0.05). There was no significant difference in the number of publications between male and female program directors. Compared to program directors, chairs had significantly more years in practice and numbers of publications, which held true for both men and women. CONCLUSIONS: Women are not only underrepresented in the department chair and program director positions, but also possess higher qualifications that may reflect differences in standards for promotion and appointment. Additional research is needed to elucidate the reasons behind the observed differences in qualifications.


Assuntos
Docentes de Medicina/organização & administração , Internato e Residência/organização & administração , Seleção de Pessoal/ética , Sexismo , Cirurgia Plástica/organização & administração , Docentes de Medicina/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/ética , Internato e Residência/estatística & dados numéricos , Liderança , Masculino , Publicações/estatística & dados numéricos , Cirurgia Plástica/ética , Cirurgia Plástica/estatística & dados numéricos
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