Current Issue : January - March Volume : 2014 Issue Number : 1 Articles : 6 Articles
Studies of psychological outcomes of cosmetic surgery generally provide low standards of \r\nevidence due to significant methodological limitations and few studies have explored the \r\noutcomes of surgery types other than breast reduction or have compared post-operative \r\noutcomes for different surgery types. This study therefore aimed to explore the psychological \r\noutcomes and post-operative satisfaction of cosmetic surgery and compare the outcomes and \r\nsatisfaction of participants undergoing different procedures. Surveys were administered to a \r\nsample of 142 elective cosmetic surgery patients prior to surgery and six months after surgery. \r\nThe surveys included standardised measures of body image (appearance evaluation, \r\nappearance orientation, body areas satisfaction), self-esteem, and mental health (psychiatric \r\ndisturbance, anxiety, depression, dysmorphic concerns). The findings revealed high rates of \r\npost-operative satisfaction and significant improvements in several dimensions of body image \r\n(appearance evaluation and body area satisfaction) and mental health (anxiety, depression, and \r\ndysmorphic concerns), but not self-esteem. Breast augmentation patients reported significantly \r\nhigher improvement on appearance evaluation, significantly higher ratings of how likely they \r\nthought it was that they had achieved, or would achieve, what they were looking for in having \r\nthe procedure, and a trend to report that the overall result of surgery was better than or as \r\nexpected than rhinoplasty patients. It is recommended that future research clarifies the degree \r\nto which self-esteem and indices of mental health improve after cosmetic surgery and fully \r\nestablishes the impact of different procedures on psychological outcomes. Level of Evidence. \r\nTherapeutic Study, Level II....
Body contouring following massive weight loss is a rapidly expanding field in plastic surgery. However, healthcare payers are\r\nreluctant to fund such procedures, viewing them as purely cosmetic. This has resulted in a flurry of studies assessing quality of life\r\n(QoL) and patient satisfaction following body contouring surgery in this cohort of patients to establish an evidence base to support\r\nthe idea that body contouring is as much (or even more) a functional procedure as it is cosmetic. However, the methods employed\r\nin these studies are seldomideal, and hence the conclusions are unreliable. The gold standard to assess QoL and patient satisfaction\r\nis to use patient specific psychometrically validated patient reported outcome (PRO) measures. Developing suchmeasures consists\r\nof a three-step process which includes a review of the current literature, qualitative patient interviews to determine what patients\r\nconsider the most important, and expert opinion. This study aims to appraise the currently available literature on assessment of\r\nQoL and patient satisfaction in body contouring surgery patients. This will hopefully provide an understanding of methodological\r\nweaknesses in current studies and inform future investigators of the design of ideal instruments for assessing QoL and patient\r\nsatisfaction in body contouring patients....
Wound healing is a complex pathway of regulated reactions and cellular infiltrates. The mechanisms at play have been thoroughly\nstudied but there is much still to learn. The health care system in the USA alone spends on average 9 billion dollars annually on\ntreating of wounds. To help reduce patient morbidity and mortality related to abnormal or prolonged skin healing, an updated\nreview and understanding of wound healing is essential. Recent works have helped shape the multistep process in wound healing\nand introduced various growth factors that can augment this process. The complement cascade has been shown to have a role in\ninflammation and has only recently been shown to augment wound healing. In this review, we have outlined the biology of wound\nhealing and discussed the use of growth factors and the role of complements in this intricate pathway....
Introduction.Mediastinitis has been reported to complicate 5% of sternotomy surgery.We have adopted an open reduction and rigid\r\ninternal fixation (ORIF) approach during the conventional rescue surgery in the treatment of mediastinitis. Methods.Aretrospective\r\nreview was performed to compare the outcomes of patients that had an ORIF to correct postoperative mediastinitis following\r\nmedian sternotomy.These were compared with the outcome of the patients that did not undergo ORIF. Results. In the 5-year study\r\nperiod, we reviewed 35 mediastinitis patient charts. Postoperatively, the ORIF patient group remained in the Intensive Care Unit\r\n(ICU) and on a ventilator for a mean of 1.5 and 0.75 days, respectively. Patients treated without ORIF spent significantly more days\r\nin the ICU (mean of 7.5 days, P < 0.05) and on a ventilator (mean of 2.15 days, P = 0.1). Furthermore, it was found that none of the\r\npatients (0%) who underwentORIF complained of any postoperative sternal instability or pain. Preoperatively, however, these rates\r\nwere as high as 72%. Conclusions. In the select patient, ORIF can be a safe option in the management of mediastinitis, which we\r\nhave shown to significantly decrease morbidity and mortality by providing anatomic reduction as well as physiologic stabilization.\r\nWe have shown that ORIF will improve the quality of life of the patient by minimizing abnormal sternal mobility and pain and will\r\nalso decrease inpatient costs by decreasing days spent in the ICU and ventilator dependence....
Background. The upper lip-nose complex contributes significantly to the concept of symmetry and proportion of the face. A\nstudy of the morphology and aesthetic preferences of the lip-nose complex will provide a database that will serve as a guide\nfor reconstruction. Subjects and Methods. Hundred Nigerian children participated in this study. Demographic data and standard\nphotographs of the philtral column and nostrils were obtained. Sixty volunteers were recruited to evaluate the photographs. Each\nvolunteer was asked to rank the photographs based on their aesthetic preference. Results. The morphology of the philtral columns\nwas classified into four groups: (1) triangular, (2) concave, (3) flat, and (4) parallel. The nostril shape was also classified into four\ngroups: (1) triangular, (2) round, (3) teardrop, and (4) rectangular. In both genders, the triangular shape of philtral column was the\nmost common. There are significant age differences in the aesthetic rankings of philtral columns and nostril shapes. Conclusion.\nOur study establishes the basal values for the morphometric and aesthetic parameters of the lip-nose complex of 5- and 6-year-old\nchildren in Nigeria.We hope our results and reconstructive surgery will intersect at a point to treat disfigurements of the philtrum\nand nostrils successfully....
Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic\r\nimpact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes\r\nof digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-,\r\nmuscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve\r\nreconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997\r\nnerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior\r\nto another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve\r\ngrafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients\r\nwho underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery\r\noutcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique\r\nshould be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a\r\ndecision tree for digital nerve repair....
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