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Biomedical subjects

J S Elbaz

Publications and source records attributed to J S Elbaz.

At least 19 recordsLinked to original sources
PubMed1999

["Classical" abdominoplasty].

The term "classical" abdominoplasty includes those procedures designed and performed before the introduction of liposuction techniques. All of these operations leave a considerable scar: the importance of this residual scar makes abdominoplasty the poor cousin of cosmetic plastic surgery. In practice, it should be generally considered to be a functional comfort surgery, which sometimes resembles cosmetic surgery. All wall lesions must be treated during abdominoplasty: retightening of the musculo-aponeurotic plane when it is distended, correction, of more or less localized fat overload, resection of any excess skin. The desire to obtain scars as small and as hidden as possible has led to the development of a large number of techniques, performed with varying frequencies. However, there has been a renewed interest in some of these techniques since the development of liposuction. The abdominoplasty skin procedures can be divided into two groups: localized abdominoplasties, only concerning a limited part of the abdomen, and extensive abdominoplasties, concern all of the abdominal wall and requiring extensive skin detachment and a procedure on the umbilicus. The most classical method of abdominoplasty is low transverse abdominoplasty with umbilical transposition. This operation raises a number of aesthetic problems and one or several defects are fairly frequently observed during objective analysis of our results. It nevertheless provides a real personal gain for the patient, in the way he or she moves and dresses and can even allow weight loss after the operation. This gain is not related to the results observed on photographs. The introduction of liposuction techniques has radically modified the technical modalities and indications for these so-called "classical" operations.

Abdominal Muscles↗
PubMed1999

[Complications of plastic surgery of the abdomen].

Plastic surgery of the abdomen remains difficult and is therefore associated with a number of complications of varying severity, but whose global incidence appears to justify a separate chapter. The most serious complications of abdominoplasty are thromboembolic complications, which may be life-threatening. The incidence of these complications must be minimized by rigorous preventive measures. Prevention is based on early mobilization of the patient, perioperative treatment with low molecular weight heparin and wearing of anti-thrombosis stockings. Skin necrosis is generally associated with one or several aetiological factors: excessive tension at the end of the operation, development of a haematoma, excessive or too superficial detachment. The so-called "Morel-Lavallée" fluid collection is best prevented by well performed postoperative compression applied continuously for three weeks after the operation. Complications of isolated abdominal liposuction are exceptional, or at least they should be, when the indication and technique are rigorously respected. The combination of liposuction and abdominoplasty does not add any complication not already described in the case of abdominoplasties and does not increase the incidence of these complications. Liposuction appears to decrease the number of abdominoplasties, but also their extent, which is beneficial in terms of the quality and safety of the postoperative course. A better definition of indications and improvement of techniques have therefore markedly decreased the severity and incidence of complications of plastic surgery of the abdomen. Truly effective preventive measures are available for each of these complications.

Abdominal Muscles↗
PubMed1995

[A study of the influence of sutures and tension on skin cicatrization in loss of substance in 18 minipigs].

This study concerned the evaluation of wound healing after extensive skin resections in 18 minipigs, sutured with: continuous intradermal Polyglactin 910 suture or Polyamide, an interrupted intradermal sutures using the same resorbable suture material. Three equivalent groups were studied: 0, 3 and 6 cm skin resections were studied after using a dynamometer to record the tension necessary to join the wound margins. Results were evaluated 1 month later by light and electron microscopy, and were statistically correlated by Pearson's test. The wound tension was correlated with skin resection (r = 0.97, p < 10-4). The scar width was exponentially correlated with tension (r = 0.70, p < 10-3); the fibrous and cellular appearances increased with the skin resection. The absence of any significant statistical results prevents any conclusion concerning the superiority of one suture material or suture technique, but the group with no resection led to homogenous results, regardless of the suture technique, or suture material used. 3 and 6 cm resection the groups led to unpredictable and various results. Granulous reactions were observed in 7 out of 12 cases with resorbable suture, and only 1 of the 8 cases with non resorbable suture, but these results are not significant.

Animals↗
PubMed1990

[Prospective study of the specific liability of the plastic surgeon].

The authors of the article first pose this question: might plastic surgery not fit into the general principles that guide any medical procedure? The general principles, especially as regards the distinction between liabilities in terms of means and liabilities in terms of results, are discussed in the first part of the survey. The authors then demonstrate that the plastic surgeon does differ from other surgeons: he has to comply with the same restraints as any surgeon. However, the survey then presents certain aspects specific to this branch of surgery, and their implications in terms of responsibilities. The article successively discusses: the patient's freedom of choice, the need for particularly thorough information and its form, the limits to the practitioner's freedom in choosing the technique, and most importantly the so-called obligation to avoid (which the authors study in particular detail in the field of analysis and responsibilities) of obviously useless operations. The authors, after recalling important recent legal precedents, come to the conclusion that it is necessary to establish an institution: "the medical ombundsman" defined by a bill in the 1988 sitting of the French Parliament.

France↗
PubMed1989

[The role of an immunologic survey prior to using collagen implants. Theoretical aspects and practical methods].

Collagen implants (Zyderm and Zyplast) are effective and well tolerated. However, certain inflammatory reactions may occur. The immunological mechanisms responsible for such reactions are analysed: cell-mediated reactions, humoral reactions (specific antibodies) and the role--certainly major--of the genetic predisposition which modulates the expression of these reactions. The practical consequences are logically derived from the histological and serological findings observed, i.e. strict respect of the systemic contraindications (auto-immune diseases, severe atopy); rigorous conduct of a preoperative skin test to detect the great majority of reactive subjects; lastly, consideration, in the evaluation of the potential risk, of individual dysimmune susceptibility (family history, personal clinical or laboratory elements) in a very small proportion of patients.

Collagen↗
PubMed1980

Bowen's disease and squamous cell carcinoma of the palm.

A case of Bowen's disease of the palm with associated squamous cell carcinoma is described. A brief general review underlines this unusual localization. Bowen's disease may occur at any cutaneous site, simultaneously involving areas protected from and exposed to the light. Involvement of the dorsum of the hand is not rare, but palmar involvement is highly unusual. Only 12 indisputable cases have been published up to the present time.

Aged↗