Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis

Abstract Background The interest in youthful appearance and rejuvenating procedures is unbroken in our society. Besides surgical procedures, permanent fillers are utilized. The incorrect and unprofessional use of these substances, auto-injections in particular, have devastating results for patients and are challenging for the plastic surgeon. The aim of this retrospective study was to delineate the differences between permanent and non-permanent filler complications and appropriate treatment options. Methods We conducted a retrospective study and researched the hospital information system in the time period from 2001 to 2020. Patients with unprofessional use of permanent fillers, auto-injections and injections of unformulated substances were determined. Age, gender, localization, complications, length of hospital stay, comorbidities, histopathological workups and surgical salvage procedures were noted. Descriptive statistics were calculated. Results Seventeen patients were identified from 2001 till 2020. In four cases, auto-injections by the patients were the cause, whereas in the other patients the injections were performed by medical staff. Ages range from 18 to 57 years. Fourteen patients were female and three were male. The injected substances could be recognized as synthol, silicone, vaseline, fat tissue, hyaluronic acid as well as non-medical substances. Surgical procedures were necessary in eleven cases. One patient died because of the underlying diseases. Conclusion Our results indicate different sequels of filler materials injected in an unprofessional way, possible complications, conservative and surgical techniques to resolve these rare complications. We suggest a staged therapy adjusted to the clinical symptoms. Milder symptoms can be handled conservatively, whereas severe infections, skin breakdowns or persistent granuloma are justifying indications for surgical treatment. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

Surgery Research and Practice ◽

10.1155/2016/6935167 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Jacob Rosenberg ◽

Kristoffer Andresen

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Surgical Procedures ◽

Operative Technique ◽

Surgical Techniques ◽

Full Description ◽

Tips And Tricks ◽

Promising Technique

Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications.

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A Novel Method of Outcome Assessment in Breast Reconstruction Surgery: Comparison of Autologous and Alloplastic Techniques Using Three-Dimensional Surface Imaging

Aesthetic Plastic Surgery ◽

10.1007/s00266-020-01749-4 ◽

2020 ◽

Vol 44 (6) ◽

pp. 1980-1987 ◽

Cited By ~ 4

Author(s):

Robin Hartmann ◽

Maximilian Weiherer ◽

Daniel Schiltz ◽

Stephan Seitz ◽

Luisa Lotter ◽

...

Keyword(s):

Breast Reconstruction ◽

Three Dimensional ◽

Surgical Techniques ◽

Full Description ◽

Surface Imaging ◽

Level Of Evidence ◽

Reconstruction Surgery ◽

Present Trial ◽

Based Medicine ◽

Dimensional Surface

Abstract Background Breast reconstruction is an important coping tool for patients undergoing a mastectomy. There are numerous surgical techniques in breast reconstruction surgery (BRS). Regardless of the technique used, creating a symmetric outcome is crucial for patients and plastic surgeons. Three-dimensional surface imaging enables surgeons and patients to assess the outcome’s symmetry in BRS. To discriminate between autologous and alloplastic techniques, we analyzed both techniques using objective optical computerized symmetry analysis. Software was developed that enables clinicians to assess optical breast symmetry using three-dimensional surface imaging. Methods Twenty-seven patients who had undergone autologous (n = 12) or alloplastic (n = 15) BRS received three-dimensional surface imaging. Anthropomorphic data were collected digitally using semiautomatic measurements and automatic measurements. Automatic measurements were taken using the newly developed software. To quantify symmetry, a Symmetry Index is proposed. Results Statistical analysis revealed that there is no difference in the outcome symmetry between the two groups (t test for independent samples; p = 0.48, two-tailed). Conclusion This study’s findings provide a foundation for qualitative symmetry assessment in BRS using automatized digital anthropometry. In the present trial, no difference in the outcomes’ optical symmetry was detected between autologous and alloplastic approaches. Level of evidence Level IV. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Surgical Outpatient Care: Triage, Time and Test

10.5772/intechopen.100170 ◽

2021 ◽

Author(s):

Satyendra K. Tiwary

Keyword(s):

Surgical Procedures ◽

Day Care ◽

Surgical Techniques ◽

Length Of Hospital Stay ◽

Developed Countries ◽

Day Care Surgery ◽

Minimally Invasive Surgical ◽

Early Return ◽

Treat All ◽

Care Surgery

Day care surgery is the standard of care for minor surgical procedures in developed countries and rapidly increasing in practice in developing countries. The main advantages of day care surgery are cost containment, early mobilization of the patient, less pain because of minimally invasive surgical techniques, early return of patient to their home and work. The downsides of day care surgery include the inability to treat all patients and perform all surgical procedures since surgical fitness for day care procedures is demanding, unforeseen readmission, the need for more operating rooms, and increasing expertise among health care workers. Considering day care surgery as systematic, scheduled and short duration stay in hospital, it is very important to select or sort out the cases which fit in the criteria according to all conventional definitions of triage. It is well organized within stipulated time frame and performed in fixed unit with proper assessment by anesthesia and nursing team in addition to core assessment of surgical team. Surgical option exercised and close follow up with ability to manage complications are integral components in working team. Delivery of more surgery in primary care has potential for enhancing patient-centred management by promoting the development of multi-specialty community providers and reducing length of hospital stay. The outpatient surgical centers provide many benefits and advantages for surgical patients with proper organizations, dedicated services, and meticulous procedures.

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Surgical Treatment of Benign Retrorectal Masses in Adults: A Retrospective Study

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i8.37599 ◽

2021 ◽

Vol 12 (8) ◽

pp. 54-59

Author(s):

Hüseyin Bilge ◽

Ömer Başol ◽

Abdullah Oğuz

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Surgical Techniques ◽

Length Of Hospital Stay ◽

Surgical Excision ◽

Diagnostic Methods ◽

Retrorectal Space ◽

Retrorectal Tumors ◽

Duration Of Surgery ◽

The Mean

Background: Tumors that occur in the retrorectal space are called retrorectal tumors. These tumors arise from various tissues. Late symptoms may therefore outweigh diagnosis and treatment. Therefore, the surgery becomes difficult. Aims and Objectives: Our study aims to reveal the difficulties in the diagnosis of retrorectal tumors, radiological diagnostic methods, and safe surgical excision surgical techniques. Materials and Methods: Twelve patients operated for retrorectal tömür between 2014 and 2020 were included in the retrospective study. Demographic features, clinical findings, diagnostic methods, surgical treatment procedures, evaluations of preoperative/postoperative complications, pathological classifications, length of hospital stay, and duration of surgery were studied. Results: Twelve patients [9 females, 3 males; the mean age was 39.3 ± 11.8 (22-56)] due to retrorectal tumors. All lesions were evaluated preoperatively using magnetic resonance imaging (MRI). According to the preoperative examination and radiological findings; Surgical resection was performed with an anterior approach to 3 patients, a posterior approach to 4 patients, and a combined approach to 5 patients. The mean tumor size was 8 ± 2.24 cm. Immature teratoma and epidermoid cyst (n = 6) were the most common tumors. We did not have any patients with features of malignancy on final histopathology. Conclusion: Although retrorectal tumors are difficult to diagnose, it is important to suspect clinically. A good evaluation of the patients with radiological imaging facilitates the resection of the tumor surgically. Surgery of the patient in centers specialized in these tumors increases surgical success.

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A comparative study of single-vs. double-row technique in surgical treatment of insertional Achilles tendinopathy

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1242 ◽

2021 ◽

Vol 15 (1) ◽

pp. 8-13

Author(s):

Ricardo Maciel ◽

Rodrigo Castilho ◽

Daniel Baumfeld ◽

Tiago Baumfeld

Keyword(s):

Retrospective Study ◽

Short Form ◽

Surgical Techniques ◽

Case Series ◽

Achilles Tendinopathy ◽

Level Of Evidence ◽

Double Row ◽

Mean Values ◽

Significance Level ◽

Insertional Achilles Tendinopathy

Objective: This retrospective study compared the clinical and functional results of single- and double-row surgical techniques for insertional Achilles tendinopathy in the postoperative period. Methods: In this case series, 29 patients who underwent surgery with one of the two techniques were followed up for one year postoperatively. Data were collected from medical records, imaging exams, and visual analog scale (VAS), Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, 12-item Short Form Health Survey (SF-12), and Foot and Ankle Ability Measure (FAAM) scores. Results: The following mean values (5% significance level) were found for single- and double-row techniques, respectively: postoperative VAS (2.9/2.2), FAAM-ADL (71.9/74.4), FAAM-Sports (28.3/29.8), SF-12 physical component (45.2/47.0), SF-12 mental component (44.9/48.2), and VISA-A (72.1/75.9). The complication rate did not differ significantly between the techniques. Conclusion: No significant differences were found in any of the scores between the two surgical techniques. Level of Evidence III; Therapeutic Studies, Comparative Retrospective Study.

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Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

Journal of Wrist Surgery ◽

10.1055/s-0040-1721435 ◽

2021 ◽

Author(s):

J. Terrence Jose Jerome

Keyword(s):

Retrospective Study ◽

Natural History ◽

Functional Outcome ◽

Grip Strength ◽

Scaphoid Nonunion ◽

Proximal Pole ◽

Degenerative Arthritis ◽

Level Of Evidence ◽

History Of ◽

The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

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En bloc transurethral resection of bladder tumor: A review of the literature

Journal of Clinical Urology ◽

10.1177/2051415821993734 ◽

2021 ◽

pp. 205141582199373

Author(s):

Jonathan Kopel ◽

Pranav Sharma

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Bladder Tumor ◽

Clinical Stage ◽

Surgical Techniques ◽

Cancer Recurrence ◽

En Bloc ◽

Level Of Evidence ◽

Alternative Technologies ◽

Bladder Cancer Recurrence

Bladder cancer remains one of the most common malignancies of the genitourinary tract. Transurethral resection of the bladder tumor (TURBT) via cystoscopy with examination under anesthesia remains the primary method for determining the diagnosis and clinical stage of bladder cancer. Given the substantial cost of treatment and risk of bladder cancer recurrence after TURBT, novel approaches to transurethral resection, such as the en bloc technique, have been developed in an attempt to address these limitations. In this review, we examined the postoperative and oncological outcomes of en bloc TURBT compared to traditional resection techniques. Further prospective clinical studies, however, are still necessary to determine whether these alternative technologies or surgical techniques may improve treatment in bladder cancer patients. Level of evidence: Not applicable.

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Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽

10.1186/s12893-021-01272-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stefano Granieri ◽

Francesco Sessa ◽

Alessandro Bonomi ◽

Sissi Paleino ◽

Federica Bruno ◽

...

Keyword(s):

Systematic Review ◽

Clinical Symptoms ◽

Rare Complication ◽

Meta Analysis ◽

Treatment Options ◽

Palliative Surgery ◽

Review Of The Literature ◽

Colovesical Fistula ◽

Level Of Evidence ◽

Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

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A Retrospective Study Comparing the Different Surgical Procedures for the Treatment of Hydatid Disease of the Liver

Digestive Surgery ◽

10.1159/000071186 ◽

2003 ◽

Vol 20 (4) ◽

pp. 279-284 ◽

Cited By ~ 8

Author(s):

Lars Mueller ◽

Dieter C. Broering ◽

Yogesh Vashist ◽

Lutz Fischer ◽

Christian Hillert ◽

...

Keyword(s):

Retrospective Study ◽

Hydatid Disease ◽

Surgical Procedures

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Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000979 ◽

2021 ◽

Vol 7 (1) ◽

pp. e000979

Author(s):

Håkan Alfredson ◽

Lorenzo Masci ◽

Christoph Spang

Keyword(s):

Achilles Tendon ◽

Clinical Symptoms ◽

Fatty Infiltration ◽

Case Series ◽

Achilles Tendinopathy ◽

Level Of Evidence ◽

Plantaris Tendon ◽

Medial Pain ◽

Tendon Insertion ◽

Insertional Achilles Tendinopathy

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.

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