Asunto(s)
Labio Leporino , Fisura del Paladar , Adolescente , Labio Leporino/cirugía , Fisura del Paladar/cirugía , HumanosRESUMEN
There is an old saying that if you think you have discovered something new then it is because you don't read the German literature and there is some truth in this. When Plastic Surgery is mentioned the usual reply is "Ah, Gillies" as though he was the fons et origo of Plastic and Reconstructive surgery. The fact is that there were many more pioneering plastic surgeons outside the British Empire, whose work preceded and even surpassed Gilles. In 1818, Karl Ferdinand von Gräefe published "Rhinoplastik" and coined the term plastic surgery (Plastische Chirurgie). Eduard Zeis, in 1838 published the textbook "Handbuch der plastischen Chirurgie" and established its meaning based on hundreds of references. Undoubtably, the first decades of the 20th century, especially the war between 1914 and 1918, were the genesis of most modern developments in plastic surgery and there were many more pioneering plastic surgeons outside the British Empire, whose work preceded, equalled and even surpassed Gillies, despite his admirable achievements.
Asunto(s)
Procedimientos de Cirugía Plástica/historia , Cirugía Plástica/historia , Europa (Continente) , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Difusión de la Información , Cooperación InternacionalRESUMEN
OBJECTIVE: The Charles procedure is an aggressive operation usually only indicated for severe lymphedema as it often yields an unpredictable outcome. We modified this procedure in order to achieve predictable results. METHODS: The modification entailed the use of a negative-pressure dressing after the initial debulking surgery and then the delay of skin grafting by 5 to 7 days. Patients were graded by means of a lower limb functional scale to assess their functional status pre- and postoperatively. RESULTS: Eight patients with severe primary lymphedema underwent a modified Charles procedure. All patients underwent this procedure without any major complications with an average resection of 8.5 kg of lymphedematous tissue. Minor complications included operative blood loss and additional regrafting (3 patients). The average follow-up was 27.3 months. CONCLUSION: The results show a dramatic functional improvement in quality of life and a high overall satisfaction rate of patients undergoing this procedure. Our modification makes this a relatively simple procedure with a predictable outcome.