Tesi sul tema "Surgery, plastic"
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1
Zolotaryova, A. "Plastic surgery". Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/33929.
Testo completoAbstract (sommario):
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/33929
2
Pieper, Steven Donald. "CAPS--Computer-aided plastic surgery". Thesis, Massachusetts Institute of Technology, 1991. http://hdl.handle.net/1721.1/13093.
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Bilokon, N. O. "A brief history of plastic surgery". Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/26010.
Testo completoAbstract (sommario):
Historically, plastic surgery have been practiced for thousands of years, going back to more primitive methods that were seen in India since around 800 B.C. At that time, plastic surgery procedures consisted of skin grafts that were performed on those that suffered from skin damaging injures. Ancient doctors developed methods to help suture the skin to the body, to help prevent scarring. They performed reconstructive operations on ears and noses that were lost in war or through punishment for a crime. The Romans were also practicing plastic surgery by the first century B.C. Their culture greatly admired the beauty of naked body thus promoting them to improve or eliminate the appearance of any bodily defect or deformity. Their procedures included breast reduction and scar removal.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/26010
4
Favaedi, Leila. "Image processing for plastic surgery planning". Thesis, Imperial College London, 2010. http://hdl.handle.net/10044/1/6063.
Testo completoAbstract (sommario):
This thesis presents some image processing tools for plastic surgery planning. In particular, it presents a novel method that combines local and global context in a probabilistic relaxation framework to identify cephalometric landmarks used in Maxillofacial plastic surgery. It also uses a method that utilises global and local symmetry to identify abnormalities in CT frontal images of the human body. The proposed methodologies are evaluated with the help of several clinical data supplied by collaborating plastic surgeons.
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Courteau, Brigitte. "Competency-based education in plastic surgery training". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=122979.
Testo completoAbstract (sommario):
In Plastic Surgery, learning objectives have been outlined by the Royal College of Physicians and Surgeons of Canada, however, a defined curriculum to meet these objectives is absent. Several factors are reducing the practicality of the current time-based model and as a result, a competency-based training model has been proposed to replace the traditional model. Implementation of a competency-based curriculum requires several steps including the identification of both specialty specific procedures and procedural steps. The present project aims to develop a methodology for identifying procedural steps for individual Plastic Surgery procedures. Previous studies have highlighted the lack of resident exposure to several areas of Plastic Surgery, particularly aesthetic surgery. Avenues for increasing resident exposure and training opportunities must be explored. An additional aim of this project is to achieve this through the development of a pilot simulator mannequin for aesthetic surgery training. The identification of Plastic Surgery procedural steps together with simulator training is a novel step forward towards implementation of competency-based education in Plastic Surgery training.En chirurgie plastique, le Collège royal des médecins et chirurgiens du Canada propose des objectifs d'études bien définis, cependant il n'y a pas de curriculum défini afin d'atteindre ces objectifs. Plusieurs facteurs réduisent l'aspect pratique du modèle en fonction du temps existant, et comme résultat, le modèle d'enseignement basé sur la compétence fut proposé pour remplacer le modèle traditionnel. La réalisation d'un curriculum basé sur la compétence demande autant l'identification des procédures spécifique de cette spécialité que des étapes procédurales. Ce projet tend à développer une méthodologie pour l'identification des étapes procédurales pour chacune des procédures de la chirurgie plastique. Les études précédentes ont démontrées que les résidents manquent d'exposition aux connaissances de plusieurs domaines de la chirurgie plastique, particulièrement vrai pour la chirurgie esthétique. Il est donc important, pour les résidents, d'explorer tous les avenues pour augmenter cette exposition et leurs opportunités de formation. La cible additionnelle de ce projet est d'atteindre ces objectifs par le développement d'un mannequin-simulateur pilote pour l'entraînement en chirurgie esthétique. L'identification des étapes procédurales en chirurgie plastique, en concert avec l'entraînement par simulateur, engendre une nouvelle étape vers la réalisation d'une éducation basée sur la compétence en chirurgie plastique.
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Catte, Michelle. "Facial plastic surgery in children and adolescents". Thesis, University of Birmingham, 2002. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269874.
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Pitak-Arnnop, Poramate. "Ethics in maxillofacial and facial plastic surgery". Paris 5, 2010. http://www.theses.fr/2010PA05T047.
Testo completoAbstract (sommario):
L’éthique en chirurgie maxillo-faciale (CMF) reste peu étudiée. Ce travail de thèse a pour but (1) d’identifier les problèmes éthiques concernant la protection des personnes (PP) et les conflits d’intérêts (CI) dans la recherche en CMF, (2) de proposer les guides pratiques pour maintenir l’intégrité scientifique et les normes éthiques en CMF, et (3) d’analyser les données cliniques concernant les lésions des mâchoires, pour discuter l’éthique de la décision médicale. Méthodes: Cette dissertation cumulative comporte 2 grandes parties : l’éthique de la recherche d’une part, et l’éthique clinique d’autre part. Partie 1 : l’éthique de la recherche, comprend une revue de la littérature, 4 études rétrospectives et 2 études transversales sur: (1) la non-conformité scientifique, (2) la PP et les CI dans les journaux en CMF, (3) la PP et les CI dans les recherches sur les 2 innovations en CMF (chirurgie piézoélectrique; sous-mandibulectomies assistées par endoscopie), (4) le biais de publication en CMF, (5) l’éthique dans les recommandations aux auteurs des journaux en CMF, et (6) une enquête internationale transversale dans un échantillon représentatif de 326 chirurgiens maxillo-faciaux. Partie 2 : l’éthique clinique, inclut une revue systématique et 3 études rétrospectives sur: (1) l’ostéoradionécrose, (2) le kératokyste odontogène, (3) l’améloblastome, et (4) les complications des lambeaux libres de péroné. Les méthodes classiques de statistiques descriptives et d’analyse univariée ont été utilisées. Les différences ont été considérées comme significatives lorsque p était < 0,05. Résultats: la PP et la déclaration des CI dans la recherche en CMF sont encore insuffisantes. Les causes peuvent provenir (1) des journaux eux-mêmes par l’absence de règles éthiques dans les recommandations aux auteurs et/ou le manque de rigueur du contrôle de l’éditeur et du comité de lecture du journal, et/ou (2) des auteurs par le manque de formation et d’expérience de l’éthique, par le biais lié à l’intérêt de la profession ou aux intérêts financiers, par ignorance, ou par une combinaison de ces facteurs. Les données cliniques sur les lésions maxillo-faciales et leur gestion peuvent être bien incorporées dans l’approche éthique de la décision médicale. Cependant, les études sur ce sujet souffrent en général d’une insuffisance de validité interne. Conclusions: la PP et la déclaration des CI reçoivent peu d’attention de la part de la communauté scientifique en CMF. Il est donc temps d’instaurer une surveillance appropriée sur l’éthique de la recherche et d’en appliquer les mécanismes comme standards scientifiques. Les auteurs et les chercheurs doivent se conformer strictement aux normes d’éthique de la recherche. La formation continue pour les chirurgiens maxillo-faciaux permettrait de réduire les mauvaises pratiques, intentionnelles ou non. La connaissance de l’éthique et de son application à la décision médicale en CMF gagnera à de plus amples investigationsIntroduction: Ethics in oral-maxillofacial surgery (OMS) remain understudied. The purposes of this dissertation were (1) to identify the ethical problems of human subject protection (HSP) and conflicts of interest (CoI) in OMS researches, (2) to propose the guidelines as to maintain scientific integrity and ethical standards in this surgical speciality, and (3) to analyse clinical data concerning jaw lesions to discuss the ethical considerations on clinical decision-making. Methods: This cumulative thesis consisted of 2 parts: research ethics and clinical ethics. Part 1: research ethics, included 1 narrative review, 4 retrospective and 2 cross-sectional studies on: (1) research misconduct, (2) HSP and CoI in OMS journals, (3) HSP and CoI in researches on 2 OMS innovations (piezoelectric surgery; endoscope-assisted submandibular sialadenectomy), (4) publication bias in the OMS literature, (5) ethical issues in the guideline to authors of OMS journals, and (6) a questionnaire survey enrolling 326 maxillofacial surgeons worldwide. Part 2: clinical ethics, comprised 1 systematic review and 3 retrospective studies on: (1) osteoradionecrosis, (2) odontogenic keratocysts, (3) ameloblastoma, and (4) complications of fibular free flaps. Descriptive and univariate statistics were computed when appropriate, and a P-value of < 0. 05 was considered statistically significant. Results: HSP and disclosure of CoI in OMS researches are still lacking. The possible reasons are (1) the OMS journals themselves (lack of ethical issues in the instructions to authors and/or failure of editors and/or reviewers to be strict with their own regulations/policies and international ethical standards) and/or (2) the OMS authors (lack of ethical education, inadequate research experience, bias from career self-interest or financial gains, ignorance about research ethics, or a combination of these). Clinical data on jaw lesions and their management can be incorporated into the ethical approach to clinical decisionmaking. However, the studies on this matter usually contain inadequate internal validity. Conclusions: The results of these studies suggest that HSP and disclosure of CoI receive little attention from the OMS speciality. It is, therefore, high time to have appropriate oversight of ethical breaches and implement the measures as a standard in peer-review publishing. An author/investigator has to adhere strictly to the research ethics standards. Adequate research training for oral-maxillofacial surgeons would help reduce both intentional and unintentional scientific malpractice. Ethics and clinical decisionmaking require further investigations
Hintergrund: Ethische Aspekte in der Mund-Kiefer-Gesichtschirurgie (MKG-Chirurgie) wurden bislang kaum beleuchtet. Anliegen der Dissertation war [1] die Identifikation von Problemen beim Schutz des Menschen und Interessenkonflikte der MKG-chirurgischen Forschung, [2] die Formulierung von Leitlinien zur Sicherstellung der wissenschaftlichen Integrität und der ethischen Standards in dieser chirurgischen Disziplin, und [3] die Analyse klinischer Daten zu Erkrankungen des Kiefers zur Erörterung ethischer Erwägungen auf die klinische Entscheidungsfindung. Methode: Diese kumulative Dissertation gliedert sich in 2 Hauptteile: [1] Ethikforschung und [2] Klinische Ethik. Der Teil 1: Ethikforschung, beinhaltet 1 traditionellen Übersichtsartikel, 4 retrospektive Studien und 2 Querschnittstudien zu [1] Fehlleistungen in der Forschung (wissenschaftliches Fehlverhalten), [2] Schutz des menschlichen Individuums in der MKG-chirurgischen Literatur, [3] Schutz des menschlichen Individuums bei zwei neuartigen MKG-chirurgischer Verfahren (piezoelektrische Chirurgie; endoskopisch gestützte Exstirpation der Glandula submandibularis), [4] Ergebnisverzerrung (Publikationsbias) in der MKG-chirurgischen Literatur, [5] Ethik-Aspekte in den Richtlinien für Autoren von MKG-chirurgischen Zeitschriften und [6] eine auf Fragebögen basierende Querschnittstudie, welche ein Kollektiv von 326 MKG-Chirurgen weltweit erfasst. Der zweite Teil: Klinische Ethik, enthält 1 systematischen Übersichtsartikel und 3 retrospektive Studien zu den Themen [1] Osteoradionekrose, [2] odontogenen Keratozyste, [3] Ameloblastom und [4] Komplikationen des freien Fibulatransfers. Deskriptive und univariate statistische Daten wurden, sofern möglich, berechnet; für das Signifikanzniveau konnte ein p-Wert von < 0,05 festgelegt werden. Ergebnis: Innerhalb der MKG-chirurgischen Forschung gibt es noch immer Defizite hinsichtlich des Schutzes des menschlichen Individuums und der Offenlegung von Interessenkonflikten. Mögliche Ursachen hierfür reichen von [1] redaktionellen Problemen bei den MKG-chirurgischen Zeitschriften (fehlende Ethik-Standards in den Instruktionen für Autoren, Unschärfen seitens der Herausgeber bzw. Gutachter bezüglich der strikten Umsetzung von journaleigenen oder globalen Regeln) bis hin zu [2] autorenbezogenen Problemen (Wissenslücken, Verwerfungen durch Karrieredenken, finanzielle Interessen); auch Kombinationen multipler Gründe sind denkbar. In die klinische Daten über kieferchirurgische Erkrankungen und deren Management sollten ethische Ansätze bei der therapeutischen Entscheidungsfindung einfließen. Bisherigen Studien zu diesem Thema fehlt es in der Regel an interner Validität. Schlussfolgerung: Die Ergebnisse der Untersuchung sprechen dafür, dass dem Schutz des menschlichen Individuums und der Offenlegung von Interessenkonflikten innerhalb der MKG-chirurgischen Forschung bisher zu wenig Aufmerksamkeit geschenkt wird. Es ist somit höchste Zeit, geeignete Überwachungsverfahren zum Schutz vor ethischen Rechtsverletzungen zu etablieren und diese Maßnahmen als Standard in den Begutachtungsprozess für internationale Publikationen (‚peer-review publishing‘) einzuführen. Jeder Autor bzw. Forscher sollte sich strikt an ethische Standards halten. Geeignete diesbezügliche Fortbildungen für MKG-Chirurgen könnten bewusste und unbewusste wissenschaftliche Fehltritte vermeiden helfen. Die klinische Entscheidungsfindung unter ethischen Aspekten bedarf in Zukunft weiterer Untersuchungen
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Rogers, Alan David. "Ventilator associated pneumonia in major paediatric burns". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2910.
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Mackenzie, Duncan Neil. "VEGF gene therapy and therapeutic angiogenesis in plastic surgery". Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406590.
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Sridharan, Srinivasan. "Porous plastic implants for bone ingrowth". Thesis, Georgia Institute of Technology, 1994. http://hdl.handle.net/1853/10101.
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Lechtape-Grüter, Reinhard. "Allotransplantation of free vascularised skin flaps". Thesis, University of Cape Town, 1988. http://hdl.handle.net/11427/26319.
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Harris-Moore, Deborah Rose. "Performing Perfection: Plastic and Cosmetic Surgery and the Rhetorical Body". Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/202537.
Testo completoAbstract (sommario):
While there is a long history of rhetorical studies that focus on oral and written discourses, the relatively recent trend of studying rhetorical images, materiality, and rhetorical bodies presents a shift toward an expanded perspective on what constitutes texts and what can be considered rhetorical. The study of bodies as rhetorical texts prompts the questions of how language is material and visual in nature. In my dissertation I examine the relationship between rhetoric and the body through Judith Butler's theories of materiality and performativity. Using Butler's theories of performance as a lens, I analyze the rhetoric of plastic and cosmetic surgery and demonstrate the role of performance in the perpetuation of and response to rhetoric of the body. Cosmetic and plastic surgery are performatives in that they not only confer a binding power on the action performed by altering the body through surgical and non-surgical means, but also initiate various citational practices within the field of medicine and in popular culture (through various mediums such as television, magazines, billboards, and websites). These procedures result in images and claims that authorize particular social expectations of beauty, youth, and sexuality.I examine a range of mass media texts related to cosmetic surgery (television shows, magazines, news clips, websites, and films) that portray different normative and deviant performativity of the body. In my research, I include interviews from volunteers in Los Angeles; my analysis involves local individuals' relationships to plastic and cosmetic surgery and their various body performatives in terms of normativity and agency. By comparing global and local perspectives, I argue that media sensationalizes the agent/victim binary in order to sell plastic and cosmetic surgeries, as well as related texts. The local stories serve to counter assumptions about the role of power in plastic surgery, revealing a far more complicated relationship between clients, rhetoric, and the reasons behind their surgeries; the agent/victim binary that is emphasized in mass media fails to capture lived experience and creates a detrimental rhetoric of empowerment.
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DE, SIMONE MATTEO. "Planning Plastic Surgery in 3D. An innovative approach and tool". Doctoral thesis, Politecnico di Torino, 2013. http://hdl.handle.net/11583/2507843.
Testo completoAbstract (sommario):
Face plastic surgery (PS) plays a major role in today medicine. Both for reconstructive and cosmetic surgery, achieving harmony of facial features is an important, if not the major goal. Several systems have been proposed for presenting to patient and surgeon possible outcomes of the surgical procedure. In this work, we present a new 3D system able to automatically suggest, for selected facial features as nose, chin, etc., shapes that aesthetically match the patient’s face. The basic idea is suggesting shape changes aimed to approach similar but more harmonious faces. To this goal, our system compares the 3D scan of the patient with a database of scans of harmonious faces, excluding the feature to be corrected. Then, the corresponding features of the k most similar harmonious faces, as well as their average, are suitably pasted onto the patient’s face, producing k+1 aesthetically effective surgery simulations. The system has been fully implemented and tested. To demonstrate the system, a 3D database of harmonious faces has been collected and a number of PS treatments have been simulated. The ratings of the outcomes of the simulations, provided by panels of human judges, show that the system and the underlying idea are effective.
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Huss, Fredrik R. M. "In vitro and in vivo studies of tissue engineering in reconstructive plastic surgery". Doctoral thesis, Linköpings universitet, Brännskadevård, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8504.
Testo completoAbstract (sommario):
To correct, improve, and maintain tissues, and their functions, are common denominators in tissue engineering and reconstructive plastic surgery. This can be achieved by using autolo-gous tissues as in flaps or transplants. However, often autologous tissue is not useable. This is one of the reasons for the increasing interest among plastic surgeons for tissue engineering, and it has led to fruitful cross-fertilizations between the fields. Tissue engineering is defined as an interdisciplinary field that applies the principles of engineering and life sciences for development of biologic substitutes designed to maintain, restore, or improve tissue functions. These methods have already dramatically improved the possibilities to treat a number of medical conditions, and can arbitrarily be divided into two main principles: > Methods where autologous cells are cultured in vitro and transplanted by means of a cell suspension, a graft, or in a 3-D biodegradable matrix as carrier. > Methods where the tissue of interest is stimulated and given the right prerequisites to regenerate the tissue in vivo/situ with the assistance of implantation of specially designed materials, or application of substances that regulate cell functions - guided tissue regeneration. We have shown that human mammary epithelial cells and adipocytes could be isolated from tissue biopsies and that the cells kept their proliferative ability. When co-cultured in a 3-D matrix, patterns of ductal structures of epithelial cells embedded in clusters of adipocytes, mimicking the in vivo architecture of human breast tissue, were seen. This indicated that human autologous breast tissue can be regenerated in vitro. The adipose tissue is also generally used to correct soft tissue defects e.g. by autologous fat transplantation. Alas 30-70% of the transplanted fat is commonly resorbed. Preadipocytes are believed to be hardier and also able to replicate, and hence, are probably more useful for fat transplantation. We showed that by using cell culture techniques, significantly more pre-adipocytes could survive and proliferate in vitro compared to two clinically used techniques of fat graft handling. Theoretically, a biopsy of fat could generate enough preadipocytes to seed a biodegradable matrix that is implanted to correct a defect. The cells in the matrix will replicate at a rate that parallels the vascular development, the matrix subsequently degrades and the cell-matrix complex is replaced by regenerated, vascularized adipose tissue. We further evaluated different biodegradable scaffolds usable for tissue engineering of soft tissues. A macroporous gelatin sphere showed several appealing characteristics. A number of primary human ecto- and mesodermal cells were proven to thrive on the gelatin spheres when cultured in spinner flasks. As the spheres are biodegradable, it follows that the cells can be cultured and expanded on the same substrate that functions as a transplantation vehicle and scaffold for tissue engineering of soft tissues. To evaluate the in vivo behavior of cells and gelatin spheres, an animal study was performed where human fibroblasts and preadipocytes were cultured on the spheres and injected intra-dermally. Cell-seeded spheres were compared with injections of empty spheres and cell suspensions. The pre-seeded spheres showed a near complete regeneration of the soft tissues with neoangiogenesis. Some tissue regeneration was seen also in the ‘naked’ spheres but no effect was shown by cell injections. In a human pilot-study, intradermally injected spheres were compared with hyaluronan. Volume-stability was inferior to hyaluronan but a near complete regeneration of the dermis was proven, indicating that the volume-effect is permanent in contrast to hyaluronan which eventually will be resorbed. Further studies are needed to fully evaluate the effect of the macroporous gelatin spheres, with or without cellular pre-seeding, as a matrix for guided tissue regeneration. However, we believe that the prospect to use these spheres as an injectable, 3D, biodegradable matrix will greatly enhance our possibilities to regenerate tissues through guided tissue regeneration.On the day of the defence date the status of article V was In Press.
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Kleintjes, Wayne George. "The vascular anatomy of the forehead related to forehead flaps and its application in plastic and reconstructive surgery". Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1144.
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Naftel, Andrew James. "Three-dimensional techniques for the geometric study of expanded skin surfaces : three-dimensional shape measurement and geometric analysis of expanded skin surfaces with a view to the optimisation of tissue expansion techniques in plastic and reconstruct". Thesis, University of Bradford, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.236489.
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Lundberg, Erika, e Petra Jonsson. "Skönhetens pris : En litteraturstudie". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2126.
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Ruiz, Fernández Guillermo. "3D reconstruction for plastic surgery simulation based on statistical shape models". Doctoral thesis, Universitat Pompeu Fabra, 2018. http://hdl.handle.net/10803/667049.
Testo completoAbstract (sommario):
This thesis has been accomplished in Crisalix in collaboration with the Universitat Pompeu Fabra within the program of Doctorats Industrials. Crisalix has the mission of enhancing the communication between professionals of plastic surgery and patients by providing a solution to the most common question during the surgery planning process of ``How will I look after the surgery?''. The solution proposed by Crisalix is based in 3D imaging technology. This technology generates the 3D reconstruction that accurately represents the area of the patient that is going to be operated. This is followed by the possibility of creating multiple simulations of the plastic procedure, which results in the representation of the possible outcomes of the surgery.
This thesis presents a framework capable to reconstruct 3D shapes of faces and breasts of plastic surgery patients from 2D images and 3D scans. The 3D reconstruction of an object is a challenging problem with many inherent ambiguities. Statistical model based methods are a powerful approach to overcome some of these ambiguities. We follow the intuition of maximizing the use of available prior information by introducing it into statistical model based methods to enhance their properties.
First, we explore Active Shape Models (ASM) which are a well known method to perform 2D shapes alignment. However, it is challenging to maintain prior information (e.g. small set of given landmarks) unchanged once the statistical model constraints are applied. We propose a new weighted regularized projection into the parameter space which allows us to obtain shapes that at the same time fulfill the imposed shape constraints and are plausible according to the statistical model.
Second, we extend this methodology to be applied to 3D Morphable Models (3DMM), which are a widespread method to perform 3D reconstruction. However, existing methods present some limitations. Some of them are based in non-linear optimizations computationally expensive that can get stuck in local minima. Another limitation is that not all the methods provide enough resolution to represent accurately the anatomy details needed for this application. Given the medical use of the application, the accuracy and robustness of the method, are important factors to take into consideration. We show how 3DMM initialization and 3DMM fitting can be improved using our weighted regularized projection.
Finally, we present a framework capable to reconstruct 3D shapes of plastic surgery patients from two possible inputs: 2D images and 3D scans. Our method is used in different stages of the 3D reconstruction pipeline: shape alignment; 3DMM initialization and 3DMM fitting. The developed methods have been integrated in the production environment of Crisalix, proving their validity.Aquesta tesi ha estat realitzada a Crisalix amb la col·laboració de la Universitat Pompeu Fabra sota el pla de Doctorats Industrials. Crisalix té com a objectiu la millora de la comunicació entre els professionals de la cirurgia plàstica i els pacients, proporcionant una solució a la pregunta que sorgeix més freqüentment durant el procés de planificació d'una operació quirúrgica ``Com em veuré després de la cirurgia?''. La solució proposada per Crisalix està basada en la tecnologia d'imatge 3D. Aquesta tecnologia genera la reconstrucció 3D de la zona del pacient operada, seguit de la possibilitat de crear múltiples simulacions obtenint la representació dels possibles resultats de la cirurgia. Aquesta tesi presenta un sistema capaç de reconstruir cares i pits de pacients de cirurgia plàstica a partir de fotos 2D i escanegis. La reconstrucció en 3D d'un objecte és un problema complicat degut a la presència d'ambigüitats. Els mètodes basats en models estadístics son adequats per mitigar-les. En aquest treball, hem seguit la intuïció de maximitzar l'ús d'informació prèvia, introduint-la al model estadístic per millorar les seves propietats. En primer lloc, explorem els Active Shape Models (ASM) que són un conegut mètode fet servir per alinear contorns d'objectes 2D. No obstant, un cop aplicades les correccions de forma del model estadístic, es difícil de mantenir informació de la que es disposava a priori (per exemple, un petit conjunt de punts donat) inalterada. Proposem una nova projecció ponderada amb un terme de regularització, que permet obtenir formes que compleixen les restriccions de forma imposades i alhora són plausibles en concordança amb el model estadístic. En segon lloc, ampliem la metodologia per aplicar-la als anomenats 3D Morphable Models (3DMM) que són un mètode extensivament utilitzat per fer reconstrucció 3D. No obstant, els mètodes de 3DMM existents presenten algunes limitacions. Alguns estan basats en optimitzacions no lineals, computacionalment costoses i que poden quedar atrapades en mínims locals. Una altra limitació, és que no tots el mètodes proporcionen la resolució adequada per representar amb precisió els detalls de l'anatomia. Donat l'ús mèdic de l'aplicació, la precisió i la robustesa són factors molt importants a tenir en compte. Mostrem com la inicialització i l'ajustament de 3DMM poden ser millorats fent servir la projecció ponderada amb regularització proposada. Finalment, es presenta un sistema capaç de reconstruir models 3D de pacients de cirurgia plàstica a partir de dos possibles tipus de dades: imatges 2D i escaneigs en 3D. El nostre mètode es fa servir en diverses etapes del procés de reconstrucció: alineament de formes en imatge, la inicialització i l'ajustament de 3DMM. Els mètodes desenvolupats han estat integrats a l'entorn de producció de Crisalix provant la seva validesa.
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Wong, Corrine Jui Yin. "Three and four dimensional computed tomographic angiography of free and pedicled flaps : investigating the vascular territories". Thesis, Queen Mary, University of London, 2013. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8387.
Testo completoAbstract (sommario):
In plastic surgery, flap reconstruction has been utilised to repair defects in every part of the body, in an effort to restore form and function to patients. The basis of every flap is its blood supply, therefore this series of studies investigates the vascular territory of named arteries, veins and even perforators, utilizing computer tomography (CT) and TeraRecon software. The latter two is technology which allows appreciation of vascular flow in 3D and 4D (dynamic studies), whereas previous studies of vascularity has only been static and in 2D. Vascular anatomy studies were performed using fresh cadavers. Perforator flaps on the anterior trunk studied were the internal mammary artery perforator (IMAP) flap, the transverse rectus abdominis musculocutaneous (TRAM) flap, the deep inferior epigastric artery perforator (DIEP) flap and the superficial inferior epigastric artery (SIEA) flap. Posterior trunk flaps included the posterior intercostal artery perforator flap, the lumbar artery perforator flap and the superior gluteal artery perforator (SGAP) flap. In the upper extremity, we studied the supraclavicular artery perforator flap. In the lower extremity, we studied the gracilis musculocutaneous flap. Trends and characteristics are noted in the vascular analyses, and four major principles drawn are discussed in the last chapter.
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Möller, Ernst Lodewicus. "Patient reported outcome measures (PROMs) in breast cancer patients after immediate breast reconstruction using the Breast-Q". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32865.
Testo completoAbstract (sommario):
Background Mastectomy is the mainstay of surgical treatment for women with breast cancer in South Africa. The increase in breast reconstruction after a mastectomy has prompted the need to evaluate patient reported outcome measures (PROMs) for this set of operative intervention. This study aimed to assess clinical and patient reported outcome measures in immediate breast reconstruction patients using the BREAST-Q and compare these with international cohorts. Methods A cross-sectional study was performed on all patients who underwent immediate breast reconstruction between January 2011 and December 2016. This consisted of a retrospective clinical record review of perioperative outcomes, and a quality of life analysis using the BREAST-Q Post-Reconstruction questionnaire. Outcome predictors were identified using Chi-square, Fisher exact, One-way ANOVA, Student t-tests and Kruskal Wallis analysis of variance. A random-effect single arm meta-analysis was performed to compare the BREASTQ scores with international cohorts. Results A total of 52 patients were included with a mean age of 43.2 (+/-9.5) years. Eighteen patients (34.6%) developed early complications; of these 8 (44.4%) were major. Thirty-one patients (59.6%) developed late complications; of these 18 (58.1%) were major. Fifteen patients (28.8%) had failed reconstruction. There was a significantly higher risk of failure following a total mastectomy (TM) (p=0.02), tissue expander reconstruction (TE) (p< 0.01) and stage 2 breast cancer (p=0.01). Patients who underwent nipple reconstruction and immediate-delayed reconstruction before 12 months, reported higher well-being and satisfaction scores. Compared to international cohorts our BREAST-Q scores were lower but fall within the 95% confidence interval for Sexual Well-Being and Satisfaction with Nipples and Care. Conclusion Immediate breast reconstruction poses a high risk of complications and reconstructive failure especially, with TM and TE. Our BREAST-Q scores are comparable to international studies and may be useful in guiding patient consent.
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Najjaar, Azzaam. "Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32930.
Testo completoAbstract (sommario):
Background Flexor tendon sheath ganglions (FTSG) comprise up to 15% of hand ganglions. The management is split between two schools of practice: percutaneous puncture or surgical excision. The literature is equivocal as to which holds true superiority in terms of recurrence rates. The cost of surgical excision is higher and the recovery is longer. In addition, surgery also brings with it the potential for surgical complications, both immediate and long term. Percutaneous puncture can be performed at the time of the initial consult and an immediate return to normal activity with no down-time for the patient. The aim of this study is to assess the recurrence rate after percutaneous puncture. We also describe our employed technique. Method The technique for percutaneous puncture involved the use of a 25-gauge needle for ganglion puncture, no sclerosant or corticosteroid was injected, and an immediate post-procedure mobilisation protocol was employed. Patients were identified from clinical records and were followed up at a minimum of six months to check for recurrence. Results Eighteen patients were included in the study, 12 females and 6 males. The majority of FTSG were found to occur in the middle finger. Two patients experienced a recurrence. Both were successfully treated with a repeat puncture. No patients experienced a complication. Conclusion In our study, we show a low recurrence rate obtained with percutaneous puncture of FTSG using a simple technique. No complications were noted in our cohort on follow-up. We, therefore, recommend employing it as a first line treatment in the management of FTSG.
22
Pillay, Kamlen. "The use of Acellular Dermal Matrices in the Management of Complex Traumatic Wounds in a Paediatric Population". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32976.
Testo completoAbstract (sommario):
Introduction Complex soft tissue injuries are common in children. Paediatric wounds associated with large soft tissue defects pose a surgical challenge. This often necessitates extensive reconstructive surgery and frequently requires the use of microvascular free flaps. Local, regional and free flap surgery in children poses several challenges related to donor site morbidity, flap failure and the long-term sequelae of repeated surgeries for flap modification in a growing child. The introduction of acellular dermal matrices (ADM's) in recent decades has dramatically influenced the management of complex soft tissue wounds. The dermis in skin represents the functional aspect of skin. ADM's represent dermal structures artificially, hence their incorporation into the wound should restore skin characteristics specifically pliability. Some authors believe that ADM's have improved prognosis and reduced morbidity in the treatment of open wounds. Combining the use of ADM's together with split-thickness skin grafting (SSG) is rapidly becoming an important method used to manage such complex wounds. In this study, we explore whether the use of this technique has been a beneficial addition to the traditional management armamentarium for complex injuries in the extremities and report the rate of complications experienced by our patients at our paediatric hospital in Cape Town. Objective This study reviewed the number of complications experienced with the use of ADM's in treating complex wounds on the extremities of children. It includes 54 children treated between the years 2011 and 2016 at a national paediatric hospital. Methodology A retrospective folder review of children treated at our hospital between the years 2011 and 2016 with extremity injuries was conducted. A total of 189 patient folders were reviewed. Children (n= 54) with complex wounds in their extremities who had received an ADM were included in this study. Both short and long-term complications were identified. The patient age range was six months - 12 years, while the mean patient follow-up period was 390 days. Results All patients treated with ADMs for traumatic extremity injuries during this period were included in the study, irrespective of age or co-morbidities. In 45 patients the ADM and SSG healed without any complication that is, not requiring revision surgery at 1 year follow up. Seven patients who did not receive postoperative splinting and occupational / physiotherapy displayed wound contractures, requiring further reconstructive surgery, 4 of which were also in the group who experienced complete ADM or graft loss below. Six patients experienced complete loss of the ADM due to infection, which led to graft failure, requiring revision surgery. Of the six patients that experienced complete loss of the ADM, five were not treated with NPWT dressings. Noteworthy, is that all 45 patients who healed without any complication were treated with NPWT dressings. Biopsies that were performed on 18 patients at 2 weeks post application of the ADM, showed only granulation tissue. No evidence of residual ADM or accessory dermal structures was found in any of the samples, which were obtained from multiple loci of the ADM in situ. The mean time to closure with this method was 3 weeks and the mean hospital stay was 26 days. Two patients were lost to follow-up and were excluded from the morbidity analysis arm of the study. Discussion We found that post-operative physiotherapy, occupational therapy and splinting are extremely important in preventing morbidity in particular scar contracture when associated with wounds treated with ADMs. There was no histological evidence to suggest that the ADM remains intact after 2 weeks post application. Our data reveals that vacuum assisted closure is a vital adjunct to this method, ensuring adequate ADM and graft take. Conclusion Complex wounds in the extremities of children pose a reconstructive dilemma to the plastic surgeon. In anatomically sensitive areas where traditional plastic surgery options are unavailable or undesirable, the use of ADMs and SSGs represent a realistic alternative for the reconstruction of large wounds associated with complex soft tissue injuries in the extremities of children.
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Hayes, Philip Michael. "Ethnic-specific associations between abdominal and gluteal fat distribution and the metabolic complications of obesity : implications for the use of liposuction". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/12235.
Testo completoAbstract (sommario):
Includes bibliographical references.More than three-quarters (77%) of the 40.5 million people living in South Africa are black African, of which more than 40% are urbanised. Black African women living in urban areas have a significantly higher prevalence (62%) of overweight than urban black males (28%) or white females (53%). It was previously thought that obesity in black South African women was not associated with deleterious metabolic sequelae and was termed "healthy" obesity...
24
Potgieter, Dawid Jacobus. "Experience with the Meek micrografting technique in major burns". Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20522.
Testo completoAbstract (sommario):
Background. Early excision of burn eschar and urgent skin cover is mandatory for survival in all major burns. The tremendous cost and time delay in cultured skin and the shortage of donor allograft can make early skin cover a life threatening problem for paediatric patients in this country. The Meek micrografting technique was introduced in 2003 as a rescue method to achieve epithelialisation in major burns. Objective. To evaluate its role in the management of major burns with reference to its efficacy, technical detail and role in major burn surgery.
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Dos, Passos Gary. "Microvascular free tissue transfer for the head and neck reconstructive in a resource-limited setting". Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22754.
Testo completoAbstract (sommario):
Background: Free tissue transfer has become the standard of care for the reconstruction of head and neck oncological defects. The Groote Schuur Hospital provides a microsurgical reconstructive service in a resource-limited setting, without access to venous couplers, invasive monitoring devices, modern microscopes or sophisticated pre-operative imaging. The reconstructive surgeons perform all anastomoses under x4.5 loupe magnification. Methods: A retrospective chart review was undertaken of cases performed by the service over a 3-year period. Demographic factors, indications for flap cover, operative details (flap used, duration and lowest recorded temperature), intensive care and hospital length of stay, and other outcomes were recorded and evaluated (including flap and systemic complications, donor site morbidity, haematomas as well as returns to theatre). Results: Over a 36-month period, 109 flaps for head and neck reconstruction were performed. The main indication for surgery was squamous cell carcinoma of the oral cavity. The mean operating time for resection and reconstruction was 6.02 h (range of 4 to 12 h). Virtually, all reconstructions were performed using one of either radial forearm, free fibula or anterolateral thigh flaps. We report a complete flap loss rate of 6 %. All four successful salvages were undertaken in the early (less than 24 h) post-operative period. Hypothermia intra-operatively appears to correlate very closely with pejorative outcomes. Conclusions: By restricting reconstructive options to three main 'workhorse' flaps and by utilising a simultaneous two-team approach for tumour ablation and flap elevation, success rates comparable to international standards have been achieved. Limited resources should not be regarded as an impassable barrier to providing a successful microvascular head and neck reconstructive service.
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van, Niekerk Gertruida. "Scalp as a donor site in children: Is it really the best option?" Master's thesis, Faculty of Health Sciences, 2017. http://hdl.handle.net/11427/30983.
Testo completoAbstract (sommario):
Introduction
Humans have several different types of hair, classified into eight different groups, of which types VII and VIII predominate in South Africa. The scalp with its abundance of hair is often used as a preferential donor site for small burns. Major reasons cited are that the donor site is hidden from view (covered by hair), rapidly epithelializes with minimal scarring and provides a relatively large surface area. The author postulates that the type of hair will have an influence on the healing of scalp donor sites, complications and aesthetic outcome. Contrary to international consensus, the Red Cross War Memorial Children’s Hospital (RCWMCH) experience indicated that the use of the scalp as donor area is not ideal due to the frequent complications seen amongst paediatric patients e.g. visible scars, recurrent folliculitis, patchy alopecia, hypertrophic scarring and areas of de- and hyperpigmentation.
Objective
This study reviewed the complications encountered with the use of the scalp as primary donor area in children of mostly black African origin (type VI-VIII hair).
Methodology
A retrospective folder review of patients admitted to RCWMCH between 2003 and 2015 with major burns (>30% total body surface area) was conducted. A total of 179 patient folders were reviewed. Only children (n=25) with unburned scalp donor areas were included in this study. Both short- long-term complications were identified. The patient age range was six months - 12 years, while the mean patient follow-up period was 580 days and mean burn TBSA was 44.92% (range 4 – 85%).
Results
Patient demographics: black African 60% descent (hair types VI-VIII), 32% mixed race (hair types III-V) and 4% Caucasian (hair types II-III). In the group of black African children 60% had short-term and 46.7% long-term complications, whereas in the mixed race children 37.5% had short-term and 25% long-term complications. No complications were encountered in the Caucasian group. Eleven (48%) of patients in total had short-term complications (88.9% folliculitis, 22.2% delayed healing) and seven (28%) had long-term complications (57,1% non-healing wounds, 42.8% recurrent folliculitis, 57.1% alopecia, 42.9% depigmented scars, 28.6% visible scars, 28.6% hypertrophic scars). The first procurement in 11 children resulted in a 91% complication rate (54.5% short-term and 36.4% long-term). Ten children had two procurements resulting in an 80% complication rate (40% short-term and 40% long-term complications). In four children with three scalp procurements an acute 25% complication rate, with no subsequent long-term complications, was encountered.
Discussion
Hair type has an influence on outcome and donor sites should be carefully selected. Hair types VI-VIII has a higher propensity for complications and these usually follow the first procurement procedure. Complications did not increase with multiple procurements. Significant complications with long-term sequelae are not uncommon when the scalp is used as donor site and these complications are difficult to treat. Although the sample size is small, it does reflect a significant complication rate.
Conclusion
Contrary to international consensus, the use of the scalp as donor site in South African children with hair types VI-VIII with large burns should not be the preferential site and should only be used as a last resort.
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Xoagus, Elizabeth Alexia. "Autologus fat grafting for mild to moderate velopharyngeal insufficiency: Our experience". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29724.
Testo completoAbstract (sommario):
The standard surgical treatment of velopharyngeal insufficiency (VPI) includes revision palatoplasty, posterior pharyngeal flap and sphincter pharyngoplasty. These procedures are not without complication and can also be challenging to the occasional cleft surgeon. The greatest complication is iatrogenic obstructive sleep apnoea particularly in high risk patients. With the introduction of posterior pharyngeal wall augmentation, a lesser and simpler surgical procedure, various materials have been used for this purpose with limited success and significant complication rates. Augmentation of the velo-pharynx with autologous fat has been practiced for decades. Autologous fat has multiple advantages compared to other biological and synthetic materials used for augmentation of the velopharynx. Autologous fat is readily available, has low donor site morbidity, does not migrate, injects easily and is non-allergenic. The outcome of fat grafting for VPI is good and stable long term, albeit unpredictable due to the resorption of fat. The procedure may therefore need to be repeated in order to achieve the desired results. The aim of this study is to evaluate and document the outcome of autologous fat grating for the treatment of mild to moderate VPI in children at the Red Cross War Memorial Children's Hospital (RCWMCH). A retrospective folder review was conducted on 9 consecutive patients who underwent velopharygeal fat grating for the treatment of mild to moderate VPI at the RCWMCH from 2010 to 2014. All the patients had had primary palatoplasty performed previously and subsequently developed VPI. Patients were assessed pre- and postoperatively by two cleft surgeons, and an experienced speech and language therapist with the aid of laterl view videofluoroscopy (VF). Pre-operative and post-operative perceptual speech assessments were performed by a dedicated speech and language therapist. Two senior cleft surgeons performed pre-and post-operative videofluoroscopy interpretations. Eleven fat grafting procedures were performed on 9 patients and an average of 5.64 ml (range 1 ml to 7 ml) of autologous fat was transferred to the velopharynx. The average age at the time of operation was 6.5 years (range 3 years to 14 years) with a follow-up period of 18 months (range 7 months to 34 months). Most of the patients (7 out of 9) showed improved speech following fat grafting. There were no complications related to the fat grafting procedure. This small study suggests that fat grafting is an effective, minimally invasive surgical alternative for the treatment of mild to moderate VPI and to our knowledge, is the first reported study from Africa.
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Moodley, Sean Thirumalay. "The role of propranolol in the treatment of infantile haemangioma". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/13923.
Testo completoAbstract (sommario):
There has been a change in the management of infantile haemangioma with the introduction of propranolol. The aim of this study is to retrospectively evaluate a simple treatment for infantile haemangioma at the Red Cross War Memorial Children’s Hospital (RCWMCH) and document the results. While it is known that all haemangiomas undergo involution at some stage, some haemangiomas pose certain problems. These relate mainly to visual axis obstruction and aesthetics. Subjects are children in the first two years of life presenting with haemangiomas. All patients were treated with oral propranolol in conjunction with haemangioma size documentation, using a simple radiological modality, i.e. ultrasound imaging. Patients are followed up and clinical and radiological evaluations are undertaken to observe changes in size and appearance. Propranolol is non-selective β-adrenergic antagonist that is used extensively for the treatment of a multitude of disorders, mainly cardiovascular indications. The main adverse effects include bradycardia, hypotension and bronchospasms. For the purposes of this study, all subjects were routinely examined, especially with regard to the cardiopulmonary systems. Any perceived anomaly was referred to the cardiorespiratory physicians at RCWMCH for further evaluation, which includes all the necessary investigations such as electrocardiograms(ECG) and echocardiograms. Therefore, only fit healthy patients were selected for this study. Patients are educated and fully informed regarding the adverse effect profile of propranolol, and advised of the appropriate route of management.
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Lelala, Ngoato Bruce. "Anthropometric Changes in a Prospective Study of 100 Patents Requesting Breast Reduction". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32773.
Testo completoAbstract (sommario):
Background The anthropomometry of the “ideal” breast is well described, but changes that occur with enlarged breasts are not. The aim of this study was to assess the prevalence of nipple asymmetry in the horizontal plane and changes in the inframammary fold (IMF) in patients presenting with macromastia (defined as excessive development of the mammary gland by Merriam-Webster dictionary). Methods One hundred patients (200 breasts) presenting to the Plastic Surgery Clinic for bilateral breast reduction were enrolled in this study. Patient's characteristics captured for this study included age, body mass index (BMI), and breast anthropometric measurements, such as suprasternal notch to nipple, nipple to IMF, IMF projected to cubital fossa, midhumeral point, and nipple measurement from meridian. Basic univariate statistical analysis were performed to evaluate the impact of nipple asymmetry. Results The average age was 37 years (SD 12 years), and the median BMI was 33 (IQR 28-37). More patients presented with nipple asymmetry, of whom 45% were classified as lateral to meridian, 19% were classified as medial to the meridian, and 36% were classified as central to the meridian. Patients with lateral asymmetry and medial asymmetry has a significantly higher BMI (median BMI 35) compared with patients with central positioning (median 30). Increasing breast size was positively associated with nipple asymmetry, whereas BMI (R = - 0.30, P =0.003) and macromastia correlated negatively with IMF position (R= - 0.38), P= 0.0001). Conclusion In macromastia, nipple displacement from breast meridian, especially lateral displacement, is common and is aggravated by an increase in BMI. The IMF also descends, and this is also common in patients with a raised BMI. These changes have clinical implications.
30
Chan, Hin-lee Henry. "The use of laser and light source for skin rejuvenation in Asians". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B4129080X.
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Wessels, William Louis Fick. "Reconstruction of the lower eye lid with a rotation-advancement tarso-conjunctival cheek flap". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5441.
Testo completoAbstract (sommario):
Thesis (MMed (Surgical Sciences. Plastic and Reconstructive Surgery))--University of Stellenbosch, 2010.The repair of full-thickness defects of the lower eyelids poses a challenge because a graft in combination with a flap is typically used to replace either the posterior or anterior lamella. This often results in aesthetically and functional unsatisfactory outcomes. A rotation-advancement tarso-conjunctival cheek flap, which reconstructs both posterior and anterior lamella with vascularized tissue similar to the native eyelid, is described. Nine patients underwent reconstruction with a rotation-advancement tarso-conjunctival cheek flap. The indications, complications and outcomes were evaluated. The follow-up time ranged from 6 to 60 months with an average of twenty three months. The main indication for use of this flap is full-thickness defects of the lower eyelid between 25 – 75 %, typically after tumour ablation. All the patients had a functional and aesthetically satisfactory outcome. One patient underwent a revision canthoplasty. The rotation-advancement tarso-conjunctival cheek flap adheres to basic plastic surgery principles resulting in a satisfactory outcome; (a) Vascularized tissue is used to reconstruct the defect. (b)The flap composition is similar to the native eyelid i.e. replace like with like. (c) The flap makes use of tissue that is excess and therefore limits donor morbidity.
32
Martin, Paula Joan. "Suzanne Noël : beauty, feminism, and cosmetic surgery in early twentieth century France /". abstract and full text PDF (free order & download UNR users only), 2007. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3279639.
Testo completoAbstract (sommario):
Thesis (Ph. D.)--University of Nevada, Reno, 2007."May 2007." Includes bibliographical references (leaves 246-259). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2007]. 1 microfilm reel ; 35 mm.
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D'Urso, Paul Steven. "Stereolithographic biomodelling in surgery /". [St. Lucia, Qld.], 1998. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17881.pdf.
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Klassen, Anne Frances. "Outcome assessment in plastic surgery : a study of patients' health related quality of life before and after cosmetic surgery". Thesis, University of Oxford, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.360423.
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Huss, Fredrik. "In vitro and in vivo studies of tissue engineering in reconstructive plastic surgery /". Linköping : Univ, 2005. http://www.bibl.liu.se/liupubl/disp/disp2005/med905s.pdf.
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Zaman, Tina. "Optical sensors for the in vivo assessment of flap perfusion in plastic surgery". Thesis, City University London, 2013. http://openaccess.city.ac.uk/3482/.
Testo completoAbstract (sommario):
Following mastectomy for breast cancer a wide variety of surgical techniques are currently available for post mastectomy breast reconstruction where autologous tissue is used to construct a natural looking breast. One of the most common types of reconstructive surgeries use Deep Inferior Epigastric Perforator (DIEP) free flap where skin and adipose tissue along with their blood supplies are transferred from the lower abdomen to the chest. The success of free flap reconstructive surgery depends strongly on the maintenance of adequate perfusion in the flap. Early diagnosis of ischaemia and surgical exploration to restore blood flow can often salvage the flap and may prevent graft failure. Even though many techniques have been used, there is still a need to develop a non-invasive, easy to use, reproducible and inexpensive monitoring device to assess flap perfusion. In an attempt to overcome the limitations of the current flap perfusion monitoring techniques a prototype reflectance three wavelength photoplethysmographic (PPG) sensor was developed. The PPG sensor consisted of two infrared (940 nm), two green (520 nm) and two red (660 nm) LEDs and a photodiode. A PPG processing system was also constructed in order to drive the optical components on the sensor and to detect and pre-process the PPG signals. A Virtual Instrument (VI) was also implemented in LabVIEW in order to display, analyse and archive the PPG signals with the capability of real-time estimation of arterial oxygen saturation (SpO2) values. The system was evaluated in a pilot study on fifteen patients undergoing breast reconstructive surgery using (DIEP) flaps. Good quality red, infrared and green PPG signals were obtained pre-operatively from the donor site (abdomen), intra-operatively (capturing reperfusion of flap following anastomosis) and post-operatively at regular intervals for up to 12 hours post surgery. SpO2 values were also estimated which were found to be in broad agreement with SpO2 values recorded from the commercial pulse oximeter attached to the patients’ finger. The flap PPGs were compared with PPGs and SpO2s acquired from the finger of a small number of patients using a custom made reflectance finger PPG probe, optically and electrically, identical as the flap probe. The finger PPGs were found to be much larger than the flap PPGs which confirms the hypothesis of inadequate perfusion in the flap during and after the operative period. Furthermore the custom made PPG processing system and flap sensor were used successfully on a series of case studies to evaluate the versatility of the system in monitoring PPG signals and estimating blood oxygen saturation in other flaps. These included monitoring two patients undergoing Latissimus Dorsi (pedicle) flap reconstructive surgery and a head and neck free flap surgery where a Vertical Rectus Abdominis Myocutaneous (VRAM) flap was used following total petrosectomy. Also, two patients undergoing reconstructive surgery of the oesophagus using jejunum free flaps were also recruited into the study. For this study a purpose build oesophageal PPG sensor was developed. These case studies demonstrated the ability to use the developed PPG sensors to acquire PPG signals and estimate SpO2s in a variety of flaps. The results have confirmed that the custom made PPG system and sensor has the potential to be used as an alternative technique for monitoring perfusion in various types of flaps at all operative periods.
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Seyidaliyeva, Aida [Verfasser], e Wael [Akademischer Betreuer] Att. "Esthetic guideliness in dentistry and interdisciplinary work with plastic surgery: a systematic review". Freiburg : Universität, 2018. http://d-nb.info/1171261713/34.
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Raith, Stefan [Verfasser]. "Applications of computational biomechanics in reconstructive cranio-maxillofacial and plastic surgery / Stefan Raith". Aachen : Hochschulbibliothek der Rheinisch-Westfälischen Technischen Hochschule Aachen, 2015. http://d-nb.info/1073185680/34.
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Farnebo, Simon. "On microvascular blood flow assessment with the new microdialysis urea clearance technique". Doctoral thesis, Linköpings universitet, Hand och plastikkirurgi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-63116.
Testo completoAbstract (sommario):
The aim of this thesis was to develop and evaluate a new way of monitoring blood flow with microdialysis. A thin catheter consisting of a semipermeable membrane is implanted in the tissue being studied. The catheter is perfused by a solution that closely resembles interstitial fluid, and small water-soluble substances are allowed to diffuse passively through the pores of the membrane with the aim at reaching equilibrium with the surrounding tissue. The minimally invasive character of microdialysis, and its ability to sample from the organ being studied, make microdialysis attractive in most research settings as well as for clinical surveillance. It has, however, become increasingly evident that microdialysis under conditions of non-equilibrium - for example, fluctuating regional blood flow, will alter the results gained. We have therefore aimed to explore the possibilities of developing a new marker of blood flow that will yield information about changes in blood flow that occur in the area of the microdialysis catheter itself. We hypothesised that the changes in the diffusion of exogenous urea could be used as markers of changes in tissue blood flow. The theoretical basis for this approach is that the mass transfer of urea will increase across the dialysis membrane secondary to increased blood flow. As removal of urea from the vicinity of the dialysis membrane increases with increased blood flow, the concentration gradient of urea between the perfusate and tissue will also increase. This in turn will result in a greater loss of urea from the perfusate. The changes noted in retrieval of urea from dialysate by the system are therefore thought to be inversely related to changes in blood flow. We tested our hypothesis in two species of animal (rat and pig) and in man, and in three organ systems (muscle, liver, and skin), and present four papers that indicate that the urea clearance technique provides reliable and reproducible results. The technique was evaluated against conventional metabolic markers (lactate and glucose), the ethanol clearance technique (microdialysis), laser Doppler perfusion imaging (LDPI), and polarisation light spectroscopy (TiVi). We present evidence that the urea clearance technique can be used to assess blood flow in the organs studied reliably and reproducibly with microdialysis. The microdialysis technique is minimally invasive and safe for the recipient, and catheters can easily be implanted during operation to monitor organs at risk. Urea is easily analysed as a standard assay among other “basic” metabolic markers (in a standard microdialysis kit) and has favourable characteristics with a standardised measurement system that is routinely used for monitoring metabolites in the clinic. The technique is also effective when used at lower perfusate flow rates (<1 μl/minute), which is advantageous as the recovery of metabolic markers increases at low perfusate flow rates.
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Rickard, Rory Frederick. "Arterial microanastomosis with size mismatch : a trial of two techniques". Doctoral thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/12777.
Testo completoAbstract (sommario):
Includes bibliographical references.Use of perforators as recipient vessels in microvascular reconstruction has led to arterial diameter discrepancy becoming an increasingly common finding. Experimental and clinical evidence confirms that patency rates decrease with increasing diameter mismatch, but no good evidence is available to direct the choice of end-to-end microanastomotic technique where a small-to-large discrepancy exists. A programme of research has been conducted comparing two techniques of endto-end arterial microanastomoses, where a small-to-large diameter discrepancy exists of between 1:1.5 and 1:2.5. These techniques are; 45º oblique section of the smaller vessel, and; invaginating the smaller vessel inside the larger.
41
Kairinos, Nicolas. "The biomechanics of negative-pressure wound therapy". Doctoral thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/10809.
Testo completoAbstract (sommario):
Includes references.Despite the success of negative-pressure wound therapy, its mechanism of action remains unclear. The common perception that it reduces tissue pressure and increases perfusion has recently been challenged following the observation that tissue necrosis can be caused as a result of its application. A programme of research has been conducted to clarify how tissue pressure changes during negative-pressure wound therapy and the resultant effect thereof on perfusion. The cause for conflicting evidence from other studies was also investigated.
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Hendricks, Mogamat Rushdi. "Evaluation of the clinical outcome of curvilinear transport distraction osteogenesis and revascularised fibula free flaps in the reconstruction of large post-maxillectomy defects". Doctoral thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25290.
Testo completoAbstract (sommario):
Background: Maxillary defects caused by trauma or tumour resection in the head and neck region can be devastating to the patient from a cosmetic and functional perspective. Patients who undergo maxillectomy procedures experience a substantial deterioration in their primary oral functions such as breathing, mastication, salivation, deglutition and phonation, which has a collective adverse influence on their quality of life (QOL). The revascularised free fibula flap (RFFF) has been demonstrated to be most reliable for the reconstruction of maxillary defects, and has been regarded as the 'gold standard.' A novel method of regenerating bone and soft tissue through the process of curvilinear transport distraction oseteogenesis (CTDO) has been developed and compared with the RFFF technique. Method: A prospective cohort study of 6 post-maxillectomy patients was compared regarding the clinical outcome of function and aesthetics with a group of 6 patients who had undergone RFFF reconstruction. The new bone (regenerate) was compared with the parent bone from which it had been generated. Objective measuring tools were employed to assess pre and post quality of life (QOL) aspects. The RFFF patients were not subjected to any invasive procedures save to undergo a clinical evaluation and undergo a CT scan of their maxillae. A cohort of 6 participants was treated prospectively using CTDO and the results were analysed within that cohort. These results were compared with a retrospective group of 6 participants of similar age and gender distribution who had undergone RFFF reconstruction as an external control. The patented Hendricks-Vicatos (H-V) maxillary transport distractor was applied to all selected participants by the primary investigator under general anaesthesia at Groote Schuur Hospital or a private clinic. The H-V maxillary transport distractor (5 prototypes) was pre-shaped and pre-fitted onto a 3-D model of the participant's maxilla, in a laboratory. This method reduced clinical installation time. If teeth were present in the area to be distracted, then at least 2 teeth were removed from the maxilla, preferably three months before the date of distraction. In the first few cases, this was the protocol for developing bone stock. This protocol was revised in the last 2 patients of the study, where no teeth were extracted at all. A linear fracture (bi-cortical) was created in the maxilla in a vertical direction (segmentally) to develop a mobile, well-vascularised transport disc. This carrier disc was attached to the metal plate of the 'crawler' via small titanium screws. The crawler was then moved on the reconstruction plate (BiometTM Zimmer Biomet,
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Agha, Riaz Ahmed. "Developing evidence-based plastic surgery : the role of research registration, protocols and reporting quality". Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:e09e93bd-6856-4108-8e4b-9bb48fb52bc2.
Testo completoAbstract (sommario):
BACKGROUND: Evidence-based medicine has had a profound impact on healthcare. In the field of Plastic surgery, powerful examples include; less radical skin cancer excision margins and skin-sparing or even nipple-sparing mastectomies and microsurgical reconstruction. Sustained progression of the field, relies on the development of a high-quality evidence base, with strong use of peer-reviewed research protocols, which are publicly registered and completed studies transparently reported. The extent of compliance with these principles is currently unknown and the author hypothesised that it would be low. The author further hypothesised that registration could be improved by the development of a new global research registry and reporting quality can be improved by the mandatory implementation of reporting guidelines in a journal. METHODS: This thesis incorporated 11 studies. The first two studies used a literature review to determine; the levels of evidence, rates of study registration and protocol publication in the recent Plastic Surgery literature. Thirdly, the design, build and launch of a new global research registry to boost compliance with registration and to determine barriers to it using a survey amongst users. This would be followed by systematic reviews to determine compliance with the STROBE and PRISMA guidelines respectively. An analysis of each guide for authors (GFA) of the surgical journals listed in the Thomson Reuters journal citation report for surgery to determine support for reporting guidelines. The impact of the mandatory implementation of reporting guidelines in a surgical journal would be assessed using a before and after design. Finally, to develop a reporting guideline for surgical case reports (SCARE) and surgical case series (PROCESS) using a DELPHI consensus exercise amongst an expert panel. RESULTS: Protocols were registered in 4% of 595 recent research studies and 0.5% were published. There was a mean compliance of 12/22 for the STROBE guideline (n=94) and 16/27 for the PRISMA guideline (n=79). The Research Registry® was launched in February 2015. Analysis of the first 500 previously unregistered studies, showed they came from 57 countries and included 1.77 million patients. Key barriers to registration were a lack of awareness of the need to register and lack of time (n=149). In addition, 45% registered their study at the time of journal submission. The GFA analysis showed 62% didnât mention reporting guidelines at all (n=193). Subsequent mandatory implementation in a single surgical journal, increased compliance with STROBE by 12% (n=152), with CONSORT by 40% (n=13) and with PRISMA by 58% (n=28). The SCARE and PROCESS reporting guidelines were developed and published in late 2016. According to Google Scholar, they have accumulated over 200 citations at the time of writing. CONCLUSION: Study registration, protocol use and reporting quality are poor in plastic surgery. Potential solutions to these long-standing problems have been developed and explored within this thesis. These include the development and use of the Research Registry® and the mandatory implementation of reporting guidelines, with both measures front-loaded within a gatekeeper framework for journals. It is now for Plastic Surgeons and the wider surgical community to pick up the gauntlet and drive forward high-quality research, evidence-based surgical practice and better outcomes for their patients and society at large.
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Wildner, Corinna Maria. "Body Modification and the Construction of Gender: Plastic Surgery and the Regulation of Femininity". Thesis, The University of Arizona, 2011. http://hdl.handle.net/10150/145098.
Testo completo
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Fredriksson, Camilla. "Keratinocytes in tissue engineering of human skin: invitro and in vivo studies". Licentiate thesis, Linköping University, Linköping University, Plastic Surgery, Hand Surgery and Burns, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-21283.
Testo completoAbstract (sommario):
Full thickness wounds, such as deep burns, need restoration of both the dermal and epidermal layers of the skin. In normal wound healing, re-epithelialization occurs by migration and proliferation of keratinocytes from the wound edges and by differentiation of stem cells from remaining hair follicles. Restoration of dermis occurs by influx of growth factors secreted by macrophages, platelets, and fibroblasts; by fibroblast proliferation and subsequent synthesis and remodeling of collagenous dermal matrix. In the case of full-thickness acute burn injuries and chronic wounds (e.g. pressure ulcers, venous ulcers and diabetic foot ulcers), these processes are defective. With the principles of tissue engineering in mind (to correct, improve and maintain tissues and their functions), researchers have developed promising materials and methods to make it possible to restore either the dermal (Integra® DRT, Alloderm®) or the epidermal layer (split thickness skin grafts (STSG), cultured epithelial autografts (CEA), autologous keratinocytes in single cell suspension). It is now well established that superior results are obtained if both dermal and epidermal components are combined, for example in a bilayered skin equivalent. Apligraf® is recommended for use on venous ulcers and is the only bilayered living skin equivalent currently approved by the FDA. Studies on different factors affecting the wound healing capacity as well as techniques in use provide valuable information for further development.
In this licentiate thesis, we evaluated different transplantation techniques for delivering cultured human keratinocytes in single cell suspension, a measure becoming more frequently used in addition to STSG and CEA for restoring the epidermal layer of the skin. We found that the pressure device, commonly used to spray cell suspension onto the wound with pressures as high as 200 kPa, killed around 0% of the cells. In comparison, an ordinary syringe with the attachment of a spray nozzle showed almost 90% viable cells post transplantation and provided an equally good distribution of the cell suspension.
We also studied different silver containing dressings regarding silver accumulation in human skin. In addition, we graded the re-epithelialization to evaluate whether the dressings caused any delay in the wound healing process. We found that the silver dressings tested, with few exceptions, caused dermal accumulation of silver, primarily aggregated around blood vessels. We could also show that most of the dressings had negative effect on the re-epithelialization.
For the restoration of the dermal layer of the skin, Integra® DRT functions as a scaffold for guided tissue regeneration of the dermis. We had the possibility to study a case of necrotizing fasciitis were the treatment consisted of the use of Integra® DTR together with sub-atmospheric pressure (after initial surgical debridement) and later transplantation of split thickness skin grafts. This measure proved to be safe as well as giving satisfactory pliable and aesthetically acceptable result.
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Vesely, Martin Jacob John. "The role of haem oxygenase-1 in the prevention of ischaemia-reperfusion injury in skeletal muscle". Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312595.
Testo completo
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Sperry, Steffanie. "Reality Cosmetic Surgery Makeovers: Potential Psychological and Behavioral Correlates". [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002122.
Testo completo
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Touarti, Christina M. "Representations of cosmetic surgery in women's magazines". [Kent, Ohio] : Kent State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1185417036.
Testo completo
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Kokorev, A. E., A. O. Kiriak e О. Г. Аврунін. "Some Models of Mechanical and Thermal Properties of Skin in the Context of Plastic Surgery". Thesis, Kharkiv, KNURE, 2019. http://openarchive.nure.ua/handle/document/10196.
Testo completo
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Al-Kasadi, Mohammed Saleh Salim. "Modeling the propagation of the consumption of two emergent businesses: Fitness Practice and Plastic Surgery". Doctoral thesis, Universitat Politècnica de València, 2014. http://hdl.handle.net/10251/39795.
Testo completoAbstract (sommario):
In recent years there has emerged a new trend focused on the body image in the Western countries. Our society is concerned with people's physical appearance and ideal body image. As consequence of this trend, two businesses emerge: fitness centers and plastic surgery clinics.
Traditionally the consumers' expenditure in these services and goods has been considered a luxury especially during the economic slowdown. However, in the recent times, (at end of 2000s both service sectors are showing an increasing trend in terms of activity and business size). Thus, customers have seen the practice of fitness and plastic surgery procedures as a necessity rather than a luxury.
The two kinds of products considered: fitness practice and plastic surgery procedures are of different nature; however they share several commonalities from the analysis point of view.
In particular, referred to the fitness practice business, this involves a parallel increase of related economic sectors such as sports clothing, energy drinks and sports equipment. Related to the Spanish population who exercise regularly, this has evolved from 27% in 2005 to 35% in 2010, which shows a significant increase of the population sportive practices. A significant example of this trend is the fact that in 2009 the 74% of the Spanish public gyms had a fitness room for bodybuilding.
On contrast, related to the market of plastic surgery measured by volume of activity, Spain occupies the level 13th position of the international ranking, which is headed by USA.
The plastic surgery market embraces low invasive (non surgical) and high invasive (surgical) plastic surgery procedures; between both types, more than 300,000 thousands procedures are performed annually mainly by women in Spain.Al-Kasadi, MSS. (2014). Modeling the propagation of the consumption of two emergent businesses: Fitness Practice and Plastic Surgery [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/39795
TESIS