ABSTRACT
The purpose of this study was to investigate the use of antibiotic prophylaxis for plastic surgical procedures at our hospital, and to perform a systematic literature review of randomized controlled trials evaluating the use of prophylactic antibiotics in plastic surgery. The records of patients who received plastic surgical procedures with Class I surgical incisions between 2009 and 2010 were retrospectively reviewed. A systematic literature review was conducted for studies examining the use of prophylactic antibiotics for Class I surgical wounds. A total of 13,997 cases with Class I surgical incisions were included. Prophylactic antibiotics were given in 13,865 cases (99.1%). The antibiotics used were primarily cefuroxime, clindamycin, metronidazole, cefoxitin sodium, and gentamicin. The average duration of administration was 4.84 ± 3.07 (range, 1-51) days. Antibiotics were administered postoperatively in >99% of cases while preoperative antibiotic administration was only given in 32 cases (0.23%). Wound infections occurred in 21 cases for an overall infection rate of 0.15%. Fourteen studies met the inclusion criteria of the systematic review. There was marked variation in the timing of antibiotic administration with antibiotics given pre-, peri-, and postoperatively. Of studies that compared the use of prophylactic antibiotics with placebo, a reduction in wound infections was noted in 4 trials and no difference was noted in 6 trials. No significant difference in infection rates was shown between the prophylactic and postoperative arms. In conclusion, prophylactic antibiotics are overused in plastic surgical procedures. Evidence-based guidelines for the use of prophylactic antibiotics in plastic surgical procedures are needed.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Antibiotic Prophylaxis , Plastic Surgery Procedures , Cefoxitin/administration & dosage , Cefuroxime/administration & dosage , China , Clindamycin/administration & dosage , Female , Gentamicins/administration & dosage , Humans , Male , Metronidazole/administration & dosage , Middle Aged , Retrospective Studies , Surgery, PlasticABSTRACT
The objective of this work was to study the effect of epidermal growth factor (EGF) induced secretions of angiogenesis factors in adipose-derived stem cells (ADSCs) and the involvement of mitogen-activated protein kinases (MAPK). ADSCs were cultured and ELISA assays were performed to quantify the vascular endothelial growth factor, the hepatocyte growth factor, and the stromal derived factor-1 in ADSC-conditioned medium before and after EGF treatments and after pharmacological inhibition of MAPKs with PD98059, SB203580, and SP600125. The tube formation assay was used to test the effects of EGF treated and inhibitor treated ADSCs on the human umbilical vein endothelial cells (HUVECs) tube formation. Liposuction was applied and ADSCs were cultured successfully. The ADSCs released a variety of angiogenic factors, with the EGF treatments enhancing secretions and promoting the HUVEC tube formation. The MAPK inhibitors PD98059 and SP600125 increased the paracrine to promote tubular formation, while the SB203580 played an opposite role. In conclusion, (1) the in vitro cultured ADSCs secrete various angiogenic factors and the EGF amplifies the secretion and can enhance the ADSCs on the HUVEC tube formation. (2) ERK1/2 and JNK pathway may be involved in the enhanced secretion capacity of ADSCs while the p38 pathway may exert an opposite effect.
Subject(s)
Epidermal Growth Factor/pharmacology , MAP Kinase Kinase 4/genetics , Mitogen-Activated Protein Kinase 1/genetics , Mitogen-Activated Protein Kinase 3/genetics , Stem Cells/drug effects , Adipose Tissue/cytology , Adipose Tissue/drug effects , Adipose Tissue/metabolism , Adult , Anthracenes/pharmacology , Chemokine CXCL12/genetics , Chemokine CXCL12/metabolism , Culture Media, Conditioned/pharmacology , Female , Flavonoids/pharmacology , Gene Expression Regulation , Human Umbilical Vein Endothelial Cells/cytology , Human Umbilical Vein Endothelial Cells/drug effects , Humans , Imidazoles/pharmacology , Lipectomy , MAP Kinase Kinase 4/metabolism , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinase 3/metabolism , Primary Cell Culture , Protein Kinase Inhibitors/pharmacology , Pyridines/pharmacology , Signal Transduction , Stem Cells/cytology , Stem Cells/metabolism , Vascular Endothelial Growth Factor A/genetics , Vascular Endothelial Growth Factor A/metabolism , p38 Mitogen-Activated Protein Kinases/genetics , p38 Mitogen-Activated Protein Kinases/metabolismABSTRACT
OBJECTIVE: To explore the reliability of humping the forehead and temple by en block frontal temporal silicone . METHODS: Make wax mold by piling up wax slices layer by layer according to the rang of depressing of the forehead and temple, the section being humped and the hight need to be projected. Order the silicone block according to the dimension of the wax mold. Make the implant from the silicon block. Under local anaesthesia dissection under the superficial temporal fascia and galea through forehead and two temporal incisions. Implant the silicon through the middle incision. RESULTS: Total 18 cases in this group were followed up for 3-12 months. Wound healed primarily without infection. I case with early blood effusion cured after aspiration. l case with later clear effusion cured after aspiration ad injection of prednisone in to the capsular. The frontal temporal contours were satisfactory . No outline of the implant was seen. CONCLUSION: It is safety and satisfied to hump the forehead and temple by en block frontal temporal silicone.