Artigos e Materiais de Revistas Científicas - LIM/04
URI Permanente para esta coleção
A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.
Navegar
Submissões Recentes
- Educational interventions on preventing pressure injuries targeted at nurses: systematic review and meta-analysis(2023) KITAMURA, J. C.; NICOLOSI, J. T.; PAGGIARO, A. O.; CARVALHO, V. F. deBackground: Although preventable, pressure injuries are commonly observed in the hospital setting and are estimated to be the third most costly condition, after cancer and cardiovascular disease. Aim: Nurses play a crucial role in the prevention and management of pressure injuries, however, published evidence on the effectiveness of educational interventions, directed specifically at nurses in the hospital environment, is scarce. Method: The authors retrieved published studies on the subject from selected databases (Pubmed/Medline, Embase, Web of Science and the Cochrane Library) in a number of languages (Portuguese, English, French and Spanish). The search yielded randomised controlled trials, as well as quasi-experimental and comparative studies. Findings: In total, 11 studies were selected. The outcomes analysed, following some type of educational intervention, included the attitudes and knowledge of the nursing professionals, as well as the incidence of pressure injuries. Conclusion: The present study demonstrated that different educational strategies can help prevent pressure injuries in the hospital environment.
- Skin-sparing mastectomy for the treatment of breast cancer(2023) MOTA, B. S.; BEVILACQUA, J. L. B.; BARRETT, J.; RICCI, M. D.; MUNHOZ, A. M.; FILASSI, J. R.; BARACAT, E. C.; RIERA, R.Background: Skin-sparing mastectomy (SSM) is a surgical technique that aims to maximize skin preservation, facilitate breast reconstruction, and improve cosmetic outcomes. Despite its use in clinical practice, the benefits and harms related to SSM are not well established. Objectives: To assess the effectiveness and safety of skin-sparing mastectomy for the treatment of breast cancer. Search methods: We searched Cochrane Breast Cancer's Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP), and ClinicalTrials.gov on 9 August 2019. Selection criteria: Randomized controlled trials (RCTs), quasi-randomized or non-randomized studies (cohort and case-control) comparing SSM to conventional mastectomy for treating ductal carcinoma in situ (DCIS) or invasive breast cancer. Data collection and analysis: We used standard methodological procedures expected by Cochrane. The primary outcome was overall survival. Secondary outcomes were local recurrence free-survival, adverse events (including overall complications, breast reconstruction loss, skin necrosis, infection and hemorrhage), cosmetic results, and quality of life. We performed a descriptive analysis and meta-analysis of the data. Main results: We found no RCTs or quasi-RCTs. We included two prospective cohort studies and twelve retrospective cohort studies. These studies included 12,211 participants involving 12,283 surgeries (3183 SSM and 9100 conventional mastectomies). It was not possible to perform a meta-analysis for overall survival and local recurrence free-survival due to clinical heterogeneity across studies and a lack of data to calculate hazard ratios (HR). Based on one study, the evidence suggests that SSM may not reduce overall survival for participants with DCIS tumors (HR 0.41, 95% CI 0.17 to 1.02; P = 0.06; 399 participants; very low-certainty evidence) or for participants with invasive carcinoma (HR 0.81, 95% CI 0.48 to 1.38; P = 0.44; 907 participants; very low-certainty evidence). For local recurrence-free survival, meta-analysis was not possible, due to high risk of bias in nine of the ten studies that measured this outcome. Informal visual examination of effect sizes from nine studies suggested the size of the HR may be similar between groups. Based on one study that adjusted for confounders, SSM may not reduce local recurrence-free survival (HR 0.82, 95% CI 0.47 to 1.42; P = 0.48; 5690 participants; very low-certainty evidence). The effect of SSM on overall complications is unclear (RR 1.55, 95% CI 0.97 to 2.46; P = 0.07, I2 = 88%; 4 studies, 677 participants; very low-certainty evidence). Skin-sparing mastectomy may not reduce the risk of breast reconstruction loss (RR 1.79, 95% CI 0.31 to 10.35; P = 0.52; 3 studies, 475 participants; very low-certainty evidence), skin necrosis (RR 1.15, 95% CI 0.62 to 2.12; P = 0.22, I2 = 33%; 4 studies, 677 participants; very low-certainty evidence), local infection (RR 2.04, 95% CI 0.03 to 142.71; P = 0.74, I2 = 88%; 2 studies, 371 participants; very low-certainty evidence), nor hemorrhage (RR 1.23, 95% CI 0.47 to 3.27; P = 0.67, I2 = 0%; 4 studies, 677 participants; very low-certainty evidence). We downgraded the certainty of the evidence due to the risk of bias, imprecision, and inconsistency among the studies. There were no data available on the following outcomes: systemic surgical complications, local complications, explantation of implant/expander, hematoma, seroma, rehospitalization, skin necrosis with revisional surgery, and capsular contracture of the implant. It was not possible to perform a meta-analysis for cosmetic and quality of life outcomes due to a lack of data. One study performed an evaluation of aesthetic outcome after SSM: 77.7% of participants with immediate breast reconstruction had an overall aesthetic result of excellent or good versus 87% of participants with delayed breast reconstruction. Authors' conclusions: Based on very low-certainty evidence from observational studies, it was not possible to draw definitive conclusions on the effectiveness and safety of SSM for breast cancer treatment. The decision for this technique of breast surgery for treatment of DCIS or invasive breast cancer must be individualized and shared between the physician and the patient while considering the potential risks and benefits of available surgical options.
- Bilateral V-Y medial fasciocutaneous thigh flap in perineal reconstruction for hidradenitis suppurativa: Case report(2023) VICENTE-RIVAS, A. F.; PAGOTTO, V. P. F.; BUSCARIOL, S.; ITO, M.; GEMPERLI, R.Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that preferentially affects the intertriginous skin and is associated with numerous systemic comorbidities. The perineal area is the second most commonly affected area after the armpit. Wide excision is the treatment most likely to achieve better results with a lower risk of recurrence. With extensive surgical excision, flap closure offers a greater likelihood of definitive treatment. Some flaps have been described to reconstruct defects in the perineal region after cancer, but few have been studied in treating HS. Case Report: A 43-year-old woman with perineal HS underwent resection of the lesions and reconstruction with a bilateral V-Y medial thigh fasciocutaneous flap to treat the disease. The flap allowed complete closure of the total perineum without serious complications. Conclusion: This case shows that it is useful and practical to use the V-Y medial thigh fasciocutaneous flap for perineal reconstruction after wide resections of skin, apocrine glands, and hair follicles in the treatment of HS, offering good skin coverage and subcutaneous cellular tissue with supply reliable vascular flap, which avoids sequelae associated with muscle sacrifice and reaches larger dimensions than other flaps, and can be considered in selected cases as an alternative in the surgical treatment of perineal HS.
- Supraclavicular flap for head and neck oncological reconstruction: A series of 62 cases(2023) TAKAHASHI, G. G.; RIBEIRO, R. D. A.; PAGOTTO, V. P. F.; FERNANDES, T. R. R.; ALVES, H. R. N.; BUSNARDO, F. D. F.; GEMPERLI, R.Introduction: The oncological reconstruction of extensive defects in the head and neck requires the plastic surgeon to make a difficult decision between the use of free flaps and pedicled flaps. The supraclavicular flap is one of the main examples of a pedicled flap, being versatile, with a thin thickness and similar color to the region to be reconstructed. Method: A retrospective study was carried out by collecting data from medical records of patients admitted to the Cancer Institute of the State of São Paulo between December 2010 and March 2020. Results: Among the 62 patients reconstructed with a supraclavicular flap, 37 were male and 25 female. Fifty-eight patients (93.5%) had some associated comorbidity. In total, 27 complications related to the flap (43.5%) were recorded, 5 of which were total necrosis (8%). Conclusion: The supraclavicular flap plays an important role in head and neck oncological reconstructions and should be considered as an option in patients who are poor candidates for microsurgical flaps.
- Treatments of palpebral congenital melanocytic nevus: a systematic review(2023) CAMARGO, Cristina Pires; SALIBA, Marita; SAAD, Elio Assaad; MILAN, Milanie; CALDERA, Jose MauricioPurpose: Palpebral congenital melanocytic nevi (PCMN) is a rare congenital skin lesion affecting the eyelids that can lead to cosmetic and psychological concerns and potential health risks such as malignancy. Several authors have analyzed therapeutical strategies to treat PCMN. However, there was no consensus in the literature. This systematic review aimed to evaluate the effectiveness, safety, and success of treatments of PCMN. Methods: We conducted a systematic review following PRISMA guidelines from October 2022 to April 2023. We included all types of study designs that described or compared PCMN treatments and interventions, as well as histology, recurrence, adverse events, patient satisfaction, and malignant transformation. The search strategy was based on specific search words through the following databases: PubMed, Embase, Latin American and Caribbean Health Sciences Literature (Lilacs), Web of Science, and Scopus. Ongoing studies and gray literature studies were included. Results: We analyzed 25 case reports with 148 participants. The effectiveness, success, and satisfaction with various treatments for PCMN depend on the specific treatment method and the individual patient's case. Conclusion: Most of the studies showed that surgical procedures (exeresis) are able to treat PCMN in the eyelid. The variability in outcomes emphasizes the importance of further research to better understand the most effective and safe approaches for treating congenital melanocytic nevi.
- Brazilian Two-Societal Bi-Annual Congress on Cleft Lip and Palate and Craniofacial Surgery: ABCCMF and ABFLP Partnership(2023) RAPOSO-AMARAL, Cassio E.; URMENYI, Geza L.; BASTOS, Endrigo O.
- Outcome analysis and assessment of the lower pole expansion following breast augmentation with ergonomic implants: Optimizing results with patient selection based on 5-year data(2024) MUNHOZ, Alexandre Mendonca; NETO, Ary de Azevedo Marques; MAXIMILIANO, Joao; FRAGA, MurilloBackground: Silicone implants have gone through adaptations to improve esthetic outcomes. With the progress of technology, including gel rheology, different properties have been introduced. Ergonomic style implants (ESI) feature enhanced rheological properties and provide a shaped contour with a round base.Objectives: This study investigated outcomes for ESI in breast augmentation concerning lower pole stretching (LPS) and implant stability and describes an algorithm to assist in decision- making.Methods: A total of 148 patients (296 breasts) underwent breast augmentation with ESI; this procedure was indicated in patients with good skin quality and < 6 cm between the nip- ple-areola complex and the inframammary fold.Results: The mean patient age was 29.6 years (range: 19-39), and 93 patients (62.8%) under- went primary breast augmentation with demi/full projection (average volume of 245 cc [175-375 cc]). Axillary incision and subfascial pocket were indicated in 115 (77.7%) and 72 (48%) cases, respectively. Average LPS values were 32.2% (24.91 mm) and 10.86% (9.42 mm) at up to 10 days and 10 days to 12 months postprocedure, respectively. Patients were followed for a mean of 29.9 +/- 26.4 months (range: 6-66). Complication rates per breast and per patient were 5% and 10%, respectively, and included subcutaneous banding in the axilla (1.6%), implant displacement (1.2%), and wound dehiscence (0.8%). No cases of infection, seroma, or rippling complications were observed.Conclusions: The present decision-making algorithm summarizes the process involved in breast augmentation using ESI and is intended to help standardize decisions. With correct planning, long-lasting outcomes can be achieved due to favorable interactions between ESI and the patient's tissues.(c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons.
- International consensus recommendations for the optimal prioritisation and distribution of surgical services in low-income and middle-income countries: a modified Delphi process(2023) HENRY, Jaymie A.; REYES, Ana M.; AMEH, Emmanuel; YIP, Cheng-Har; NTHUMBA, Peter; MEHES, Mira; LELCHUK, Ashley; HOLLIER, Larry; WAQAINABETE, Ifereimi; ABDULLAH, Noor Hisham; HILL, Andrew; FERGUSON, Mark K.Objectives To develop consensus statements regarding the regional-level or district-level distribution of surgical services in low and middle-income countries (LMICs) and prioritisation of service scale-up. Design This work was conducted using a modified Delphi consensus process. Initial statements were developed by the International Standards and Guidelines for Quality Safe Surgery and Anesthesia Working Group of the Global Alliance for Surgical, Obstetric, Trauma and Anesthesia Care (G4 Alliance) and the International Society of Surgery based on previously published literature and clinical expertise. The Guidance on Conducting and REporting DElphi Studies framework was applied. Setting The Working Group convened in Suva, Fiji for a meeting hosted by the Ministry of Health and Medical Services to develop the initial statements. Local experts were invited to participate. The modified Delphi process was conducted through an electronically administered anonymised survey. Participants Expert LMIC surgeons were nominated for participation in the modified Delphi process based on criteria developed by the Working Group. Primary outcome measures The consensus panel voted on statements regarding the organisation of surgical services, principles for scale-up and prioritisation of scale-up. Statements reached consensus if there was >= 80% agreement among participants. Results Fifty-three nominated experts from 27 LMICs voted on 27 statements in two rounds. Ultimately, 26 statements reached consensus and comprise the current recommendations. The statements covered three major themes: which surgical services should be decentralised or regionalised; how the implementation of these services should be prioritised; and principles to guide LMIC governments and international visiting teams in scaling up safe, accessible and affordable surgical care. Conclusions These recommendations represent the first step towards the development of international guidelines for the scaling up of surgical services in LMICs. They constitute the best available basis for policymaking, planning and allocation of resources for strengthening surgical systems.
- Surgical treatment of sacral pressure wounds in patients with COVID-19: A case series(2023) FERREIRA, Joao; NICOLAS, Gregory; VALENTE, Daniel; MILCHESKI, Dimas; SALIBA, Marita; GEMPERLI, Rolf
- Access to reconstructive plastic surgery for patients undergoing bariatric surgery in the Unified Health System (SUS)(2023) SECANHO, MURILO SGARBI; CINTRA JR, WILSON; CARNEIRO, IGOR CASTRO; ALVES, GUILHERME FREDERICO FERRO; GEMPERLI, ROLFABSTRACT Introduction: obesity is one of the most common diseases worldwide, and the most effective treatment to it is the bariatric surgery. One of the negative impacts of this procedure is the body dysmorphia caused by overhanging skin. In Brazil, the national health system - Sistema Único de Sáude (SUS) - provide body contouring surgery to treat post-bariatric patients, since 2007. This article aims to describe the Brazilian public health approach to post bariatric patients and perform an analyze in the Brazilian health care database. Methods: in Brazilian Health System database, a search for the post-bariatric procedures performed between 2007 to 2021 was done. The variables analyzed were geographic location, year, mean days of hospitalization, death, and mortality rate. Also, we evaluated the number of bariatric procedures done in the same period. Statistical analysis was performed using the Student-t and the chi-square tests and p-value <0.5 was considered significant. Results: a total of 12,717 plastic surgery procedures in post bariatric patients were done, with a national prevalence of 13.8%. Dermolipectomy was the most performed procedure, with 6,719. The years of 2020 and 2021 suffered a decreased of 64.3% and 70.9% in the number of surgeries (p<0,001). Bariatric Procedures had a high rate and a higher percentage of growth comparing to post bariatric surgery (p<0,001), totalizing 93,589 surgeries. Conclusions: Brazil had a significant number of body contouring surgery, however with a low prevalence. Dermoliepctomy was the most common procedure performed. We could notice a significant impact of COVID pandemic in those procedures .
- Análise morfométrica do lábio superior e da ação do envelhecimento(2013) LONGO, MARCO VINICIUS LOSSO; ISHIDA, LUIS HENRIQUE; FORTES, FERNANDO SARTOR GUIMARÃES; KASAI, KIRIL ENDO; ISHIDA, LUIS CARLOS; ALONSO, NIVALDO; FERREIRA, MARCUS CASTROABSTRACT Background: A pleasant smile depends on harmonious relationships between the teeth, gums, and lips. The present study measured upper lip changes related to ageing using a morphometric analysis. Methods: Fortysix Caucasian women at least 15 years of age were selected and divided into four groups: 15 - 30 years old, 31 - 45 years old, 46 - 60 years old, and > 60 years old. Frontal photographs with closed lips and parted lips were taken. The following measurements were performed: upper lip height, upper vermilion height in parted and closed lips positions, and exposure of the central upper incisors in the relaxed position. Results: Upper lip height increased with age. The average upper lip height in the closed lips position was 13.75 mm in the youngest age-range (15 - 30 years old). The upper lip height gradually increased with age until reaching an average of 19.24 mm was observed in the > 60 years old group. The opposite result was observed in upper vermilion height, which decreased with increasing age. The average vermilion height in the parted lips position was 7.09 mm in the youngest age-range (15-30 years old) and decreased to 4.58 mm in the oldest group (> 60 years old). Teeth exposure decreased with age. The average upper teeth exposure was 3.55 mm in the youngest group and decreased to 0.40 mm in the oldest group. Conclusion: The upper lip height increases, while the upper vermilion height and exposure of the upper teeth decrease with age.
- Extracellular Matrix-Derived Hydrogels to Augment Dermal Wound Healing: A Systematic Review(2022) VRIEND, Linda; SINKUNAS, Viktor; CAMARGO, Cristina P.; LEI, Berend van der; HARMSEN, Martin C.; DONGEN, Joris A. vanChronic, non-healing, dermal wounds form a worldwide medical problem with limited and inadequate treatment options and high societal burden and costs. With the advent of regenerative therapies exploiting extracellular matrix (ECM) components, its efficacy to augment wound healing is to be explored. This systematic review was performed to assess and compare the current therapeutic efficacy of ECM hydrogels on dermal wound healing. The electronic databases of Embase, Medline Ovid, and Cochrane Central were searched for in vivo and clinical studies on the therapeutic effect of ECM-composed hydrogels on dermal wound healing (April 13, 2021). Two reviewers selected studies independently. Studies were assessed based on ECM content, ECM hydrogel composition, additives, and wound healing outcomes, such as wound size, angiogenesis, and complications. Of the 2102 publications, 9 rodent-based studies were included while clinical studies were not published at the time of the search. Procedures to decellularize tissue or cultured cells and subsequently generate hydrogels were highly variable and in demand of standardization. ECM hydrogels with or without additives reduced wound size and also seem to enhance angiogenesis. Serious complications were not reported. To date, preclinical studies preclude to draw firm conclusions on the efficacy and working mechanism of ECM-derived hydrogels on dermal wound healing. The use of ECM hydrogels can be considered safe. Standardization of decellularization protocols and implementation of quality and cytotoxicity controls will enable obtaining a generic and comparable ECM product. Impact statementExtracellular matrix (ECM)-based hydrogels are biocompatible and harbor growth factors that can instruct tissue healing. Their application is a novelty in (pre)clinical wound healing treatment. This systematic review provides an overview of the current evidence for ECM hydrogels in enhancing wound healing and an extensive overview of the decellularization procedures used. Lastly, challenges and future directions to standardize decellularization procedures and implement quality controls are proposed.
- Reoperative Transaxillary Subfascial Breast Augmentation and Fat Grafting: Technical Highlights and a Step-by-Step Video Guide(2023) MUNHOZ, Alexandre Mendonca; MARQUES NETO, Ary de Azevedo; MAXIMILIANO, JoaoReoperative procedures after breast augmentation are frequently more complex than primary cases because of local complications and insufficient soft-tissue coverage. Although the transaxillary incision is often indicated in primary breast augmentation, limitations of this approach include secondary surgery and correcting complications after using this approach via the same incision. Combining the transaxillary technique with a subfascial pocket has been suggested to avoid breast scarring and the limitations of submuscular pockets represented by breast animation. With advances in autogenous fat grafting (AFG) techniques, implant coverage alternatives and more natural outcomes have been reported from more superficial implant pockets. Simultaneous AFG with silicone implants (defined as hybrid breast augmentation) has been evaluated recently as an attractive procedure. These two techniques combine to provide breast projection and natural cleavage while camouflaging implant edges. AFG is also important to reduce the intermammary distance and achieve a smoother transition between the breasts. The transaxillary approach can be useful in reoperative breast augmentation and avoids additional scarring on the breast. This article and the accompanying videos provide a detailed, step-by-step guide to reoperative hybrid breast augmentation using a subfascial transaxillary approach, with a predictable and optimized surgical outcome.
- Adipose tissue-derived stem cells as a therapeutic strategy for enterocutaneous fistula: an experimental model study(2023) PAGOTTO, Vitor Penteado Figueiredo; CAMARGO, Cristina Pires; CACERES, Paula Vitoria; ALTRAN, Silvana Cereijido; GEMPERLI, RolfPurpose: Enterocutaneous fistula (ECF) is a condition in which there is an abnormal connection between the intestinal tract and the skin. It can lead to high morbidity and mortality rates despite the availability of therapeutic options. Stem cells have emerged as a potential strategy to treat ECF. This study aimed to evaluate the effect of adipose tissue-derived stem cells (ASC) on ECF in an experimental model. Methods: ECF was induced in 21 Wistar rats, and after one month, they were divided into three groups: control group (C), culture medium without ASC group (CM), and allogeneic ASC group (ASC). After 30 days, the animals underwent macroscopic analysis of ECF diameter and histopathological analysis of inflammatory cells, tissue fibrosis, and vascular density. Results: The study found a 55% decrease in the ECF diameter in the ASC group (4.5 +/- 1.4 mm) compared to the control group (10.0 +/- 2.1 mm, p = 0.001) and a 59.1% decrease in the CM group (11.0 +/- 4.3 mm, p = 0.003). The fibrosis score in the ASC group was 20.9% lower than the control group (p = 0.03). There were no significant differences in inflammation scores among the three groups. Conclusion: This study suggests that ASC treatment can reduce ECF diameter, and reduction in tissue fibrosis may be a related mechanism. Further studies are needed to understand the underlying mechanisms fully.
- Subfascial Axillary Hybrid Breast Augmentation: Technical Highlights and Step-by-Step Video Guide(2023) MUNHOZ, Alexandre Mendonca; NETO, Ary de Azevedo Marques; MAXIMILIANO, JoaoAdvances in breast augmentation techniques have led to safety improvements and better aesthetic results. The concurrent combination of the axillary approach with a subfascial pocket has been suggested for augmentation procedures, because it avoids breast scarring and the limitations of submuscular positioning represented by breast animation when the pectoral muscle is contracted. With the improvement of autogenous fat grafting techniques, new implant coverage options and more natural results have been proposed with more superficial implant pockets; simultaneous autogenous fat grafting with silicone implants (defined as hybrid breast augmentation) has recently been evaluated as a promising technique. Combining these two procedures allows core volume projection and natural cleavage while camouflaging implant edges. Fat grafting is also useful in reducing intermammary distance and achieving a smaller and smoother transition between the breasts. This article and the accompanying videos provide a detailed, step-by-step guide to hybrid breast augmentation using a subfascial axillary approach, with a predictable and optimized surgical outcome.
- The First Hybrid International Educational Comprehensive Cleft Care Workshop(2023) KANTAR, Rami S.; ESENLIK, Elcin; ABYAD, Omar S. Al; MELHEM, Antonio; YOUNAN, Robert A.; HADDAD, Mario; KEITH, Kristen; KASSAM, Serena; ANNAN, Beyhan; VIJAYAKUMAR, Charanya; PICARD, Arnaud; PADWA, Bonnie L.; SOMMERLAD, Brian; RAPOSO-AMARAL, Cassio Eduardo; FORREST, Christopher R.; GILLETT, David A.; STEINBACHER, Derek M.; RUNYAN, Christopher M.; TANIKAWA, Daniela Y. S.; CHONG, David K.; FISHER, David M.; MARK, Hans; CANTER, Halil Ibrahim; LOSEE, Joseph E.; PATEL, Krishna G.; HARTZELL, Larry D.; JOHNSON, Adam B.; COLLARES, Marcus Vinicius Martins; ALONSO, Nivaldo; CHEN, Philip Kuo-Ting; TSE, Raymond; MANN, Robert J.; PRADA-MADRID, Jose Rolando; KOBAYASHI, Shinji; HUSSAIN, Syed Altaf; KUMMER, Ann; SELL, Debbie A.; PEREIRA, Valerie J.; MABRY, Kelly; GONSOULIN, Courtney K.; PERSSON, Martin; DAVIES, Gareth; SETHNA, Navil F.; MUNOZ-PAREJA, Jennifer C.; KUIJPERS-JAGTMAN, Anne Marie; GRAYSON, Barry H.; GROLLEMUND, Bruno; GARIB, Daniela G.; MEAZZINI, Maria Costanza; KHARBANDA, Om P.; SANTIAGO, Pedro E.; NALABOTHU, Prasad; BATRA, Puneet; STIEBER, Erin; PRASAD, Dushyant; BREWSTER, Hugh; AYALA, Ruben; ERBAY, Elif; AKCAM, M. Okan; GRIOT, J. Peter W. Don; VYAS, Raj M.; FLORES, Roberto L.; BREUGEM, Corstiaan C.; HAMDAN, Usama S.Objective Describe the first hybrid global simulation-based comprehensive cleft care workshop, evaluate impact on participants, and compare experiences based on in-person versus virtual attendance. Design Cross-sectional survey-based evaluation. Setting International comprehensive cleft care workshop. Participants Total of 489 participants. Interventions Three-day simulation-based hybrid comprehensive cleft care workshop. Main Outcome Measures Participant demographic data, perceived barriers and interventions needed for global comprehensive cleft care delivery, participant workshop satisfaction, and perceived short-term impact on practice stratified by in-person versus virtual attendance. Results The workshop included 489 participants from 5 continents. The response rate was 39.9%. Participants perceived financial factors (30.3%) the most significant barrier and improvement in training (39.8%) as the most important intervention to overcome barriers facing cleft care delivery in low to middle-income countries. All participants reported a high level of satisfaction with the workshop and a strong positive perceived short-term impact on their practice. Importantly, while this was true for both in-person and virtual attendees, in-person attendees reported a significantly higher satisfaction with the workshop (28.63 +/- 3.08 vs 27.63 +/- 3.93; P = .04) and perceived impact on their clinical practice (22.37 +/- 3.42 vs 21.02 +/- 3.45 P = .01). Conclusion Hybrid simulation-based educational comprehensive cleft care workshops are overall well received by participants and have a positive perceived impact on their clinical practices. In-person attendance is associated with significantly higher satisfaction and perceived impact on practice. Considering that financial and health constraints may limit live meeting attendance, future efforts will focus on making in-person and virtual attendance more comparable.
- Fatores preditivos de complicações em procedimentos da cirurgia plástica - sugestão de escore de segurança(2014) SALDANHA, OSVALDO RIBEIRO; SALLES, ALESSANDRA GRASSI; LLAVERIAS, FRANCIS; SALDANHA FILHO, OSVALDO RIBEIRO; SALDANHA, CRISTIANNA BONETTOABSTRACT Introduction: This study analyzed the association between plastic surgery complications and risk factors in the study population, and presents a safety scale for planning plastic surgery procedures. Methods: A case-control study was performed, including patients who underwent procedures at various plastic surgery centers from 2010-2011 and who had some type of postoperative complication. The control group consisted of patients who underwent similar procedures during the same period without complications. Descriptive analysis was performed using absolute and relative frequency and measures of central tendency (mean and median) and dispersion (standard deviation and minimum and maximum value). Associations were analyzed using the chi-squared test of association and univariate and multiple logistic models. In all analyses, statistical significance was defined as p-values <0.05. Results: A total of 168 patients were analyzed: 75 cases with complications (Group I, 44.64%) and 93 controls (Group II). There was a statistically significant association between the presence of a complication and two variables: undergoing an associated procedure (p = 0.049) and surgery duration greater than 240 minutes (p=0.049). Conclusion: The literature shows multifactorial risks for plastic surgery procedures. Proper patient selection, preoperative planning, and intraand postoperative prophylactic care have contributed to decreased incidence of serious complications. The main risk factors associated with post-surgical complications were surgery durations longer than 4 hours and associated procedures.
- Fator de Impacto da Revista Brasileira de Cirurgia Plástica(2016) SALLES, ALESSANDRA GRASSI
- Os riscos das publicações rápidas durante a pandemia de Covid-19(2020) GOLDENBERG, Dov
- Influência das complicações pós-operatórias no insucesso da reconstrução de mama imediata com implante de silicone(2015) CHING, AN WAN; COSTA, MÁRCIO PAULINO; BRASOLIN, ADRIANO GUIMARÃES; FERREIRA, LYDIA MASAKOABSTRACT Introduction: Immediate breast reconstruction with silicone implants following mastectomy is a simple method, but can develop complications culminating in implant removal. The aim of this study was to analyze postoperative complications and evaluate their correlation with implant removal. Method: In a period of 4 years, 323 cases of immediate breast reconstruction with silicone implants following total mastectomy were retrospectively studied in the Institut Gustave-Roussy, France. Results: The most frequent complication was lymphocele (34.9%), followed by cutaneous necrosis (22.9%), infection (19.3%), and hematoma (13.3%). Implant removal was more frequent when a surgical complication occurred, and even more frequent when there was more than one type of complication. The most frequent complication leading to implant removal was infection (75.0%). The expander was the implant that had the highest correlation with implant removal. The use of implants with a volume greater than 300 ml was associated with a significantly higher risk of implant removal. Conclusions: 1) The presence of postoperative complications was a risk factor for implant removal. 2) The risk of removal was higher when more than one complication was present. 3) Infection was the main type of complication associated with implant removal. 4) The expander presented a higher risk of complications and implant removal. 5) The use of implants with a volume greater than 300 ml had a greater risk of need for removal.