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Biomedical subjects

S W Perkins

Publications and source records attributed to S W Perkins.

10 recordsLinked to original sources
PubMed1997

Prevention of seromas and hematomas after face-lift surgery with the use of postoperative vacuum drains.

OBJECTIVE: To evaluate the rate of hematoma and seroma formation in a series of rhytidectomies performed with and without the use of intrawound vacuum drains. DESIGN: Retrospective chart review of 222 consecutive face-lifts performed by a single surgeon using an identical surgical technique before and after the use of vacuum wound drains. The patients were divided into 2 groups of 111 patients each. Group 1 patients underwent surgery without drains, while group 2 patients had suction drains placed at the time of surgery. MAIN OUTCOME MEASURE: The occurrence of seromas and hematomas within the first 24 hours after surgery. RESULTS: In group 1, 41 patients (37%) developed seromas and 9 (8%) developed hematomas; the hematomas were small and were treated by aspiration alone. In group 2, 17 patients (15%) developed seromas and 8 (7%) developed hematomas. The decrease in the rate of seroma occurrence was statistically significant, while the decrease in hematoma formation did not reach statistical significance. CONCLUSIONS: The use of intrawound vacuum drains during the first 24 hours after surgery significantly decreases the rate of seroma formation. The occurrence of hematomas is also reduced, but less dramatically.

Exudates and Transudates↗
PubMed1996

Transconjunctival blepharoplasty.

Cosmetic blepharoplasty is directed at the surgical correction of undesirable changes of the eyelids that are usually of an acquired nature and caused by aging. The goals are to improve the appearance and, many times, the function of the eyelids. Just as important as attaining these goals is avoiding any complications or undesirable sequelae of a blepharoplasty procedure. In this article, the technique and application of transconjunctival blepharoplasty are reviewed. The differences in the preseptal and retroseptal approaches are discussed and illustrated. The transconjunctival technique can be expanded through the use of various other techniques in order to apply it to a wider variety of patients. These expanded techniques of transconjunctival blepharoplasty allow the surgeon to manage excess skin and rhytids more effectively. Transconjunctival blepharoplasty, therefore, represents a technique in the armamatarium of surgeons performing cosmetic blepharoplasty that has gained new popularity. The technique can be effectively applied to a wide variety of patients. Transconjunctival blepharoplasty allows the surgeon to accomplish many of the esthetic goals of blepharoplasty while reducing the incidence of many of the associated problems, i.e., lid malposition and a visible cutaneous scar.

Aged↗
PubMed1996

Prevention of facial herpetic infections after chemical peel and dermabrasion: new treatment strategies in the prophylaxis of patients undergoing procedures of the perioral area.

A proposed clinical strategy is offered for the prevention and treatment of facial herpetic infection associated with phenol chemical peel or dermabrasion of the perioral area. A retrospective evaluation of 181 consecutive patients undergoing perioral chemical peel or dermabrasion from 1983 to 1990 was performed. No patients were excluded and the minimum follow-up was 6 to 24 months. All procedures were done at a private practice ambulatory surgery center. Patients with any history of oral herpetic lesions were pretreated with oral acyclovir. The vast majority of these patients received dosages far exceeding previously described regiments. A subset of patients (n = 12) whose procedures predated acyclovir's commercial availability received no prophylactic treatment and allowed for a comparison group. The incidence of postoperative infection was measured to determine the effectiveness of prophylactic acyclovir treatment. In patients reporting previous herpetic infection, postoperative herpetic outbreaks were far more likely to occur (50 percent infection rate) in the absence of prophylactic acyclovir. An 8.3 percent infection rate was noted in patients with a similar history who received standard acyclovir prophylaxis. Once high dose prophylactic treatment was initiated, no further herpetic outbreaks were observed. Even among patients with a negative history of oral herpes (no treatment), 6.6 percent developed postoperative infections. Pretreatment with high dose acyclovir clinically minimizes the incidence and severity of postoperative herpetic infection in patients undergoing perioral chemical peel or dermabrasion. All patients should be treated preoperatively with acyclovir regardless of past history, because even those patients reporting no previous outbreaks of oral herpes may develop postoperative infections.

Acyclovir↗
PubMed1994

Transconjunctival approach to lower eyelid blepharoplasty. Experience, indications, and technique in 300 patients.

Despite the fact that transconjunctival approach to lower eyelid blepharoplasty is not a new technique, the indications, patient selection, technique, and results using this technique have not previously been widely reported. Specifically, we have compared the results of this blepharoplasty procedure in terms of the indications, expected results, postoperative complications, and patient satisfaction in 300 successive cases of skin-muscle flap approach with those in 300 cases in which the transconjunctival approach was used. The orientation and details of this approach for the facial plastic surgeon are well outlined. Associated adjunctive procedures such as simultaneous chemical peeling and the "pinch" technique for skin excess removal are discussed. Both short- and long-term complications are significantly reduced with the transconjunctival approach to lower lid blepharoplasty compared with the skin-muscle flap approach. Therefore, for the removal of pseudoherniation of orbital fat of the lower eyelid, the transconjunctival approach to lower lid blepharoplasty should have a significant place in the surgical armamentarium of the facial plastic surgeon.

Adipose Tissue↗
PubMed1993

Use of submentoplasty to enhance cervical recontouring in face-lift surgery.

A number of surgical techniques for recontouring the aging neck are available. Using liposuction and direct lipectomy, the surgeon can sculpt the jowl and submental contour. Posterior tightening of the ptotic platysma refines the submental area, while incisional or excisional techniques, along with midline plication, remove anterior banding. Despite these maneuvers, recurrent submental and cervical ptosis is noted in some patients. These individuals can benefit from a secondary submentoplasty, a submental tuck-up face-lift operation, usually within 6 to 18 months after their initial surgery. We have identified several reliable causes for a secondary submentoplasty. Submentoplasty as a planned second-stage surgery in certain patients allows achievement of more dramatic and long-lasting rejuvenation of the neck.

Adult↗
PubMed1989

SASMAS suspension rhytidectomy. Rationale and long-term experience.

Prudent surgeons who perform face-lifting operations continue to alter techniques to reduce morbidity and achieve lasting results. The philosophy and technique herein described arose from the premise that suspension of the superficial musculoaponeurotic system (SMAS) suspends the skin-adipose unit (SA). In turn, suspension of the skin-adipose unit (SA) suspends the SMAS. When proper suspension is achieved, both systems function in tandem as a single unit, ie, the SASMAS (skin-adipose superficial musculoaponeurotic system). The SASMAS technique has been performed in approximately 1200 patients with gratifying results and minimal complications.

Female↗