• Title/Summary/Keyword: Bio-surgery

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Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol

  • Marangi, Giovanni Francesco;Segreto, Francesco;Poccia, Igor;Campa, Stefano;Tosi, Daniele;Lamberti, Daniela;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.360-364
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    • 2016
  • Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.

Upper eyelid Merkel cell carcinoma treated with neoadjuvant chemotherapy and surgical excision

  • Toto, Vito;Colapietra, Alfredo;Alessandri-Bonetti, Mario;Vincenzi, Bruno;Devirgiliis, Valeria;Panasiti, Vincenzo;Persichetti, Paolo
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.121-125
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    • 2019
  • Merkel cell carcinoma is a rare cutaneous carcinoma, featured by an aggressive clinical course and a mortality rate of 28% at 2 years. A 71-year-old female was affected by a 4.1-cm-wide locally advanced Merkel cell carcinoma of the upper eyelid, previously misdiagnosed as chalazion, with involvement of the extraocular muscles. Although the tumor showed a macroscopic spontaneous regression in size after the incisional biopsy, the mass was treated with neoadjuvant chemotherapy and surgical excision. Good functional and aesthetic result with preservation of the eyeball and absence of tumor recurrence were achieved at 3-year follow-up. In our experience, the combination of the inflammatory cascade due to the incisional biopsy and neoadjuvant chemotherapy led to the regression of a locally advanced large Merkel cell carcinoma of the eyelid.

THE SKELETAL STABILITY OF LE FORT I MAXILLARY ADVANCEMENT (Le Fort I 상악골전진술 후 안정성에 관한 연구)

  • Seo, Min-Gyo;Koo, Sung-Young;Kim, Eun-Ju;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.149-153
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    • 2010
  • The purpose of this retrospective study was to evaluate relapse, comparing large and small maxillary advancements with four-plate rigid fixation and without bone grafting. All patients had skeletal class III malocclusion, and underwent bimaxillary surgery. Standardized cephalometric analysis by one examiner was performed on serial radiographs of 14 patients immediately before surgery, and within 1 week and at least 6 months postoperatively (mean 10 months). The group was divided into two subsets to determine whether the magnitude of relapse. In group 1 ($\leq$ 5 mm, n = 8), the average advancement was $4.0{\pm}0.9\;mm$, with a mean relapse of $0.1{\pm}0.5\;mm$. In group 2 (6-8 mm, n = 4), the average advancement was $6.8{\pm}0.9\;mm$, with a mean relapse of $0.7{\pm}0.4\;mm$. There was no statistical difference in the measured relapse among the groups. Maxillary advancement with a 1-piece Le Fort I osteotomy is a relatively stable procedure.

Delayed Pulmonary Artery Rupture after Using BioGlue in Cardiac Surgery

  • Woo, Wongi;Hong, Soonchang;Kim, Tae-Hoon;Baek, Min-Young;Song, Suk-Won
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.474-476
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    • 2017
  • A 56-year-old woman, who underwent cardiac surgery 3 months previously, presented to the emergency room with pulmonary artery rupture due to the cytotoxic effects of BioGlue (CryoLife Inc., Kennesaw, GA, USA). She was successfully treated with surgical management. Although surgical glue can be effectively used for hemostasis, it can induce delayed vascular complications. Therefore, surgical glue should be used cautiously.

THE USEFULNESS OF IMMEDIATE IMPLANTATION USING $BIO-OSS^{(R)}$ AND $BIO-GIDE^{(R)}$. IN $ITI^{(R)}$. IMPLANT SYSTEM ($ITI^{(R)}$ implant system에 있어서 $Bio-Oss^{(R)}$$Bio-Gide^{(R)}$를 이용한 발치 후 즉시 임플란트의 유용성)

  • Park, Kwan-Soo;Yoon, Kyu-Ho;Cheong, Jeong-Kwon;Shin, Jae-Myung;Hong, Sung-Chul;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.58-67
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    • 2006
  • In the recent studies, many authors have reported that the success rate of immediate implantation has no difference compared to conventional staged implantation. Although the immediate implantation has many advantages over conventional approach, many clinicians don't seem to practice because they think that most of the extraction sockets will have some bony gab with defects around implant and that this situation makes the result of immediate implantation unpredictable. We clinically analyzed 23 implanted sites of 18 patients treated with immediate implantation in our hospital from September 2003 to January 2004. The $ITI^{(R)}$. dental implant system was used and GBR procedure with $Bio-Oss^{(R)}$. and $Bio-Gide^{(R)}$. was done simultaneously. The pre & post-op. measurements were recorded such as alveolar crest-adjacent tooth CEJ distance, gingival crest-adjacent tooth CEJ distance, existence of periapical lesion, vertical defect around the extraction socket, horizontal defect around the extraction socket, probing depth, radiologic change of alveolar crest height. We report a positive outcome about immediate implantation with review of literatures.

Initial Stability after Bilateral Sagittal Split Ramus Osteotomy Application in Patients with Mandibular Prognathism (하악골 전돌증 환자에서 하악지 시상분할골 절단술 적용술 후 초기 안정성 평가)

  • Kwon, Myung-Hee;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.218-224
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    • 2011
  • Purpose: The purpose of this study is to evaluate the post-operative skeletal stability after surgical correction of patients with mandibular prognathism by bilateral sagittal split ramus osteotomy (BSSRO) and to evaluate the horizontal relapse tendency after the surgery. Methods: Twenty-six patients with Class III dental and skeletal malocclusion were selected for this retrospective study. Fifteen of them underwent BSSRO for mandibular setback and eleven of them underwent two-jaw surgery (Lefort I and BSSRO). In each patient, lateral cephalometric radiographs were taken pre-operatively, post-operatively within 1 week, and post-operatively after eight months. After tracing of the cephalometric radiographs, various parameters were measured. The analyses were done by linear measurement to evaluate the change in position of hard tissue B point, pogonion and mandibular plan angle by examination on lateral cephalograms. Results: The horizontal relapse rate was 27.1% at B point and 31.6% at pogonion in patients who underwent BSSRO. The horizontal relapse rate of the group where the amount of correction exceeded 10 mm was 25.69% at B point. Conclusion: There were no statistical differences on the magnitude of setback and direction of rotation of the mandible in mandibular stability. There were also no statistical differences between single mandibular surgery and two-jaw surgery for mandibular stability.