Marc Busche - Academia.edu (original) (raw)
Papers by Marc Busche
Der Unfallchirurg
BACKGROUND Needlestick injuries (NSI) are potentially infectious injuries from sharp or pointed m... more BACKGROUND Needlestick injuries (NSI) are potentially infectious injuries from sharp or pointed medical instruments and through contact with blood on mucous membranes or nonintact skin. Although the European Union (EU) Council directive 2010/32/EU on the prevention of NSI was implemented in EU countries in 2013, information on the effectiveness of the measures is limited. OBJECTIVE The aim of this study was to evaluate the effectiveness of a safety concept according to the EU Council Directive 2010/32/EU on prevention of NSI. MATERIAL AND METHODS In 2016 the NSI safety concept at a large regional hospital was improved according to 2010/32/EU, specifically by an update of blood screening profiles and standard operating procedures (SOP), better dissemination of information to employees and complete conversion to safety cannulas and scalpels. The medical records of all NSIs from 2015-2017 were retrospectively anonymized and evaluated and a cost analysis was performed. RESULTS The number of NSIs in 2017 was significantly reduced by 48.4% as compared to 2016 and NSIs with scalpels were completely prevented. The proportion of employees with NSIs who were adequately immunized against hepatitis B was significantly increased to 84.1% in 2017. Furthermore, identification of the index patient was significantly increased to 82.5% in 2017. The cost of avoiding NSIs increased by a total of 24.1% in 2017 as compared to 2015 before introduction of the safety concept. CONCLUSION Implementation of the EU Council directive 2010/32/EU, resulted in an almost 50% reduction in NSIs over 1 year, including the complete prevention of NSIs due to scalpels. In addition, the anamnestic presence of immunization against hepatitis B and index patient identification were significantly increased.
Journal of Burn Care & Research
The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancou... more The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancouver Scar Scale" (VSS) on patients' quality of life and their correlation with objective scar assessment tools, such as the Cutometer®, is not fully elucidated. In addition, long-term results of the dermal substitute Matriderm® used in combination with split-thickness skin grafting (STSG) remain unclear. We evaluated burn scars of 45 patients at least 2 years postburn injury using the Cutometer® MPA 580, the VSS, and the POSAS with three additional questions regarding quality of life and correlated the results. Study groups were: 1) scars following conservative treatment, 2) scars following STSG, and 3) scars following STSG in combination with Matriderm®. Cutometer® measurements demonstrated better elastic qualities in the Matriderm® group compared with the STSG group. VSS and extended POSAS were rated best for the conservative group, followed by the STSG group and the Matriderm® group. There was a significant correlation between POSAS and VSS, quality of life and the objective Cutometer® measurements. Conservatively treated superficial dermal burns do not reach the elastic qualities of healthy skin, and the use of Matriderm® significantly improves the long-term elastic qualities of STSG in deep dermal and full-thickness burns 2 years post injury. Results from the VSS and the POSAS correlate with restrictions in the quality of life of patients and also with objective Cutometer® measurements and are therefore useful tools in scar evaluation following burn injury.
Annals of Plastic Surgery
Introduction In burn care, as in other medical fields, there is a tendency to increase the requir... more Introduction In burn care, as in other medical fields, there is a tendency to increase the required number of patients for center certifications. Does the increase in patient load automatically improve the quality of burn care? What are the benchmark parameters that have been shown to improve burn care? Methods To answer these questions, Medline, Cochrane Library, and Livivo were searched from inception through January 2018 for all studies evaluating the influence of treatment parameters on outcomes in different burn care settings. Results Fifteen studies were included in this systematic review. In adults, not a single study showed a decreased mortality due to a higher patient load. However, in children, 2 studies demonstrated a further decrease of the already low mortality due to an increase in patient load. In contrast to patient load, benchmark parameters that had a significant influence on the outcome of burn care for adults and children were: single bed isolation, residency programs, American Burn Association certifications of burn centers, speed of wound closure, and standard operating procedures for burn care. Conclusions This systematic review demonstrates that a clear correlation between patient load and mortality reduction in adult burn treatment is not supported by the existing literature, requiring future studies. In contrast, all efforts aiming to improve the quality of burn care, such as isolation of burn patients, speed of wound closure, American Burn Association verification and especially standard operating procedures for burn care improve survival and quality of burn care.
Journal of Reconstructive Microsurgery, 2015
We read with interest the article “Case Report of a Supraclavicular Artery Island Flap for Recons... more We read with interest the article “Case Report of a Supraclavicular Artery Island Flap for Reconstruction of a Nonhealing Cervical Spine Wound” by Razdan et al.1 In this article, the authors present a very interesting and novel application of the supraclavicular artery island flap, also known as supraclavicular island flap or supraclavicular artery perforator (SAP) flap for closure of posterior cervical spine defects.1 We appreciate the worldwide increasing interest in the SAP flap and congratulate the authors on the first published successful treatment of a posterior cervical spine defect with a SAP flap. In their article, the authors discuss the advantages of the SAP flap (thin skin paddle, short harvest time, preservation of regional muscle units, and good color match of the skin island) in comparison to other flaps traditionally used to cover posterior spine defects, such as paraspinous, latissimus dorsi, and trapezius flaps.1 In addition, the authors give an overview of the use of the SAP flap for reconstruction of head and neck defects in the literature, such as pharynx,2–4 parotid,2,3 and skin defects.4 While most citations in the article are correct, Razdan et al refer to a publication by Pallua et al from 2010, as a publication about the use of the SAP flap for esophagocutaneous fistulas.5 However, the authors are mistaken, since the article by Pallua et al from 2010 introduced the SAP flap as an option for closure of tracheocutaneous fistulas and not for esophagocutaneous fistulas.5 In this article, Pallua et al also proposed a defect classification and a treatment algorithm using the tunneled supraclavicular artery island flap for functional and esthetic reconstruction.5 Additionally, the reviewed literature regarding the SAP flap in the article by Razdan et al is missing an important publication by Pallua et al from 1997, describing the SAP flap for the first time: “The Fasciocutaneous Supraclavicular Artery Island Flap for Releasing Postburn Mentosternal Contractures.”6 Since Razdan et al discuss the use of the SAP flap not only for posterior spine defects but also for head and neck reconstruction, it could be of interest for the reader to mention the anterior supraclavicular artery perforator (a-SAP) flap, primarily described by Pallua et al in 2013 as a similar treatment option.7 The a-SAP flap is an improvement of the SAP flap, using a separate anterior supraclavicular pedicle, placing the skin island into the deltoideopectoral fossa.7 Compared with the SAP flap, the a-SAP flap is even thinner and has an even better color match to the face.7
Der Unfallchirurg
Scaphotrapeziotrapezoid (STT) arthrodesis has been proposed to stabilise the radial column and to... more Scaphotrapeziotrapezoid (STT) arthrodesis has been proposed to stabilise the radial column and to redirect the load away from the lunate. Midterm effects on force transmission are still unclear. Six patients who were treated with triscaphe arthrodesis were examined after an average of 5 years using CT osteoabsorptiometry of both wrists. STT arthrodesis had been performed in four cases with Kienböck's disease type IIIb and in two cases of scaphotrapeziotrapezoid arthritis. At all contralateral wrists peak mineralisations were found beyond the lunate fossa and in the scaphoid fossa of the distal radius. At the side with STT arthrodesis there was only one peak. In five cases this density maximum was beyond the scaphoid fossa and in one case half beyond the lunate and half beyond the scaphoid fossa. Triscaphe arthrodesis allows load transmission from the lunate to the radial column.
German medical science : GMS e-journal, Jan 8, 2010
Ischemic heart disease is the leading cause of death worldwide. The complement system plays a maj... more Ischemic heart disease is the leading cause of death worldwide. The complement system plays a major role in inflammation and tissue injury following myocardial ischemia and reperfusion (MI/R) injury. Systemic C5 inhibition in clinical studies has resulted in mixed results and the role of earlier complement components (e.g., C3a), upstream from C5 cleavage, has not been elucidated for MI/R injury. Therefore, we evaluated the role of C5 or C3a in a mouse model of MI/R injury. We performed experimental MI/R with 30 min of ischemia and 4 hr of reperfusion in 8-12 wk old C57BL/6 (WT) mice. Systemic C5 or C3a inhibition was performed with an anti-C5 monoclonal antibody (BB5.1) 30 min prior to reperfusion or with a C3a receptor antagonist (C3aRA). Since the C3aRA induces neutropenia that resolves within 120 min, we administered C3aRA at two different time points in two separate groups: 30 min prior to reperfusion within the neutropenic time frame and 120 min prior to reperfusion, when the ...
Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen, 2009
While use of biocomposite temporary dressings in burn wounds is common practice, the complex anat... more While use of biocomposite temporary dressings in burn wounds is common practice, the complex anatomic structures of the hand make this treatment option challenging. For this reason, the Biobrane ((R)) Glove (Smith&Nephew) has been developed. However, limited information regarding burn treatment with Biobrane ((R)) Gloves can be found in the literature. Functional and cosmetic outcomes of 13 second degree burn wounds of the hand in 10 patients treated with Biobrane ((R)) Gloves were evaluated using the Vancouver scar scale (VSS) and the DASH-score (disabilities of the arm, shoulder and hand). We evaluated wound healing times and questioned patients about pain related to Biobrane ((R)) Glove treatment in comparison to conventionally managed second degree burn wounds in other parts of the body and about acceptance of Biobrane ((R)) Glove treatment. In addition, we estimated the costs for use and wound management time for both Biobrane ((R)) Glove treatment and conventional wound manage...
Interactive cardiovascular and thoracic surgery, 2009
Current problems in dermatology, 1999
... Allergen-Specific T-Cell Reactions Thomas Werfel, Renate Reekers, Marc Busche, Petra Schmidt, ... more ... Allergen-Specific T-Cell Reactions Thomas Werfel, Renate Reekers, Marc Busche, Petra Schmidt, Anja Constien, Miriam Wittmann, Alexander Kapp Department ... 19 Ortolani C, Pastorello EA, Farioli L, Ispano M, Pravettoni V, Berti C, Incorvaia C, Zanussi C: IgE-mediated allergy ...
Interactive cardiovascular and thoracic surgery, 2009
Journal für Ästhetische Chirurgie, 2009
ZusammenfassungHalstedt konstatierte: „Je weniger vollkommen die Technik des Chirurgen, desto grö... more ZusammenfassungHalstedt konstatierte: „Je weniger vollkommen die Technik des Chirurgen, desto größer die Notwendigkeit für eine Drainage. Gar keine Drainage ist besser als deren unkundige Anwendung.“ Die Verwendung von Drainagen in der plastischen Chirurgie ist nicht unumstritten. Während Drainagen routinemäßig nach Facelift-Operationen, Mammareduktionsplastiken, Abdominoplastiken oder auch freien Lappentransferoperationen angewendet werden, ist die rationale Basis für die Anwendung oftmals brüchig. Vielmehr konnten randomisiert-kontrollierte Studien für die Mammareduktionsplastik eine erhöhte Komplikationsrate bei Verwendung von Drainagen nachweisen. Bei Facelift-Operationen ist die Drainageentfernung nach 24 Stunden nicht mit veränderten Komplikationsraten gegenüber keiner Drainage verbunden. Möglicherweise kann die Seromhäufigkeit an der Hebestelle des M. latissimus dorsi durch Fibrinkleber, Triamcinolon-Injektion und bestimmte Nahttechniken reduziert werden. Insgesamt ist der routinemäßige Einsatz von Drainagen in der plastischen Chirurgie nicht durch randomisiert-kontrollierte Studien abgesichert. Die Anlage einer Drainage sollte daher auch nicht routinemäßig durchgeführt, sondern bei jeder Operation als Einzelfall entschieden werden.AbstractAs Halstedt stated:“The more imperfect the technique of the surgeon, the greater the necessity for drainage. No drainage at all is better than the ignorant employment of it”. Drainage is a matter of debate in plastic surgery and is not undisputed. While drainage is applied in face-lifting procedures, mammoplasty, abdominoplasty and free flap transfers on a routine basis, the rationale for usage is often weak. Randomised controlled trials could show a significantly higher complication rate using drainage in breast reduction surgery. Performing reduction mammoplasty without the use of closed suction drainage is safe and is preferred by the patients. Postoperative drainage after face lifting procedures does not influence the incidence of postoperative complications but does reduce the degree of postoperative bruising. The likelihood of seromas at the donor site of the latissimus dorsi muscle can be reduced by fibrin glue, triamcinolone injections and/or progressive tension sutures. The routine use of drainage in plastic surgery is not supported by evidence-based recommendations. Therefore, drainage should not be automatically employed in plastic surgery, but as an operative decision for each individual patient.
Plastic and Reconstructive Surgery, 2010
Praxis der Plastischen Chirurgie, 2011
Unter der Haut und dem Unterhautfettgewebe der Wange befindet sich das subkutane muskuloaponeurot... more Unter der Haut und dem Unterhautfettgewebe der Wange befindet sich das subkutane muskuloaponeurotische System (SMAS). Die Muskulatur der Wange wird vom M. orbicularis occuli, dem M. zygomaticus und dem M. masseter gebildet. Die Gefasversorgung erfolgt aus Endasten der A. carotis externa , v. a. der A. facialis.
Molecular Immunology, 2007
Plastic and reconstructive surgery. Global open, 2013
Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive w... more Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive wound infections of the feet as complications in patients with diabetes and/or peripheral arterial occlusive disease (PAOD). Microcirculatory changes seem to play an important role. However, the evaluation of functional changes in the soft tissue microcirculation at the plantar foot using combined Laser-Doppler and Photospectrometry System has not yet been performed in patients with DM or PAOD. A prospective, controlled cohort study was designed consisting of a total of 107 subjects allocated to 1 of 3 groups-group A: healthy subjects (57% males, 63.3 y); group B: patients with diabetes mellitus (DM) (53% males, 59.4 y); and group C: patients with PAOD (81% males, 66.1 y). Microcirculatory data were assessed using a combined Laser-Doppler and Photospectrometry System. Global cutaneous oxygen saturation microcirculation at the plantar foot of healthy individuals was 8.4% higher than in pat...
Der Unfallchirurg
BACKGROUND Needlestick injuries (NSI) are potentially infectious injuries from sharp or pointed m... more BACKGROUND Needlestick injuries (NSI) are potentially infectious injuries from sharp or pointed medical instruments and through contact with blood on mucous membranes or nonintact skin. Although the European Union (EU) Council directive 2010/32/EU on the prevention of NSI was implemented in EU countries in 2013, information on the effectiveness of the measures is limited. OBJECTIVE The aim of this study was to evaluate the effectiveness of a safety concept according to the EU Council Directive 2010/32/EU on prevention of NSI. MATERIAL AND METHODS In 2016 the NSI safety concept at a large regional hospital was improved according to 2010/32/EU, specifically by an update of blood screening profiles and standard operating procedures (SOP), better dissemination of information to employees and complete conversion to safety cannulas and scalpels. The medical records of all NSIs from 2015-2017 were retrospectively anonymized and evaluated and a cost analysis was performed. RESULTS The number of NSIs in 2017 was significantly reduced by 48.4% as compared to 2016 and NSIs with scalpels were completely prevented. The proportion of employees with NSIs who were adequately immunized against hepatitis B was significantly increased to 84.1% in 2017. Furthermore, identification of the index patient was significantly increased to 82.5% in 2017. The cost of avoiding NSIs increased by a total of 24.1% in 2017 as compared to 2015 before introduction of the safety concept. CONCLUSION Implementation of the EU Council directive 2010/32/EU, resulted in an almost 50% reduction in NSIs over 1 year, including the complete prevention of NSIs due to scalpels. In addition, the anamnestic presence of immunization against hepatitis B and index patient identification were significantly increased.
Journal of Burn Care & Research
The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancou... more The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancouver Scar Scale" (VSS) on patients' quality of life and their correlation with objective scar assessment tools, such as the Cutometer®, is not fully elucidated. In addition, long-term results of the dermal substitute Matriderm® used in combination with split-thickness skin grafting (STSG) remain unclear. We evaluated burn scars of 45 patients at least 2 years postburn injury using the Cutometer® MPA 580, the VSS, and the POSAS with three additional questions regarding quality of life and correlated the results. Study groups were: 1) scars following conservative treatment, 2) scars following STSG, and 3) scars following STSG in combination with Matriderm®. Cutometer® measurements demonstrated better elastic qualities in the Matriderm® group compared with the STSG group. VSS and extended POSAS were rated best for the conservative group, followed by the STSG group and the Matriderm® group. There was a significant correlation between POSAS and VSS, quality of life and the objective Cutometer® measurements. Conservatively treated superficial dermal burns do not reach the elastic qualities of healthy skin, and the use of Matriderm® significantly improves the long-term elastic qualities of STSG in deep dermal and full-thickness burns 2 years post injury. Results from the VSS and the POSAS correlate with restrictions in the quality of life of patients and also with objective Cutometer® measurements and are therefore useful tools in scar evaluation following burn injury.
Annals of Plastic Surgery
Introduction In burn care, as in other medical fields, there is a tendency to increase the requir... more Introduction In burn care, as in other medical fields, there is a tendency to increase the required number of patients for center certifications. Does the increase in patient load automatically improve the quality of burn care? What are the benchmark parameters that have been shown to improve burn care? Methods To answer these questions, Medline, Cochrane Library, and Livivo were searched from inception through January 2018 for all studies evaluating the influence of treatment parameters on outcomes in different burn care settings. Results Fifteen studies were included in this systematic review. In adults, not a single study showed a decreased mortality due to a higher patient load. However, in children, 2 studies demonstrated a further decrease of the already low mortality due to an increase in patient load. In contrast to patient load, benchmark parameters that had a significant influence on the outcome of burn care for adults and children were: single bed isolation, residency programs, American Burn Association certifications of burn centers, speed of wound closure, and standard operating procedures for burn care. Conclusions This systematic review demonstrates that a clear correlation between patient load and mortality reduction in adult burn treatment is not supported by the existing literature, requiring future studies. In contrast, all efforts aiming to improve the quality of burn care, such as isolation of burn patients, speed of wound closure, American Burn Association verification and especially standard operating procedures for burn care improve survival and quality of burn care.
Journal of Reconstructive Microsurgery, 2015
We read with interest the article “Case Report of a Supraclavicular Artery Island Flap for Recons... more We read with interest the article “Case Report of a Supraclavicular Artery Island Flap for Reconstruction of a Nonhealing Cervical Spine Wound” by Razdan et al.1 In this article, the authors present a very interesting and novel application of the supraclavicular artery island flap, also known as supraclavicular island flap or supraclavicular artery perforator (SAP) flap for closure of posterior cervical spine defects.1 We appreciate the worldwide increasing interest in the SAP flap and congratulate the authors on the first published successful treatment of a posterior cervical spine defect with a SAP flap. In their article, the authors discuss the advantages of the SAP flap (thin skin paddle, short harvest time, preservation of regional muscle units, and good color match of the skin island) in comparison to other flaps traditionally used to cover posterior spine defects, such as paraspinous, latissimus dorsi, and trapezius flaps.1 In addition, the authors give an overview of the use of the SAP flap for reconstruction of head and neck defects in the literature, such as pharynx,2–4 parotid,2,3 and skin defects.4 While most citations in the article are correct, Razdan et al refer to a publication by Pallua et al from 2010, as a publication about the use of the SAP flap for esophagocutaneous fistulas.5 However, the authors are mistaken, since the article by Pallua et al from 2010 introduced the SAP flap as an option for closure of tracheocutaneous fistulas and not for esophagocutaneous fistulas.5 In this article, Pallua et al also proposed a defect classification and a treatment algorithm using the tunneled supraclavicular artery island flap for functional and esthetic reconstruction.5 Additionally, the reviewed literature regarding the SAP flap in the article by Razdan et al is missing an important publication by Pallua et al from 1997, describing the SAP flap for the first time: “The Fasciocutaneous Supraclavicular Artery Island Flap for Releasing Postburn Mentosternal Contractures.”6 Since Razdan et al discuss the use of the SAP flap not only for posterior spine defects but also for head and neck reconstruction, it could be of interest for the reader to mention the anterior supraclavicular artery perforator (a-SAP) flap, primarily described by Pallua et al in 2013 as a similar treatment option.7 The a-SAP flap is an improvement of the SAP flap, using a separate anterior supraclavicular pedicle, placing the skin island into the deltoideopectoral fossa.7 Compared with the SAP flap, the a-SAP flap is even thinner and has an even better color match to the face.7
Der Unfallchirurg
Scaphotrapeziotrapezoid (STT) arthrodesis has been proposed to stabilise the radial column and to... more Scaphotrapeziotrapezoid (STT) arthrodesis has been proposed to stabilise the radial column and to redirect the load away from the lunate. Midterm effects on force transmission are still unclear. Six patients who were treated with triscaphe arthrodesis were examined after an average of 5 years using CT osteoabsorptiometry of both wrists. STT arthrodesis had been performed in four cases with Kienböck's disease type IIIb and in two cases of scaphotrapeziotrapezoid arthritis. At all contralateral wrists peak mineralisations were found beyond the lunate fossa and in the scaphoid fossa of the distal radius. At the side with STT arthrodesis there was only one peak. In five cases this density maximum was beyond the scaphoid fossa and in one case half beyond the lunate and half beyond the scaphoid fossa. Triscaphe arthrodesis allows load transmission from the lunate to the radial column.
German medical science : GMS e-journal, Jan 8, 2010
Ischemic heart disease is the leading cause of death worldwide. The complement system plays a maj... more Ischemic heart disease is the leading cause of death worldwide. The complement system plays a major role in inflammation and tissue injury following myocardial ischemia and reperfusion (MI/R) injury. Systemic C5 inhibition in clinical studies has resulted in mixed results and the role of earlier complement components (e.g., C3a), upstream from C5 cleavage, has not been elucidated for MI/R injury. Therefore, we evaluated the role of C5 or C3a in a mouse model of MI/R injury. We performed experimental MI/R with 30 min of ischemia and 4 hr of reperfusion in 8-12 wk old C57BL/6 (WT) mice. Systemic C5 or C3a inhibition was performed with an anti-C5 monoclonal antibody (BB5.1) 30 min prior to reperfusion or with a C3a receptor antagonist (C3aRA). Since the C3aRA induces neutropenia that resolves within 120 min, we administered C3aRA at two different time points in two separate groups: 30 min prior to reperfusion within the neutropenic time frame and 120 min prior to reperfusion, when the ...
Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen, 2009
While use of biocomposite temporary dressings in burn wounds is common practice, the complex anat... more While use of biocomposite temporary dressings in burn wounds is common practice, the complex anatomic structures of the hand make this treatment option challenging. For this reason, the Biobrane ((R)) Glove (Smith&Nephew) has been developed. However, limited information regarding burn treatment with Biobrane ((R)) Gloves can be found in the literature. Functional and cosmetic outcomes of 13 second degree burn wounds of the hand in 10 patients treated with Biobrane ((R)) Gloves were evaluated using the Vancouver scar scale (VSS) and the DASH-score (disabilities of the arm, shoulder and hand). We evaluated wound healing times and questioned patients about pain related to Biobrane ((R)) Glove treatment in comparison to conventionally managed second degree burn wounds in other parts of the body and about acceptance of Biobrane ((R)) Glove treatment. In addition, we estimated the costs for use and wound management time for both Biobrane ((R)) Glove treatment and conventional wound manage...
Interactive cardiovascular and thoracic surgery, 2009
Current problems in dermatology, 1999
... Allergen-Specific T-Cell Reactions Thomas Werfel, Renate Reekers, Marc Busche, Petra Schmidt, ... more ... Allergen-Specific T-Cell Reactions Thomas Werfel, Renate Reekers, Marc Busche, Petra Schmidt, Anja Constien, Miriam Wittmann, Alexander Kapp Department ... 19 Ortolani C, Pastorello EA, Farioli L, Ispano M, Pravettoni V, Berti C, Incorvaia C, Zanussi C: IgE-mediated allergy ...
Interactive cardiovascular and thoracic surgery, 2009
Journal für Ästhetische Chirurgie, 2009
ZusammenfassungHalstedt konstatierte: „Je weniger vollkommen die Technik des Chirurgen, desto grö... more ZusammenfassungHalstedt konstatierte: „Je weniger vollkommen die Technik des Chirurgen, desto größer die Notwendigkeit für eine Drainage. Gar keine Drainage ist besser als deren unkundige Anwendung.“ Die Verwendung von Drainagen in der plastischen Chirurgie ist nicht unumstritten. Während Drainagen routinemäßig nach Facelift-Operationen, Mammareduktionsplastiken, Abdominoplastiken oder auch freien Lappentransferoperationen angewendet werden, ist die rationale Basis für die Anwendung oftmals brüchig. Vielmehr konnten randomisiert-kontrollierte Studien für die Mammareduktionsplastik eine erhöhte Komplikationsrate bei Verwendung von Drainagen nachweisen. Bei Facelift-Operationen ist die Drainageentfernung nach 24 Stunden nicht mit veränderten Komplikationsraten gegenüber keiner Drainage verbunden. Möglicherweise kann die Seromhäufigkeit an der Hebestelle des M. latissimus dorsi durch Fibrinkleber, Triamcinolon-Injektion und bestimmte Nahttechniken reduziert werden. Insgesamt ist der routinemäßige Einsatz von Drainagen in der plastischen Chirurgie nicht durch randomisiert-kontrollierte Studien abgesichert. Die Anlage einer Drainage sollte daher auch nicht routinemäßig durchgeführt, sondern bei jeder Operation als Einzelfall entschieden werden.AbstractAs Halstedt stated:“The more imperfect the technique of the surgeon, the greater the necessity for drainage. No drainage at all is better than the ignorant employment of it”. Drainage is a matter of debate in plastic surgery and is not undisputed. While drainage is applied in face-lifting procedures, mammoplasty, abdominoplasty and free flap transfers on a routine basis, the rationale for usage is often weak. Randomised controlled trials could show a significantly higher complication rate using drainage in breast reduction surgery. Performing reduction mammoplasty without the use of closed suction drainage is safe and is preferred by the patients. Postoperative drainage after face lifting procedures does not influence the incidence of postoperative complications but does reduce the degree of postoperative bruising. The likelihood of seromas at the donor site of the latissimus dorsi muscle can be reduced by fibrin glue, triamcinolone injections and/or progressive tension sutures. The routine use of drainage in plastic surgery is not supported by evidence-based recommendations. Therefore, drainage should not be automatically employed in plastic surgery, but as an operative decision for each individual patient.
Plastic and Reconstructive Surgery, 2010
Praxis der Plastischen Chirurgie, 2011
Unter der Haut und dem Unterhautfettgewebe der Wange befindet sich das subkutane muskuloaponeurot... more Unter der Haut und dem Unterhautfettgewebe der Wange befindet sich das subkutane muskuloaponeurotische System (SMAS). Die Muskulatur der Wange wird vom M. orbicularis occuli, dem M. zygomaticus und dem M. masseter gebildet. Die Gefasversorgung erfolgt aus Endasten der A. carotis externa , v. a. der A. facialis.
Molecular Immunology, 2007
Plastic and reconstructive surgery. Global open, 2013
Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive w... more Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive wound infections of the feet as complications in patients with diabetes and/or peripheral arterial occlusive disease (PAOD). Microcirculatory changes seem to play an important role. However, the evaluation of functional changes in the soft tissue microcirculation at the plantar foot using combined Laser-Doppler and Photospectrometry System has not yet been performed in patients with DM or PAOD. A prospective, controlled cohort study was designed consisting of a total of 107 subjects allocated to 1 of 3 groups-group A: healthy subjects (57% males, 63.3 y); group B: patients with diabetes mellitus (DM) (53% males, 59.4 y); and group C: patients with PAOD (81% males, 66.1 y). Microcirculatory data were assessed using a combined Laser-Doppler and Photospectrometry System. Global cutaneous oxygen saturation microcirculation at the plantar foot of healthy individuals was 8.4% higher than in pat...