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Stress-relaxation is a well-established mechanism for laboratory skin stretching, with limited clinical application in conventional suturing techniques due to the inherent, concomitant induction of ischemia, necrosis and subsequent suture failure. Skin defects that cannot be primarily closed are a common difficulty during reconstructive surgery. The TopClosure tension-relief system (TRS) is a novel device for wound closure closure, providing secured attachment to the skin through a wide area of attachment, in an adjustable manner, enabling primary closure of medium to large skin defects. The aim of this study was to evaluate the efficiency of the TopClosure TRS as a substitute for skin grafting and flaps for primary closure of large soft tissue defects by stress-relaxation. We present three demonstrative cases requiring resection of large to huge tumors customarily requiring closure by skin graft or flaps. TRS was applied during surgery serving as a tension-relief platform for tension sutures, to enable primary skin-defect closure by cycling of stress-relaxation, and following surgery as skin-secure system until complete wound closure. All skin defects ranging from 7 to 26 cm in width were manipulated by the TRS through stress-relaxation, without undermining of skin, enabling primary skin closure and eliminating the need for skin grafts and flaps. Immediate wound closure ranged 26 to 135 min. TRS was applied for 3 to 4 weeks. Complications were minimal and donor site morbidity was eliminated. Surgical time, hospital stay and costs were reduced and wound aesthetics were improved. In this case series we present a novel technology that enables the utilization of the viscoelastic properties of the skin to an extreme level, extending the limits of primary wound closure by the stress-relaxation principle. This is achieved via a simple device application that may aid immediate primary wound closure and downgrade the complexity of surgical procedures for a wide range of applications on a global scale.

Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment

Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Cracked Corners Of Mouth, Cheilitis, Angular Cheilitis Remedy, Angular Cheilitis Medicine, Cheilitis--- http://angularcheilitis-end.cbwin1.com --- Foods Which Can Limit the Occurrence of Angular Cheilitis. People suffering from Angular Cheilitis know that this is one of the most troubling and annoying skin condition one can experience. It prevents you from eating, drinking and speaking normally. Many people even refuse to go out of the house when suffering from this condition, thus becoming isolated from the rest of the world. This is why it is better to prevent it then having to treat it. If you have had it long time ago and are afraid that will come back, if you have it and want to treat it faster or if you do not want to have this terrible experience ever, you should start by eating the foods listed below. They will provide your body with all the vitamins and nutrients necessary to effectively fight this disease and prevent it from appearing ever again. Most of the times, Angular Cheilitis appears as a result of a weak immune system. Thus, you will need to have a balanced diet, filled with fruits and vegetables that will supply you with all the things you need to remain healthy and have a strong immune system. The first thing that you will need to have in your body to fight Angular Cheilitis is iron. If you no longer want to have those anesthetic and painful cracks around your mouth, if you want to eat, drink and speak normally without experiencing any pain when opening your mouth, then check out this new and revolutionary treatment! It will get you rid of Angular Cheilitis in just a few days and you will be able to enjoy life to its fullest again, without worrying about those otiose cracks! Click Here. http://angularcheilitis-end.cbwin1.com

Laparoscopic anterior resection for cancer colon in Qatar by Dr. Al-Emadi

The Urinary System is a group of organs in the body concerned with filtering out excess fluid and other substances from the bloodstream. The substances are filtered out from the body in the form of urine. Urine is a liquid produced by the kidneys, collected in the bladder and excreted through the urethra.

This cosmetic plastic surgery graphically shows breast implants being removed in an operating room in an actual surgery.

According to a Danish study , frequent sex may help prevent pre-eclampsia. Researchers believe it's because of a protein found in sperm that can regulate the body's immune system. Yet because the cause of preeclampsia is unknown, it's important to keep your prenatal visits and talk to your doctor about your risk.

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Your thyroid lies below your Adam’s apple, along the front of the windpipe. The thyroid has two side lobes, connected by a bridge (isthmus) in the middle. When the thyroid is its normal size, you can’t feel it.

Pediatric Neurological Examination Introduction

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Aspirin, or acetylsalicylic acid (ASA) is a salicylate drug, and is generally used as an analgesic (something that relieves pain without producing anesthesia or loss of consciousness) for minor aches and pains, to reduce fever (an antipyretic), and also as an anti-inflammatory drug.

Pulmonary edema Email this page to a friend Email this page to a friend Facebook Twitter Google+ Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath. Causes Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs. This fluid reduces normal oxygen movement through the lungs. These two factors combine to cause shortness of breath.

What is Osteoporosis

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Diabetic Foot Surgical Debridement

Nasal polyps are linked to allergic rhinitis, asthma, aspirin allergy, sinus infections, acute and chronic infections, something stuck in the nose, and cystic fibrosis. But many times the cause is unknown. Sometimes, people get them before they develop asthma or sinusitis