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Body Contouring after Massive Weight Loss – Case Report

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Zieliński T., Antoszewski B.
Polish Journal of Surgery
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2012
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vol. 84
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issue 11
585-589
EN
The paper presents a 25-year-old woman who is using a strict diet of 1000 kcal lost 83 kg in 18 months. Despite her young age, weight loss caused numerous cutaneous fatty folds, because her skin was not elastic or resilient enough. The patient undergo a multi-stage surgical treatment aiming to rectify the deformations. This example illustrates the problems of patients having undergone intensive slimming procedures and presents surgical treatment methods that rectify typical deformations in these patients.
2
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Photographic documentation in plastic surgeon’s practice

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Kasielska-Trojan A., Korczak K., Niedźwiedziński M., Antoszewski B.
Polish Journal of Surgery
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2016
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vol. 88(3)
125-129
EN
The aim of the study was to analyze practices of clinical photographic documentation management among plastic surgeons in Poland as well as to gain their opinion about the characteristics of “ideal” software for images archiving. Material and methods. The on-line survey link was send (via e-mail) to all members of Polish Society of Plastic, Reconstructive and Aesthetic Surgery. From 187 members, 86 subjects (47.5%, 54 men and 32 women, of the mean age 40.8 years ± 10.6 years) filled in the on-line questionnaire, which constitutes a representative sample of plastic surgeons practicing in Poland. Results. The study showed that only 7% of plastic surgeons use IT applications dedicated to archiving photographs. Instead, more than half of them store photos in ordered folders on computers. The majority of respondents (89.3%) are interested in using a dedicated computer application to archive photographic documentation. The most important features, which an application of this type should have are (265 answers): quick search (26%), easy to use (24%), quick data entry (22%), data security (15%), an ability to print selected data (7%), availability only to authorized employees of the unit (5%). Conclusions. Cooperation of health care providers with informatics may lead to the conceptualization of a program fulfilling the requirements of specific medical groups. On the basis of the questionnaire study we have collected the data necessary to create the concept of the unique software that would be useful for clinical practice of plastic surgeons as well for other specialists dealing with photographic documentation.
3
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Dermatoscopy as a helpful tool in plastic surgeon’s practice – a preliminary study

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Antoszewski B., Fijałkowska M., Stabryła P., Kasielska-Trojan A.
Polish Journal of Surgery
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2015
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vol. 87(12)
609-613
EN
The aim of the study was to examine the utility of dermatoscopy in plastic surgeons’ practice in pigmented and non-pigmented skin lesions management. Material and methods. The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned. Results. The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation. Conclusions. Dermatoscopy seems to be helpful in surgeons’ dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions’ removal (electro resection), which gives better aesthetic results.
4
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What does a (general and abdominal) surgeon need to know on plastic surgery?

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Kraus A., Infanger M., Meyer F.
Polish Journal of Surgery
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2019
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vol. 91(5)
42-51
EN
Background: Plastic surgery was first introduced as a sub-specialty of general surgery in Germany in 1978. Since then, this surgical subspecialty/discipline has evolved enormous potential, e.g. in collaboration with other disciplines such as general andabdominal surgery. Aim: To highlight and summarize the basic potential, technical options and novel aspects of plastic surgery, which are relevant for the common interdisciplinary surgical strategies of plastic and general as well as abdominal surgery in clinical practice. Method: Short and compact narrative review based on 1) a selection of relevant references from the medical scientific literature and 2) surgical experiences obtained in daily practice. R esults (selected corner points): 1) Biological protection procedures in vascular surgery by flap coverage after meticulous debridement with or without autogenic vascular reconstruction are used to overcome infection of a vascular prosthesis, a serious problem, associated with the risk of anastomotic rupture and bleeding by transfer of immunological competence due to tissue coverage and finally to induce healing in the area of an infected vascular prosthesis. 2) Fistula treatment for aorto-tracheal or aorto-duodenal fistulas, a big challenge for the referring general surgeon, can be treated by flap coverage, i.e. interposition of the pectoralis-major flap and the omentum-majus flap, respectively. 3) With regard to nerve surgery, encouraging results have been reported after early microsurgical recurrent laryngeal nerve repair, i.e. improved subjective voice quality or reconstitution of respiratory capacity in diaphragmatic. 4) Lymphatic surgery for lymphedema occurring either primarily due to an absence or lack of lymphatic vessels or secondarily due to infection, trauma, radiation therapy or surgery can be indicated in specialized microsurgical centers, e.g. for surgical repair of the lymphatic pathway: I) the interrupted lymphatic system can be reconstructed by an interposition, or II) the lymphatic fluid can be drained extraanatomically (e.g. by a lymphatic-venous anastomosis). Further techniques are the following: free lymph node transplantation included in a free vascularized groin flap or autologous lymphatic vessel transfer or vein graft interposition (used for lymphatic vessel interposition). 5) Mass reduction such as dermolipectomy with subsequent split-thickness is a valuable option, which provides excellent volume reduction. 6) Defect coverage: A. Split- or full-thickness skin grafts are a common method of defect coverage (in cases of clean and well-vascularized wound bed and lacking donor skin, or if the graft bed is of questionable quality) using various allogenic or xenogenic skin substitute materials. B. Further methods offer a wide-range armamentarium of local and free fasciocutaneous and musculocutaneous flaps, e.g. after abdomino-perineal rectum extirpation using the vertical rectus-abdominis myocutaneous flap (VRAM) or propeller flaps according to the “angiosome”. 7) Abdominal wall hernia closure with instable skin coverage, flap closure, either alone or in combination with mesh is superior to mesh closure only. 8) Free flaps: If there is no option for a local or pedicled flap available, free flaps can be well used for abdominal wall defect closure (complication rate in experienced hands is low). Conclusion: Plastic surgery is an indispensable partner for specific surgical problems and clinical situations of general and abdominal surgery, which indicates that each general and abdominal surgeon should be well notified on great options and surgical techniques offered by modern plastic surgery to achieve best outcomes and quality of life for patients and should combine the expertise of these two surgical disciplines.
5
Content available remote

Dermatoscopy as a Helpful Tool in Plastic Surgeon’s Practice – A Preliminary Study

100%
Antoszewski B., Fijałkowska M., Stabryła P., Kasielska-Trojan A.
Polish Journal of Surgery
|
2015
|
vol. 87
|
issue 12
609-613
EN
The aim of the study was to examine the utility of dermatoscopy in plastic surgeons’ practice in pigmented and non-pigmented skin lesions management. Material and methods. The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned. Results. The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation. Conclusions. Dermatoscopy seems to be helpful in surgeons’ dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions’ removal (electro resection), which gives better aesthetic results.
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