Biomedical subjects

Marguerite E Aitken

Publications and source records attributed to Marguerite E Aitken.

5 recordsLinked to original sources

PubMed2006

Liposuction and tumescent surgery.

When guidelines for tumescent surgery are followed, treatment of patients with a broad range of concerns can be extremely effective. Whether its use is as a primary technique as in liposuction, or as an adjunct to another procedure such as reduction mammoplasty, the effects of reduced blood loss, pain control, and fluid management make it a powerful tool for the surgeon. Constant awareness of volumes infiltrated and aspirated, as well as the patient's clinical status, are critical in the safe delivery of tumescent surgery.

Anesthetics, Local↗

PubMed2006

Liposuction: techniques and guidelines.

The apparent simplicity of liposuction and the ease with which it is performed, may lull the novice plastic surgeon into overlooking the evolutionary developments that have brought it to today's level of popularity in body contouring surgery. Patients who may benefit from liposuction range widely from the thin patient desiring contouring of localized areas of stubborn adiposity to the obese patient in whom diet has failed to control weight. One of the major drawbacks of liposuction is its ability to thin, but not tighten. Reliance upon skin retraction to affect a proper outcome will only lead to disappointment, and this patient may instead benefit from an excisional-type procedure. Careful patient selection, education, and proper administration of the technique as a primary or an adjunctive tool will help deliver the most desirable aesthetic result.

Bandages↗

PubMed2002

Combined otoplasty technique: chondrocutaneous conchal resection as the cornerstone to correction of the prominent ear.

The failure to correctly analyze the complex deformity that comprises the prominent ear is the most common cause of the undesired surgical result. Recognizing conchal hypertrophy as one of the leading causes of the prominent ear deformity has led to a versatile and reproducible otoplasty technique that is easily modified to the common side-to-side variation in deformity. From January of 1993 to August of 2000, chondrocutaneous conchal resection has been used as the cornerstone to a combined sequence of maneuvers in otoplasty. The operation was performed on 47 patients (40 bilateral cases and 7 unilateral), and the total number of ears operated on was 87. There were three complications requiring revision surgery, and follow-up periods ranged from 6 months to 7 years, with all patients achieving a satisfactory result. Detailed methods of chondrocutaneous conchal resection along with the sequence of the authors' combined otoplasty techniques are presented.

Adult↗

PubMed2002

Double-muscle flap repair of the tethered tracheostomy scar.

Whether for facial trauma, extensive cancer resection, or long-term pulmonary ventilation, the final result after prolonged placement of a tracheostomy is usually a widened, depressed scar that is adherent to the underlying trachea. This adherence creates an unsightly up-and-down movement to the scar with swallowing. This "tracheal tug" is distressful emotionally to many patients and may even be painful. Simple methods of repair do not separate the skin closure adequately from the trachea, leading to recurrence of the tracheal tug. Use of the surrounding strap muscles to cover the trachea in conjunction with allogeneic dura mater has been described as one method of repair. In an attempt to perform a repair without the need for an outside tissue source, the double-muscle flap technique was developed. During this procedure the retracted scar is released from the trachea, the strap muscles are used to cover the tracheal closure, and the medial edge of the platysma muscle on each side is dissected free and sutured together in the midline. This separates effectively the tracheal closure from the skin, allowing the trachea to move independently. The cutaneous scar is revised along skin tension lines to create a fine-line linear scar. This procedure has been used in 2 patients with tracheal tug after prolonged tracheostomy placement. In each patient, the tracheal tug was eliminated completely, and an imperceptible cutaneous scar was the only remaining evidence of what had been a long and arduous recovery for these patients. In each case, patient satisfaction was complete. The authors recommend this technique as a simple and effective method of closure for these troublesome scars.

Adult↗

PubMed2002

Why change a good thing? Revisiting the fleur-de-lis reconstruction of the breast.

Although the latissimus flap is known for its simplicity and reliability, use of the fleur-de-lis pattern was plagued by undesirable T-shaped donor sites and small breast volumes in thin patients. We report a modified technique for optimal shaping of the standard latissimus with the successful application of a modified fleur-de-lis pattern. Because a "wet" tumescent infiltration was utilized and large amounts of subcutaneous fat were harvested, these changes permitted application to a wide variety of patients, with generous breast volumes reducing the size of the implant placed and resulting in excellent donor-site scars. This is a retrospective cohort study of 53 delayed or immediate reconstructions performed consecutively by the principal author (M.E.A.) on 48 patients at a university-based, urban hospital. Each case was analyzed between April of 1995 and February of 1999, with a follow-up from 2.5 to 44 months. All patients underwent injection of tumescent solution into the subcutaneous plane and harvest of large amounts of subcutaneous fat with the neurologically intact latissimus muscle. The last 25 reconstructions utilized the modified fleur-de-lis skin pattern, an inferiorly based vertical limb and replacement of skin deficiency in both axes. Of 11 perioperatively irradiated patients, none required skin grafting, whereas 6 percent of all native mastectomy flaps were grafted. There was one instance of minor distal tip flap necrosis in a nonirradiated patient. No implants became infected or were extruded. Donor sites were without wound complications and unveiled a 16 percent overall seroma rate.Through selective addition of harvested tissue, this modified technique, particularly the fleur-de-lis pattern, permits improved volume and projection in the inferior pole. The T-shaped donor-site closure is not only acceptable, but is also desirable, with reduced wound tension and minimization of dog-ear formation. With a relative paucity of complications, this conceptually ideal modification is technically simple and aesthetically comparable to our transverse rectus abdominis muscle flap results.

Adult↗