The Effect of Quilting Sutures on the Tension Required to Advance the Abdominal Flap in Abdominoplasty

2021 ◽  
Author(s):  
Maria Roberta Cardoso Martins ◽  
Betina Zimmermann Fontes de Moraes ◽  
Daniel Capucci Fabri ◽  
Hugo Alexandre Sócrates de Castro ◽  
Lucas Rostom ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Postoperative Complications ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Tensile Force ◽  
Wound Dehiscence ◽  
Seroma Formation ◽  
Hypertrophic Scars ◽  
Before And After ◽  
Number Of Births

Abstract Background Quilting sutures attaching the abdominal flap to the aponeurosis contribute to the prevention of seroma formation post-abdominoplasty. The sutures distribute the tension over the subcutaneous tissue along the flap length, theoretically decreasing tension at the distal (cutaneous) end of the flap. This is expected to reduce the risks of necrosis, dehiscence, and enlarged or hypertrophic scars. Objectives The study sought to verify whether quilting sutures decrease the tension required to advance the dermal-fat flap in abdominoplasty. Methods Thirty-four women undergoing abdominoplasty with quilting sutures participated in the study. The tensile force required for flap advancement was measured before and after the placement of quilting sutures, using a digital force gauge, and then compared. Differences in tensile force were tested for correlations with body mass index (BMI), age, weight of flap tissue removed, number of previous pregnancies, and postoperative complications, including seroma formation, hematoma, necrosis, dehiscence, and enlarged or hypertrophic scars. Results A mean reduction in tension of 27.7% was observed at the skin suture after the placement of quilting sutures (p < 0.001). No significant correlation was found of reduced flap tension with BMI, age, weight of tissue removed, and number of births. A case of seroma formation and two cases of enlarged scars were observed, but no case of hematoma, necrosis or wound dehiscence was detected. Conclusions The use of quilting sutures to attach the abdominal flap to the aponeurosis of the anterior abdominal wall reduced tension at the advancing edge of the flap in abdominoplasty.

Influence of Human-oriented Nursing Mode on Self-Care Ability, Unhealthy Emotion and Quality of Life of Patients with Benign Prostatic Hyperplasia

2021 ◽  
Vol 7 (4) ◽  
pp. 635-646
Author(s):  
Feifei Peng ◽  
Guangchi Xu ◽  
Caihong Zhu ◽  
Lanchun Sun ◽  
Bo Dong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Postoperative Complications ◽  
Self Care ◽  
Nursing Intervention ◽  
Prostatic Hyperplasia ◽  
The Self ◽  
Nursing Satisfaction ◽  
Before And After

To explore the influence of human-oriented nursing mode on the self-care ability, unhealthy emotion and quality of life of patients with benign prostatic hyperplasia (BPH), 147 patients with BPH admitted to our hospital from February 2018 to August 2019 were selected and all patients were separated into two groups on the basis of the nursing intervention mode. 77 cases in the research group (RG) were given the human-oriented nursing mode and 70 cases in the control group (CG) were given the conventional nursing mode. The bladder irrigation time (BIT), indwelling catheter time (ICT), postoperative hospitalization time (PHT) and the incidence rate of postoperative complications were observed in the two groups after nursing intervention. Before and after nursing intervention, the self-care ability of patients was evaluated in the two groups by Exercise of Self-Care Agency Scale (ESCA). In the two groups, the anxiety and depression status were evaluated by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The Quality of Life Scale for Benign Prostatic Hyperplasia Patient (BPHQLS) was applied to evaluate the quality of life in both groups before and after nursing intervention. The International Prostate Symptom Score (IPSS) was used to assess the lower urinary tract symptoms (LUTS) of patients in the two groups before and after nursing intervention. The self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction in the two groups. The BIT, ICT and PHT in RG after nursing intervention were obviously lower than those in CG, and the incidence of postoperative complications in RG was also obviously lower than that in CG (p < 0.05). The ESCA score of patients in RG after nursing intervention was significantly higher than that in CG (P < 0.05). The SAS and SDS scores of patients in RG after nursing intervention were significantly lower than those in CG (P < 0.05). The BPHQLS score in RG after nursing intervention was obviously higher than that in CG (P < 0.05). The IPSS score of patients in RG after nursing intervention was obviously lower than that in CG (p < 0.05). The nursing satisfaction score in RG after nursing intervention was obviously higher than that in CG (p < 0.05).Condusion: The application effect of the human-oriented nursing mode on patients with BPH is definite, which can improve self-care ability, unhealthy emotion and effectively ameliorate the quality of life.

scholarly journals Acoustic voice assessment in Parkinson's disease patients submitted to posteroventral pallidotomy

2005 ◽  
Vol 63 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Lucia Figueiredo Mourão ◽  
Patrícia Maria de Carvalho Aguiar ◽  
Fernando Antônio Patriani Ferraz ◽  
Mara Suzana Behlau ◽  
Henrique Ballalai Ferraz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postoperative Complications ◽  
Speech Disorders ◽  
Acoustic Parameters ◽  
Voice Assessment ◽  
Before And After ◽  
Posteroventral Pallidotomy

Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence of interest in pallidotomy as an option of treatment. However, postoperative complications such as speech disorders can occur. PURPOSE: The aim of this study is to evaluate the acoustic voice in PD patients, before and after posteroventral pallidotomy. METHOD: Twelve patients with PD were submitted to neurological and voice assessments during the off and on phases, in the pre-operative, 1st and 3rd post-operative months. The patients were evaluated with the UPDRS and the vocal acoustic parameters - f0, NHR, jitter, PPQ, Shimmer, APQ (using the software MultiSpeech - Kay Elemetrics - 3700). RESULTS: The off phase UPDRS scores revealed a tendency to improvement at the 1st month and the off phase worsened. The shimmer and APQ improved. CONCLUSION: This study shows that pallidotomy has little improvement on functional use of communication of PD patients.

scholarly journals Laparoscopic surgery for endometrial cancer: increasing body mass index does not impact postoperative complications

2011 ◽  
Vol 22 (3) ◽  
pp. 168 ◽  
Author(s):  
C. William Helm ◽  
Cibi Arumugam ◽  
Mary E. Gordinier ◽  
Daniel S. Metzinger ◽  
Jianmin Pan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Body Mass

Mechanical effects of obesity on airway responsiveness in otherwise healthy humans

2009 ◽  
Vol 107 (2) ◽  
pp. 408-416 ◽  
Author(s):  
Roberto Torchio ◽  
Alessandro Gobbi ◽  
Carlo Gulotta ◽  
Raffaele Dellacà ◽  
Marco Tinivella ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Lung Function ◽  
Body Mass ◽  
Airway Hyperresponsiveness ◽  
Healthy Subjects ◽  
Rest Period ◽  
Healthy Humans ◽  
Before And After ◽  
Maximum Expiratory Flow ◽  
Residual Capacity

We investigated whether obesity is associated with airway hyperresponsiveness in otherwise healthy humans and, if so, whether this correlates with a restrictive lung function pattern or a decreased number of sighs at rest and/or during walking. Lung function was studied before and after inhaling methacholine (MCh) in 41 healthy subjects with body mass index ranging from 20 to 56. Breathing pattern was assessed during a 60-min rest period and a 30-min walk. The dose of MCh that produced a 50% decrease in the maximum expiratory flow measured in a body plethysmograph (PD50MCh) was inversely correlated with body mass index ( r2 = 0.32, P < 0.001) and waist circumference ( r2 = 0.25, P < 0.001). Significant correlations with body mass index were also found with the maximum changes in respiratory resistance ( r2 = 0.19, P < 0.001) and reactance ( r2 = 0.40, P < 0.001) measured at 5 Hz. PD50MCh was also positively correlated with functional residual capacity ( r2 = 0.56, P < 0.001) and total lung capacity ( r2 = 0.59, P < 0.001) in men, but not in women. Neither PD50MCh nor body mass index correlated with number of sighs, average tidal volume, ventilation, or breathing frequency. In this study, airway hyperresponsiveness was significantly associated with obesity in otherwise healthy subjects. In obese men, but not in women, airway hyperresponsiveness was associated with the decreases in lung volumes.

Long-term mild jogging increases insulin action despite no influence on body mass index or VO2 max

1989 ◽  
Vol 66 (5) ◽  
pp. 2206-2210 ◽  
Author(s):  
Y. Oshida ◽  
K. Yamanouchi ◽  
S. Hayamizu ◽  
Y. Sato
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Clearance Rate ◽  
Insulin Action ◽  
Metabolic Clearance ◽  
Metabolic Clearance Rate ◽  
Before And After ◽  
Plasma Insulin Levels ◽  
Improve Glucose Tolerance

Physical training has been shown to improve glucose tolerance and insulin sensitivity. In the present study, insulin action was determined using the euglycemic clamp technique in six untrained nonobese subjects before, during, and after long-term mild regular jogging. After 1 yr of jogging, steady-state plasma insulin levels (I) decreased significantly, and the metabolic clearance rate of insulin was increased by 87%, although insulin infusion rate during the clamp was constant for each individual. The amount of glucose infused (glucose metabolism, M) tended to increase from 6.16 +/- 0.94 to 8.15 +/- 1.94 mg.kg-1.min-1 after regular jogging for 1 yr, although that was not statistically significant. However, M/I increases significantly from 0.060 +/- 0.012 to 0.184 +/- 0.056 (P less than 0.05) after 1 yr. The concentrations of plasma free fatty acids during the hyperinsulinemic clamp decreased more significantly after 1 yr of jogging (P less than 0.05). The concentrations of plasma glycerol decreased gradually before and after long-term regular jogging, showing only a 50–60% reduction in 120 min. Therefore, long-term mild regular jogging, which did not influence either body mass index or maximal O2 uptake, appears to improve insulin action in both carbohydrate and lipid metabolism and to increase the metabolic clearance rate of insulin.

scholarly journals Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 884
Author(s):  
Kenneth P. van Knegsel ◽  
Bergita Ganse ◽  
Pascal C. Haefeli ◽  
Filippo Migliorini ◽  
Mario F. Scaglioni ◽  
...  
Keyword(s):  
Blood Flow ◽  
Soft Tissue ◽  
Oxygen Saturation ◽  
Subcutaneous Tissue ◽  
Skeletal Traction ◽  
Non Invasive ◽  
Femur Fractures ◽  
Vasoactive Factors ◽  
Before And After ◽  
Haemoglobin Content

Background and Objectives: Wound infections provoked by alterations in microcirculation are major complications in the treatment of trochanteric femur fractures. Surgical fracture fixation on a traction table is the gold standard for treatment, but the effect on tissue microcirculation is unknown. Microcirculation could be impaired by the pull on the soft-tissue or by a release of vasoactive factors. We hypothesized that intraoperative traction impairs soft-tissue microcirculation. Materials and Methods: In 22 patients (14 women, eight men), average age 78 years (range 36–96 ± 14), with trochanteric femur fractures, non-invasive laser-Doppler spectrophotometry was used to assess oxygen saturation, hemoglobin content, and blood flow in the skin and subcutaneous tissue before and after application of traction. Measurements were recorded in nine locations around the greater trochanter at a depth of 2, 8, and 15 mm before and after fracture reduction by traction. Results: No differences were found in any depth with traction compared to without (oxygen saturation: p = 0.751, p = 0.308, and p = 0.955, haemoglobin content: p = 0.651, p = 0.928, and p = 0.926, blood flow: p = 0.829, p = 0.866, and p = 0.411). Conclusion: In this pilot study, the application of traction does not affect skin and subcutaneous microcirculation in the surgery of proximal femur fractures.

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