Minerva chirurgica
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Comparative Study Clinical Trial
Short review on face rejuvenation procedures: focus on preoperative antiseptic and anesthetic delivery by JetPeel™-3 (a high pressure oxygen delivery device).
Nowadays there is great attention in trying to slow and reverse the facial aging process. Esthetic medicine has been primarily based on the surgical approach for many years, but now, in order to solve the problem of aging skin, there is an increasing interest into non-invasive, possibly painless, procedures that can guarantee the patient a quick recovery. In this perspective the use of chemical peeling and dermabrasion, to achieve skin rejuvenation, is growing worldwide. These techniques are also relevant to treat skin pigmentation irregularities and to remove keratoses, lentigines, acne and other skin related conditions. One of the most interesting, safe and painless devices, useful for the effective antiaging face treatment, is JetPeel™-3. The aim of this study was to assess the device efficacy starting from a short review on face rejuvenation procedures. ⋯ JetPeel™-3 has proved to be a good non-invasive approach and its use is recommended since it induces local anesthesia in a short time.
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The open abdomen is increasingly used for the treatment and prevention of abdominal compartment syndrome. The leading non-traumatic conditions that may cause abdominal compartment syndrome requiring surgical decompression include secondary peritonitis, ruptured abdominal aortic aneurysm and severe acute pancreatitis. Patients may also end up with the open abdomen when the laparotomy wound cannot be closed without tension because of excessive visceral swelling. ⋯ Although fascial closure rate varies between techniques, there are few evidence-based data to support one technique over another. However, recent evolution of temporary abdominal closure techniques have decreased the number of patients with frozen abdomen and reduced the need for planned hernia management. Highest fascial closure rates have been achieved with vacuum-assisted closure systems and systems that provide continuous fascial traction.
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Repair of parastomal hernia remains controversial. Open suture repair of the fascial defect or stoma resiting are both associated with high morbidity and unacceptably high recurrence rates and are no longer recommended for routine use. Mesh repair appears to provide the best results. ⋯ A polypropylene based mesh with an anti-adhesive layer covering the visceral side seems to be applicable using the keyhole technique with a slit as well as the modified Sugarbaker technique. A PTFE mesh should preferably be used with the modified Sugarbaker technique. If a PTFE mesh is used with the keyhole technique parastomal hernia is likely to recur.
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Obesity is the leading public health concern in the industrialized world with the advent of the very obese or "super obese" increasing exponentially. Bariatric surgery remains the only effective and enduring treatment for morbid obesity and can be safely accomplished in experienced centers. Surgery in the very obese may be considered high-risk: however, this risk may be managed with an experienced bariatric surgery team, appropriate anesthetic consideration, preoperative risk assessment, employment of venothrombotic event prevention, preoperative weight loss, and understanding of particular anatomic considerations. With appropriate preparation, the very obese surgical patient can achieve safe and effective surgical outcomes.
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Sentinel lymph node biopsy has evolved as the surgical procedure of choice for women with clinically negative axillae, as part of an effort to move toward the less invasive surgical management of breast cancer. Axillary lymph node dissection remains the standard of care for patients with a positive axillary node and was previously performed on all patients with breast cancer prior to the implementation of the sentinel lymph node biopsy. There is, however, controversy regarding whether or not all patients with a positive sentinel lymph node need to undergo completion axillary dissection for either prognostic or therapeutic purposes. This article reviews the literature related to this controversial and evolving topic.