Background:
Although a large number of adult women worldwide are affected by lipedema, the physiologic conditions triggering onset and progression of this chronic disease remain enigmatic. In the present study, a descriptive epidemiologic situation of postoperative lipedema patients is presented.
Methods:
The authors developed an online survey questionnaire for lipedema patients in Germany. The survey was conducted on 209 female patients who had been diagnosed with lipedema and had undergone tumescent liposuction.
Results:
Most of the participants (average age, 38.5 years) had noticed a first manifestation of the disease at the age of 16. It took a mean of 15 years to accomplish diagnosis. Liposuction led to a significant reduction of pain, swelling, tenderness, and easy bruising as confirmed by the majority of patients. Hypothyroidism [n = 75 (35.9 percent) and depression [n = 48 (23.0 percent)] occurred at a frequency far beyond the average prevalence in the German population. The prevalence of diabetes type 1 [n = 3 (1.4 percent)], and diabetes type 2 [n = 2 (1 percent)] was particularly low among the respondents. Forty-seven of the lipedema patients (approximately 22.5 percent) suffered from a diagnosed migraine. Following liposuction, the frequency and/or intensity of migraine attacks became markedly reduced, as stated by 32 patients (68.1 percent).
Conclusions:
Quality of life increases significantly after surgery with a reduction of pain and swelling and decreased tendency to easy bruising. The high prevalence of hypothyroidism in lipedema patients could be related to the frequently observed lipedema-associated obesity. The low prevalence of diabetes, dyslipidemia, and hypertension appears to be a specific characteristic distinguishing lipedema from lifestyle-induced obesity.
Background:There exist various operative approaches for the treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundsborg’s resection arthroplasty (RA) with implantation of a total endoprosthesis.Patients and Methods:In this 2-center study, we retrospectively analyzed 71 patients with symptomatic osteoarthritis of the carpometacarpal I joint stage III according to the Eaton-Littler classification. Thirty-two patients underwent a Lundsborg’s RA group, and 39 patients received a total endoprosthesis of the carpometacarpal I joint (TEP group). We evaluated operative time, DASH score, postoperative time until resolution of symptoms, pain level, pinch force, and satisfaction with the treatment.Results:Both groups had a similar mean length of follow-up of 42 months (TEP group) and 36 months (RA group). The final DASH score was significantly better in the TEP-group (10.1 versus 21.5 in the RA group; P ≤ 0.05). Also, the time interval from surgery till absence of any pain (1.5 versus 5.9 months) and the time of inability to work (6 versus 21 weeks) were significantly shorter for the TEP group compared with the RA group (P ≤ 0.05). The pinch force, pain intensity, and the satisfaction with the treatment were comparable (P > 0.05). The duration of the operation was significantly shorter in the RA group (31 min versus 65 min in the TEP group; P ≤ 0.05).Conclusion:Both techniques resulted in improved function of the operated hand and a clear reduction of symptoms. However, the implantation of a total endoprosthesis seems to have advantages, given a significantly better DASH score and a significantly shorter time until resolution of symptoms.
Backround
Tactile sensibility plays a critical role in medicine, especially in surgical practice. In order to prevent surgical site infections and protect the surgeon, the use of surgical gloves is standard practice. However, wearing these might affect the sensibility of the hand disadvantageously, especially in disciplines that require precision work.
Methods
We evaluated the influence of six different glove types, as well as gloves wearing habits (double gloving, over- and undersized gloves) on tactile sensibility using two-point-discrimination and Semmes-Weinstein monofilament testing in 27 non-surgeons.
Results
There were significant differences regarding tactile sensibility of gloved compared to bare hands and between different types of gloves. While undersized gloves and double gloving did not affect tactile sensibility, oversized gloves were associated with a significant deterioration of the sensibility of the hand in the Semmes-Weinstein monofilament test.
Conclusion
This study demonstrates that surgical gloves negatively affect the sensibility of the hand and show significant differences between different types of gloves.
Extensive partial- and full-thickness burns, especially of the hands, continue to pose a surgical challenge. With improved knowledge regarding fluid balance, burn pathophysiology, and lately also given the introduction of topical negative pressure wound (TNPW) therapy, treatment regimes have changed in many burn centers. The authors evaluated the results regarding long-term outcomes of patients with partial- and full-thickness burns of the hands treated with TNPW. Over a period of 72 months, 51 patients with 80 hand burns received TNPW treatment. Medical records of all patients were reviewed retrospectively. All patients were further invited by letter, telephone, and/or email to participate in follow-up examinations. Finally, 30 patients with 47 involved hands participated in this study. Follow-up examinations were performed at a mean of 35 (range: 14-72) months postinjury. Measurements regarding the ability to completely dorsally extend the fingers and complete active fist closure showed no restrictions in 85.1 and 78.7% of cases. Mean Disabilities of the Arm, Shoulder, and Hand score among all patients was 13.8 (range: 0-35.8). Regarding the quality of the scars of the hand, 41 hands showed good quality with no signs of hypertrophic scar formation and 6 hands showed acceptable quality of scars with partial hypertrophic scar formation. In the authors' experience, TNPW therapy is a safe and effective modality to treat burns of the hand.
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