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Biomedical subjects

Claire Sanger

Publications and source records attributed to Claire Sanger.

4 recordsLinked to original sources

Impact of significant weight loss on outcome of body-contouring surgery.

Morbid obesity in the United States has reached startling proportions, with serious physical and psychosocial ramifications. As the number of patients undergoing bariatric surgery increases to treat this problem, it is expected there will be an increase in the number of patients presenting to plastic surgery offices for body contouring after weight loss. It is imperative that plastic surgeons prepare patients with extreme weight loss as to the risks and complications as compared with the general population undergoing body contouring. In this retrospective chart review, 26 patients undergoing body contouring from May 2001 to November 2004 were reviewed. Only patients who had extreme weight loss, defined as losing greater than 50 pounds, were included in this study. The age, gender, amount of weight lost, comorbidities, tobacco use, and weight-loss method were recorded. Additionally, the type of body-contouring procedure and presence of complications were collected from the records. The percentage of complications in our patient population is significantly higher than reported in the literature for the general population undergoing an abdominoplasty. We believe the increased wound complications seen in our patients can be attributed to the inherent complications seen with obese patients.

Abdomen↗

Dermatofibrosarcoma protuberans of the face: surgical management.

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive, rarely metastatic, spindle cell tumor. It is most commonly found on the trunk and rarely on the head and neck. Recurrence has been found to be more common in the head and neck region, which may be attributable to delayed patient presentation or a reluctance for wide excision in that region. The authors report a rare case of DFSP presenting as a large mass of the face. Surgical treatment required aggressive local resection of the tumor, including the underlying maxillary antrum. The soft tissue was cleared by Mohs technique. More than one procedure was required to obtain clear bone margins. Adjuvant radiation therapy was used to gain local control. Reconstruction was performed using a cheek advancement flap, as well as a forehead flap and split-thickness graft to the donor site.

Dermatofibrosarcoma↗

Cost-effective management of isolated facial fractures.

The purpose of this study was to evaluate the subset of costs incurred for surgical treatment of isolated midface and mandible fractures of patients admitted directly from the emergency department compared with those admitted as outpatients after evaluation and discharge from the emergency department. After institutional review board approval, the records of patients admitted to Wake Forest University Baptist Medical Center were studied retrospectively for patients who underwent surgical repair of an isolated facial fracture between July 1, 1999 and June 30, 2000. Patients were placed into one of two groups: admission from the emergency department versus admission as an out-patient. Total hospital charges were compared, and complications were evaluated. Mechanism of injury, age, and gender were recorded within each group. Forty-two patients met the study criteria. Twenty-eight patients were admitted directly from the emergency department (Group A), and 14 were admitted as outpatients after elective scheduling for operative repair (Group B). Operative charges based on utilization of time and materials showed no statistical significance between Group A (P = 0.275) and Group B (P = 0.393). Patients admitted directly from the emergency department had a mean hospital charge of 3,556.66 dollars higher (P< or = 0.001) and stayed 2 days longer in the hospital as compared with the outpatient group. No differences were noted in complications between the study groups. The results of this study reveal a significant decrease in cost for patients with isolated facial fractures admitted as outpatients on scheduling surgery as compared with immediate admission from the emergency department.

Adult↗

Dynamic spring-mediated cranioplasty in a rabbit model.

Since the beginning of craniofacial surgery, there has been an ongoing search for surgical techniques to enhance outcome while, at the same time, decreasing the invasiveness of the surgical treatment of craniofacial deformities. The purpose of this study was to test a recently reported minimally invasive treatment modality, the dynamic spring, in a rabbit calvarial model for efficacy and safety. Specifically, the results of spring cranioplasty on skull growth, the underlying brain, and adjacent bone were to be assessed. The study population consisted of 36 7-week-old New Zealand white rabbits. The rabbits were divided into four treatment groups (9 rabbits each): control, sham surgery, stainless steel springs, and memory metal springs. Postoperative analysis included weekly radiographs to evaluate movement of amalgam markers placed at standardized locations. Additionally, 16 rabbits (4 from each group) were killed at 14 days after surgery, and postmortem histological analysis was done. The remaining rabbits were followed until they were adults and were then killed and similarly analyzed. No morbidity or mortality occurred in the immediate perioperative period secondary to the surgery. Postmortem histological analysis of all study animals revealed no intracranial, subcutaneous, or skin infections and no technical complications related to the surgery. Statistical analysis using ANOVA and pair-wise comparisons between treatment groups revealed a statistically significant difference (P < 0.05) between the marker movement in the spring groups versus the sham and control groups. There were no significant differences between the sham and control groups or between the two spring groups. In conclusion, this study confirms the efficacy and safety of the dynamic spring in a rabbit model.

Analysis of Variance↗