Skin sensibility to pressure measured with a system of loads.
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Humans↗
Biomedical subjects
Fabio Xerfan Nahas
Publications and source records attributed to Fabio Xerfan Nahas.
[The significance of research in the Brazilian plastic surgery].
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Biomedical Research↗
[Research designs].
The purpose of this study is to analyze the classifications and concepts found in the literature regarding the research models on scientific studies commonly used in medical articles. This paper provides elements to facilitate the creation of a research model. It also helps the researcher to identify which is the research model of an article. This article will enable the reader of a scientific paper to have a more accurate sense of criticism of the Methods of a study.
Biomedical Research↗
[Developing a study: initial strategy].
In this article the preparation of a scientific paper and its project are described. The possible reasons that lead to rejection of an article such as the proper focus of the chosen journal, its writing and mistakes in the grammar are considered. The initial steps of a scientific paper such as the choice of an idea, literature search, and the selection of related articles are described. After a group discussion about the purpose of the paper and its methods (brainstorm), the project is described and its items (Introduction, Objective, Methods, Protocol, References and Chronogram) are analyzed.
Biomedical Research↗
[Analysis of the topics of a scientific paper].
The items of a scientific paper are described and its contents are objectively analyzed. The title, the most powerful weapon to attract the reader should be short and bring up the information regarding the ideas within the article. The Introduction situates the reader, showing concisely the relevancy of the study. The purpose of the study the main question that should be answered along the article--should be written at the end of the Introduction. In Methods, the most used types of samples in the medical field are reported and analyzed. The different ways to display the Results and the special forms to express the data such as the use of tables and graphics are analyzed. The logic of the Discussion, respecting the sequence of the items of a scientific paper and the results obtained by the author are compared with the literature data. The Abstract written by items (structured) and the References and its situation on the text are also analyzed.
Biomedical Research↗
[The art of writing a scientific paper].
The special characteristics of the scientific writing are described in this paper. The difficulty of writing of the medical author, the inadequate use of the medical jargon and the writing basic rules are analyzed. The author is oriented since the initial stage of the writing and how to progressively write his ideas, organizing them on a draft and improving the manuscript. Good writing such as the use of simple terms, direct order and objectivity which are reported and discussed.
Biomedical Research↗
[Photography in medical research].
Medical photography is an adequate scientific document when performed on a standard fashion. A proper photography is an important issue on a scientific publication. Plastic surgeons are experts in clinical photography and, frequently, an image is a more significant data than the written part of a paper. The purpose of this article is to describe the principles developed in this specialty. Basic photographic equipment used for clinical pictures is described. Standardized pictures determined by patient position and framing using anatomical references are reported. Using these rules it is possible to compare pre and post operative pictures. Topics such as intra operative pictures in endoscopic surgery, computer fotogrametry and in Experimental Surgery are also analyzed.
Animals↗
[How to choose a journal to submit an article].
On a submission process, the choice of the journal is a fact that may lead to the acceptance or rejection of the paper. Some facts must be considered when a journal is chosen. The journal focus, the study type, the scientific value of the study, and the innovation that the study will bring to the medical field are issues that must be considered when submitting a paper. The data base index and the impact factor of the journal are determinant facts that increase the chance of citation of the paper. The editorial evaluation process of the journals is described and reviewed.
Bibliometrics↗
[Financing of the scientific publication and protection of the scientific knowledge].
The main purpose of a study is its publication on a scientific journal. Research financing agencies are important institutions so that studies can be developed and published. The most important research financing agencies that are discussed in this article are: "Coordenação de Aperfeiçoamento de Pessoal de Nível Superior" (CAPES), "Conselho Nacional de Desenvolvimento Científico e Tecnológico" (CNPq) and "Fundação de Amparo à Pesquisa do Estado de São Paulo" (FAPESP). CAPES' activities can be grouped in four different strategy lines: a) it evaluates the stricto sensu, at the post-graduation level; b) it provides access and development of scientific research; c) it provides investment on the development of high qualified human resources in Brazil and abroad, and d) it promotes international scientific cooperation. Although CAPES does not support directly scientific publications, almost all actions of this agency contribute to the development of scientific research and publication. CNPq has two main purposes: financing researches and development of human resources. It provides the researchers with financial aid to scientific publication. The grants for editing were specifically created for supporting the national scientific and technical publications edited by Brazilians institutions or societies. CNPq can also support Congresses, Symposiums and similar short-term courses. The Plataforma Lattes is also a branch of CNPq on which the Curriculum Lattes is available. This site has the curriculum vitae of the scientific community and is of great value for researchers. FAPESP also finances journal publications, articles and books that bring up original results of studies made by researchers from the state of São Paulo. It finances, partially, the travel expenses of innovative papers authors in meetings within the country or abroad. Brazilian authors are increasing the number of international publications. Universities, research institutes, financing agencies and private companies are more and more concerned with knowledge property. Researchers must understand the need of knowledge property and the financing agencies have to consider the patents achieved as a criteria of evaluation of scientific production.
Biomedical Research↗
Long-term follow-up of correction of rectus diastasis.
BACKGROUND: Correction of rectus diastasis is a procedure performed by most surgeons during abdominoplasty. The purpose of this study was to demonstrate the long-term efficacy of the correction of rectus diastasis when plication of the anterior rectus sheath is performed with a nonabsorbable suture. METHODS: Twelve female patients who underwent abdominoplasty were studied. Rectus diastasis was measured preoperatively with two computed tomographic scan slices: one above and one below the umbilicus. The bony levels where the slices were obtained served as a reference for the postoperative computed tomographic scans. During the operation, rectus diastasis was measured at the same levels as the preoperative scan slices. At the same time, the necessary force to bring the medial edge of the rectus muscle to the midline was measured with a dynamometer. Postoperative scans were obtained at 3 weeks and 6 months after the operation. A long-term follow-up scan was obtained from 76 to 84 months postoperatively for every patient. RESULTS: The 3-week postoperative scan proved that the correction of rectus diastasis had been achieved by the procedure. Despite the fact that there were different levels of abdominal wall resistance and that the average weight gain in this period was 6.5 kg, the long-term computed tomographic scans showed that there was no recurrence of rectus diastasis in any patient of this series, both in the superior and inferior abdomen. CONCLUSIONS: Plication of the anterior rectus sheath with nonabsorbable suture appears to be a long-lasting procedure for correcting rectus diastasis.
Abdominal Muscles↗
The use of tissue adhesive for skin closure in body contouring surgery.
BACKGROUND: Abdominoplasty and mammoplasty are cosmetic surgeries that demand relatively more time for skin closure. METHODS: Skin closure with 4.0 Mononylon (Ethicon, Summerville, NJ, USA) continuous subcuticular suture and with Dermabond (Ethicon, USA) (octylcyanoacrylate) was compared among 37 patients who had undergone body contouring surgery (23 abdominoplasties and 14 mammoplasties). Each side of the scar, randomly selected, was closed either with adhesive or suture. The time required for skin closure and the aesthetic aspect of these scars were compared. Three observers evaluated the scars at 3, 6, and 12 months postoperatively using a categorical and a modified visual analog scale. RESULTS: The average time for closure using suture was 7 min and 45 s for the abdominoplasty and 4 min and 25 s for the vertical incision of the mammoplasty. This was significantly different statistically, as compared with the 2 min required for polymerization of the skin adhesive. The mammoplasty and abdominoplasty scars showed no statistical difference at 3, 6, and 12 months according to both scales. CONCLUSIONS: The aesthetic aspects of the mammoplasty and abdominoplasty scars were similar on both sides at 3, 6, and 12 months. However, the adhesive allowed a shorter surgical time.
Abdominal Wall↗
Ondansetron for the prevention of postoperative nausea and vomiting: which is the best dosage for aesthetic plastic surgery?
BACKGROUND: Ondansetron has been used widely in plastic surgery to prevent postoperative nausea and vomiting. A literature search showed controversial dosages of this drug, and because of its short half-life, its use only before anesthetic induction could have a limited effect. The purpose of this study was to assess the efficacy of intravenous (IV) ondansetron (4 mg) for aesthetic plastic surgery performed with the patient under general anesthesia and the prophylaxis of postoperative nausea and vomiting (PONV) in two situations: (a) only before anesthetic induction and (b) before anesthetic induction and immediately before extubation. METHODS: Of the 60 patients who had general anesthesia for aesthetic plastic surgery, 30 received 4 mg of IV ondansetron before anesthetic induction (control group) and 30 received 4 mg of IV ondansetron before anesthetic induction plus 4 mg IV immediately before extubation (experimental group). The PONV was recorded in the postanesthetic care unit and in the hospital room. RESULTS: The total occurrence of PONV (n = 60) was 6.7%. In the postanesthetic care unit, one patient in the experimental group (3.3%) manifested this symptom. In the hospital room, two patients in the control group (6.7%) and one patient in the experimental group (3.3%) manifested PONV. CONCLUSION: According to the findings, there was no statistical difference between the groups. However, the dosage used in the control group was effective and less expensive.
Adult↗
Sensibility of the abdomen after abdominoplasty.
Abdominal skin hypesthesia may occur after abdominoplasty. The purpose of this study was to find out (1) which sensibility modalities are decreased and (2) which areas of the abdominal wall are affected, so that patients can be warned preoperatively about this condition. Forty patients were divided in two groups of 20 patients each. In the control group, patients had no previous abdominal incisions. The sensibility evaluation of patients from the experimental group was made from 12 to 60 months after abdominoplasty, with an average of 31.5 months. These patients were divided into two groups of 10 patients each, a short-term follow-up group (12 to 30 months postoperatively) and a long-term follow-up group (31 to 60 months postoperatively). The abdominal skin was divided into 12 areas; nine were above the abdominoplasty incision and three were below it. Sensibility to superficial touch, superficial pain, and hot and cold modalities was recorded as positive in all areas by a variable number of patients of the experimental group. However, in area 8 (hypogastric area), a statistically significant number of patients had decreased sensibility in all sensibility modalities (Fisher's test and t test). Patients in the experimental group also showed decreased sensibility to hot and cold temperature in area 11 (pubic area). Sensibility to pressure decreased significantly in all areas of the abdomen when compared with the control group (t test). When patients of the short-term follow-up group were compared with those of the long-term follow-up group, there was no statistically significant difference for all modalities of sensibility in the areas studied, except for area 5. In this area it was found that long-term follow-up patients recovered sensibility to cold and hot temperatures. These findings help plastic surgeons to orient their patients about possible risk of exposure to injuries in the areas with decreased sensibility after abdominoplasty. Most importantly, as these patients have decreased sensibility to pressure and hot temperature in a more extensive area of the abdomen, they are exposed to a higher risk of burn injury.
Abdominal Wall↗
Suspicious node found at the time of reduction mammaplasty.
A case of a patient with a suspicious glandular node found during reduction mammaplasty is described. The preoperative search for such nodes, the management of cases on which a suspicious node is found intraoperatively, and a situation on which the diagnosis of breast cancer is made during histology are discussed. When a suspicious small node (with a diameter up to 2 cm) is detected during a cosmetic breast surgery, lumpectomy can be performed. It may be a definite surgical treatment, depending on stage and tumor type. In the case presented, histology revealed intraductal papilloma, a benign tumor, therefore lumpectomy was a suitable procedure with an acceptable cosmetic result. With the increased incidence of breast cancer, this situation will happen more often and technical options for the management of such cases deserves the attention of plastic surgeons.
Adult↗
Pregnancy after abdominoplasty.
A case of a 25-year-old while female, who had undergone abdominoplasty and got pregnant two and a half years later, is described. The pregnancy was uneventful and the baby was delivered at 38 weeks of pregnancy. Fifteen months after the baby was born, the patient's abdomen was reevaluated and a CT-scan was performed. At the clinical examination there was little excess skin and the patient had no weight gain. Although the patient presented a rectus diastasis of 2.8 cm measured at a level 3 cm above the umbilicus before its correction during abdominoplasty, there was no separation between the rectus muscles palpable after pregnancy. At the CT-scan slices made above and below the umbilicus, there was no evidence of recurrence of rectus diastasis. Therefore, on this case, the tissues of the myoapoueurotic layer of the abdominal wall elongated as the fetus grew, except for the area of the corrected rectus diastasis. The effect of this pregnancy was not as evident in the myoaponeurotic layer. Although it is not possible to assume that this situation will occur with all patients that may have pregnancy after abdominoplasty, correction of rectus diastasis may be a very effective procedure.
Abdomen↗
An efficient way to correct recurrent rectus diastasis.
BACKGROUND: Recurrent rectus diastasis is a troublesome complication because its correction requires an extensive procedure. CASE REPORTS: Two patients with recurrent rectus diastasis secondary to abdominoplasty corrected by plication of the anterior rectus sheath are presented. These patients had lateral insertion of the rectus muscles. They were treated by the advancement of the rectus muscles after undermining of the posterior rectus sheath and a two-layer closure to correct the rectus diastasis. Good cosmetic results and postoperative pain control were achieved in both cases. DISCUSSION: The causes, prevention, and treatment for this type of rectus diastasis are described. The main reason for recurrence of this deformity in these patients was lateral insertion of the rectus muscles on the costal margins. On the basis principle, an efficient technique to correct this deformity is described. A postoperative compute tomography scan with slices made at the same bony level as the preoperative control examination demonstrated total correction of rectus diastasis over a long-term follow-up evaluation. CONCLUSION: Advancement of the recti muscles seems to be a reliable method for correcting recurrent rectus diastasis in patients with lateral insertion of the recti muscles.
Abdomen↗
Guidelines for pubic hair restoration.
BACKGROUND: Although the loss of pubic hair is a relatively frequent condition, there have been few reports about pubic hair restoration. This report aims to describe the demarcation and technical guidelines for pubic hair restoration using follicular micrografts. METHODS: Demarcation is described and based on anatomic parameters such as the level of the greater trochanters and the labium majus. The angle of micrograft insertion and direction also are described. RESULTS: The use of micrografts for pubic hair restoration is a procedure that promotes very natural results. CONCLUSIONS: The described parameters of demarcation and technical details are important issues that should be considered to obtain a natural result in pubic hair restoration.
Adult↗