Aesthetic surgery journal
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Aesthetic surgery journal · May 2009
ReviewMethicillin-sensitive and methicillin-resistant Staphylococcus aureus: preventing surgical site infections following plastic surgery.
The reader is presumed to have a broad understanding of aesthetic surgical procedures. After studying this article, the participant should be able to: 1. Explain the microbiology of Staphylococcus species and discuss antibiotic resistance development in Staphylococcus species and assess how clinical outcomes are affected. 2. ⋯ The incidence of methicillin-resistant S aureus (MRSA) has increased in the US over the past decade, largely due to the emergence of community-acquired MRSA (CA-MRSA). This article reviews the microbiology and epidemiology of methicillin-sensitive S aureus (MSSA) and MRSA, risk factors for surgical site infections among plastic surgery patients, the evidence supporting preoperative screening and decolonization measures to prevent surgical site infections caused by MRSA, recommendations for anti-microbial prophylaxis, and treatment recommendations for surgical site infections. Other proven methods of reducing SSI, including maintenance of normothermia during surgery, glucose control, cessation of nicotine use, and not shaving the surgical site preoperatively are discussed.
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Aesthetic surgery journal · Jan 2008
ReviewBariatric surgery: current concepts and future directions.
The increasing use of bariatric procedures in the treatment of morbidly obese patients means that aesthetic plastic surgeons can expect to care for more and more patients who have undergone bariatric surgery. It is important for aesthetic surgeons to understand the procedures, outcomes, and possible complications to recognize the signs and symptoms of any potential problems. Candidates for bariatric surgery must have a body mass index (BMI) of at least 40 kg/m(2) or a BMI of 35 kg/m(2) with at least one comorbidity, plus demonstrated failure of nonsurgical means of weight control to control weight and no significant psychiatric disorders. ⋯ Results of bariatric surgery are impressive and include not only significant and sustained weight loss but also improvement or resolution of major comorbid conditions. Significant complications include anastomotic leak, marginal ulceration, and internal herniation, as well as wound infection, incisional hernia, hemorrhage, deep venous thrombosis, and pulmonary embolus. Innovative procedures now under study include gastrointestinal neuromodulation, sleeve gastrectomy, intragastric balloons, intraluminal sleeves, and other endoscopic procedures.