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Plast Reconstr Surg ; 145(2): 329e-336e, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985630


BACKGROUND: Videos on YouTube can be posted without regulation or content oversight. Unfortunately, many patients use YouTube as a resource on aesthetic surgery, leading to misinformation. Currently, there are no objective assessments of the quality of information on YouTube about aesthetic surgery. METHODS: YouTube was queried for videos about the 12 most common aesthetic surgical procedures, identified from the 2015 American Society of Plastic Surgeons procedural statistics between May and June of 2016. The top 25 results for each search term were scored using the modified Ensuring Quality Information for Patients criteria based on video structure, content, and author identification. Average Ensuring Quality Information for Patients score, view count, and video duration were compared between authorship groups. RESULTS: A total of 523 videos were graded after excluding duplicates. The mean modified Ensuring Quality Information for Patients score for all videos was 13.1 (SE, 0.18) of a possible 27. The videos under the search "nose reshaping" had the lowest mean score of 10.24 (SE, 0.74), whereas "breast augmentation" had the highest score of 15.96 (SE, 0.65). Physician authorship accounted for 59 percent of included videos and had a higher mean Ensuring Quality Information for Patients score than those by patients. Only three of the 21 search terms had a mean modified Ensuring Quality Information for Patients score meeting criteria for high-quality videos. CONCLUSIONS: The information contained in aesthetic surgery videos on YouTube is low quality. Patients should be aware that the information has the potential to be inaccurate. Plastic surgeons should be encouraged to develop high-quality videos to educate patients.

Disseminação de Informação/métodos , Internet , Educação de Pacientes como Assunto , Cirurgia Plástica/métodos , Gravação em Vídeo , Humanos , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Estados Unidos , Gravação em Vídeo/normas
Plast Reconstr Surg ; 145(2): 433e-437e, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985662


BACKGROUND: Women now constitute 40.5 percent of integrated plastic surgery residents; however, in 2007, women represented only 11.3 percent of the leadership positions in plastic surgery societies and journal editorial boards. The authors analyzed female representation in these societies and editorial boards over the past 10 years. METHODS: Names of board members from the major plastic surgery societies (American Society of Plastic Surgeons, The Plastic Surgery Foundation, and American Society for Aesthetic Plastic Surgery, among others) for the past 10 years and the major plastic journals (Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and so on) from the past 5 years were extracted from their websites. The yearly percentage of female plastic surgery residents was obtained from Accreditation Council for Graduate Medical Education published data. The proportions of women in society leadership, editorial boards, and residency were compared with data analyses of time series trend and linear and Auto Regressive Integrated Moving Average time series modeling. RESULTS: Over the past 10 years, the percentage of female residents has grown steadily, from 21.84 percent to 37.31 percent. Similarly, female representation in society leadership has grown from 6.78 percent to 20.29 percent. Both growth coefficients were statistically significant and showed no statistical difference between the two. In contrast, editorial board leadership over the past 5 years showed statistically insignificant growth and showed a statistically significant difference when compared to the growth of the percentage of female residents and female representation in society leadership. CONCLUSION: Female representation in plastic surgery society leadership shows promising growth, whereas their representation on editorial boards showed significantly less growth, which may reflect the slower turnover on these boards.

Médicas/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Feminino , Humanos , Liderança , Masculino , Editoração , Distribuição por Sexo , Sociedades Médicas , Estados Unidos
Plast Reconstr Surg ; 145(2): 576-584, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985665


BACKGROUND: Prior studies demonstrate that social media are used by plastic surgeons to educate and engage. The hashtag #PlasticSurgery has been studied previously and is embraced by American plastic surgeons and journals; however, no studies have examined its use or adoption across Europe. METHODS: A retrospective analysis of 800 tweets containing the words "plastic surgery" or the hashtag #PlasticSurgery in four of the most spoken European languages worldwide excluding English (Spanish, #CirugiaPlastica; French, #ChirurgiePlastique; Portuguese, #CirurgiaPlastica; and German, #PlastischeChirurgie) was performed. The following were assessed: identity of author, subject matter, use of the hashtag #PlasticSurgery in each language, whether posts by surgeons and academic institutions were self-promotional or educational, and whether a link to a journal article or a reference in PubMed was provided. RESULTS: Seventeen percent and 3 percent of analyzed tweets came from plastic surgeons or academic institutions, respectively; only 17.5 percent of them were for educational purpose. None of them had any digital link to a peer-reviewed article or a scientific journal. CONCLUSIONS: This study demonstrates the low participation of plastic surgeons and academic institutions in social media (especially for education) in four of the major world languages. Social media should be considered in Europe as an opportunity to increase leadership, improve education, and spread knowledge of plastic surgery by board-certified plastic surgeons.

Educação Médica/estatística & dados numéricos , Liderança , Cirurgia Plástica/educação , Europa (Continente) , Humanos , Linguagem , Estudos Retrospectivos , Mídias Sociais/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Terminologia como Assunto
Cient. dent. (Ed. impr.) ; 16(3): 223-230, sept.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-ET2-3544


La aplicación de materiales de relleno como alternativa a las intervenciones quirúrgicas estéticas con el fin de corregir defectos faciales en la piel tales como arrugas o imperfecciones, es una práctica que cada vez es más demandada por los pacientes en el día a día en la consulta. Existen distintos materiales capaces de devolver a la piel ese volumen perdido con los años. Estos, se clasifican en función de su composición y de su duración. El ácido hialurónico es el material de relleno más empleado por los odontólogos al gozar de un gran éxito por ser efectivo y versátil además es un producto seguro, ya que sus posibles complicaciones son mínimas

The application of filling materials as an alternative to aesthetic surgical interventions, in order to correct facial defects in the skin, such as wrinkles or imperfections, is a practice that is increasingly demanded by patients on a day-to-day basis in the practice.There are several materials capable of returning the skin that volume lost over the years. These are classified according to their duration and duration.Hyaluronic acid is the most used filling material for dentists to enjoy great success because it is effective and versatile, it is also a safe product since it is possible to have minimal problems

Humanos , Ácido Hialurônico/uso terapêutico , Cirurgia Plástica/tendências , Odontologia/normas , Técnicas Cosméticas , Tecido Conjuntivo/efeitos dos fármacos , Colágeno , Derme/efeitos dos fármacos , Géis de Silicone , Legislação Odontológica
Zhonghua Shao Shang Za Zhi ; 35(12): 866-871, 2019 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-31877609


Objective: To analyze application and funding projects of National Natural Science Foundation of China (NSFC) in the discipline of burns and plastic surgery over the years, so as to provide reference for subsequent fund application and the search for new research directions in the discipline. Methods: Annual statistical reports on funding projects and Internet-based Science Information System of NSFC were used to search the application and funding situation of the science foundation projects related to the discipline of burns and plastic surgery during 1986-2018. The relevant situation was statistically analyzed during 2009-2018, including the amount of applications and grant, funding rate, and appropriation. The amount of the application and grant, funding rate, appropriation, and funding strength of multiple series (Exploration, Talent, Tools, Integration) during 2009-2018 were statistically analyzed. Main granted projects in each year during 2009-2018 were statistically analyzed. Funding situation of research direction in the discipline of burns and plastic surgery was analyzed. Results: (1) During the past 33 years, the amount of application and funding in the discipline of burns and plastic surgery were on increase trend generally. (2) During 2009-2018, the total funding rate of the science foundation was 18.63% (611/3 279), with a total appropriation of 26 167.5 ten thousand yuan. (3) During 2009-2018, the more funding projects in the discipline of burns and plastic surgery were General Program of Exploration series and Young Scientists Fund, and Fund for Less Developed Regions of Talent series in turn, their funding rates were respectively 19.11% (330/1 727), 17.72%(216/1 219), and 19.26%(47/244), with appropriations of 18 115.0, 4 450.0, and 1 780.0 ten thousand yuan and funding strength of 54.89, 20.60, and 37.87 ten thousand yuan per project respectively. In addition, the funding rate of the Key Program of Exploration series was 6.82% (3/44) with appropriation of 828.0 ten thousand yuan, and funding strength for each was 276.00 ten thousand yuan. The International (Regional) Cooperation and Exchange Programs received 15 applications, and 4 projects were funded with appropriation of 524.5 ten thousand yuan and the funding strength of 131.13 ten thousand yuan for each. National Science Fund for Distinguished Young Scholars of Talent series received 12 applications, and 1 project was funded with appropriation of 200.0 ten thousand yuan. Tools and Integration series projects received only a few or no application, and none of the application was funded. (4) The funding amount of General Programs was the most, peaking at 50 in 2012, and was decreased slightly in the past 6 years. The funding amount of Young Scientists Fund was relatively less, but it was on increase trend year by year. The funding amount of Fund for Less Developed Regions was the least relatively, with a steady increase trend in general. (5) The amount of funding projects according to the research direction in the discipline of burns and plastic surgery in the order from more to less were H1507 wound healing and scar (219, 35.84%), H1505 burns (168, 27.50%), H1508 body tissue and organs deformity, damage and repair, and regeneration (143, 23.40%), H1509 body surface tissue organ transplantation and reconstruction (53, 8.67%), H1510 cranial and maxillofacial deformities and correction (27, 4.42%), H1506 frostbite (1, 0.16%). Conclusions: In recent years, the amount of science foundation projects in the discipline of burns and plastic surgery was on the rise, mainly including General Programs, Young Scientists Fund, and Fund for Less Developed Regions. In the process of science foundation application in the discipline of burns and plastic surgery, it is necessary to provide more ability training and policy support for young outstanding scientific and technological talents. At the same time, we should attach importance to international and regional academic exchanges, and provide a favorable platform for cooperative projects. Besides, research on new hotspots such as chronic wounds and prevention and treatment of scar or not in popular research such as frostbite should be strengthened.

Queimaduras , Disciplinas das Ciências Naturais , Cirurgia Plástica , China , Fundações , Humanos
J Clin Ethics ; 30(4): 303-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851621


A face transplant is as challenging a surgical procedure as any patient can undergo. In this introduction I present the medical aspects of this surgery, the profound ethical issues it raises, and optimal interventions that clinicians can pursue to help these patients and their loved ones. I then discuss how to help other kinds of patients and loved ones who confront similar stresses. I end by presenting a goal that author Sharrona Pearl puts forth after she studied many face transplant patients. The efforts she urges should maximize our capacity to see face transplant patients-and anyone-as they are, as opposed to how they look.

Face/cirurgia , Transplante de Face/ética , Consentimento Livre e Esclarecido/ética , Cirurgia Plástica/ética , Confidencialidade , Ética Médica , Transplante de Face/psicologia , Feminino , Humanos
Rev. bras. cir. plást ; 34(4): 582-583, oct.-dec. 2019.
Artigo em Inglês, Português | LILACS | ID: biblio-1047937


As informações no leito, sobre a necessidade de manobras do paciente, em intervalos de 2 h, para evitar o aparecimento de lesões por pressão podem reduzir o tempo de permanência, diminuir o risco de lesões de pele e os custos de manutenção do paciente.

Bedside information on the need for repositioning the patient at 2 h intervals to avoid the appearance of pressure ulcers can reduce hospitalization time, risk of skin lesions, and maintenance costs.

Humanos , Cirurgia Plástica , Ferimentos e Lesões , Lesão por Pressão , Tempo de Internação , Cirurgia Plástica/reabilitação , Ferimentos e Lesões/terapia , Lesão por Pressão/cirurgia , Lesão por Pressão/complicações , Lesão por Pressão/prevenção & controle , Lesão por Pressão/terapia
Rev. bras. cir. plást ; 34(4): 546-551, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047923


Introdução: A abdominoplastia é um procedimento para a melhoria do contorno corporal e a técnica tem sido aprimorada pela associação da dissecção limitada do retalho cutâneo e pontos de adesão no mesmo ato operatório, evitando-se a formação de seroma pós-abdominoplastia, complicação que incomoda tanto o paciente quanto o cirurgião. Portanto, o objetivo é avaliar se o uso de pontos de adesão está associado a menor incidência de seroma após abdominoplastia quando comparado ao uso de drenos. Métodos: Revisão sistemática da literatura com metanálise, envolvendo as seguintes bases de dados: Science Direct, Scielo, Pubmed, Lilacs, CINAHL e Scopus. Para analisar os dados foi utilizado o programa Stata 12.0 e a estatística I² proposta por Higgins, com intervalo de confiança de 95% para o risco relativo para seroma, segundo o tipo de intervenção (dreno, ponto de adesão, dreno com ponto de adesão). Sendo registrado no PROSPERO sob o número CRD42019120399. Resultados: Cinco estudos preencheram os critérios de inclusão e foram incluídos na metanálise. Ao comparar o uso de dreno de sucção com pontos de adesão, os pontos de adesão mostraram um fator de proteção na prevenção do seroma (RR: 0,13; IC 95%: 0,02-0,66). Conclusão: Os achados sugerem que o uso de pontos de adesão em abdominoplastia em detrimento do uso de drenos pode ser uma técnica eficaz para prevenção da formação de seromas.

Introduction: Abdominoplasty, which aims to improve body contour, has been upgraded by its association with limited dissection of the cutaneous flap and quilting sutures in the same surgery to avoid the formation of postabdominoplasty seroma, a complication that troubles both patient and surgeon. Therefore, this study aimed to assess whether the use of quilting sutures is associated with a lower incidence of seroma after abdominoplasty than the use of drains. Methods: A systematic review of the literature and a meta-analysis were performed of the Science Direct, Scielo, Pubmed, Lilacs, CINAHL, and Scopus databases. The data analysis was performed using the Stata 12.0 program and the I² statistic proposed by Higgins, with a 95% confidence interval for the relative risk for seroma by intervention type (drain, quilting sutures, drain with quilting sutures). The study was registered in PROSPERO (CRD42019120399). Results: Five studies met the inclusion criteria and were included in the meta-analysis. Quilting sutures showed a protective effect (versus use of drain with quilting sutures) in the prevention of seroma (relative risk, 0.13; 95% confidence interval, 0.02­0.66). Conclusion: These findings suggest that the use of quilting sutures instead of drains in abdominoplasty can effectively prevent seroma formation.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Sucção , Cirurgia Plástica , Drenagem , Metanálise como Assunto , Seroma , Abdome , Abdominoplastia , Sucção/métodos , Sucção/estatística & dados numéricos , Cirurgia Plástica/métodos , Cirurgia Plástica/estatística & dados numéricos , Drenagem/métodos , Drenagem/estatística & dados numéricos , Seroma/cirurgia , Seroma/terapia , Abdominoplastia/métodos , Abdominoplastia/estatística & dados numéricos , Abdome/cirurgia
Rev. bras. cir. plást ; 34(4): 504-508, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047913


Introdução: Lesões geradas por queimaduras representam um importante problema de saúde pública, constituindo a quarta causa de morte na infância no Brasil e Estados Unidos. Além disso, poucas são as doenças que trazem prejuízos tão importantes, com considerável morbidade pelo desenvolvimento de sequelas físicas e psicossociais. Diante disso, o objetivo deste estudo é traçar o perfil epidemiológico de crianças de 0-18 anos atendidas em um hospital escola de Curitiba, Paraná. Métodos: Estudo transversal e retrospectivo realizado através da análise de 625 prontuários de internação de crianças de 0-18 anos vítimas de queimaduras, entre janeiro de 2010 a dezembro de 2017. Foram coletadas informações sobre idade, sexo, tempo de internação, óbito, região corporal atingida, extensão da superfície corporal, grau de profundidade, agente etiológico e abordagem terapêutica. Resultados: A maior parte da amostra era composta por lactentes (43%), com média de idade de 12,6 anos. O sexo mais afetado foi o masculino e os pacientes permaneceram cerca de 14,5 dias internados. No estudo, 98% das queimaduras apresentaram como etiologia o agente térmico, principalmente por líquido quente. Em relação ao grau de profundidade, a maioria das queimaduras foram de 2º grau (61,3%), atingindo até 25% de superfície corporal queimada (SCQ), sendo o tronco o mais afetado. Dentre as modalidades de tratamento, 44% dos pacientes necessitaram de intervenção cirúrgica com debridamento e enxertia. Conclusão: Crianças mais novas são mais propensas a sofrerem queimaduras principalmente no ambiente domiciliar e, além disso, uma equipe preparada e capacitada é de crucial importância no prognóstico destes doentes.

Introduction: Injuries caused by burns represent a significant public health problem, constituting the fourth leading cause of childhood death in Brazil and the United States. In addition, few diseases carry such substantial losses as burns, with considerable morbidity due to the development of physical and psychosocial sequelae. This study aimed to outline the epidemiological profile of 0­18-year-old children treated for burns at a teaching hospital in Curitiba, Paraná. Methods: This cross-sectional, retrospective study involved analysis of 625 medical records of 0­18-year-old children who were victims of burns from January 2010 to December 2017. Information was collected on age, sex, length of hospitalization, death, body region affected, burned body surface area (BSA), depth, etiologic agent, and therapeutic approach. Results: A plurality of the sample were infants (43%), and the average age of the sample was 12.6 years. Most of the sample was comprised males, and the patients remained hospitalized for an average of 14.5 days. Of the burns, 98% were caused by thermal agents, particularly hot liquids. Most burns were second-degree burns (61.3%), reaching up to 25% of the BSA, and the most affected region was the trunk. Among the treatment modalities, 44% of the patients needed surgical intervention with debridement and grafting. Conclusion: Younger children are more prone to burns, especially in the home environment. A prepared and qualified team is of crucial importance for optimizing outcomes in these patients.

Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , História do Século XXI , Cirurgia Plástica , Perfil de Saúde , Queimaduras , Traumatismo Múltiplo , Inquéritos Epidemiológicos , Cirurgia Plástica/métodos , Cirurgia Plástica/estatística & dados numéricos , Queimaduras/cirurgia , Queimaduras/terapia , Traumatismo Múltiplo/cirurgia , Traumatismo Múltiplo/terapia , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos
Rev. bras. cir. plást ; 34(4): 485-496, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047909


Introdução: É consenso no meio jurídico que os resultados referentes às atividades médicas sejam obrigação de meio, e não de resultado. Contudo, há grande discussão quando se trata de procedimentos estéticos. A Resolução nº 1621/2001, do Conselho Federal de Medicina, define que o objetivo do ato médico na cirurgia plástica também constitui obrigação de meio. O estudo avaliou, entre novembro de 2015 a novembro de 2017, 106 casos, para verificar se o entendimento do Judiciário se alinha à Resolução do CFM [Conselho Federal de Medicina]. Foram quantificados o número de processos e a porcentagem dos casos julgados como procedentes ou improcedentes, além de verificar as principais posições doutrinárias e jurisprudenciais que embasaram as sentenças admitidas como procedentes. Foi, ainda, quantificado o número de casos cuja decisão do magistrado foi relacionada com o posicionamento do laudo pericial médico. Métodos: Foi feita busca no banco de sentenças do site do Tribunal de Justiça do Estado de São Paulo (SP), por meio da palavra-chave "Cirurgia Plástica", de todos os processos de indenização relacionados a cirurgias plásticas estéticas. Resultados: Foram sentenciados como improcedentes 61 casos (58%). Foram sentenciados como procedentes 45 casos (42%). Em 96% dos casos (102) a sentença relacionou-se positivamente com a análise pericial. Conclusão: Foram 102 sentenças concordantes aos laudos periciais e apenas quatro casos cuja sentença divergiu do entendimento do laudo. Estes dados mostram a importância crucial da análise pericial para a definição das sentenças judiciais. Analisando todas as sentenças, observou-se que em nenhum caso os juízes levaram em conta a Resolução do CFM [Conselho Federal de Medicina].

Introduction: There is a legal consensus that the results of medical activities represent obligations of means, not results. However, there is ample discussion when it comes to aesthetic procedures. Resolution 1621/2001 of the Federal Council of Medicine also defines the objective of a medical act in plastic surgery as an obligation of means. This study evaluated 106 cases between November 2015 and November 2017 to verify whether the decisions of the Judicial Power agree with the Resolution of the Federal Council of Medicine. The number of lawsuits and the percentage of claims granted or denied were quantified, and the opinions of jurists and courts that supported the claims granted were verified. The number of cases in which the judge's decision was related to the opinion of a medical expert was also quantified. Methods: The authors searched the judgment database located on the website of the Court of Justice of the State of São Paulo (SP) for damage related to aesthetic plastic surgery, using the keyword "Plastic Surgery" for all actions. Results: A total of 61 claims (58%) were denied, and 45 (42%) were granted. In 96% of cases (102) the judgment was positively related to the expert report. Conclusion: There were 102 cases in which the judgment agreed with the expert reports and only four cases in which the judgment did not agree with the reports. These data show the crucial importance of experts' reports in defining judicial judgments. The analyses of all judgments showed that there were no cases in which the judge considered the Resolution of the Federal Council of Medicine.

Humanos , História do Século XXI , Administração em Saúde Pública , Cirurgia Plástica , Erros Médicos , Decisões Judiciais , Estética , Medicina Legal , Jurisprudência , Administração em Saúde Pública/legislação & jurisprudência , Administração em Saúde Pública/métodos , Administração em Saúde Pública/estatística & dados numéricos , Cirurgia Plástica/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Medicina Legal/estatística & dados numéricos
Rev. bras. cir. plást ; 34(4): 468-476, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047904


Introdução: A lipoaspiração corporal e abdominoplastia são cirurgias muitas vezes realizadas em conjunto para obter melhores resultados na modelagem corporal. Cirurgias associadas sempre aumentam a espoliação, por isto conhecer o comportamento da hemoglobina (Hb) no pós-operatório e a recuperação do paciente submetido a estas cirurgias combinadas é importante para sua segurança. O objetivo deste trabalho foi estudar a queda da Hb e a recuperação clínica e laboratorial dos pacientes submetidos à cirurgia combinada de lipoaspiração corporal e lipoabdominoplastia. Métodos: Realizou-se um estudo prospectivo em pacientes submetidos à lipoaspiração corporal e lipoabdominoplastia, coletando-se hemogramas antes da indução anestésica, ao final da cirurgia, antes da alta hospitalar, após a 1ª, 2ª e 4ª semanas de pós-operatórios e também acompanhando suas evoluções clínicas. Resultados: A média da Hb ao final da cirurgia e na alta hospitalar foi de 10,4g/dl (desvio padrão (DP) 0,76) e 8,92g/dl (DP 0,86), respectivamente. A recuperação em média da Hb após 1ª, 2ª e 4ª semanas foi de 2,4% (DP 18,07), 41,6% (DP 18,4) e 74% (DP 15,2), respectivamente, em relação a redução que ocorreu entre a Hb inicial e a da alta hospitalar. Queixas de fraqueza e lipotimia foram frequentes até o segundo dia. Conclusão: A melhora clínica ocorreu até o segundo dia de pós-operatório (DPO) e a hemoglobina levou aproximadamente 1 mês para normalizar na maioria dos pacientes tratados apenas com reposição oral de ferro, sem necessidade de hemotransfusão.

Introduction: Body liposuction and abdominoplasty are surgeries often performed together to obtain superior results in body modeling. Since associated surgeries often increase spoliation, being aware of the evolution of hemoglobin (Hb) in the postoperative period and during the recovery of the patients undergoing these associated surgeries is important for their safety. This study aimed to analyze the decrease in Hb and the clinical and laboratory results throughout the recovery of patients undergoing body liposuction associated with lipoabdominoplasty. Methods: A prospective study was conducted with patients undergoing body liposuction and lipoabdominoplasty. CBCs were collected before anesthetic induction, at the end of the surgery, before hospital discharge, after the 1st, 2nd, and 4th postoperative weeks, and during their clinical follow-up period. Results: The average Hb values at the end of surgery and hospital discharge were 10.4 g/dL (standard deviation (SD) 0.76) and 8.92 g/dL (SD 0.86), respectively. The average values during the recovery of Hb after the 1st, 2nd, and 4th weeks were 2.4% (SD 18.07), 41.6% (SD 18.4), and 74% (SD 15.2), respectively. This is in relation to the reduction between the initial Hb and at hospital discharge. Complaints of weakness and lipothymia were frequent until the second day. Conclusion: Clinical improvement was observed until the second postoperative day (PO day). Hemoglobin required approximately 1 month to normalize in most patients. These patients were treated only with oral iron replacement and did not require blood transfusions.

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Pacientes , Complicações Pós-Operatórias , Pesquisa , Cirurgia Plástica , Lipectomia , Evolução Clínica , Estudos Prospectivos , Abdome , Contorno Corporal , Anemia , Complicações Pós-Operatórias/sangue , Pesquisa/normas , Cirurgia Plástica/métodos , Lipectomia/efeitos adversos , Lipectomia/métodos , Evolução Clínica/métodos , Contorno Corporal/efeitos adversos , Contorno Corporal/métodos , Abdome/cirurgia , Anemia/complicações
Rev. bras. cir. plást ; 34(4): 517-523, oct.-dec. 2019. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1047918


A atenção e zelo do médico no período pré e pós-operatório é de extrema importância para a manutenção da boa relação médico/paciente. A organização e o adequado registro documental, contribui para a obtenção de um bom vínculo e assegura importante ferramenta jurídica ao médico. Hoje, com os avanços tecnológicos, o prontuário eletrônico é uma forma segura e democrática de lidar com estas informações. Nas instituições públicas o governo tem buscado implementar este sistema, mas os resultados são ainda discretos, talvez pela falta principalmente de recursos para investimento nesta área. Diante deste cenário e da grande relevância de um prontuário médico prático, informativo e dinâmico, objetivamos apresentar a nossa experiência com o uso complementar de um recurso digital sem custos. Associado ao prontuário médico de uso habitual dos serviços, descreve-se um sistema complementar, utilizando-se uma plataforma digital de armazenamento de dados na "nuvem". Por meio desse sistema é possível fornecer informações adicionais sobre cada paciente, incluindo o seguimento ambulatorial, assim como o registro fotográfico do pré, intra e pós-operatório, além de viabilizar um acesso rápido, sincronizado e remoto por meio da internet. O sistema gera economia de recursos, planejamento cirúrgico e melhora na relação médico/paciente. Favorece maior integração da equipe médica, discussão dos casos e distribuição das cirurgias por preceptor e residente. Assim, é um recurso alternativo para incrementar os prontuários médicos com dados importantes para a atuação das equipes médicas, com especial atenção às peculiaridades da cirurgia plástica.

The attention and enthusiasm of doctors in the pre- and postoperative period is of extreme importance in maintaining good doctor/patient relationships. An adequate organization and documentary record contributes to achieving a good relationship and ensures an important legal tool for physicians. With current technological advances, the electronic medical record is a secure and democratic way to deal with this information. The government has sought to implement this system in public institutions; however, results are still modest, perhaps mainly due to the lack of resources for investment in this area. In light of this, and given the relevance of practical, informative, and dynamic medical records, we aim to present our experience with the use of a complementary digital resource that is commonly associated with medical records and uses a free of cost digital platform for storing data in the "cloud". This system can provide additional information about each patient, including outpatient follow-up, as well as photographic records of the pre-, intra-, and post-operative periods, and also facilitates quick, synchronized, and remote access through the internet. The system generates optimization of resources, surgical planning, and improvement in patient/ doctor relationships. It also leads to greater integration of the medical team, particularly in the discussion of cases and distribution of surgeries by preceptors and residents. Thus, it is an alternative resource to improve medical charts with important data regarding the performance of medical teams, paying special attention to the peculiarities of plastic surgery.

Humanos , História do Século XXI , Cirurgia Plástica , Administração de Serviços de Saúde , Registros Médicos , Inovação , Assistência ao Paciente , Cirurgia Plástica/organização & administração , Administração de Serviços de Saúde/normas , Registros Médicos/normas , Assistência ao Paciente/métodos , Assistência ao Paciente/normas
Handchir Mikrochir Plast Chir ; 51(6): 418-423, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31698485


The profitability of medical treatment has gained increasing importance in health politics and likewise has become a considerable part of a microsurgeon's daily practice. The resulting cost pressure leads to microsurgeons having to justify their often complex and expensive treatments against hospital providers and health insurances. In this position paper of the German Speaking Group for Microsurgery of Peripheral Nerves and Vessels, we analyze the current status of profitability of microsurgical extremity and breast reconstruction, and its impact on choice of therapy and residency training. We specifically highlight the available literature, that shows often reduced long-term treatment costs after microsurgical reconstruction in comparison to cheaper initial treatments. The statements are based on a consensus workshop on the 40th meeting of the DAM in Lugano, Switzerland.

Microcirurgia , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Internato e Residência , Mamoplastia/economia , Microcirurgia/economia , Microcirurgia/métodos , Nervos Periféricos/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/economia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Suíça
Handchir Mikrochir Plast Chir ; 51(6): 434-439, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31698486


BACKGROUND: After loss of a thumb, the big toe is a possible donor site for reconstruction with wrap-around free flap and trimmed-toe transfer techniques. Early reconstructions seem to reduce the risk of post-operative infections, despite several studies that show different infection rates of the recipient site in immediate toe-to-hand transfer. The authors carried out a retrospective analysis of their experience in thumb reconstruction with big toe transfer and evaluated the results achieved with both immediate and delayed reconstructions in terms of infection occurrence. PATIENTS AND METHODS: From 2000 to 2017, patients who presented cut, crush and avulsion injuries in the thumb were selected and 33 toe-to-thumb transfers were performed. Patients were divided into two groups: in group A, patients underwent immediate reconstruction, while in group B delayed reconstructions were performed. The two groups received identical antimicrobial prophylaxis. Reliability of the immediate or delayed reconstruction was compared in terms of flap survival, requirement for a secondary intention healing and, in particular, rate of infection. RESULTS: 29 male and 4 female patients were treated. Toe-to-thumb transfers were performed in both groups: in group A, 8 wrap-around free flaps and 4 trimmed toe transfers; in group B, 11 wrap-around and 10 trimmed toe transfers. No flap loss occurred in either groups. No cases of infection were detected in the transferred toes. CONCLUSION: For toe-to-thumb transfer, there are published reports of a wide range of infection rates of the recipient sites. The authors compared their results in terms of infection rate between immediate reconstruction, group A, and delayed reconstruction, group B. Immediate toe-to-thumb transfer showed equal success rates to delayed transfer. No statistically significant difference in risk of infection between the two groups was found. Results showed that the immediate reconstruction was as safe and reliable as the delayed one.

Amputação Traumática , Procedimentos Cirúrgicos Reconstrutivos , Polegar/cirurgia , Dedos do Pé/transplante , Amputação Traumática/cirurgia , Feminino , Traumatismos dos Dedos/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Cirurgia Plástica/métodos , Dedos do Pé/cirurgia
Harefuah ; 158(10): 639-642, 2019 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-31576708


INTRODUCTION: Examinations are an integral part of the process of medical specialization in the State of Israel and a resident cannot receive an expert degree without passing the exams. The Scientific Council is the body responsible for the physician's training process, and the Higher Examinations Committee for the exams. Professional examinations committees are subject to the professional guidance by the Higher Examinations Committee. The residency exams are performed in two phases: Stage A (written examination) and Stage B (oral examination). Changes in Stage A exams, Stage B exams, and in the process of appeals to the exam results, are conducted after thorough thinking and testing procedures and under the guidance of professionals. During the course of the current Higher Examinations Committee, a number of significant changes were made in Stage A exams, including: 1. Reducing the number of questions in the surgical fields exams; 2. Consolidating the two parts of the exam in General Surgery, Urology, Vascular Surgery, Plastic Surgery, and Pediatric Surgery. 3. Exposing the questions and answers after the examination and altering the appeals process. There have also been changes in some specialties in Stage B exams according to the following rules: 1. Aspiration for multi-test stations; 2. Two examiners in each station; 3. Structured and unified content on all exam stations; 4. Structured evaluation forms; 5. Filling out the evaluation form by the examiners without consulting between them; 6. Automatic calculation of scores based on the percentage of accumulated points that the examinees accumulated from the maximum possible points; 7. An upfront decision on the passing score. The Higher Examinations Committee of the Scientific Council works, and will act constantly, for the construction of professional, fair, reliable and valid residency examinations.

Internato e Residência , Médicos , Faculdades de Medicina , Criança , Competência Clínica , Avaliação Educacional , Humanos , Israel , Especialização , Cirurgia Plástica
J Craniofac Surg ; 30(8): 2617, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31569183


Reconstruction of the upper lip represents a unique challenge because of its anatomical, functional and aesthetic requirements. In all the scientific sources and practical manuals the algorithms for central and lateral upper lip defects revolve around using advancement flaps, lip-switch techniques, and skin grafts only. The author offers a new approach for upper lip repair by using the Dufourmentel flap which is a pivotal local flap. The advantages and some tips are discussed.

Lábio/cirurgia , Retalhos Cirúrgicos , Humanos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante de Pele/métodos , Cirurgia Plástica
Laryngorhinootologie ; 98(5): 325-332, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-31618775


BACKGROUND: The body dysmorphic disorder (BDD) is considered to be a sub-form of somatoform disorders. BDD can express itself in a delirious experience, an excessive evaluation and employment of the external appearance, in particular the face. Preliminary results suggest that individuals with BDD do not benefit from plastic surgery, so that aesthetic surgery often results in aggravation of their symptoms. Thus, the identification of signs for a BDD is crucial, whether a patient should be operated plastically-aesthetically. This overview explains the often difficult diagnostics of the BDD by summarizing the current literature on its screening. STUDY DESIGN: Systematic overview METHODS: An electronic search was conducted in the German and English-language literature in order to identify all screening instruments for the BDD. The specific development RESULTS: Six different screening instruments were identified for the BDD. Only two of these were evaluated in a cosmetic setting: the "Body Dysmorphic Disorder Questionnaire Dermatology Version" (BDDQ-DV) and the "Dysmorphic Concern Questionnaire" (DCQ). The influence on the subjective results after a plastic-aesthetic procedure was measured only for the DCQ. CONCLUSION: The limited availability of validated screening instruments for BDD in plastic surgery is markedly in contrast to the supposedly high prevalence of the disease of 2.4 %. Among the currently used screening tools, the BDDQ-DV and the DCQ appear to be most suitable. Further research efforts are needed to establish better screening methods for the BDD in the plastic surgical patient population and to examine the effects of BDD on treatment results.

Transtornos Dismórficos Corporais , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Transtornos Dismórficos Corporais/diagnóstico , Estética , Humanos , Inquéritos e Questionários
Handchir Mikrochir Plast Chir ; 51(5): 377-383, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31574552


Reconstruction of the burned hand requires detailed knowledge and surgical skills to develop a therapeutic concept for optimal functional outcomes through predictive planning. The key to success is to use a broad spectrum of plastic surgery and hand surgery techniques, individually applied to the patient's situation.In this overview article, we describe basic principles, timing of reconstruction, classification of deformities, and the corresponding techniques for surgical correction.

Queimaduras , Traumatismos da Mão , Procedimentos Cirúrgicos Reconstrutivos , Traumatismos do Punho , Queimaduras/cirurgia , Traumatismos da Mão/cirurgia , Humanos , Cirurgia Plástica , Traumatismos do Punho/cirurgia