Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
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Intracutaneous lidocaine is used for anesthesia in dermatologic surgery for skin cancer excision and repair with exceedingly low incidence of reported adverse events. ⋯ Toxicity associated with local anesthesia other than lidocaine was not studied. Volumes of lidocaine in skin cancer excision and repair are modest and within safe limits. Lidocaine toxicity is exceedingly rare to entirely absent. For comparable indications, lidocaine is safer than conscious sedation or general anesthesia.
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The use of autologous fat transfer for breast augmentation is still controversial due to ongoing concerns regarding its efficacy and safety, most notably, concerns about breast cancer risk and detection. ⋯ Autologous fat transfer for breast augmentation is not yet standardized. Therefore, outcomes vary widely depending on the surgeon's expertise. The majority of reported complications are of low morbidity, and based on available data, the procedure has a good long-term safety profile. Although there is no evidence that fat grafting increases breast malignancy risk, long-term follow-up is required.
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The American Council of Graduate Medical Education, which oversees much of postgraduate medical education in the United States, has championed the concept of "milestones," standard levels of achievement keyed to particular time points, to assess trainee performance during residency. ⋯ Milestones are now available for CDS fellowship directors to implement in combination with other tools for fellow evaluation.
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Today, autologous skin transplantation is frequently used for full-thickness skin defects. There is still a high demand for new wound-healing products to replace autologous skin transplantation. ⋯ The new collagen-gelatin scaffold supports and accelerates dermal wound repair compared to untreated control wounds. Nevertheless, wound treatment with the scaffold was only performed on the first day. In further studies, the impact of multiple scaffold applications on full-thickness skin defects should be investigated.
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Multicenter Study Clinical Trial
A Comprehensive Approach to Multimodal Facial Aesthetic Treatment: Injection Techniques and Treatment Characteristics From the HARMONY Study.
The HARMONY study is the first clinical trial to assess the impact of a global approach to facial rejuvenation with several minimally invasive modalities, using patient-reported outcome measures. ⋯ The investigators' perspectives and experience with the injection pattern, sequencing, volumes, and techniques may provide valuable guidance for a multimodal approach to facial aesthetic treatment.