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Biomedical subjects

J Fissette

Publications and source records attributed to J Fissette.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Breast implants].

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Autoimmune Diseases↗
PubMed1998

[External rhinoplasty: a useful approach for a young plastic surgeon].

Among the frequently performed plastic surgery operations, rhinoplasty is the most difficult to obtain consistently good results. It is very challenging for young plastic surgeons to modify the external appearance of the nose and restore or maintain a good airway. The external approach has alleviated some of the problems due to understanding and learning of the rhinoplasty operation. Actually, open rhinoplasty allows better visualization of anatomical deformities and better manipulation of tissues allowing better integration of nasal anatomy and physiology. This paper reviews a personal series of 82 patients operated via an open approach between October 94 and October 97. During the same period, 24 patients were operated via an endonasal or percutaneous approach (osteotomies). Indications, advantages and disadvantages of the open approach are discussed. The various techniques used in this series are described and then critically analyzed. In open rhinoplasty, our present revision rate is 8.5%. In conclusion, the open approach seems to be useful for young rhinoplastic surgeons.

Adolescent↗
PubMed1997

Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study.

Stress reducing strategies are useful in patients undergoing surgery. Hypnosis is also known to alleviate acute and chronic pain. We therefore compared the effectiveness of these two psychological approaches for reducing perioperative discomfort during conscious sedation for plastic surgery. Sixty patients scheduled for elective plastic surgery under local anesthesia and intravenous sedation (midazolam and alfentanil upon request) were included in the study after providing informed consent. They were randomly allocated to either stress reducing strategies (control: CONT) or hypnosis (HYP) during the entire surgical procedure. Both techniques were performed by the same anesthesiologist (MEF). Patient behavior was noted during surgery by a psychologist, the patient noted anxiety, pain, perceived control before, during and after surgery, and postoperative nausea and vomiting (PONV). Patient satisfaction and surgical conditions were also recorded. Peri- and postoperative anxiety and pain were significantly lower in the HYP group. This reduction in anxiety and pain were achieved despite a significant reduction in intraoperative requirements for midazolam and alfentanil in the HYP group (alfentanil: 8.7 +/- 0.9 microg kg(-1)/h(-1) vs. 19.4 +/- 2 microg kg(-1)/h(-1), P < 0.001; midazolam: 0.04 +/- 0.003 mg kg(-1)/h(-1) vs. 0.09 +/- 0.01 mg kg(-1)/h(-1), P < 0.001). Patients in the HYP group reported an impression of more intraoperative control than those in the CONT group (P < 0.01). PONV were significantly reduced in the HYP group (6.5% vs. 30.8%, P < 0.001). Surgical conditions were better in the HYP group. Less signs of patient discomfort and pain were observed by the psychologist in the HYP group (P < 0.001). Vital signs were significantly more stable in the HYP group. Patient satisfaction score was significantly higher in the HYP group (P < 0.004). This study suggests that hypnosis provides better perioperative pain and anxiety relief, allows for significant reductions in alfentanil and midazolam requirements, and improves patient satisfaction and surgical conditions as compared with conventional stress reducing strategies support in patients receiving conscious sedation for plastic surgery.

Adult↗
PubMed1997

[Nose injuries].

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Accidents, Traffic↗
PubMed1996

Mechanical properties of skin and liposuction.

BACKGROUND: Liposuction removes fat, setting the skin under tension, and could therefore alter the overall viscoelastic properties of the teguments. OBJECTIVE: To measure in vivo the mechanical properties of skin at the site of liposuction and to compare the viscoelastic values with those of the inner aspect of the forearms. METHODS: The Cutometer SEM 474 equipped with a 8-mm probe was used. RESULTS: Data show that cutaneous laxity, which is characteristic for an aging aspect, is not higher at the liposuction sites than on the reference area. CONCLUSION: Liposuction does not increase the clinical aspects of skin aging.

Adult↗
PubMed1994

Anatomical basis for a safe and easier approach to composite rhytidectomy.

The authors present the anatomical findings that have made an easier approach to composite rhytidectomy possible. The lower lateral border of the orbicularis oculi muscle (OOM) overlies the zygomaticus major muscle (ZMM), the upper third of which tightly adheres to the malar bone. The OOM is innervated throughout over its circumference by a plexus of small facial nerve branches. From its deeper surface, the ZMM is innervated by two to four branches in its upper third and middle third. These branches are jeopardized in an extended sub-SMAS dissection as this tends to go deep into the ZMM. The malar fat pad is superficial to the SMAS layer that invests the zygomaticus and levator labii muscles and, with age, tends to slide downward, medially deepening the nasolabial folds. An extended dissection beyond the OOM tends to remain superficial to the upper part of the ZMM, zygomaticus minor, and levator muscle complex. We have found that extending the suborbicularis dissection inferiorly and laterally offers three major advantages: (1) The correct deep subcutaneous plane just above the ZMM, zygomaticus minor muscle, and levator complex can be found easily, leaving all of the fat attached to the skin. The only structures at risk are some minor motor branches to the OOM that can be divided without any morbidity because of the extensive plexiform innervation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

The cutaneous territory of the transverse tensor fascia lata flap: further anatomical considerations.

The cutaneous territory and the anatomical variations of the lateral circumflex femoral artery (LCFA) were studied on 20 fresh cadavers. This territory extends transversally on an average of 20 per 18 cm on the supero-lateral aspect of the thigh. The LCFA divides into three terminal branches as it enters the tensor fascia lata muscle. The posterior transverse branch is constant and makes the transverse tensor fascia lata (TFL) flap highly reliable, as opposed to the classical longitudinal TFL flap. The latter is based on the descending branch of the LCFA which is missing in 5 out of 20 cadavers. The lateral circumflex femoral artery also gives 1 to 2 ascending branches running toward the iliac crest and providing its periosteal blood supply. Based on these branches, it might be possible to raise an osteomyocutaneous flap of tensor fascia lata and iliac crest.

Aged↗
PubMed1993

[Mediastinitis: diagnosis, risk factors and treatment].

The authors review the literature concerning post-sternotomy mediastinitis. The incidence, mortality, diagnosis and risk factors are discussed, but above all, the various treatments are reviewed and compared with respect to their advantages and risks, their respective usefulness and results, in order to define a reasonable way of management of this highly pejorative surgical complication. Open technique, closed irrigation and surgical flaps of omentum, pectoralis major and rectus abdominis are successively considered.

Anti-Bacterial Agents↗
PubMed1992

Anatomical rationale for use of the latissimus dorsi flap during the cardiomyoplasty operation.

The cardiomyoplasty procedure involves the use of a transformed skeletal muscle to augment cardiac pump function or to substitute for the heart after parietal resection. This study of the intramuscular vascularization of latissimus dorsi was carried out in order to establish the relationship between the dominant thoracodorsal blood supply and the distal supply issued from the intercostal and lumbar arteries. This data is mandatory for the safe manipulation of the muscle flap during cardiomyoplasty. Thirty human latissimus dorsi flaps were carefully studied. We confirmed anatomically as well as angiographically previous macroscopic anatomical reports, as well as the constancy of the neurovascular pedicle. Three principal branching patterns were observed for the thoracodorsal artery. The thoracodorsal artery divides into three main tributaries in 20/30 (67%), and into two tributaries in 10/30 (33%) of the flaps observed. When three tributaries were observed, one of them was a small recurrent artery for the proximal third of the latissimus dorsi (14/20, 70%). Thus the distal vascularization is actually dependent on three principals in 6/30 (20%) and two principals in 24/30 (80%). From these two or three principals emerge several subsequent longitudinal branches (5 to 9) that have a straight course until their distal anastomoses with segmental arterial pedicles issued from intercostal and lumbar arteries. The latter ligation can thus occur without ischemic damage to the medial and distal aspect of the flap. This study emphasizes that, due to macroscopic anatomic features and systematic intramuscular vascular distribution, the latissimus dorsi is probably the most suitable muscle for the purpose of cardiomyoplasty.

Assisted Circulation↗
PubMed1991

A benign tumor of the sciatic nerve: case report and review of the literature.

Tumors arising from the sciatic nerve are a rare occurrence. A case is described of such a tumor developing as a large painless mass in the posterior right midthigh. The preoperative diagnosis was easily achieved by means of ultrasonography and computed tomography. Excision of the tumor, with preservation of the involved nerve, was performed. Microscopic examination showed a neurofibroma with however some features of a schwannoma. Problems of histological diagnosis and treatment are emphasized.

Diagnostic Imaging↗