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Objective To evaluate the efficacy and safety of fractional laser combined with smooth mode laser for the treatment of facial photoaging.Methods Thirty subjects with facial photoaging treated in Department of Plastic Surgery of China-Japan Friendship Hospital were enrolled.All subjects received treatment with fractional Nd:YAG laser combined with smooth mode Er:YAG laser,once every 4 weeks for 3 sessions.Subjects were followed up before the first treatment(V1),4 weeks after the second treatment (V2),4 weeks after the third treatment(V3)and 12 weeks after the third treatment(V4).During each follow-up,Global Scores for Photoaging (GSP) were used to evaluate the photoaging degree on the whole face,Global Aesthetic Improvement Scale(GAIS) were applied to evaluate the improvement degree of facial photoaging,and the Visual Analogue Scale(VAS)was adopted to assess pain induced by treatment.After the last treatment,self-assessment on the degree of satisfaction with therapeutic effects was conducted.Results All 30 subjects completed the treatments and follow-up.GSP decreased with the increase of visiting time after treatment (r=-0.736,P＜0.0 1).GAIS increased with the increase of visiting time after treatment (r=0.616,P＜0.01).There were significant differences in the measurements of VISIA Skin Detector at V 1,V2,V3 and V4 (all P＜0.01).There was a positive correlation between GAIS and VISIA measurements at V2,V3 and V4;the correlation coefficients were 0.453 (P=0.012),0.552 (P=0.002) and 0.564 (P=0.001),respectively.The average VAS score of 30 subjects after treatment was 1.2 ± 0.1.No side effect was observed.The self-satisfaction rate was 76.7％ (23/30).Conclusion Fractional Nd:YAG laser combined with smooth mode Er:YAG laser can be applied to treat facial photoaging safely and effectively.
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Objective To analyze the clinical efficacy and technical key points of genioplasty for the deformities of the chin.Methods 153 patients with chin deformities were treated with the genioplasty,and the chin was moved in any direction,including sagittally,vertically and transversely;the key points of this procedure were summarized.Results There was no severe complication such as infection or nonunion observed.15 patients had ecchymosis and faded in 2 weeks;33 patients had hypaesthesia and recovered in 12 weeks.With the 12-24 months follow-up,all the patients healed well with satisfactory aesthetic results.Conclusions The genioplasty is a reliable and efficient method for the deformities of the chin,and it can significantly improve the appearance of the chin.
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Objective To compare the efficacy between autologous fat and hyaluronic acid in filling nasolabial grooves.Methods Sixty patients who wanted improvement of nasolabial grooves were involved in the study.They were randomly and equally classified into two groups:autologous fat injection group and hyaluronic acid injection group.Photographs were taken before,half a year,and one year after injection.The nasolabial grooves were also graded before,half a year,and one year after injection.The grade improvement was obtained after postoperative grade minus preoperative grade.If the grade improvement was more than 1 grade,the treatment was regarded as effective to evaluate the outcome between the two methods.Results The results of the two groups were tested by SPSS 13.0 software.The effects of the two methods were not significantly different after half a year of filling (P＞0.05).The difference was significant one year after filling (P＜0.05).In autologous fat injection,the patients had a long and magnificant swelling and redness around the nasolabial grooves;on the contrary,the patients who underwent hyaluronic acid had slight and short-time local reaction like swelling and redness.No other serious complications were found in both the groups.Conclusions The effects of the autologous fat and the hyaluronic acid are equal after half a year of filling.The autologous fat has a longer effect in one year.Both methods are safe and effective.Surgeons can select the method accordingly.
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<p><b>INTRODUCTION</b>The detachment planes used in endoscopic facelifts play an important role in determining the results of facial rejuvenation. In this study, we introduced the use of multiple detachment planes for endoscopic facelifts of the frontal and temporal areas, and examined its outcome.</p><p><b>METHODS</b>This study included 47 patients (38 female, 9 male) who requested frontal and temporal facelifts from January 2009 to January 2014. The technique of dissection in multiple planes was used for all 47 patients. In this technique, the frontal dissection was first carried out in the subgaleal plane, before being changed to the subperiosteal plane about 2 cm above the eyebrow line. Temporal dissection was carried out in both the subcutaneous and subgaleal planes. After detachment, frontal and temporal fixations were achieved using nonabsorbable sutures, and the incisions were closed. During follow-up (ranging from 6-24 months after surgery), the patients were shown their pre- and postoperative images, and asked to rate their satisfaction with the procedure. Complications encountered were documented.</p><p><b>RESULTS</b>All 47 patients had complete recovery without any serious complications. The patient satisfaction rate was 93.6%. Minor complications included dimpling at the suture site, asymmetry, overcorrection, transitory paralysis, late oedema, haematoma, infection, scarring and hair loss. These complications resolved spontaneously and were negligible after complete recovery.</p><p><b>CONCLUSION</b>Dissection in multiple planes is valuable in frontal and temporal endoscopic facelifts. It may be worthwhile to introduce the use of this technique in frontal and temporal facelifts, as it may lead to improved outcomes.</p>
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Adult , Female , Humans , Male , Middle Aged , Endoscopy , Face , General Surgery , Follow-Up Studies , Patient Satisfaction , Retrospective Studies , Rhytidoplasty , Surgery, Plastic , Treatment OutcomeABSTRACT
Objective To observe the effect of hydrocolloid dressings with instant ice compress on the healing process,postoperative pain and efficacy of patients with acne scar treated by 2940 nm erbium pixel laser.Methods We selected 60 patients with acne scar from November 2012 to June 2014 treated by the erbium pixel laser.They were randomly divided into two groups:hydrocolloid dressings with ice compress after treatment were used in observation group (n=37)and postoperative wound dry were kept in control group (n=23);pain,duration of burning,erythema duration,efficacy,decrustation time,postoperative complications were evaluated and quantitatively analyzed.Results Compared with the control group,the application of hydrocolloid dressings with ice compress group (observation group) received less postoperative paim postoperative VAS pain score was (5.81± 0.64) in observation group and (6.09±0.69) in control group;duration of burning was shorter:(1.86± 0.75) h in observation group and (3.65±0.93) h in control group;duration of erythema was shorter:(2.27±0.73) d in observation group and (3.52 ±0.79) d in control group;decrustation time was shorter:(5.76± 1.06) d in observation group and (8.09±0.95) d in control group;postoperative complications were reduced:(5.4％,2/37) in the observation group and (30.4％,7/23) in the control group,with statistically significant difference (all P＜0.05).The differences were not statistically significant in the intraoperative VAS score and the curative effect.Conclusions The application of hydrocolloid dressing with instant ice compress after erbium pixel laser in the treatment of acne scar can effectively reduce postoperative pain and burning sensation,shorten the duration of erythema and crusting time after operation.It also reduces the incidence of complications.
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OBJECTIVE:To investigate the new management model of the hospital pharmacy established by application of vender managed inventory (VMI) model. METHODS:Concerned about the implementation of VMI model,its effects and prob-lems,new management model of hospital pharmacy were described after the hospital cooperated with two suppliers. The hospital is mainly in charge of the management and application of pharmaceutical staff and equipment,drug capital flow,and the selection and optimization of drug use list;focus on the training of pharmaceutical talents;improve drug quality management,pharmaceuti-cal administration,pharmaceutical care and rational drug use. Two suppliers are mainly in charge of drug logistics,and the alloca-tion of servicer,software and hardware(as automatic medicine dispensing machine);share logistic cost of supply chain. Drug in-formation flow was established by both hospital and supplier. RESULTS:After cooperation,pharmaceutical staff,related equip-ment and inventory cost(floating capital decreased by 10 million yuan each month)were decreased,and the efficiency of distribu-tion improved;the error rate of drug dispensing in outpatient pharmacy were decreased (decreasing from 0.39‰ to 0.12‰) after the establishment of automatic pharmacy. The establishment of early warning system for abnormal patients flowrate in pharmacy window shortened the time of getting medicine,and improved service level and satisfactory degree of patients (increasing from 84.91% to 93.62%). CONCLUSIONS:New management model of hospital pharmacy based on VMI model provides reference for public hospital reform and hospital-enterprise cooperation under New Medical Reform.
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Objective To introduce the advantages of the endoscopic assistance in primary and secondary face-lift in the frontal and temporal areas.Methods 67 cases were involved in the study,22 of them were secondary facelift cases.The follow-up period ranged from 1 month to 2 years.The patients and doctors satisfactory rate were recorded and the complications were also reported.Results All 67 cases had complete recovery without serious complications.The patient's satisfactory rate was 85％ (57/67),and the doctor's satisfactory rate was 89％ (60/67).Some early minor complications included dimpling at the suture site,asymmetry,overcorrection,transitory paralysis,late edema,scar and fall-off of hair among 80％ or so of patients.4 cases experienced hematoma on the frontal areas.The hematoma disappeared after early aspiration and later fomentation.2 cases had wound ulceration in the temporal 3 months after operation.The anchoring materials were removed and the ulceration tissues were excised 6 months after operation.The wound healed completely.2 patients experienced skin necrosis and depression due to careless electric cauterization on the frontal area.The depression gradually became smooth and inconspicuous after 6 months.All these complications were resolved and became negligible about 6 months after operation.Conclusions Endoscopic assistance is valuable in primary and secondary face-lift in the frontal and temporal areas.It is reliable and worthwhile to introduce the technique for patients aged less than 50-year-old.
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Objective To discuss the application of internal fixation technique in eyebrow lift and infrabrow excision blepharoplasty.Methods With the incision within eyebrow or infrabrow excision incision,fixation of the eyebrow to the brow periosteum using 4-0 silk thread and then suturing the upper and lower border of the incision could lift the eyebrow and correct the ptosis of upper eyelid skin and fishtail lines.Results All the 138 cases got good results,showing that the eyebrow and upper eyelid skin ptosis and lateral fishtail lines were all corrected.Conclusions Internal fixation technique can get better results in eyebrow lift and infrabrow exicion blepheraplasty surgery.
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Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.