Annals of plastic surgery
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Annals of plastic surgery · Jan 2015
Clinical TrialSafe extensive tumescent liposuction with segmental infiltration of lower concentration lidocaine under monitored anesthesia care.
Tumescent anesthesia makes it feasible to perform liposuction in an office setting. There are often patients who desire extensive liposuction on approximately 30% of total body surface area, which means the lidocaine total dose might be over the dosing recommendation. So the segmental infiltration is applied, although the concentration of lidocaine in tumescent fluid is gradually reduced to 0.0252%. ⋯ Our previous study on the fluid management has demonstrated the risk of hypovolemia or fluid overload is very low with this technique, although the patients who received only maintenance fluid (500 mL) in the operating room and could discharge and resume oral intake after 6 hours of recovery room stay. The adequate anesthesia support is available in our office-based setting with adequate recovery facilities in place. It has a high margin of safety, without increasing of lidocaine toxicity or adverse cardiopulmonary sequelae while using a segmental tumescent infiltration with lower concentration of lidocaine.
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Annals of plastic surgery · Jan 2015
Randomized Controlled Trial Comparative StudyA prospective randomized controlled trial comparing N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), and subcuticular suture for closure of surgical incisions.
The use of tissue adhesives for the closure of surgical incisions is increasing. Few studies directly compare tissue adhesives to one another or focus on the difference in wound closure time between tissue adhesives. We compared the use of N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), or subcuticular suture in incisions resulting from reduction mammoplasty, mastopexy, panniculectomy, and abdominoplasty. ⋯ Our results demonstrate a decreased time required for wound closure using N-butyl-2 cyanoacrylate compared to both suture and octyl cyanoacrylate regardless of incision type with no significant difference in scar width or satisfaction ratings.
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Annals of plastic surgery · Jan 2015
Biography Historical ArticleRalph Ger, MD: an innovator in reconstructive surgery.
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Annals of plastic surgery · Dec 2014
Randomized Controlled TrialProspective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis.
Most randomized trials have shown similar results with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR); however, there are studies suggesting less postoperative pain, faster improvement in grip and pinch strength, and earlier return to work with the endoscopic technique. The goal of this study was to prospectively examine subjective and functional outcomes, satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient, serving as their own control. ⋯ This interim analysis, using the same patient as an internal control, suggests that both OCTR and ECTR are well tolerated with no differences in functional outcomes, symptom severity and functional status questionnaires, or complications. Although there were no differences between groups using our study metrics, patients still preferred the ECTR, demonstrated by significantly higher overall satisfaction scores at the conclusion of the study.