scholarly journals Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Operative Time ◽  
Surgical Techniques ◽  
Satisfaction Rate ◽  
Areola Complex ◽  
Different Types ◽  
Aesthetic Results ◽  
The Mean ◽  
Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

scholarly journals Batwing mammoplasty: a safe oncoplastic technique for breast conservation in breast cancer patients with gigantomastia

2020 ◽  
Vol 102 (2) ◽  
pp. 115-119
Author(s):  
TM Manie ◽  
MMG Youssef ◽  
SN Taha ◽  
A Rabea ◽  
AM Farahat
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Operative Time ◽  
Breast Conservation ◽  
Breast Cancer Patients ◽  
Short Operative Time ◽  
Areola Complex ◽  
Major Breast ◽  
The Mean ◽  
Complications Rate

Background Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. Materials and methods Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. Results All patients had a body mass index above 30kg/m2 with a mean of 36.7kg/m2 (range 31.6–44.9kg/m2). The mean distance from midclavicular point to nipple was 42cm (range 38–50cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2kg (ranging from 1.035–1.63kg). Postoperative complications occurred in 14.2% of patients. Nipple–areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61–74). The mean score for physiological wellbeing was 77.3 (range 64–84) and the mean score for physical wellbeing was 35 (range 31–40). Conclusion Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.

Volar Plate Arthroplasty for Closed Proximal Interphalangeal Joint Injuries

1992 ◽  
Vol 17 (4) ◽  
pp. 422-428 ◽  
Author(s):  
G. DURHAM-SMITH ◽  
G. M. MCCARTEN
Keyword(s):  
Patient Satisfaction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Middle Phalanx ◽  
Satisfaction Rate ◽  
Joint Injuries ◽  
Original Procedure ◽  
Patient Satisfaction Rate

The anatomy and histology of the volar plate at the proximal interphalangeal joint and the mechanism of fracture/subluxation of the base of the middle phalanx in closed proximal interphalangeal joint injuries is reviewed. Our current technique of repair for these injuries and its evolution from Eaton’s original procedure is described. The results of 71 cases of volar plate arthroplasty performed over a five-year period for fracture/subluxations of the proximal interphalangeal joints are presented with follow-up ranging from six months to four years. 62 (87%) patients achieved a stable pain-free joint with a range of motion from 5° to 95° within two months. Complications were uncommon and correctable with an overall eventual patient satisfaction rate of 94%.

Keller Arthroplasty: A Prospective Review

Foot & Ankle ◽  
1987 ◽  
Vol 8 (1) ◽  
pp. 46-54 ◽  
Author(s):  
T. R. Love ◽  
A. S. Whynot ◽  
I. Farine ◽  
M. Lavoie ◽  
L. Hunt ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Hallux Valgus ◽  
Joint Pain ◽  
Female Patients ◽  
Satisfaction Rate ◽  
Level Of Activity ◽  
A Prospective Study ◽  
Patient Satisfaction Rate

A prospective study of the Keller procedure for hallux valgus was carried out on 44 female patients (75 feet) with an average age of 66 years. The average follow-up was 31 months (range, 12–64 months). The operation was effective in improving symptoms (joint pain and bunion tenderness), cosmesis, function (footwear and level of activity) and in decreasing the deformity. The operation did not have an influence on metatarsal calluses. Cock-up deformity was common postoperatively but did not affect the results. The overall patient satisfaction rate was 77%.

scholarly journals 1212 A Novel Approach to Alleviating Surgical Anxiety: QI Study in a Primary Care Government Centre

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Peri
Keyword(s):  
Patient Satisfaction ◽  
Support Groups ◽  
Elective Surgery ◽  
Treatment Modalities ◽  
Satisfaction Rate ◽  
Adequate Knowledge ◽  
Operative Care ◽  
Novel Approach ◽  
Pdsa Cycle ◽  
Patient Satisfaction Rate

Abstract Aim Surgical Anxiety is a challenging problem in the peri-operative care of a patient often leading to poor surgical outcomes and repeated visits by the patient to the hospital. Despite being well documented, in practice, it still remains the most neglected and haphazardly adopted part of patient care. This study aimed to make the overall experience of surgery, safer and pleasant to the patient by instituting a novel, multimodal and easy to follow protocol. Method A self-made questionnaire formed the source for data collection from 43 patients listed for elective surgery in a government setup, throughout the duration of their admission and review period. Patient satisfaction rate was assessed by re-audits, post implementation of changes via a Plan-Do-Study-Act (PDSA) cycle. The ease of protocol administration and sustainability were assessed from staff via an audit and it was further simplified to ensure adoption was easy and patient satisfaction rate remained high as well. Results Initial audit showed only 49% (n = 21) of patient satisfaction rate at the time of admission. Significant variations of > 90% (n = 39) patient satisfaction rate was noted post implementation of changes after the first PDSA cycle. A second PDSA cycle was instituted to simplify the protocol and post audit >90% acceptance rate from staff were noted. Conclusions Shared Decision Making, Peer Support Groups, Adequate knowledge of the treating surgeon, the disease, treatment modalities and complications instituted via a proper protocol helped to alleviate surgical anxiety and prepare a positive patient for surgery.

scholarly journals Remnant gall bladder and cystic duct stump stone after cholecystectomy: tertiary multicenter experience

2018 ◽  
Vol 5 (11) ◽  
pp. 3478 ◽  
Author(s):  
Samir A. A. Mageed ◽  
Mohammed A. Omar ◽  
Alaa A. Redwan
Keyword(s):  
Retrospective Study ◽  
Cystic Duct ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Biliary Injury ◽  
Endoscopic Retrograde ◽  
Biliary Pain ◽  
The Mean ◽  
Experienced Team

Background: There is no doubt that cholecystectomy relieves pre-surgical symptoms of gallbladder (GB) disease. The persistence of symptoms mainly biliary pain was recorded in 10 - 20% of cases, with variety of causes. Residual GB/cystic duct stump stone is one of the most important un-expected cause. The present study was conducted to study and evaluate those patients, with their surgical treatment.Methods: This retrospective study was conducted on 27 cases with residual GB/cystic duct stump stone. The diagnosis was guided by ultrasound and magnetic resonance cholangio-pancreatography. All cases were managed by using completion cholecystectomy - either open or laparoscopic. All preoperative, operative, and postoperative data were collected.Results: Preoperative endoscopic retrograde cholangio-pancreatography and papillotomy were required in 13 patients whom were presented with obstructive jaundice. Open completion cholecystectomy techniques were done in the majority of cases (21 patients) while laparoscopic approach was feasible in only 6 cases with one conversion (1/6). The mean operative time was (89.57 ± 12.05 and 118.16 ± 12.6 min), and the mean blood loss was (195.5 ± 19.22 and 187.5 ± 23.61 ml) respectively. Intra-operative minor biliary injury occurred in two cases and repaired instantaneously. The mean hospital stay was (4.76 ± 2.81 and 2.33 ± 1.32 days) respectively. All patients were reported to be symptom-free at the follow-up after surgical treatment.Conclusions: Residual GB/cystic duct stump stone is a preventable and correctable cause of post-cholecystectomy complaint. Completion cholecystectomy is a proven treatment of choice to relieve symptoms and avoid complications; furthermore, it can be carried out laparoscopically with experienced team and facilities in spite of difficulties.

scholarly journals Keystone Flap for Reconstruction of Sacral and Ischial Pressure Injury

2021 ◽  
Vol 8 (1) ◽  
pp. 30-37
Author(s):  
Narottama Tunjung ◽  
Nandita Melati Putri
Keyword(s):  
Retrospective Study ◽  
Operative Time ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Complete Healing ◽  
Type Iv ◽  
Pressure Injury ◽  
The Mean ◽  
The Right ◽  
Thorough Debridement

Introduction: Reconstruction of sacral and ischial pressure injury offers great challenges due to its high complication and recurrence rate. Providing durable tissue coverage with minimal donor site morbidity is paramount while ensuring fast operative time for the patients who often possess multiple comorbidities. This study aims to present cases of sacral and ischial pressure injury reconstruction using a keystone flap. Method: A retrospective study was performed by reviewing data from fifteen patients with a sacral and ischial pressure injury who underwent reconstruction using various types of keystone flaps in our center between 2019 and 2020. Results: The patients’ age ranged from 10 to 83 years old (average, 40.5 years old). The average wound dimensions were 9.4 ± 3.1 cm x 6.5 ± 2.7 cm and the mean area of the defects was 52.3 ± 35.7 cm2, with the largest defect was 15 x 12 cm (141.3 cm2). Mean operative time was 140 ± 24.5 minutes with nine wounds were reconstructed using type IV keystone flap (60%) and six patients using type IIA (40%). Postoperative complications occurred in three patients (20%). Other patients resulted in uneventful complete healing. Conclusion: The keystone flap is reliable, simple, has a fast technique, and minimal donor site morbidity to cover the defects of sacral and ischial pressure injury. Performing thorough debridement, choosing the right type of keystone flap, elevating the flap adequately to allow mobilization, preserving perforator “hotspots”, and suturing of the flap without tension are keys to achieve satisfactory results.

scholarly journals Clinical results of arthroscopic tight fibrous band release for adult moderate-to-severe gluteal fibrosis using anterior and posterior portals: a retrospective analysis of 118 consecutive cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shu-guang Gao ◽  
Wei-jie Liu ◽  
Ming Yang ◽  
Jing-ping Li ◽  
Chao Su ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Operation Time ◽  
Radiofrequency Energy ◽  
Fatty Tissue ◽  
Fibrous Band ◽  
Gluteal Muscle ◽  
Satisfaction Rate ◽  
Gluteal Fibrosis ◽  
Patient Satisfaction Rate

Abstract Background To evaluate the clinical outcomes of arthroscopic tight fibrous band release in the treatment of adult moderate-to-severe gluteal fibrosis using anterior and posterior portals during mid-term follow-up. Methods The data of 138 patients (58 males, 80 females) aged between 18 and 42 years (mean, 28.6 years), presenting with bilateral moderate-to-severe gluteal fibrosis (GF) from October 2013 to August 2019, was retrospectively analyzed. All patients underwent arthroscopic tight fibrous band release using anterior and posterior portals with radiofrequency energy. Under arthroscopic guidance through the posterior portal, we debrided the fatty tissue overlying the contracted band of the gluteal muscle and excised the contracted bands using a radiofrequency device introduced through the anterior portal. The pre- and post-operative gluteal muscle contracture disability (GD) scale and the patient satisfaction rate were compared to evaluate the curative effect of the operation. Results The average operation time was 18 min (range, 10–30 min) and the average blood loss was 4 ml (range, 2–10 ml) for unilateral arthroscopic release. Two cases of post-operative minimal hematomas, 2 cases of bruising and 2 cases of local subcutaneous edema were observed as early complications and were cured by conservative treatment. After surgery, all incisions healed in stage I, and no other complications such as wound infection, nerve and blood vessel injury were detected. One hundred eighteen patients were followed up for 6 to 72 months (mean, 36 months). No lateral instability of the hip was observed and all patients returned to normal gait. The degree of adduction of the hip joint in all these 118 patients was significantly improved relative to their pre-operative conditions. One hundred fifteen patients (97.5%) were able to crouch with knees close to each other after surgery. One hundred fourteen patients (96.6%) were able to cross the affected leg completely without any support. The GD scale was improved from 55.5 ± 10.6 before operation to 90.1 ± 5.2 at the last follow-up (p < 0.05). The patient satisfaction rate was 95.8%. Conclusion Arthroscopic tight fibrous band release using anterior and posterior portals is minimally invasive for adult moderate-to-severe gluteal fibrosis, with a high success rate, quick recovery after surgery and reliable medium-term effect.

scholarly journals Dermoglandular Rotation Flaps for Breast-Conserving Therapy: Aesthetic Results, Patient Satisfaction, and Morbidity in Comparison to Standard Segmentectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ursula Hille-Betz ◽  
Bernhard Vaske ◽  
Helga Henseler ◽  
Philipp Soergel ◽  
Sudip Kundu ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Breast Conserving Surgery ◽  
Breast Conserving Therapy ◽  
Outer Quadrant ◽  
Areola Complex ◽  
Aesthetic Results ◽  
Degree Of Satisfaction ◽  
Good Cosmetic ◽  
Treated Breast ◽  
The Relationship

We compared a dermoglandular rotation flap (DGR) in the upper inner, lower inner, and upper outer quadrant regarding similar aesthetic results, patient satisfaction, and comfort after breast-conserving therapy with standard segmentectomy (SE). Between 2003 and 2011, 69 patients were treated with breast-conserving surgery using DGR for cancers with high tumor-to-breast volume ratios or skin resection in the three above mentioned quadrants; 161 patients with tumors in the same quadrants were treated with SE. The outcome of the procedures was assessed at least 7 months after completed radiation therapy using a patient and breast surgeon questionnaire and the BCCT.core software. Symmetry, visibility of the scars, the position of the nipple-areola complex, and the appearance of the treated breast were each assessed on a scale from 1 to 4 by an expert panel and by the patients. Univariate and multivariate analysis were used to evaluate the relationship between patient-, tumor-, and treatment-dependent factors and patient satisfaction. 94.2% of the patients with rotation flaps and 83.5% of the patients with lumpectomy were very satisfied with the cosmetic appearance of their breast. Younger patient age was significantly associated with a lower degree of satisfaction. DGR provides good cosmetic results compared with SE and shows high patient satisfaction despite longer scarring and higher median resection volume.

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