فهرست مطالب

World Journal of Plastic Surgery
Volume:3 Issue: 2, Jun 2014

  • تاریخ انتشار: 1393/05/22
  • تعداد عناوین: 12
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  • Nasrin Nejadsarvari, Ali Ebrahimi Pages 81-86
    Providing an informed consent has an important role in promotion of medical treatments and reduction of judiciary litigations in this process. Today with cultural changes and wide propagation that is usually charming, the request for aesthetic surgery has an increasing trend. These problems with complexity of cosmetic surgeries lead to deeper differences of information between plastic surgeons and patients, so the discussion on giving information to a patient is of great importance. Regarding the elective choice of aesthetic surgeries, there is a need on providing a standard informed consent form. There are some problems on advertisements of aesthetic surgeries by non-plastic surgeons, taking insufficient or incorrect information to the patients affecting the patients’ autonomy. In fact, correct operative information should be share with the patients. Probable complications and alternative procedures should be presented to the patient to choose an operative option freely and without any charming. Obtaining a written informed consent can protect researchers and their sponsor institutions from any litigation. Patients with psychiatric problems can not benefit from aesthetic surgery and also they have no competency for giving any informed consent. So psychiatric problems can even worsen the surgical interventions. In this article, fundamentals of plastic surgery to provide an informed consent were reviewed and the legal and ethical considerations were evaluated.
    Keywords: Aesthetic, Surgery, Informed consent, Obligation, Patient
  • Zeinab Salehahmadi, Amir Manafi Pages 87-92
    Healthcare professionals usually should make complex decisions with far reaching consequences and associated risks in health care fields. As it was demonstrated in other industries, the ability to drill down into pertinent data to explore knowledge behind the data can greatly facilitate superior, informed decisions to ensue the facts. Nature has always inspired researchers to develop models of solving the problems. Bee colony algorithm (BCA), based on the self-organized behavior of social insects is one of the most popular member of the family of population oriented, nature inspired meta-heuristic swarm intelligence method which has been proved its superiority over some other nature inspired algorithms. The objective of this model was to identify valid novel, potentially useful, and understandable correlations and patterns in existing data. This review employs a thematic analysis of online series of academic papers to outline BCA in medical hive, reducing the response and computational time and optimizing the problems. To illustrate the benefits of this model, the cases of disease diagnose system are presented.
    Keywords: Bee colony algorithm, Diagnose diseases system, Medicine
  • Hamid Reza Fathi, Mahdi Fathi, Alireza Ghannadan, Mina Alavion, Kambiz Kamyab, Zahra Khazaipour, Saeed Amanpour Pages 93-98
    Background
    Peripheral nerve repair is often complicated by fibroblastic scar formation, nerve dysfunction, and traumatic neuroma formation. Use of silicone may improve outcomes of these repairs. In this study, we tried to evaluate effectiveness of silicone gel on rats’ sciatic nerve repair, axon regeneration and scar formation around and in the nervous tissues.
    Methods
    This experimental study was performed on 18 rats. They underwent bilateral sciatic nerve dissection. Then, right and left damaged sciatic nerves were sutured. In left side, silicone gel was applied. Two months later, both sides were evaluated regarding to myelin fiber diameter (µm), total fascicular area (mm2), axon diameter (µm), myelin thickness (µm), G- ratio (axon diameter/myelin thickness), connective tissue area, ratio of connective tissue area/fascicular area, neuroma and foreign body formation in liver and lungs and spleen reaction. Results of right and left sides were compared.
    Results
    Silicone was significantly more effective in increasing myelin thickness in the side that silicone was applied) than the control side. It was not associated with inflammation, scar formation, granuloma, and neuroma formation. No foreign body reaction occurred in liver, spleen and lungs after silicone application; but axonal regeneration did not improve with after its use.
    Conclusion
    According to our findings, it seems that silicone application in the cases with significant complications or in the cases that nerve graft is not possible would be an ideal option.
    Keywords: Silicon, Sciatic, Axon regeneration, Neuroma, Nerve Repair, Scar Formation
  • Nader Tanideh, Pedram Rokhsari, Davood Mehrabani, Soleiman Mohammadi Samani, Fatemeh Sabet Sarvestani, Mohammad Javad Ashraf, Omid Koohi Hosseinabadi, Shahram Shamsian, Nasrollah Ahmadi Pages 99-106
    Background
    Burn is still one of the most devastating injuries in emergency medicine while improvements in wound healing knowledge and technology have resulted into development of new dressings. This study was undertaken to evaluate the healing effect of licorice in Pseudomonas aeruginosa infected burn wounds of experimental rat model.
    Methods
    One hundred and twenty female Sprague-Dawley rats were randomly allocated to 4 equal groups. Group A received silver sulfadiazine ointment, Group B received 10% licorice extract and Group C was considered as control group and received gel base as the base of medication. Group D did not receive any medication and just underwent burn injury. A standard 3rd degree burn wound was produced by a hot plate with similar size about 20% of total body surface area (TBSA) and at identical temperature. After 24 h of burn production, 108 colony forming units (CFU) of toxigenic strains of P. aeruginosa (PA 103) were inoculated subcutaneously into the burnt area. After 3, 7, 14, 21 and 28 days of therapy, the animals were sacrificed and burn areas were macroscopically examined and histologically evaluated.
    Results
    Decrease in size of the burn wounds, in inflammation and re-epithelialization were poor in groups B-D. Infection to P. aeruginosa was still visible in groups B-D but was absent in Group A. The mean histological score, tensile strength, maximum stress, yield strength and stiffness in groups B-D were lower compared with Group A.
    Conclusion
    Licorice extract in 10% concentration was shown not to be effective in healing of P. aeruginosa infected burn wounds.
    Keywords: Burn, Wound, Healing, Licorice, Silver sulfadiazine, P. aeruginosa
  • Muhammad Saaiq, Bushra Ashraf Pages 107-114
    BACKGROUND; Self-inflicted burn injuries carry considerable mortality and morbidity among otherwise fit young individuals. This study assessed the epidemiologic pattern and outcome of these injuries in a burn care facility in Pakistan.
    Methods
    The study was carried out at Pakistan Institute of Medical Sciences (PIMS) Burn Care Centre in Islamabad over a period of 2 years. It included all adult patients of either gender, aged over 14 years who presented as cases of burn suicides and attempted burn suicides during the study period. Convenience sampling technique was employed. The sociodemographic profile of the patients, motives underlying the act of self-immolation, any underlying psychiatric illness, alcohol abuse, total body surface area (TBSA) burnt, depth of burn injury, associated inhalation injury, duration of hospital stay, and mortality were all recorded.
    Results
    Seventy five patients (80.64%) were female while 18 patients (19.35%) were male. The overall mean age was 26.89±6.1 years (range=15-52 years). The affected TBSA ranged from 15%-100% with an overall mean of 69.30±25.42%. The hospital stay ranged from 1-37 days with a mean of 7.16±6.60 days. Marital conflicts constituted the most frequent motive underlying the suicidal attempts (n=57; 61.29%) followed by failed love affairs (n=9; 9.67%). There was an overall mortality of 84.95%. The most common sufferers of self inflicted burn injuries were young, married, illiterate housewives who were resident of rural area. Getting marriage was the most common triggering cause for such injuries.
    Conclusion
    There is need to institute appropriate preventive measures to address the issue in a national perspective.
    Keywords: Burn, Suicide, Burn, Injury, Pakistan
  • Fatemeh Mohaddes Ardabili, Soybeh Pourhajari, Tahereh Najafi Ghzljeh, Hamid Haghani Pages 115-118
    Background
    Burn is a tragedy that follows multiple problems in a patient including pain, anxiety and lack of confidence into medical team. This study evaluated the effect of shiatsu massage on pain intensity of burn patients.
    Methods
    A total of 120 burn patients from Motahhari Burn Hospital and of both genders were randomly divided into 4 groups of undergoing hand massage, leg massage, both hand and leg massages, and the control group. The effect of shiatsu massage in pain relief of burned patients was evaluated. The visual analog scale (VAS) was used to assess pain in burn patients.
    Results
    Pain intensity in the control group before and after the intervention was not statistically significant (p=1). In all massage groups, the difference for pain intensity before and after the intervention was statistically significant.
    Conclusion
    According to our data, shiatsu method over both hands and legs were effective in pain reduction and can be recommended together with analgesics to decrease the dose.
    Keywords: Burn, Pain, Control, Massage, Shiatsu
  • Seyed Esmail Hassanpour, Seyed Mehdi Moosavizadeh, Mohsen Fadaei Araghi, Bahram Eshraghi Pages 119-121
    Background
    The nasal septal deviation (NSD) is one of the major causes of nasal obstruction. This condition increases upper airway resistance. In This study we evaluated the mean pulmonary artery pressure (MPAP) in patients with markedly deviated septum.
    Methods
    Sixty two patients with NSD (Age range: 26-45 years, 34 men and 28 women) were included in the study. Mean pulmonary artery pressure was measured in preoperative period by Doppler echocardiography with the assistance of an expert cardiologist.
    Results
    The mean preoperative MPAP value (22.5 mmHg in men and 20.03 mmHg in women) of the patients in this study was higher than normal population (20 mmHg). The MPAP of nine patients (14.5%) was greater than 25 mmHg. This value was significantly higher than values for normal population.
    Conclusion
    Markedly deviated septum had improper effects in cardiovascular system due to increase in MPAP.
    Keywords: Nasal septum, Deviation, Septorhinoplasty, Pulmonary artery pressure
  • Mehdi Eskandarlou, Sadrollahe Motamed Pages 122-128
    Background
    In rhinoplasty, functional and cosmetic problems of the nose are corrected. These problems cause imbalance between the nasal subunit and face. Throughout these deformities, there are 4 variants, so there is a need for careful preoperative evaluation either for treatment or prevention of the occurrence. According to functional and aesthetic effects of these variables in rhinoplasty, evaluation of the frequency with focus to diagnostic methods was undertaken.
    Methods
    A descriptive study was done over 100 volunteer patients for primary rhinoplasty. After history taking, nasal examination, desirable paraclinical work up and photography taking, presence of 4 anatomical variants was evaluated on the base of definition about normal and abnormal characteristic of them.
    Results
    Twenty nine male and 71 female patients underwent primary rhinoplasty. Open rhinoplasty was done in 85 and close technique in 15 patients. Forty six patients had only one and 23 patients had two of 4 anatomical variant concomitantly. 77% of patients had at least one of four anatomical nasal variations and preoperative diagnosis. The most common anomaly was alar cartilage malposition (51%) and frequency of others was low radix (36%), inadequate tip projection (35%) and middle vault collapse (15%). Frequency of low radix in male patients was 2.5 times more than females. CONCLUSON As at least one of four anatomical nasal variations in preoperative diagnosis was noticed, so it can be the predictor of occurrence and their correction has an important role in the outcome and success in rhinoplasty needs careful nasal analysis and evaluation. As frequency of middle vault narrowing was low, a definitive diagnosis of alar cartilage malpositioning seems necessary in surgical exploration.
    Keywords: Alar cartilage, Radix, Middle vault, Tip projection
  • Ahmad Tavassoli Ashrafi Pages 129-137
    Background
    Handling of upper lateral cartilages (ULCs) is of prime importance in rhinoplasty. This study presents the experiences among 2500 cases of rhinoplasty in the past 10 years for managing of ULCs to minimize unwilling results of the shape and functional problems of the nose.
    Methods
    All cases of rhinoplasties were done by the same surgeon from 2002 to 2013. Management of ULCs changed from resection to preserving the ULCs and to enhance their structural and functional roles. The techniques were spreader grafts, suturing of ULC together at the level or above the septum, using ULCs as auto-spreader flaps and very rarely trimming of ULCs unilaterally or bilaterally for making symmetric dorsal aesthetic lines. Fifty cases were operated based on this classification. Most cases were in type II and III. There were 7 cases in type I and 8 cases in type IV.
    Results
    Among most cases, the results were satisfactory although there were 8 cases for revision and among them, 2 cases had some fullness on dorsum and supra-tip because of inappropriate judgment on keeping the relationship between dorsum and tip. The problems in the shape and airways role of the nose reduced dramatically and a useful algorithm was presented.
    Conclusion
    ULCs have great important roles in shape and function of nose. Preserving methods to keep these structures are of importance in surgical treatments of primary rhinoplasties. The presented algorithm helps to manage the ULCs in different anatomic types of the noses especially for surgeons who are in learning curve period.
    Keywords: Management, Upper Lateral Cartilages, Rhinoplasty
  • Kn Manjunath Venkatesh Pages 138-141
    Penoscrotal transposition (PST) is a rare anomaly of the external genitalia that can be complete or incomplete while incomplete type is more common. Various surgical methods are described for correction of incomplete PST. Modified Glenn Anderson’s method is commonly used. This method is known to cause major penile lymphoedema following surgery. Various modifications have been described to preserve the dorsal penile skin to reduce this lymphoedema. We present here our experience with M-Plasty, where the dorsal penile skin is cut in the form of V so that it breaks the constricting effect of circumferential incision and prevents lymphoedema.
    Keywords: M, Plasty, Penoscrotal transaposition, Lymphoedema
  • Ali Akbar Mohammadi, Seyed Morteza Seyed Jafari Pages 142-145
    Background
    Trichoepithelioma is a rare benign skin lesion that originates from hair follicles. Trichoepitheliomas are mostly seen in the scalp, nose, forehead, and upper lip.
    Methods
    We present a large family of Iranian origin with 15 individuals affected with multiple familial trichoepithelioma in four generations, and treated with three different methods.
    Results
    Trichoepithelioma is histologically similar to basal cell carcinoma and has a rare risk of malignant transformation. In addition, most frequent incidence of this disease in young to elderly women may lead to social and psychological issues.
    Conclusion
    Precise diagnosis and management of this rare disease seem necessary.
    Keywords: Trichoepithelioma, Diagnosis, Treatment
  • Nikhil Panse, Parag Sahasrabudhe Pages 146-147