The Benefits Of Glue Used In Facelift Surgery

The Benefits Of Glue Used In Facelift Surgery

Facelift Surgery

Dr. Davis B. Nguyen, M.D.'s and Dr. Frank M. Kamer, M.D.'s
co-authored study on the benefits of the use of fibrin glue adherent in facelift surgery has been published in the September issue of world's premier Plastic and Reconstructive Surgery Journal, that of the American Society of Plastic Surgeons. The study represents the most comprehensive clinical assessment of the use of fibrin glue in facelifts to date and its conclusions demonstrate a significant advancement in surgical facelift technique.

The study was conducted at the venerated Lasky Clinic in Beverly Hills, one of the first accredited outpatient ambulatory surgical centers in greater Los Angeles, founded by Dr. Frank Kamer in 1981. Dr. Nguyen and Dr. Kamer analyzed two hundred patients undergoing elective facelifts in a consistent fashion. One hundred patients over a one year period received fibrin glue during facelift surgery and their healing was measured prospectively. Another one hundred patients from the previous year who had not received fibrin glue had their charts retrospectively reviewed. All patients underwent facelifts by the same surgeon using the deep plane technique, which involves repositioning large skin flaps at multiple levels of the face. Patient healing was evaluated in stages at 24 hours, 48 hours, 1 week, 1 month, and 3 months postoperatively.

The use of fibrin glue was associated with several significant benefits in both the short and long-term healing processes of the patients studied. Fibrin glue alleviated the need for drainage tubes postoperatively that can cause discomfort. The tubes are normally placed under the skin for 1-2 days following facelift surgery to collect blood and prevent swelling. The fibrin glue adherent, which is applied before the external skin flap is resealed, also reduced the incidence of severe complications such as hematoma, seroma, and death. Most notably, zero percent of patients who received fibrin glue suffered prolonged swelling, discoloration, or hardness as opposed to twenty-two percent of patients who had not received fibrin glue.

Fibrin Tissue adhesive dates back to World War I when it was used topically to control the bleeding of wounded soldiers. Since then, it has been utilized with success in a variety of surgical procedures. It has been approved by the US Food and Drug Administration for colostomy procedure, cardiopulmonary bypass, and splenic surgery. Its use in aesthetic surgery, though popular in Europe, has been less widespread in the United States. Dr. Davis Nguyen, former chief surgical resident at Yale University, is among the few facial plastic surgeons employing this advanced facelift technique. "This advancement has had a tremendous impact on my practice," states Nguyen. "The major concerns for my patients are results, risk, and downtime. With this technique, my patients benefit from shorter recovery periods, fewer complications, and superior surgical outcomes."

By: Dr. Davis B. Nguyen, M.D. on Oct 01 2007

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By: Dr. Davis B. Nguyen, M.D. on Oct 01 2007
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Structured programmes for MRCS

Structured programmes for MRCS

Recognition: Professor Gautam Sen, chairman, Indian Chapter of The Royal College of Surgeons of Edinburgh.

“The Medical Council of India (MCI) has to take many factors into consideration before giving blanket recognition for [degrees such as] MRCS and FRCS and MRCP,” says Professor Gautam Sen, chairman of the Indian Chapter of The Royal College of Surgeons of Edinburgh.

MRCS is only an acknowledgement that the candidate is fit for four more years of training before he or she could be certified to practise surgery, says Dr. Sen. In an e-mail interview with Education Plus, he explained the background of these degrees.

“MRCS diploma is Membership of Royal College of Surgeons of all Royal College of Surgeons in England — The Royal College of Surgeons of England, The Royal College of Surgeons of Edinburgh and The Royal College of Surgeons of Glasgow. This diploma came into existence only in 2000, when the training to become a surgeon became more structured. It was provided in two stages — a two-year basic surgical training (BST), and only after two years of Basic Surgical Training (after MBBS) and a Basic Surgical Skills Course — one could appear for this basic diploma and if successful become member of either of the Royal College of Surgeons.”

MRCS was a first step to undertake four more years of higher surgical training in the U.K. On completion, a certificate of completion of surgical training (CCST) is issued. Thus after six years of training in the U.K., one could appear for the FRCS examination. Only after this could one become a consultant surgeon.

Changes introduced

In 2001- 2003, changes in training methods were introduced under the new Postgraduate Medical Education and Training Board (PMETB) — an autonomous body, set up by the U.K. Government and independent of all Royal Colleges. This was followed by the Modernising Medical Career (MMC) Document, which the U.K. considers as basic to train their doctors into specialists. “The emphasis is on structured training, competence-based continuous and in-training assessment,” Dr. Sen says.

Basically, there is Foundation Year 1, Foundation Year 2 and Foundation Year 3, training which is common to all, after MBBS, followed by, if selected, further four years of continuous training before one can get a Completion Certificate of Training. This means a student could be considered for appointment as consultant in NHS hospitals.

Phased out

“The present pattern of MRCS Examination is soon going to be phased out. The Indian Chapter of the Royal College of Surgeons of Edinburgh brought FRCS examination to India in 1998 so that surgical trainees here could write it. The examination was discontinued in 2000 in favour of the BST and HST system.

“The Colleges conduct MRCS examination in India that does not require training as eligibility criterion, unlike in the U.K., where a structured training programme after MBBS is a pre-requisite.

“Theoretically, one may take this examination in India, without a single post of training, and get MRCS Diploma,” he explains. Earlier, successful non-European Union MRCS students could go to the U.K. and work in NHS hospitals.

Basic and Higher training

The Indian chapter has initiated a dialogue with the Royal College of Surgeons of Edinburgh, for conducting the Basic Foundation Years of Structured Training (3 years), followed by MRCS examination and then continuing further four years of structured training in Specialty, followed by FRCS examination as in the U.K.

Recognising MRCS diploma as an eligibility to practise surgery does not arise. If a candidate undergoes BST and HST for six to seven years in Indian hospitals then the MCI should recognise such training and the FRCS degree as Postgraduate Degree in Surgery or in higher specialty in Surgery.

As regards recognising the old FRCS — that is, 1975 to 2000 (FRCS prior to 1975 was recognised) is welcome, as most of the doctors with this old FRCS had enough experience and developed competence working in the U.K. and later in India.

MRCS is the first step to undertake four more years of higher surgical training in the U.K.

R. SUJATHA

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SBi Launches RHead(TM) Lateral Radial Head Implant And.....

SBi Launches RHead(TM) Lateral Radial Head Implant And RHead(TM) Plating Systems To Expand Its Elbow Management System

Small Bone Innovations, Inc. (SBi), a single-source provider of products, technology and education for the small bone and joint orthopedic market sector, announced the launch of the rHead(TM) Lateral Radial Head Implant System. To further augment its Elbow Management System, the company also launched the rHead(TM) Plating System for internal fixation of proximal radius fractures.

The rHead Lateral Implant is a side-loading radial head prosthesis that allows for a minimally invasive approach and exposure in radial head replacement surgery. The head and stem of the implant connect by the means of a dove-tail locking mechanism that does not require a set screw - saving time in the operating room.

The rHead implant and new plating systems have received 510(k) clearance by the FDA. The rHead Lateral is indicated for treatment of arthritic and traumatic conditions of the radial head.

Anthony G. Viscogliosi, Chairman & CEO of SBi, said: "The addition of the rHead Lateral implant and the complementary new plating system responds to surgeon demand for a full range of treatment options for every disease stage or severity of trauma in the elbow."

The stem of the rHead Lateral implant is plasma coated with titanium for immediate stability in the canal and optimum osteo-integrating properties. As with SBi's existing rHead implants, the stem has a 12-degree curve to match the anatomy of the radius. This stem is available with a 2 mm standard collar or a 6 mm extended collar.

"The modularity of treatment options now available from SBi is making the often complicated alignment challenges in elbow repair or reconstruction more manageable and predictable in outcome," said Amit Gupta, M.D, who completed the first procedure using the Lateral rHead at the Louisville Arm and Hand Center.

"A unique feature of the system is the coupling mechanism between the radial head and stem that enables the implant to be implanted sideways to reduce ligament disruption," Dr. Gupta added.

According to SBi, surgeons have been instrumental in creating the Elbow Management System. The first rHead(TM) device was released in 1999 by Avanta (later acquired by SBi) and two years later a bi-polar version, the rHead Recon was introduced.

This was followed last year with the introduction of the SBi UNI-Elbow Radio Capitellum System(TM) as the first commercially available uni- compartmental elbow arthroplasty system. The new rHead Lateral implant heads are approved for use with the UNI-Elbow System for patients requiring a uni- compartmental solution.

Surgeons using SBi's Elbow Management System are also benefiting from the company's Precise Guidance Technology (PGT(TM)) instrument system that assists anatomical placement of the rHead implants. The trialing system helps to size the implant to render it as minimally invasive as is practicable.

The new rHead Lateral implant comes with an assembly tool for quick engagement or disengagement of the head and stem. The accompanying impactor tool is configured to assure precise positioning of the implant by referencing the surrounding anatomy.

About Small Bone Innovations, Inc.

Small Bone Innovations, Inc. (SBi) was founded in 2004 by Viscogliosi Brothers, LLC, (VB), the New York-based merchant banking firm that specializes in the musculoskeletal/orthopedic sector. VB created SBi as the first company to focus purely on small bone & joint science. By integrating established companies and professionals in the field, SBi can offer a broad, clinically proven portfolio of products and technologies to treat trauma and diseases in small bones & joints. Today, SBi has more than 130 employees at facilities in New York, NY, Morrisville, PA, and Bourg-en-Bresse, France.

SBi was a 2006 recipient of Red Herring magazine's annual "Red Herring 100 North America" award, recognizing SBi as one of the nation's leading technology companies and the only orthopedic device company selected among an initial entry of more than one thousand firms.

Additionally, SBi's Artelon(R) CMC-I Spacer, developed for patients with osteoarthritis at the base of the thumb, was featured on the cover and highlighted within Medical Design Technology magazine's "Year of Innovation" issue as one of the most fascinating technologies influencing the medical device industry.

Medical Device & Diagnostic Industry magazine named SBi to its list of "50 Companies to Watch" in 2006, noting, "Small Bone Innovations is going against the grain in its determination to become a market leader in the small bone & joint device sector."

About Viscogliosi Bros., LLC

Established by Marc R. Viscogliosi, John J. Viscogliosi and Anthony G. Viscogliosi in New York City in 1999, Viscogliosi Bros., LLC (VB) was the first venture capital/private equity and merchant banking firm dedicated to the musculoskeletal/orthopedics sector of the health care industry.

Today, VB is a leading independent firm with a mission to create, build and finance companies founded on innovations developed by surgeons and uniquely focused on "life changing" musculoskeletal/orthopedic technologies. VB has worldwide surgeon, industry and trade relationships and significant financial expertise in the musculoskeletal/ orthopedic sector.

As principals of VB, the Viscogliosi brothers have a combined total of nearly half a century of experience analyzing and investing in the musculoskeletal-orthopedics sector, directing literally billions of dollars through the orthopedics industry.

The Viscogliosi brothers have pioneered innovative financial, strategic and management initiatives for nearly 150 companies in the sector, from start- up, seed and development stage all the way to exit, while helping people lead better lives through the orthopedic and spinal products marketed and sold by the companies they have assisted in developing and financing. For more information about VB, please visit: http://www.vbllc.com

Forward-looking statements:

This press release contains forward-looking statements as defined in the U.S. Private Securities Litigation Reform Act of 1995. Readers are cautioned not to place undue reliance on these forward-looking statements. Actual results may differ materially from those indicated by these forward-looking statements as a result of risks and uncertainties impacting SBi's business including increased competition; the ability of SBi to expand its operations and to attract and retain qualified professionals; technological obsolescence; general economic conditions; and other risks.

Small Bone Innovations, Inc.
http://www.totalsmallbone.com

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Imported surgeons could cut by 80 per cent

`Imported surgeons could cut by 80 per cent...

By Rosemary Mirondo, Ifakara

It has been revealed that Tanzania is the largest exporter of surgery patients for overseas treatment in sub-Saharan Africa due to lack of surgeons and facilities needed to conduct surgery in the country.

This was said by president of the Tanzania Surgical Association, Dr Petronila Ngiloi, during an official opening of the Second Congress of the International Federation of Rural surgeons held at St Francis Hospital, Ifakara on Thursday.

Dr Ngiloi said that 95 per cent of patients went overseas for surgery, while 80 per cent could otherwise be treated locally if the country were to substitute the export of patients with importation of surgeons.

`It is cheaper and less risky for a surgeon to travel to follow a patient than a patient to follow a surgeon and it also strengthens the local capacity,` said Dr Ngiloi.

She said that the association`s target was to have at least one surgeon in each regional hospital.

She added that for 13 years, her association had been striving to promote the art of surgery and inspiring young doctors to take up the trade as their specialty.

Dr Ngiloi said that the number of surgeons in Tanzania was less than 100 for a population of more than 35 million people, leaving the bulk of surgeries to be conducted by medical officers or Assistant Medical Officers.

Elaborating, she said that there were only four pediatric surgeons for the whole country, three neurosurgeons and only two thoracic surgeons who however, did not have the necessary equipment to fully utilise their skills.

She said under such circumstances, patients who needed surgery services could take several months or even years before getting one.

She called on the government to train surgeons in various super-specialties by setting up a programme in collaboration with overseas colleagues.

She added that if one surgeon of a certain special skill was invited during the setting of surgical camps, Tanzania could gain by having more patients operated and it would help capacity building locally so that in a few years there would be non or very few overseas referrals patients.

She also urged the government to improve operating theatres and to recognise the contribution of the private sector saying that 70 per cent of health services in Dar es Salaam were provided by private hospitals.

The Vice President, Ali Mohammed Shein who graced the meeting, commended surgeons who work in rural areas.

He said the burden posed by surgical problems in rural areas especially in developing world was working on constrained budgets leading to inadequate health financial allocations, crisis of human resources and poor infrastructure and illiteracy.

He added that the government would take seriously the importance of developing and promoting rural surgery.

SOURCE: Guardian

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SA surgeon in trailblazing TV operation

SA surgeon in trailblazing TV operation

Xolani Mbanjwa

A leading South African doctor has shown the world how it's done in a groundbreaking surgery viewed by thousands of doctors around the world.

Professor Heine van der Walt, from Pretoria, a world leader in laparoscopic surgery, performed seven surgical operations during a live transmission at Netcare's Unitas Hospital in Centurion, Tshwane, to colleagues around the world.

The operations were broadcast live to a two-day Digestive Apparatus Surgery Conference in Rome, where surgeons and surgical students, including 2 500 conference attendees, watched the procedures on big screens.

Thousands more also viewed the operations in various countries, including Australia, Japan, Belgium and the United States.

While many doctors around the world still cut their patients to perform medical operations, Van der Walt demonstrated the delicate operation, which requires only about three to five holes, no more than 3mm, to be drilled in the surgery area.

He said that while the procedure is expensive, it saves time as most patients take only two days to recover instead of the normal six weeks when they are cut open.

"Instead of cutting a patient to get to a particular organ, you drill small little holes where you insert a camera and your working tools.

"You look at the monitor to view your surgery. It's cleaner, quicker, pain-free and chances of infection are minimal."

It was the third time Van der Walt had participated in the conference to demonstrate what he calls "telemedicine".

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Pioneering surgery cuts out scalpel

Pioneering surgery cuts out scalpel

Provided by: Sun Media
Written by: MEGAN GILLIS

Dr. Marc Ruel has pioneered the surgical technique of placing grafts on a beating heart through an incision a little bigger than a paper-clip.

But even more revolutionary is his research at the University of Ottawa Heart Institute into using cells transplanted from the bloodstream to regenerate the heart without using a scalpel at all.

It's made the surgeon, scientist and scholar the first cardiovascular surgeon to win the Royal College of Physician and Surgeons' prestigious gold medal in surgery.

"Our work at the Heart Institute shows the potential to regenerate the heart and takes us one more step toward new treatments to restore heart function," Ruel said. "We are just scratching the surface in this area. But our cardiac surgery research team is still growing, moving us into the future with a new vision of how cardiac research will evolve."

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Ruel won the gold medal for research that suggests that transplanted cells from the patient's bloodstream could be used to regenerate blood vessels, restoring blood supply to the heart.

Ruel studied medicine at the University of Ottawa but left Canada for a fellowship at Harvard University. He was lured back to Canada with a grant from the Canadian Centre for Innovation, which allowed him to set up a lab.

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'Controversies And Advances' Conference For Cardiologists And Heart Surgeons

'Controversies And Advances' Conference For Cardiologists And Heart Surgeons

Main Category: Cardiovascular / Cardiology News

Stem cell therapy for cardiac regeneration and the controversial issue of medicine and the media will be the focus of the keynote addresses at the seventh annual "Controversies and Advances in the Treatment of Cardiovascular Disease" conference. Conducted by Cedars-Sinai Medical Center at the Beverly Hills Hotel on Oct. 4 and 5, the conference is co-sponsored by the California Chapter of the American College of Cardiology, the California Chapter of the Society of Thoracic Surgeons, and Promedica International CME.

Professional differences of opinion often have stood between heart surgeons and cardiologists, and recent innovations in minimally invasive medical procedures have done nothing to reduce the friction. The ongoing debate as to whether it is better to replace and repair aortic and mitral valves surgically or to manage them medically is just one example. And when considering treatment options for Atrial Fibrillation, the choices are even more diverse -- should the physician opt for minimally invasive surgery, drugs or a catheter treatment? And then there is the highly controversial stent issue -- drug-eluting vs. bare metal which is better?

This major symposium -- one of the very few that brings together both cardiologists and heart surgeons -- will directly explore the controversies and latest medical and surgical advances in an open forum. Many subjects will be addressed in debate formats. Others will be lectures presented by highly respected leaders in their fields.

Lawrence K. Altman, M.D., author of the book "Who Goes First? The Story of Self-Experimentation in Medicine" and a member of the New York Times science news staff since 1969, will be one of two keynote speakers. Altman, senior medical correspondent at the Times, has published an average of 100 scientific stories a year and writes the column "Doctor's World." His remarks will focus on medicine and the media.

A clinical professor at New York University Medical School, Altman has received three Howard W. Blakeslee Awards from the American Heart Association and the George Polk Award for excellence in journalism.

Eduardo Marbán, M.D., Ph.D., recently named director of the Cedars-Sinai Heart Institute, will be the second keynote speaker and will discuss stem cell therapy for cardiac regeneration. Prior to joining Cedars-Sinai, Marbán was a member of The Johns Hopkins University School of Medicine faculty for 22 years, most recently serving as chief of cardiology and professor of cardiology, physiology and biomedical engineering.

Editor-in-Chief of the journal Circulation Research and an expert in molecular and cellular mechanisms underlying heart problems, Marbán is widely known for directing major multidisciplinary research programs leading to gene therapy, drug treatment and stem cell discoveries.

"The field of cardiology is poised for a revolution in which cell-based methods will be used to regrow healthy heart muscle after myocardial infarction or in chronic heart failure. Cardiac stem cells (CSCs) show great promise for regenerative therapy. Before 2003, when these resident stem cells within the heart were first discovered, the heart was thought to have little or no regenerative potential," said Marbán, providing a preview of his address.

"We have isolated cardiac stem cells from adult human and porcine endomyocardial biopsy specimens, differentiated them in vitro and characterized their functional properties. They can regrow healthy heart muscle and blood vessels," Marbán continued. "We also have developed methods to isolate and expand CSCs from routine biopsy specimens; they readily become excitable and contractile. These observations provide both a simple method and a solid rationale for the use of CSCs for autologous cardiac regeneration therapy."

Autologous refers to cells reimplanted within one patient, not transplanted from one person to another.

Marbán came to Cedars-Sinai to serve as the first director of the Heart Institute, which integrates and oversees the development of programs in cardiology, cardiac surgery, cardiac imaging and other areas. He has received funding to support three clinical studies reintroducing cardiac stem cells into heart patients, with first enrollment anticipated early next year.

Additional keynote speakers will include Dr. Jack Lewin, CEO American College of Cardiology, who will speak on healthcare reform.

Program directors for "Controversies and Advances in the Treatment of Cardiovascular Disease" include: Gregory P. Fontana, M.D., cardiothoracic surgeon and vice chairman of Surgery; Raj Makkar, M.D., cardiologist and director, Interventional Cardiology; P.K. Shah, M.D., cardiologist and director of the Division of Cardiology; Alfredo Trento, M.D., cardiothoracic surgeon and director of the Division of Cardiothoracic Surgery at Cedars-Sinai; and John G. Harold, M.D., FACC, cardiologist and President, California Chapter American College of Cardiology (ACC), ACC Governor for Southern California, and a recent Chief of Staff at Cedars-Sinai.

Sessions on Thursday, Oct. 4, will address coronary artery disease (part 1), mitral valve and carotid artery disease, arrhythmias and atrial fibrillation, and the future and new techniques. Friday's sessions look at coronary artery disease (part 2), aortic valve disease, congenital heart disease, and surgery and interventional cardiology. Several lectures and/or debates will be presented on each subject.

----------------------------
Article adapted by Medical News Today from original press release.

The first in Southern California and one of only 10 hospitals in the state whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles' most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP). Additional information is available at http://www.cedars-sinai.edu/.

Source: Sandy Van
Cedars-Sinai Medical Center

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