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Preparation For Surgical Patients With A Latex Allergy

A couple of nice articles recently on latex allergy have crossed my path – one in a journal I subscribe to (Aesthetic Surgery Journal) and the other via twitter and @Allergy (Ves Dimov, M.D., blogs at Allergy Notes).  I’ve put both full references below.

Latex allergy became widely recognized in the late 1980s and early 1990s.  The increase in latex allergies cases is felt to be associated with the increase use of latex gloves and implementation of universal precautions (now known as standard precautions) in the 1980s.

Management of possible or confirmed latex allergic patients begin with history and suspicion:

All patients who present for surgical procedures or exams which require latex gloves (pelvic exam, dental exams, etc) should be questioned about possible latex allergy.

Patients at highest risk include those who Read more »

*This blog post was originally published at Suture for a Living*

Aesthetic Surgery Journal Examines Nonablative Treatment Of Stretch Marks

Stretch marks (striae distensae) are common.  They represent linear dermal scars accompanied by epidermal atrophy.  Stretch marks aren’t a significant medical problem, but can be a source of significant emotional distress.

There are many treatments available, ranging from therapy applied to the skin, laser therapy, and even more invasive surgical methods. Unfortunately, stretch marks remain a tricky problem to target, in which no established treatment exists.

A recent article in the  May issue of the Aesthetic Surgery Journal (full reference below) discusses the use of fractional nonablative laser treatment for stretch marks.

Dr. Francesca de Angelis and colleagues conducted a clinical study involving 51 patients with striae, three male and 48 female,  who were treated between May 2007 to May 2008.  Several patients had striae on multiple areas of the body so a total of 79 striae locations were treated.

Patient ages ranged from 13 to 56 years (mean, 33 years). Fitzpatrick skin type ranged from II to IV. The duration of striae ranged from one to 40 years, with an average duration of 12 years. The striae formed as a result of pubertal growth (41%, n = 21), pregnancy (31%, n = 16), weight change (20%, n = 10), muscular atrophy (2%, n = one ), or unknown causes (6%, n = three).

Anatomical locations for treatment included the hips, breasts, abdomen, flanks, knees, buttocks, arms, thighs, and shoulders, with the majority of treatments occurring on the first three sites.

The stated objective of this study was to determine Read more »

*This blog post was originally published at Suture for a Living*

“Twilight”-Inspired Plastic Surgery: A “Vampire” Facelift?

I first saw mention of the “vampire facelift” two weeks ago as a news article listed in the July 9th issue of the Plastic Surgery SmartBrief“Vampire facelift” uses patient’s platelets and fibrin in dermal filler.”

The article begins:

Instead of a traditional facelift, patients are being offered another option to get rid of wrinkles. It’s called Selphyl or the “vampire facelift,” and it uses a person’s own blood to sculpt the face.

Selphyl, according to the company’s website:

The patented SELPHYL® System enables the safe and rapid preparation of an activated Platelet-rich Fibrin Matrix (PRFM).  A small volume of the patient’s blood is collected and the platelets and fibrin are concentrated during a simple centrifuge process.  The resulting product (liquid, gel or membrane) can be applied to a treatment area of the face or body to stimulate natural, new tissue growth.  SELPHYL® prepared PRFM has been shown to increase skin volume and rejuvenation.

SELPHYL® ensures a preparation of fibrin and platelets, with virtually no red or white blood cells. Studies have shown these platelets to be viable and intact.  Platelets will release proteins, which have been reported to trigger cell migration, proliferation and differentiation over time.

With over 45,000 procedures performed world-wide, this technology has been extensively used for soft tissue regeneration in plastic surgery, orthopedics and maxillofacial surgery.

So how does Sephyl create any face-lifting effect? Read more »

*This blog post was originally published at Suture for a Living*

The Lack Of Evidence Behind Retinoids For Anti-Aging

Many over-the-counter (OTC) cosmetic products contain retinoids and are promoted (advertised) as anti-aging products.

An article in the February 2010 issue of the Aesthetic Surgery Journal is a review of the evidence behind retinoids in cosmeceutical products. It turns out there isn’t much. Read more »

*This blog post was originally published at Suture for a Living*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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