Subject(s)
Cryotherapy , Lipectomy/methods , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: Labiaplasty is a surgery currently booming. The number of publications on this subject is also increasing significantly. With the increase of the operated cases, we see more and more consultations for revisions after a labiaplasty, called secondary labiaplasty. The author reports here his experience with secondary labiaplasties in 44 cases. MATERIAL AND METHOD: The study carried out by the author reports 44 cases divided into two categories of secondary labiaplasties. The first category is characterized by a wound dehiscence, including those following the author's lambda laser procedures, which are easily repaired under local anesthesia after border cutting and suture. The second category is characterized by over-resections or real amputations or even remains of atypical flaps. DISCUSSION: The over-resection is a technical fault. In this case, the technique used to improve the aesthetic, functional and psychological aspect is the use of the remains of labia minora in the form of a flap to avoid a dog-ear appearance at the anterior and posterior part. The use of lipofilling of the labia majora is to mask the area and improve the function. The future of this surgery is probably the reconstruction of the labia minora by local flaps. CONCLUSION: The conclusion of the study is that it is imperative that surgeons performing labiaplasties be trained in both anatomy and labiaplasty techniques and avoid as much as possible over-resections and amputations, mending being often difficult.
Subject(s)
Plastic Surgery Procedures/methods , Reoperation , Vulva/surgery , Annual Reports as Topic , Female , Humans , Retrospective StudiesABSTRACT
INTRODUCTION: In spite of a rigorous technique, a graft will not necessarily completely take on a burned area. We propose to preserve on the donor site the excess skin graft harvested during the excision-graft procedure. PATIENTS AND METHODS: A clinical study was carried out in nine patients who had their excess skin graft preserved at the time of excision-graft for deep burn. The unused fragments of skin graft were preserved on the donor site. In the event of a small skin graft failure, the preserved skin graft was separated from its donor site and used as a new skin graft during wound dressing. RESULTS: Nine patients required the use of 10 preserved skin grafts. The average age was 54years and the average burned third degree surface was 17% total body surface area. In seven procedures for six patients, the preserved skin graft was taken off without pain and was used with a complete take. In three cases, the preserved skin graft was not used because in two cases, the take of the initial skin graft was complete and in one case, a definitely insufficient take required reoperation. CONCLUSION: The preservation and use of the skin graft as a complement was simple and useful and made it possible to easily complete a skin graft when the initial take was incomplete. It would appear to be efficient in burn surgery since it accelerates cicatrisation and avoids the need for a new graft harvesting procedure.
Subject(s)
Burns/surgery , Skin Transplantation/methods , Surgical Flaps , Transplant Donor Site , Adult , Aged, 80 and over , Body Surface Area , Burns/complications , Burns/diagnosis , Female , Graft Survival , Humans , Inpatients , Male , Middle Aged , Plastic Surgery Procedures/methods , Severity of Illness Index , Time Factors , Treatment Outcome , Wound HealingSubject(s)
Osteitis/therapy , Pressure Ulcer/therapy , Suction/methods , Wound Infection/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement , Enterococcus faecalis , Female , Gram-Positive Bacterial Infections/therapy , Humans , Male , Osteitis/etiology , Osteitis/pathology , Osteotomy , Paraplegia/complications , Postoperative Care , Pressure Ulcer/etiology , Pressure Ulcer/pathology , Staphylococcal Infections/therapy , Staphylococcus aureus , Suction/instrumentation , Surgical Flaps , Treatment Outcome , Wound Healing , Wound Infection/etiology , Wound Infection/pathologyABSTRACT
Fibromatosis (Desmoid tumor) of the male breast is an exceptional location. We present a case of such a tumor, in the context of Gardner's syndrome. A palpable mass was discovered in the right breast of a 52 years old man, with a history of rectocolic adenomatous polyposis. Mammography ant thoracic CT scan showed a stellar tumor, mimicking a breast cancer. Treatment consisted of wide excision and histology revealed a desmoid tumor. Desmoid tumors of the breast are benign lesions; they should be widely excised because of a high risk of recurrence. Coloscopy is indicated in the presence of mammary fibromatosis, to look for associated multiple polyps, confirming the diagnosis of Gardner's syndrome.
Subject(s)
Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/surgery , Fibromatosis, Aggressive/pathology , Fibromatosis, Aggressive/surgery , Gardner Syndrome/complications , Colonoscopy , Humans , Male , Middle Aged , Risk Factors , Tomography, X-Ray ComputedABSTRACT
Fifty injuries by stingrays are annually examined in the New Caledonia hospital. The injuries occur most often in the lower extremity, rare puncture injuries to the thorax or abdomen can cause death. The wound is associated with envenomation. The pain is intense with oedema, cyanosis, erythema often followed by tissue necrosis. In many cases, the management of stingray wounds is inadequate and the gravity often not well appreciated. Localized morbidity and prolonged healing may occur without an effective surgical management. Wound exploration and debridement are particularly indicated after first-aid measures, such as immersion in hot water. The characteristics, treatment and prevention are discussed in connection with two cases.
Subject(s)
Bites and Stings/classification , Bites and Stings/surgery , Surgical Procedures, Operative/methods , Adult , Bites and Stings/therapy , Child , Foot , Humans , Oceans and SeasABSTRACT
Communication using images proves to be the superior way to persuade audiences. Thus, in cosmetic surgery, images are widely used to inform and to lure consumers. The superpower of visual communication is being bolstered by viewers' credulity, who never call into question the authenticity of photos as long as those photos are credible. Colorful digital images are broadcasted among scientific meetings, displayed in medical offices, and posted on the Internet. They generate a virtual world where cosmetic surgery is idealized: plastic surgeons are talented and handsome, operations are successful, and complications do not occur. We consider that digital imaging and the Internet should serve as a means to provide information that will ultimately strengthen the surgeon-patient relationship.
Subject(s)
Image Interpretation, Computer-Assisted , Internet , Surgery, Plastic/trends , User-Computer Interface , Communication , Humans , Interprofessional Relations , Photography , Physician-Patient Relations , Treatment Outcome , Truth DisclosureABSTRACT
UNLABELLED: Convergence of medicine and Internet may be one of the most remarkable transformations in the health care business. Following the path led by the United States, the number of French websites related to cosmetic surgery is growing rapidly. In this study, we intend to assess the quality of French websites dedicated to cosmetic surgery regarding good quality criteria currently available and recommendations suggested by the French Medical Association. MATERIALS AND METHODS: We browsed the main French search engines on the Web that initially answering the following question: how many webpages are available regarding cosmetic surgery and what are the best referenced websites. For each website, we surveyed the following data: author's name and qualification, date of creation and last update, sources of information, level of interactivity, and adherence to a chart of quality such as HON. RESULTS: Eighty-five websites were surveyed and assessed. Forty-five French websites were active websites dedicated to cosmetic surgery. Websites are mainly hosted by private clinics (18 sites = 40%), with informative content. We found that no website adheres to any chart of quality, and the French Society for Plastic Surgery (SOF.C.P.R.E.) is never mentioned. Intrinsic quality criteria for websites (author's identification, last update, sources of information, confidentiality) are only partially present. DISCUSSION: We recall the key statistics regarding e-health business in the world, the various charts of quality available for medical websites, and recommendations provided by the French Medical Association. We suggest that websites should be available as a service (for information to the patient, for managing the office, for setting up medical records) rather than a poor personal webpage or a showcase. CONCLUSION: The quality of websites for cosmetic surgery is poor; however, as in the USA, the number of web surfers on medical sites is growing. Online presence of our speciality should evolve. To improve medical websites, collective awareness is required. We recommend using a specific chart of quality, with recommendations rather than constraints.
Subject(s)
Internet/standards , Quality of Health Care , Surgery, Plastic/standards , France , Health Care Surveys , Humans , Information Services , Quality Control , Societies, MedicalABSTRACT
Applying a postoperative dressing on a child's hand is a very important matter, for it must be done rigorously and according to well established principles in order to be effective and inoffensive. The strictness of execution, that holds the surgeon's attention, makes us sometimes forget that the dressing is for a child who is usually anxious. First, we recall the general principles of a postoperative dressing adapted to young children. Then, we explain a method of applying a dressing in the shape of a puppet, which at first can appear to be funny, but seriously which is completely adapted to a young child. This pediatrician adaptation, that parents appreciate very much, makes the situation less stressful because the child finds himself in a game situation. The puppet dressing seems to be an advantageous modification of the traditional dressing of a child's hand.
Subject(s)
Bandages/standards , Child, Hospitalized/psychology , Hand Injuries/surgery , Play and Playthings , Postoperative Care/methods , Postoperative Care/psychology , Age Factors , Child , Child, Preschool , Hand Injuries/psychology , Humans , InfantABSTRACT
Bilateral traumatic dissection of an internal carotid artery (BTDIC) after a closed injury is very rare. We report a case of bilateral thrombosis caused by internal carotid artery dissection due to a closed injury. The 22 cases documented in the literature are also reviewed. Six of the patients (26%) were asymptomatic at the initial examination, but all developed secondary symptoms, during the first 48 hours. Sixteen patients (69%) had associated traumatic lesions. Six patients died during the week after the accident, all of them had initial neurological symptoms. Magnetic resonance imaging (MRI) provided more items of information than angiography, showing a dissection on an occluded artery and a clearer picture of the length of the dissection, directly visualizing the wall hematoma and a residual signal that showed the persistence or arrest of blood flow. Treatment of BTDIC is based on early anticoagulation therapy.
