Intraoral Vacuum-Assisted Closure Therapy-A Pilot Study in Medication-Related Osteonecrosis of the Jaw.

PURPOSE: For approximately 2 decades, vacuum-assisted closure (VAC) therapy has been widely used for the management of complex wounds and soft tissue defects on the external surface of the body. As yet, this technique has not been studied for intraoral wound management. Therefore, this study evaluated the feasibility, safety, and effectiveness of intraoral VAC therapy in patients with medication-related osteonecrosis of the jaw (MRONJ). PATIENTS AND METHODS: After successful construction of an intraoral device providing sufficient airtight sealing, individually manufactured appliances were used in a prospective clinical trial of 3 patients using the VAC therapy system. RESULTS: Intraoral VAC therapy showed some success and did not produce serious side effects. Different positive effects, such as formation of new granulation tissue, cessation of pain, and pus suppuration, were found. CONCLUSION: This prospective proof-of-principle study showed that intraoral VAC therapy is feasible and safe. It could play a role in the management of MRONJ and other types of intraoral wounds (eg, osteoradionecrosis, postoperative wound dehiscence, etc).

Reduction mammaplasty: outcome analysis based on bodyweight.

UNLABELLED: This retrospective study aimed to evaluate how reduction mammaplasty influences the bodyweight of patients 5 years after the procedure. The literature shows controversy regarding the effect of breast reduction on the progression of bodyweight. Between 1 January 2006 and 31 July 2007, 249 reduction mammaplasties were performed in the Department of Plastic, Reconstructive, and Aesthetic Surgery at the University Hospital Innsbruck. The exclusion criteria ruled out patients with oncoplastic breast reduction plasties, unilateral reduction mammaplasty, no documented preoperative weight, and bariatric procedures. The study finally included 50 women with a mean age of 44 ± 12 years. Of these 50 women, 26 (52 %) gained weight, 18 (36 %) lost weight, and 6 (12 %) remained stable during a 5-year follow-up period after the procedure. The mean weight gain was 4.50 ± 3.5 kg, and the mean weight loss was 3.44 ± 2.20 kg. The results of the study suggest that reduction mammaplasty is not a stimulus for weight loss. Although a tendency to gain weight was discovered, the weight gain compared with that of the standard population did not reach statistical significance. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .