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At least 145 records · Page 8Linked to original sources
PubMed1999

Periodontal plastic surgery.

As the demand for esthetic dentistry has increased, dentistry has developed techniques to meet this demand. Periodontal plastic surgery has been part of this effort. This article outlines the scope of periodontal plastic surgery procedures to aid the dental team in diagnosis and treatment of esthetic dental cases.

Alveolar Ridge Augmentation↗
PubMed2003

[Aesthetic snapshot: study about cosmetic surgical procedures and complications].

A questionnaire was addressed to 600 members of the French Society of Plastic Reconstructive and Aesthetic Surgery. Out of 19,000 interventions, thanks to the analysis of 112 answers, we were able to get a good picture of the activity in aesthetic surgery, showing the number and type of complications experienced during each intervention. Cosmetic surgical procedure represents 35% of global surgical activity of the French plastic surgeon. The most frequent interventions are liposuction (19%), breast augmentation (16%), eye-lid surgery (14%), abdominoplasty (12%), mammaplasty (10%), facelift (10%) and rhinoplasty (8%). The techniques for which we register more than 10% of problems are: abdominoplasty and mammaplasty. The techniques for which we register between 5% and 10% of problems are: rhinoplasty, facelift and breast augmentation. The techniques for which we register less than 5% of problems are: liposuction and eye-lid surgery. On average, the most frequent cosmetic surgical procedures give rise to 7% of complications.

Adult↗
PubMed2001

Diclofenac and metamizol in postoperative analgesia in plastic surgery.

BACKGROUND: Postoperative pain relief after major surgery cannot be achieved with opioids alone in all patients without respiratory depression or other significant drawbacks. Modern medical practice, therefore, dictates the use of alternative analgesic agents as an adjunct or substitute to minimize the deleterious effects and to facilitate an earlier return to work and daily activities. Diclofenac and metamizol inhibit prostaglandin synthesis, thus attenuate the peripheral nociceptive sensitization caused by the surgical trauma. This investigation was conducted to determine the potency of diclofenac compared with metamizol in the control of postoperative pain after various plastic surgical operations under general anesthesia. METHODS: A multiple-dose, randomized, double-blind clinical trial composed of one hundred and sixty-six patients was conducted. Group M patients received 1 g intramuscular metamizol (every 8 hours) and Group D patients received 75 mg intramuscular diclofenac (every 12 hours). Additional analgesia requirements were recorded and meperidine was used as the complementary analgesic when needed. Pain was assessed by visual analogue scores. Platelet count and bleeding time analyses were performed preoperatively and on the first postoperative day. RESULTS: Metamizol decreased the additional analgesia requirement during the 18 hours following surgery. This was also associated with significantly lower pain scores. There was no significant difference between the patients receiving either metamizol or diclofenac in terms of pain scores, additional request for analgesia and frequency of side effects from the 18th until the 48th hour postoperatively. However, the use of diclofenac was associated with reduced side effects, though a reduction in platelet number and prolongation of bleeding time was noted in the majority of the patients receiving diclofenac. CONCLUSIONS: Metamizol is significantly superior to diclofenac for the reduction of postoperative pain after plastic surgery in the first 18 hours after plastic surgery procedures and reduces the need for additional analgesia.

Adult↗
PubMed2006

Outbreak of epidemic methicillin-resistant Staphylococcus aureus in a regional burns unit: management and implications.

Colonization of burn patients with methicillin-resistant Staphylococcus aureus (MRSA) is not uncommon, however an outbreak that necessitates closure of a burns unit is relatively rare. The objective of this study was to present the experience of a regional adult burns unit where an outbreak of epidemic MRSA-15 (EMRSA-15) took place. During the studied period, 176 patients were admitted to the unit, 52 with burns, 48 for elective plastic surgery procedures while the remainder belonged to other specialties. Patients admitted under burns and plastic surgery were investigated together with 46 staff members to control the outbreak. MRSA was isolated in 18 patients out of which 12 had EMRSA-15. Among the staff members, MRSA was isolated in nine of which five had EMRSA-15. The burns unit was closed to all admissions to terminate this outbreak. The MRSA positive staff members were sent on "special leave" and underwent treatment with nasal mupirocin and triclosan body wash. All staff members were able to return to work after one week's treatment. The burns unit underwent re-furbishment and decontamination while it was closed. In conclusion, the study shows that an outbreak of EMRSA was controlled successfully, however, it highlights the implications of such an event for a regional burn service with regard to staff, patients and guidelines for management.

Adult↗
PubMed2002

Outcomes instruments in facial plastic surgery.

The accurate measurement of patient-related outcomes of facial plastic surgery procedures relies upon the development, standardization, and use of validated, procedure-specific quality of life instruments. Although other fields of medicine and surgery have embraced the use of such instruments for the quantification and measurement of otherwise subjective or qualitative aspects of patient satisfaction, in the fields of both general and facial plastic surgery, little has been done in this realm. The study of outcomes research and the application of outcomes research to facial plastic surgery have already been discussed in this issue. Outcomes research is founded upon the ability to measure in some fashion those aspects of patient satisfaction that have hitherto been ignored or at best poorly quantified in the assessment of the results of a medical or surgical intervention. In facial plastic surgery, particularly cosmetic facial plastic surgery, the overwhelming majority of results are subjective in nature, be they patient related or based upon the surgeon's own personal assessment of outcome. For this reason, the use of validated instruments to quantify and measure these results is of particular importance in facial plastic surgery compared with other fields of medicine where many outcomes are objectively determined, such as mortality. This article outlines the background of the use of quality of life instruments in the field of outcomes research to provide a basic understanding for the application of such tools to the work of facial plastic surgery. Specific instruments that have already been developed and validated are described as well. Finally, future directions are highlighted that may allow the improved measurement of patient satisfaction as the field of outcomes research in facial plastic surgery continues to evolve.

Attitude to Health↗
PubMedDate not supplied

The emerging role of laser resurfacing in combination with traditional aesthetic facial plastic surgery.

Traditional aesthetic plastic surgery procedures (facelift, browlift, blepharoplasty, etc.) can make dramatic improvement in the facial appearance by removing excess skin and fat and tightening and repositioning the soft tissues of the face, but make no improvement in the quality of the skin. Laser resurfacing is the safest, most predictable method for improving facial wrinkles and actinic damage. This paper discusses the combination of these techniques in pursuit of optimal rejuvenation of the face.

Aged↗
PubMed2004

Update on botulinum toxin use in facial plastic and head and neck surgery.

PURPOSE OF REVIEW: The purpose of this review is to discuss current trends in the medicinal use of botulinum toxin in head and neck and facial plastic surgery. The basic science of botulinum toxin is presented along with a comparison of the subtypes currently available on the market. Site-specific applications of botulinum toxin in the head and neck region are presented. RECENT FINDINGS: The use of botulinum toxin continues to expand, both in volume and in number of applications. The main application of botulinum toxin in facial plastic surgery is in the effacement of dynamic or hyperkinetic facial lines. The granting of US Food and Drug Administration approval for the use of Botulinum Toxin type A in the treatment of glabella lines marks a major milestone for the more widespread usage of this product in cosmetic settings. Additional cosmetic applications include crow's feet, marionette lines, and platysma banding. Noncosmetic applications in the head and neck include dystonias (including torticollis), facial and generalized muscle spasms, migraine headaches, hyperhidrosis, spasmodic dysphonia, sialorrhea, gustatory sweating, and involuntary movement disorders. SUMMARY: The use of botulinum toxin in the treatment of hyperkinetic conditions and disorders of excessive salivation is well established and enjoys an excellent safety profile. The cosmetic use of botulinum toxin continues to expand. The chronic use of botulinum toxin specifically for cosmetic purposes is worthy of additional study.

Botulinum Toxins↗
PubMed2005

Review of the liposuction, abdominoplasty, and face-lift mortality and morbidity risk literature.

BACKGROUND: The statistical discrepancies that exist in the mortality and morbidity risk literature are such that surgeons and patients cannot accurately assess the true risk rates associated with plastic surgery procedures. OBJECTIVES AND METHODS: To review any relevant literature published to date in which the risk rates from liposuction, abdominoplasty, and rhytidectomy are cited and to reassess these figures alongside those published for both elective and emergency general surgeries. RESULTS AND CONCLUSION: Despite the lack of reliable, comprehensive reporting of deaths and complications resulting from cosmetic surgeries, published data demonstrate that the risks associated with liposuction and rhytidectomy compare favorably with those from most general surgical procedures. In contrast, the morbidity and mortality rates from abdominoplasty remain unacceptably high. A significant lack of literature documenting cosmetic breast implant surgery and blepharoplasty risks is observed, which should be of concern to both patients and physicians. Liposuction and face-lift surgery data generally show that surgical centers are statistically safer than hospital operating rooms, although the data have not been standardized for the patients' American Society of Anesthesiologists (ASA) risk class, the health of the patient prior to surgery. General anesthesia may carry a risk roughly equivalent to or perhaps greater than cosmetic surgery, although, again, ASA class variables confound clear comparison between studies. Recent anesthesia literature refutes the many claims that general anesthesia risks are now remote: a landmark study that surveyed the entire scholarly literature showed a mortality rate of 1 in 13,000, roughly similar to overall cosmetic surgery mortality risks. Moreover, a prolonged operating time has been repeatedly implicated in other surgical literature to be related to morbidity and mortality. The latter certainly has relevance to cosmetic surgery.

Abdominal Wall↗
PubMed2001

The use of midazolam and small-dose ketamine for sedation and analgesia during local anesthesia.

UNLABELLED: Small-dose ketamine in combination with sedative drugs has increasingly been used for sedation and analgesia in local anesthesia. We compared the clinical efficacy of midazolam with two different ketamine infusion regimens during plastic surgery under local anesthesia. Sixty patients undergoing plastic surgery procedures with local anesthesia were randomly assigned to two groups of 30 patients each in a double-blinded fashion. All patients received a bolus of 0.05 mg/kg midazolam, followed by a stepwise infusion: 1.67 microg x kg(-1) x min(-1) for the first 30 min, then reduced to 1.33 microg x kg(-1) x min(-1) for 90 min and subsequently to 1 microg x kg(-1) x min(-1). Two minutes before the infiltration of local anesthetic solution, a bolus of ketamine 0.3 mg/kg IV was administered, followed by a stepwise infusion of ketamine: Group A, 16.67 microg x kg(-1) x min(-1) for 30 min, 13.3 microg x kg(-1) x min(-1) for 90 min, and subsequently 10 microg x kg(-1) x min(-1); Group B, 8.33 microg x kg(-1) x min(-1) for 30 min, 6.67 microg x kg(-1) x min(-1) for 90 min, and then 5 microg x kg(-1) x min(-1). The level of sedation was evaluated by using the modified Observer's Assessment of Alertness/Sedation scale. We observed the effects of the two ketamine infusion regimens on sedation levels, respiratory and cardiovascular variables, and perioperative side effects. In both groups, midazolam and ketamine produced adequate sedation (with Observer's Assessment of Alertness/Sedation scores of 2-4) without significant respiratory and cardiovascular depression during surgery. However, there were fewer disruptive movements and there was less postoperative vomiting in Group B (P < 0.01). In conclusion, ketamine and midazolam provided satisfactory intraoperative sedation, analgesia, and amnesia in both groups. However, side effects associated with ketamine occurred less often in the smaller-dose ketamine group. IMPLICATIONS: Sedation and analgesia are often provided during local anesthesia. This study demonstrates that a small-dose ketamine infusion in combination with midazolam provided satisfactory intraoperative sedation, analgesia, and amnesia in healthy plastic-surgery patients when it was used to supplement local anesthesia.

Adolescent↗
PubMed2005

Orthognathic surgery: is there a future?

BACKGROUND: Despite significant clinical advances in orthognathic surgery, a perceived decrease in recent years in the number of orthognathic cases was noted at the authors' institution. Word of mouth suggested that this phenomenon was region-wide. To explore this possible dichotomy, a one-page questionnaire was designed and sent to all plastic surgeons in the American Society of Maxillofacial Surgeons and to all active practicing oral surgeons and orthodontists in the state of Ohio. METHODS: The questionnaire was designed to estimate both the surgeons' and the orthodontists' perception of whether the number of orthognathic cases was increasing, decreasing, or remaining the same over a 5-year period (from 1996 to 2000). A second questionnaire was then sent only to plastic surgeons and oral surgeons to further evaluate reasons for this possible increase or decrease. RESULTS: The overall response to the first survey was 39 percent (236 of 601 surveys sent); 87 responses (32 percent) were from plastic and oral surgeons, and 132 (40 percent) were from orthodontists. Seventy-five percent of responders perceived a decrease in the number of orthognathic operations. Of those, more than 80 percent claimed that reimbursement was the major reason for the reduction in the number of surgical procedures. The degree of reduction in reimbursement over this 5-year period was documented at the authors' institution, and the perceived reduction over this 5-year period was estimated by the respondents. Finally, reimbursement per hour was calculated for orthognathic cases and compared with three other standard plastic surgery procedures. CONCLUSION: Implications of this reduction in orthognathic surgery in Ohio are discussed, and suggestions for better documentation of this health care issue are suggested.

Fees, Dental↗