共查询到20条相似文献,搜索用时 62 毫秒
1.
2.
Background
Pediatric burn injuries are one of the most psychologically and physically traumatizing injuries. They can cause lifelong stigma due to scarring. Conservative therapy for scar management follows on directly from acute burn treatment. However, it is not always possible to prevent the development of hypertrophic scars and scar contractures.Methods
This article describes the principles of percutaneous collagen induction (PCI) and its successful use as a minimally invasive method in scars following thermal injuries in children and adolescents.Results
Between November 2013 and March 2018, a total of 122 PCI treatments were performed on 43 children and adolescents. A medical roller device (Dermaroller®, Dermaroller GmbH, Wolfenbüttel, Germany) with 2.5?mm long needles was used and the procedures were carried out under general anesthesia. All patients applied a 0.5% vitamin-A ointment on the treated scars every evening over a period of 4 weeks. Post-treatment scar assessments in 20 patients performed with an integrated skin testing device (DermaLab® Combo, Cortex Technology, Hadsund, Denmark) with high frequency ultrasound showed improved collagen synthesis after only one PCI.Conclusions
PCI with medical needling is an effective method for scar treatment following thermal injuries, having a maximum effect on scar elasticity and patient satisfaction. It provides an ideal treatment option for pediatric and adolescent burn survivors whishing to avoid surgery due to their history of suffering, but still desire a functional or aesthetic improvement of their scars.3.
4.
5.
6.
Vachara Niumsawatt Keli Chow Xiao-You Shen Warren Matthew Rozen David J. Hunter-Smith 《European journal of plastic surgery》2016,39(1):41-48
Background
Despite the utility of the deep inferior epigastric artery perforator (DIEP) flap, the presence of abdominal wall scars can limit flap perfusion. Pfannnstiel scars are among the most common abdominal scars, during which undermining at either a subfascial or suprafascial level can damage perforators. There is an anecdotal belief that raising a DIEP flap in the presence of a Pfannenstiel scar may be less reliable due to vascular disruption.Methods
A clinical prospective analysis of retrospectively recorded imaging from 150 patients (300 hemi-abdominal walls) was undertaken. Preoperative imaging, with two computer software programmes used to reconstruct three dimensional (3-D) volume-rendered images and analyse vasculature, was used to accurately identify and measure perforators.Results
A total of 959 perforators were identified, with 319 perforators identified in the ‘Pfannenstiel scar’ group and 640 perforators in the ‘no abdominal scar’ group. All patients, except for one patient with a Pfannenstiel scar, had one or more perforators that were larger than 1.0 mm in diameter. There were no differences in the number of DIEA perforators (6.81 vs 6.22, p?=?0.2819); however, perforators of the ‘Pfannenstiel scar’ group were of larger mean diameter than the ‘no abdominal scar’ group (0.96 vs 0.85 mm (p?=?0.0027).Conclusions
The presence of a Pfannenstiel scar is associated with larger perforator size than controls and no diminution in overall perforator number. As such, a Pfannenstiel scar may in fact aid DIEP flap harvest, a finding consistent with anecdotal outcomes.Level of Evidence: Level III, risk / prognostic study.7.
Pablo González Isaza Kinga Jaguszewska Jose Luis Cardona Mariusz Lukaszuk 《International urogynecology journal》2018,29(2):211-215
Introduction and hypothesis
The aim of this study was to evaluate the long-term effect of thermoablative fractional CO2 laser (TACO2L) as an alternative treatment for early stages of stress urinary incontinence (SUI) in postmenopausal women with genitourinary syndrome of menopause.Methods
A total of 161 postmenopausal patients (age 53.38 ± 5.1 years, range 45–65 years) with a clinical diagnosis of mild SUI were prospectively enrolled in the study. Patients received one treatment with TACO2L every 30–45 days, each treatment comprising four sessions, followed in all patients by a yearly treatment session at 12, 24 and 36 months. SUI was evaluated using the International Continence Society 1-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after TACO2L treatment.Results
TACO2L treatment was associated with a significant improvement in ICIQ-UI SF scores and 1-h pad weight test at 12 months (both p < 0.001), 24 months (both p < 0.001) and 36 months (both p < 0.001). Improvements were maintained for up to 36 months without the need for any further intervention. The results were confirmed by significant histological changes related to trophic restoration of the vagina, responsible for extrinsic and intrinsic mechanisms involved in urinary continence.Conclusions
Our results suggest that TACO2L is an efficient and safe novel treatment strategy in patients with mild SUI. Further investigation to confirm the long-term results presented here is still warranted.8.
9.
Meltem Akcaboy Serdar Kula Tayfun Göktas Bijen Nazlıel Semiha Terlemez Nurullah Celik Bülent Celik Necla Buyan 《Pediatric nephrology (Berlin, Germany)》2016,31(3):473-483
Background
Hypertension (HT) is a major comorbidity of obesity that is associated with an increased risk of cardiovascular disease and higher mortality. The aim of our study was to evaluate cardiac function in obese hypertensive (OHT) and obese normotensive (ONT) pediatric patients and determine the effects of plasma nitric oxide (NOx) values on cardiac function, while demonstrating the role of plasma NOx in HT in obese pediatric patients.Methods
The study population consisted of 62 patients (27 boys, 35 girls), aged 13–18 years and 21 age-matched healthy controls. All subjects enrolled in the study underwent echocardiography (Echo) evaluation and ambulatory blood pressure monitoring for HT. Plasma NOx and biochemical values were studied in both patient groups separately.Results
Plasma NOx levels were found to be lower in the OHT group than in the ONT and control groups (p?<?0.001) and to be negatively correlated with left ventricular mass index values (p?<?0.05). Both the OHT and ONT groups had concentric hypertrophy of the heart.Conclusions
Plasma NOx plays an essential role in obesity-induced HT. Concentric hypertrophy of the left ventricle was found in both the OHT and ONT groups, indicating structural deformation of the heart.10.
11.
Luyun Chen Florian Lenz Céline D. Alt Christof Sohn John O. De Lancey Kerstin A. Brocker 《International urogynecology journal》2017,28(8):1131-1138
Introduction and hypothesis
To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures.Methods
This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction. High-resolution sagittal T2-weighted (T2w) sequences, transverse T1-weighted (T1w) FLASH 2D, and transverse T1w FLASH 3D sequences were performed to evaluate Fe3O4 polypropylene mesh MRI visibility and overall post-surgical pelvic anatomy 3 months after reconstructive surgery. Full mesh course in addition to important pelvic structures were reconstructed using the 3D Slicer® software program based on T1w and T2w MRI.Results
Three women with POP-Q grade III cystoceles were successfully treated with a partially absorbable MRI-visible anterior vaginal mesh with six fixation arms and showed no recurrent cystocele at the 3-month follow-up examination. The course of mesh in the pelvis was visible on MRI in all three women. The mesh body and arms could be reconstructed allowing visualization of the full course of the mesh in relationship to important pelvic structures such as the obturator or pudendal vessel nerve bundles in 3D.Conclusions
The use of MRI-visible Fe3O4 polypropylene meshes in combination with post-surgical 3D reconstruction of the mesh and adjacent structures is feasible suggesting that it might be a useful tool for evaluating mesh complications more precisely and a valuable interactive feedback tool for surgeons and mesh design engineers.12.
13.
14.
15.
H.‑R. Metelmann S. Hammes M. Schuster R. Rutkowski M. Mksoud S. Kindler U. Westermann 《Der MKG-Chirurg》2016,9(4):269-275
Background
Maxillofacial surgery is constantly developing and introducing new medical technology, such as laser and plasma devices.Objective
Process-oriented quality management by continuing postgraduate education in new technological procedures.Material and methods
Compilation of essential guidelines and quality-oriented educational programs in laser and plasma medicine.Results
The university based continuing education for a diploma in aesthetic laser medicine (DALM) is a postgraduate study program accredited in 1999 by the state authorities and based on an interdisciplinary, multicenter, industry-independent and scientific curriculum that leads to board certification.Conclusion
The DALM program is an important instrument for process-oriented quality management in plasma and aesthetic laser medicine.16.
17.
18.
19.
20.