Biomedical subjects

Refaat B Karim

Publications and source records attributed to Refaat B Karim.

5 recordsLinked to original sources

PubMed2006

Risk of breast cancer among reduction mammaplasty patients and the strategies used by plastic surgeons to detect such cancer.

BACKGROUND: Estimates of the occurrence of breast cancer among reduction mammaplasty patients vary from 0.05 to 1.66 percent, and the chance of finding such cancers is affected by the thoroughness of preoperative and postoperative examinations. The authors' aims were to make a more exact and age-specific estimation of this occurrence and to evaluate the strategies used by Netherlands plastic surgeons to detect these cancers. METHODS: The annual number of reduction mammaplasty patients per 5-year age group and the annual age-specific incidence rate of breast cancer for the years 1992 through 2001 were obtained from two national registries. Using these, the authors estimated the expected number of breast cancers among reduction mammaplasty patients in each year. In 2002, the authors sent an anonymous questionnaire to 220 Dutch consultant and trainee plastic surgeons to evaluate their detection strategies. RESULTS: The fraction of patients aged 50 years or older increased from 9.6 percent to 23 percent, and the estimated occurrence of breast cancer among patients increased from 0.05 percent to 0.11 percent. Responders to the questionnaire were inconsistent regarding their preoperative and postoperative detection strategies, with only 3 percent of them routinely requiring a preoperative mammogram and 75 percent of them routinely submitting the surgical specimen for histopathologic examination. CONCLUSIONS: The occurrence of previously undetected breast cancer among reduction mammaplasty patients in The Netherlands is likely to increase further. The authors advocate preoperative mammography for all reduction mammaplasty patients aged 40 years or older and argue that a history and physical examination should be performed for all patients.

Adult↗

PubMed2006

Saving labium minus skin to treat possible urethral stenosis in female-to-male transsexuals.

In our hands, neourethral stenosis is the main complication following metaidoioplasty in female-to-male transsexuals. We introduce the use of surplus of minor labial skin to correct these stenoses. The surplus was used as a subcutaneously pedicled flap with a 1.5 x 3.5 cm skin paddle to correct the circumferential deficit of neourethral lining at the level of the stenosis. After minimum undermining, the pedicle was retracted laterally to allow for a median external urethrotomy. The skin paddle was turned outside in to fit the resulting longitudinal neourethral defect. Subsequently, the major labial subcutis and skin were approximated in layers to cover the subcutaneous pedicled flap and to close the labioscrotum in the midline. Patients were kept immobilized for 3 days, and a suprapubic catheter was left open for 7 days. This technique was applied successfully in 15 of the 70 female-to-male transsexuals who consequently underwent metaidoioplasty in Amsterdam up to March of 1999. We conclude that the surplus of labial skin ought to be retained during primary surgery because it is an ideal substitute to correct neourethral stenosis.

Female↗

PubMed2004

Plastic solutions for orthopaedic problems.

INTRODUCTION: Infection and exposure of the implant may occur in 1-12% of patients operated on for arthroplasty or osteosynthesis. Variables such as tissue viability, presence of infection, exposure of osteosynthesis material and patient-related factors contribute to the lack of general consensus regarding the management of these defects. MATERIALS AND METHODS: Between January 1999 and January 2001, six patients were treated for complex soft-tissue defects following various orthopaedic procedures at the Department of Plastic Surgery in the Slotervaartziekenhuis in Amsterdam, a rheuma-orthopaedic orientated hospital. All patients were initially treated by radical debridement and vacuum-assisted closure (VAC) system of the wound. After 1 week, this was followed by transplantation of a pedicled or free flap to cover the defect. We studied the medical history, initial orthopaedic procedure, wound treatment, transplanted flap and outcome of plastic surgery in this group. RESULTS: Plastic surgical intervention led to wound closure in all cases. In only one case was the osteosynthesis material removed because of osteomyelitis. CONCLUSIONS: We conclude that the earlier coverage with vital tissue is obtained, the lower the incidence of infection. Early consultation by a plastic surgeon will increase a positive outcome of treatment of complex tissue defects.

Adult↗

PubMed2003

Honey-medicated dressing: transformation of an ancient remedy into modern therapy.

Honey has been applied for medicinal purposes since ancient times. Its antibacterial effects have been established during the past few decades. Still, modern medical practitioners hesitate to apply honey for local treatment of wounds. This may be explained by the expected messiness of such local application. Moreover, secondary infectious disease may be caused by contamination of honey with microorganisms. Hence, if honey is to be applied for medicinal purposes, it has to meet certain criteria. The authors evaluated the use and safety of a honey-medicated dressing that was developed to meet these criteria in a feasibility (phase II) study featuring 60 patients with chronic (n = 21), complicated surgical (n = 23), or acute traumatic (n = 16) wounds. In all but 1 patient, it was found easy to apply, helpful in cleaning the wounds, and without side effects. Based on these results, the authors advise to subject this dressing to a randomized, double blind, phase III study.

Adolescent↗

PubMed2002

Digital photography as a means of enhancing interconsultant communication in oncological cutaneous surgery.

Plastic surgeons have associated themselves closely with photography almost since the inception of medical photography. Photographs are used for documentation of medical records and comparison of pre- and postoperative status. Digital photography allows instant picture viewing and printing as well as Web-based mailing and, as a result, it facilitates interconsultant communication between the dermatologist, surgeon, and pathologist during the surgical treatment of cutaneous neoplasms. Moreover, it enhances patient monitoring during long-term follow-up.

Humans↗