فهرست مطالب

World Journal of Plastic Surgery
Volume:5 Issue: 3, Sep 2016

  • تاریخ انتشار: 1395/07/04
  • تعداد عناوین: 20
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  • Nasrin Nejadsarvari, Ali Ebrahimi, Azin Ebrahimi, Haleh Hashem, Zade Pages 207-212
    Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient–physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved.
    Keywords: Medical ethics, Plastic surgery, Aesthetic
  • Seyedeh Leila Nabavizadeh, Davood Mehrabani, Zabihallah Vahedi, Farzad Manafi Pages 213-225
    In recent years, the cloning technology has remarkably developed Iran, but unfortunately, the required legal framework has not been created to support and protect such developments yet. This legal gap may lead to abuse of scientific researches to obtain illegal benefits and to undermine the intellectual property rights of scientists and researchers. Thus to prevent such consequences, the attempts should be made to create an appropriate legal-ethical system and an approved comprehensive law. In this review we concluded that the right method is guiding and controlling the cloning technology and banning the technique is not always fruitful. Of course, it should be taken into accounts that all are possible if the religion orders human cloning in the view of jurisprudence and is considered as permission. In other words, although the religious order on human cloning can be an absolute permission based on the strong principle of permission, it is not unlikely that in the future, corruption is proved to be real for them,. Jurists rule it as secondary sanctity and even as primary one. If it is proved, the phenomenon is considered as example of required affairs based on creation of ethical, social and medical disorders. Religious and ethical rulings cannot be as permission for it, and it seems that it is a point that only one case can be a response to it and it needs nothing but time.
    Keywords: Cloning, Bioethics, Legal, Jurisprudence, Regenerative medicine, Iran
  • Leitermann Mona, Hoffmann Klaus, Kasten Erich Pages 226-235
    Background
    Nowadays, with the help of cosmetic surgery almost every woman and man can achieve a highly attractive appearance. The question is, why so many people do not take advantage of these opportunities? This pilot-study investigates individual attitudes of people towards aesthetic plastic surgery.
    Methods
    A questionnaire was developed which combined self-developed items for a measurement of attitudes towards plastic surgery. In addition, items of the “Freiburger Personality Inventory” (FPI-R) were used. The study was conducted in Hamburg/Germany. 104One hundred and four test persons participated in the survey (81 females, 23 males, age 20-30 years). Eighty six of the participants (82.7%) had an A-level as degree of education, 14.4% achieved the secondary school certificate and 2.9% had completed their bachelor on a high school.
    Results
    The data supported the hypothesis that people who are unsatisfied with their body appearance showed more willingness for a surgical intervention. On the other hand, fear of complications and pain as far as anxiety before an unsatisfactory result hinders them from a decision for an intervention. Significant correlations with regard to extraversion-introversion and the education level were not found. Females showed more willingness regarding an intervention than men. Gender-specific differences concerning the cost factor were not found.
    Conclusion
    Interestingly more than 65% of the total sample felt dissatisfaction with a specific body part and are thus target of aesthetic surgery. The yellow press often reports about failed cosmetic surgery, especially in VIP-persons. Aesthetic surgery should keep working to reduce unwarranted fears of people toward these kinds of operations.
    Keywords: Plastic surgery, Operation, Aesthetic, Beauty, Cosmetic surgery, Fear
  • Erkan Kahraman, Yakup Cil, Armagan Incesulu Pages 236-243
    Background
    The efficiency of nasal surgeries can be determined by objective or subjective methods. We have assessed the effect of nasal obstruction after different nasal surgeries using Acoustic Rhinometry (AR) and Nasal Obstruction Symptom Evaluation (NOSE) Scale.
    Methods
    Between May 2011 and May 2012, 40 young adult patients and 10 healthy volunteers as control group who referred to Otorhinolaryngology Clinic in Eskisehir Military Hospital due to nasal obstruction were enrolled. Depending on operation, patients were divided into four equal groups. Group 1: Septoplasty, Group 2: Septoplasty with sprader graft, Group 3: Septorinoplasty and Group 4: Septorhinoplasty with spreader graft. The patients completed NOSE scale, 1 week before and 1 month after the surgery and AR measurements.
    Results
    There were a significant improvement in mean NOSE scores of patients and statistical difference was found between pre and post-operational values for each group. There was a statistically significant change of the mean minimal cross section areas (MCA) of the deviated side of nasal passages measured by AR between pre and postoperative period.
    Conclusion
    In patients with nasal obstruction, functional nasal surgeries which were performed after appropriate medical examination and with right operation methods had a positive impact on quality of life and patient satisfaction. We observed that nasal findings were correlated with NOSE scores and MCA values. So, we suggest that NOSE scale and AR to be used for evaluation of the efficiency of functional nasal surgeries.
    Keywords: Nasal obstruction, nasal surgery, acoustic rhinometry, NOSE scale
  • Wagih Ghnnam, Ashraf Elrahawy, Magdy El Moghazy Pages 244-251
    Background
    Increased body mass index (BMI) increase the incidence of seroma formation and wound infection rates and subsequently increases wound dehiscence and ugly scar formation following abdomenoplasty and body contour surgery and also many other aesthetic and plastic surgery. The aim of this study was to determine the effect of BMI on the outcome of abdominoplasty operation.
    Methods
    We carried out a prospective study of all patients who underwent abdominoplasty at our institution. Patient were divided into two groups. Group I were subjects with body mass index 30 kg/m2. Demographics and complications (minor and major) were recorded.
    Results
    Sixty seven patients were enrolled. Group I were 32 patients with a mean age of 35.71 and group II 35 patients with mean age of 36.26 years. Seroma formation, wound complications, prolonged hospital stay and complications were significantly more in group II.
    Conclusion
    We found that increased BMI significantly increased operative time, hospital stay, drainage duration and drainage amount. Our findings showed that obesity alone could increase the incidence of complications and poor outcome of abdominoplasty.
    Keywords: Abdominoplasty, Body Mass Index, Complications, Seroma, Patient satisfaction
  • Silvio Bromberg, Roberto Giordano Pages 252-258
    Background
    Conservative surgical treatment has been the treatment of choice for early breast cancer. It allows feasible oncological treatment with a satisfactory cosmetic approach and fast recovery. However, in some cases mastectomy is necessary. This study proposes a surgical approach with only one surgical access through the same incision, which is in line with precepts mentioned above. It is called the prime incision and modified moving window techniques.
    Methods
    Thirty one patients with a breast cancer diagnosis who would have to undergo surgery were enrolled. The proposed technique was used and its advantages and feasibility were assessed and evaluated.
    Results
    Twenty three conservative surgeries, 7 adenectomies and 1 axillary surgery were performed. All cases were appropriately treated and progressed without complications and had adequate aesthetic results. The technique presented allows only one surgical access to approach the axilla and breast cancer treatment.
    Conclusion
    This study proved the aesthetic advantage provided by only one surgical incision access feasible for surgical treatment as a secure approach. The minimally invasive approaches of prime incision and modified moving window were shown to provide adequate surgical access with only one scar, thus having a better cosmetic result.
    Keywords: Breast cancer, Treatment, Minimally invasive surgery, Modified moving window, Prime Incision
  • Mohaddese Mahboubi, Mohammad Mehdi Feizabadi, Tahereh Khamechian, Nastaran Kazempour, Mohsen Razavi Zadeh, Farhang Sasani, Mohsen Bekhradi Pages 259-264
    Background
    Staphylococcus aureus is one of the most causative organisms in the skin wound infections. Development of resistant S. aureus to current treatments in individuals with low immunity is a global concern. The aim of this study was to evaluate the efficacy of herbal formulation against skin wound infection.
    Methods
    The efficacy of herbal formulation containing Oliveria decumbens and Pelargonium graveolens essential oils was evaluated in comparison to mupirocin against Methicillin Resistant S. aureus (MRSA) related skin wound infection in mice animal model.
    Results
    The herbal cream and mupirocin decreased the log CFU by 2.5±0.26 and 2.46±0.32, respectively, while the log CFU of S. aureus from wound skin were 5.9±0.26 and 5.65±0.23 for placebo and control groups, respectively. Moreover, the histological examinations showed that this cream improved the wound healing and increased the collagen deposition and wound contraction.
    Conclusion
    This natural new formulation with O. decumbens and P. graveolens essential oils could be recommended as a new candidate for wound healing.
    Keywords: Oliveria decumbens, Pelargonium graveolens, Healing, Infected wound, Mouse
  • Thittamaranahalli Muguregowda Honnegowda Muguregowda, Echalasara Govindarama Padmanabha Udupa, Pragna Rao, Pramod Kumar, Rekha Singh Pages 265-273
    Background
    Thermal injury is associated with several biochemical and histopathological alteration in tissue. Analysis of these objective parameters in research and clinical field are common to determine healing rate of burn wound. Negative pressure wound therapy has been achieved wide success in treating chronic wounds. This study determines superficial burn wound healing with intermittent negative pressure wound therapy under limited access and conventional dressings
    Methods
    A total 50 patients were randomised into two equal groups: limited access and conventional dressing groups. Selective biochemical parameters such as hydroxyproline, hexosamine, total protein, and antioxidants, malondialdhyde (MDA), wound surface pH, matrix metalloproteinase-2 (MMP-2), and nitric oxide (NO) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing under intermittent negative pressure.
    Results
    Patients treated with limited access have shown significant increase in the mean hydroxyproline, hexosamine, total protein, reduced glutathione (GSH), glutathione peroxidase (GPx), and decrease in MDA, MMP-2, wound surface pH, and NO. Histopathologic study showed that there was a significant difference after 10 days of treatment between limited access vs conventional dressing group, Median (Q1, Q3)=3 (2, 4.25) vs 2 (1.75, 4).
    Conclusion
    Limited access was shown to exert its beneficial effects on wound healing by increasing ground substance, antioxidants and reducing MMP-2 activity, MDA, NO and providing optimal pH, decreasing necrotic tissue, amount of inflammatory infiltrate, increasing ECM deposition and angiogenesis.
    Keywords: Burn, Healing, Intermittent negative pressure, Limited access dressing, Conventional dressing
  • Ehsan Fayazzadeh, Hana Yavarifar, Seyyed Reza Rafie, Sadrollah Motamed, Maryam Sotoudeh Anvari, Mohammad Ali Boroumand Pages 274-279
    Background
    One of the main challenges in skin flap surgery is tissue ischemia and following necrosis. The present study compares the effects of fibroblast growth factors 1 and 2 on increasing cutaneous vasculature, improving ischemia, and preventing distal necrosis in ischemic skin flaps in rat model.
    Methods
    Thirty rats were allocated into 3 groups (n=10) and 2×8 cm dorsal random-pattern skin flaps were raised after four daily subdermal injections of normal saline (control group), fibroblast growth factor 1 (FGF-1 group; 2.5 µg/day), or fibroblast growth factor 2 (FGF-2 group; 2.5 µg/day) at designated flap areas. Skin flap viability and number of blood vessels were evaluated on day 10 after elevation by planimetric analysis and histological examination.
    Results
    It was shown that administrations of FGF-1 and FGF-2 significantly decreased the percentage of flap necrosis and improved the percentage of ischemic survivable area, compared to the control samples. Meanwhile, the differences between these factors in terms of preventing skin flap necrosis and improving ischemia were also significant. The number of visible blood vessel sections was also higher in FGF-1 and FGF-2 groups than in the control group.
    Conclusion
    These findings suggest that, while FGF-2 is still much more potent than FGF-1, treatment with either of these drugs could be very effective in increasing the survival of surgical flaps at risk (length to width ratio>3) in situations that other therapeutic options could not be considered.
    Keywords: Acidic fibroblast growth factor, Basic fibroblast growth factor, Ischemic necrosis, Skin flap survival, Rat
  • Navid Kalani, Mohammad Sadegh Sanie, Hasan Zabetian, Mohammad Radmehr, Reza Sahraei, Hossein Kargar Jahromi, Hadi Zare Marzouni Pages 280-286
    Background
    New drugs are increasingly used to induce analgesia during surgeries. This study compared the analgesic effects of paracetamol and magnesium sulfate.
    Methods
    Sixty patients with American Society of Anesthesiologists (ASA) class I or II patients who were candidates for surgery of the lower limbs were randomly divided into three equal groups who were age and gender matched. Group 1 received paracetamol, and group 2, the magnesium sulfate during surgery and group 3 as the control. Pain intensities were measured and recorded using the Visual Analog Scale before surgery, in the recovery room, and 6, 12, and 18 hours after surgery.
    Results
    Pain intensities (7.10, 5.80, and 4.10) were higher in the control group; 6, 12, and 18 hours after surgery compared to the paracetamol (6.45, 4.15, 2.50) and the magnesium groups (7.25, 4.55, and 2.05), but the difference was not statistically significant.
    Conclusion
    Paracetamol and magnesium sulfate were shown to have postoperative analgesic effects and reduce the quantity of narcotic use after surgery.
    Keywords: Paracetamol, Magnesium sulfate, Analgesia, Pain, Limb
  • Ahmad Reza Taheri, Mohammad Reza Farahvash, Hamid Reza Fathi, Koorosh Ghanbarzadeh, Bijan Faridniya Pages 287-292
    Background
    Surgery, as the main approach in higher stages of gynecomastia, has different techniques regarding the staging of the disease. The more the grade of gynecomastia, the more complicated the used surgical techniques, conventionally. This study assessed the success rate of the simplest surgical technique in higher grades of gynecology as well as the satisfaction rate in patients and surgeon to offer using the technique for higher grades of the disease.
    Methods
    To evaluate the success and the satisfaction rates of periareolar incision and liposuction among patients with grade II and III gynecomastia, this cross-sectional study was conducted.
    Results
    The satisfaction rate was the main concern of the present study. The patients had a mean satisfaction score of 8.1±1.396 with the range of 5-10 from total 10 score. The majority of the patients expressed their satisfaction by 9 score. The total mean of physician satisfaction score was 8.36 at all levels.
    Conclusion
    Like aesthetic reasons which lead individuals to seek solutions for their annoying gynecomastia, aesthetic satisfaction is a prominent concern for people who undergo surgical approach. So, the least surgical scar and complications are absolutely the most area of focus in this regard.
    Keywords: Gynecomastia, Periareolar incision, Liposuction, Satisfaction rate
  • Sameh Ibrahim Sersar, Ibrahim Yassin, Mohammed Saad Eldin Aly Pages 293-297
    Diced rib cartilage is an acceptable option in severe nasal deformities. We present our preliminary experience in KAMC in nasal septoplasties using the autologous diced costal cartilage. This is a retrospective study of the 22 cases who needed the autologous diced costal cartilage in our centre in 4 years. All our patients needed autologous diced rib cartilages. Twelve were wrapped with temporalis fascia, eight needed rectus fascia and perichondrium was used in only 2 cases. The naso-frontal angle for the whole series decreased by a mean of 4.41° (p=0.008) for the group using the rectus fascia diced cartilage graft. From the aesthetic point of view, all cases were satisfied except 3 (13.6%); two in the group of diced cartilage temporalis fascia; group 1. From the functional breathing view, only 1 case was not satisfied. He was in group 1. Autologous rib cartilage was shown to be a good graft in nasal septoplasty especially if wrapped with rectus fascia.
    Keywords: Autologous cartilage, Nasal septoplasty, Rectus fascia
  • Waleed Alshehri, Sara Alfadil, Alhanouf Alothri, Abdulaziz O. Alabdulkarim, Shabeer A. Wani, Sari M. Rabah Pages 298-302
    Aplasia Cutis Conginita (ACC) is a condition characterized by congenital absence of skin, usually on the scalp. ACC can occur as an isolated condition or in the presence of other congenital anomalies. Here we describe a case of a 16 days old baby girl with an isolated ACC of the scalp. Her elder two siblings have been diagnosed with ACC with concomitant cardiac or limb anomalies. The patient was managed conservatively until the defect has scarred 6 months later.
    Keywords: Aplasia cutis congenita, Scalp, Reconstruction, Familial
  • Titiksha Aggarwal, Kirti Chawla, Arundeep Kaur Lamba, Farrukh Faraz, Shruti Tandon Pages 303-307
    Lip is an important aspect of facial features affecting ones personality. A deformity of the lip characterized by excessive tissue sagging below the usual giving it thicker wider appearance is referred to as double lip. It is a rare occurrence with a proposed male predilection. This article is a report of a 20 years old male with this deformity who presented with the complaint of difficult speech and poor aesthetics. There was no other history patient being systemically healthy. It was successively treated with a simple surgical technique without recurrence over a period of 12 months.
    Keywords: Double lip, Surgery, Congenital, Acquired, Suturing
  • Shaal Ramdial, Desigan Pillay, Anil Madaree Pages 308-312
    A three day old neonate was referred to our department with a problem of a sternal cleft. Sternal clefts are often associated with a myriad of other abnormalities ranging from mild to severe. We present our experience with such a problem, and review the current literature concerning it.
    Keywords: Sternal cleft, Bifid sternum, Chest wall deformity, Chest wall abnormality
  • Mohd Altaf Mir, Imran Ahmad, Yaseen Mihd Pages 313-318
    The musculoskeletal extrapulmonary tuberculosis is uncommon, the upper extremity tuberculosis is not common and the mycobacterial involvement of skin of hands and synovial sheath of tendons is rare. This prospective observational study was undertaken between August 2014 and December 2015 in a tertiary referral hospital. Patients attending with suspected primary tuberculosis of soft tissue of the hand were included. Anteroposterior and lateral radiographs of the hand, wrist and lung and MRI were undertaken. A diagnosis of tuberculosis was made based on histology, and positive culture for Mycobacterium. Split thickness skin grafting was done after excision of tubercular cutaneous ulcers of hand. Postoperatively patients were treated with home based anti-tubercular chemotherapy. Lesions of synovial sheath of tendons were excised. Splints or plaster slabs were used in all patients. There were 3 males and 2 females with a mean age of 44.75±6.61 years (19-48 years). Based on clinical suspicion, plain radiographs and MRI, there were 3 patients with involvement of synovial sheath of tendons and 2 patients with involvement of skin of hand. Tuberculosis was confirmed histologically and Mycobacterium bovis was confirmed microbiologically. The delayed diagnosis is often due to slow progression and numerous differential diagnoses, which often leads to complications. Early radical excision of the infected tissues combined with anti- tubercular multidrug therapy gives good functional results and prevents recurrence.
    Keywords: Tuberculosis, Flexor tendon sheath, Cutaneous, Hand
  • Arash Beiraghi, Toosi, Seyed Mohammad Motamedalshariati, Samira Ghanei, Rowshanak Afshar Pages 319-322
  • Mohammadreza Akhoondinasab, Roohollah Sobhani Pages 323-324
  • Guillermo Ramos.Gallardo Pages 328-331