PubMed · 5905852
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O C Schroeder. 1966. Scars. Evaluation and presentation.. https://pubmed.ncbi.nlm.nih.gov/5905852/
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In any discussion of surgical exposure, it is important to remember that of chief importance is what is done in the operative field, rather than how the site is exposed. Selection of approach is based on tradeoffs that must be weighed by the surgeon and tailored to the deformity for a given patient. Despite a recent surge in the popularity of the transconjunctival technique, periorbital surgery by a cutaneous approach is still a valid means of access for a variety of esthetic and particularly trauma procedures. There are few solid data comparing the two approaches, and what does exist shows little or no significant difference between them. A cutaneous approach spares the conjunctiva, bypasses transconjunctival-related complications, and eliminates the need for lateral canthotomy for access. The subtarsal lid crease incision appears to offer the benefits of the orbital rim incision with respect to speed, exposure, and low incidence of lid malposition, with cosmetic scar appearance that is comparable to the subciliary incision.
If liposuction considerably improves abdominal contours, notably in the infraumbilical area, the results are reduced, or imperfect, for stretched abdomens, or with older persons, whose derma contains less elastic fibers. In this last case, a tightening by cutaneous and adipose suprapubic resections is most usually necessary. This tightening becomes possible due to fixation to the pubis of the fibrous and fibrous vasculars tracts connecting the fascia to the superficial fat. After initial proportional liposuction, shift expansion of the upper half of the superficial dermoadipose level of the infraumbilical abdomen and retraction of its lower half result in a harmonious, strengthened, and tightened abdominal surface, without remaining visible scars.
PURPOSE: We documented the morphological changes on enhanced MR imaging studies that occur in epidural scar over a period of 1 year after lumbar diskectomy. METHODS: The study population was culled from a randomized, multicenter clinical trial designed to evaluate the efficacy of a device inhibiting postoperative epidural fibrosis after single-level, unilateral laminectomy/diskectomy for herniated lumbar disk. Analysis was restricted to 71 control subjects who did not receive the device. All patients underwent surgery after receiving clinical and MR examinations, with follow-up MR studies at 6 and 12 months. Evaluation of all MR images was performed by one interpreter, who was blinded to treatment arm and clinical findings. The extent of epidural scar seen at the 6- and 12-month MR examinations was graded on a scale of 0 to 4 for each quadrant at each imaging section encompassing the surgical level. RESULTS: Eighty-five percent of the patients had no change in the amount of anterior epidural scar between the 6- and 12-month MR examinations; 75% of the patients showed no change in the amount of posterior epidural scar between the 6- and 12-month examinations. CONCLUSION: The majority of our patients had no change in the amount of epidural scarring visible at enhanced MR imaging over a 1-year period after lumbar laminectomy/diskectomy.