Background Cryolipolysis is a proven and effective means of fat reduction; however, there are no standardized means of measuring volume reduction. Objectives We aim to assess the volume loss using a 3-dimensional (3D) analysis following submental cryolipolysis. Methods A retrospective cohort study between April 2016 and August 2018 was performed. Thirty-five patients underwent a single 45-minute cycle of cryolipolysis to the submental region using the CoolSculpting System. A 3-fold analysis was performed employing an independent observer assessment of 2-dimensional photographs and 3D volumetric analysis utilizing the Vectra XT system, and patient satisfaction was measured with the FACE-Q questionnaire. Results Our results suggested the mean (standard deviation) pretreatment volume (n = 35) was 104.12 cm3 (28.78). The 6-week mean posttreatment volume (n = 26) was 81.55 cm3 (21.29). The mean volume reduction found at 6 weeks posttreatment showed a reduction of 22.46 cm3 (19.10) (95% CI 14.74 to 30.17, P < 0.0001). The 12-week mean posttreatment volume (n = 24) was 82.24 cm3 (23.97). The 12-week posttreatment demonstrated a reduction of 22.30 cm3 (14.04) (95% CI 16.37 to 28.23, P < 0.0001). The mean percentage correct for each reviewer correctly identifying the pretreatment and posttreatment photograph was 76.33% (7.14). Patient satisfaction showed a mean FACE-Q score of 54.10 (20.41). Conclusions The study further affirms that submental cryolipolysis is an efficacious and safe, noninvasive method for reducing submental adiposity resulting in notable patient satisfaction rates. Furthermore, results suggest that patients can have a volume loss of about 20% on average, allowing them to be more confident and comfortable with their appearance. Level of Evidence: 4
COVID-19 has been formally declared a pandemic by World Health Organization on the 11th of March 2020. 1 The effects of this on the health systems cannot be under-rated. In this unprecedented situation, perhaps one of the more under-estimated repercussions will be on medical students. There are several challenges common to all medical students such as the uncertainty in course requirements, the fear of exposure to COVID-19, the lack of guidance and the loss of learning opportunities. Nonetheless, it has also affected medical students of different levels indistinctly.Pre-clinical medical students are accessing e-learning solely while socially isolating themselves. E-Learning certainly has its merits but lacks the engaging qualities of in-person learning. The study of medicine is complex, requiring a multimodal approach with specialists providing clinical experience and guiding students out of the maze of endless archaic textbooks. Adjuncts to classroom teaching such as anatomy dissections, microbiology and histopathology labarotory work as well as the development of interpersonal skills in clinical interactions are paramount to these years. Furthermore, e-learning may present new challenges including technical issues, adaptability-struggle and computer literacy. It may be unaccessible by some, without access to on-campus wifi. To overcome this, certain universities have provided USB modems to students to increase accessibility to internet facilities. 2 Other universities have altered term outlines and exam dates. 3 These amendments in addition to technical issues that arise during exams may cause unneccesary added stress. There have also been concerns that students may be disadvantaged when exams are un-invigilated, with co-students cheating. During such times, we have little choice but to trust that students will maintain the highest standards of academic integrity.Students in clinical years are experiencing different challenges. Disruption to normal teaching and examination has left many students feeling uncertain and disoriented. The structure and length of clinical placement blocks are modified, along with semester breaks. Traditional examinations en masse are not possible. Practical assessments such as Objective Structured Clinical Examinations require alteration given the transmission risk associated with close contact of simulated patients and examiners. Most students in this group have been removed from clinical placement, leaving them without any practical teaching to rely upon.Final-year medical students face a more diverse spectrum of outcomes, albeit from a much stronger vantage point to both comprehend pandemic management and contribute to it directly. Their core study comprises almost exclusively of clinical placement with practical teaching in preparation for internship. For these students, changes to staffing and services are challenging. In Victoria, where
Background In Australia, the COVID‐19 pandemic has caused severe social disruptions, including restrictions to the movement of people. Healthcare centres around the world have seen changes in the nature of injuries acquired during the COVID‐19 pandemic; we therefore hypothesize that social isolation measures have changed the pattern of plastic and reconstructive surgery presentations. Methods A prospective cohort study was designed comparing patient presentations during the enforced COVID‐19 lockdown to two previous periods. All emergency referrals requiring operative intervention by the plastic and reconstructive surgery unit of our institution were included. Patient demographics, place and mechanism of injury, drug and alcohol involvement, delays to presentation, length of admission and complication rates were collected. Results Demographics and complication rates were similar across all groups. A 31.8% reduction in total number of emergency cases was seen during the lockdown period. Increase in do‐it‐yourself injuries ( P = 0.001), bicycle injuries ( P = 0.001) and injuries acquired via substance abuse ( P = 0.041) was observed. Head and neck injuries, mostly due to animal bites and falls, were also more prevalent compared to the same period the previous year ( P = 0.007). As expected, over 80% of plastic surgery operations during the COVID‐19 period were due to injuries acquired at home, a significant increase compared to previous periods. Conclusion Despite changes in the pattern of presentations requiring plastic and reconstructive emergency surgery, traumatic injuries continued to occur during the pandemic. Thus, planning will be essential to ensure resource allocation for emergency procedures is sustained as second and third waves of COVID‐19 cases emerge worldwide.
Introduction: Incisional negative pressure wound therapy (iNPWT) has been applied to bilateral breast reduction patients and shown a reduction in surgical complications. However, its effects on opioid use and hospitalisation length in this patient group has not been investigated.Methods: In this single surgeon retrospective cohort study, 52 patients who underwent bilateral breast reduction were analysed, with 23 patients in the iNPWT cohort and 29 in the standard-of-care (SOC) wound dressing cohort. Hospitalisation length, postoperative opioid use and surgical site complications were compared between cohorts. Mean (range) follow-up time was 369.15 (77-1329) days.Results: Hospitalisation length in days was significantly less in the iNPWT cohort (1.35) than the SOC cohort (2.03). Total ward opioid use was significantly reduced in the iNPWT cohort (45.50mg) compared to the SOC cohort (62.50mg). Discharge opioid prescription was significantly reduced in the iNPWT cohort (125.50mg) compared to the SOC cohort (230.00mg). The number of surgical site complications was significantly different between the groups (p=0.014).Discussion: This study suggests the use of iNPWT in bilateral breast reduction provides significant benefit through the reduction of hospitalisation, complications and opioid use. Conclusion: This is the first study to provide evidence for iNPWT in bilateral breast reduction in reducing postoperative opioid use and hospitalisation. It supports current literature showing a reduction in surgical site complications using iNPWT in bilateral breast reduction.
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