reconstructive plastic surgery

重建整形外科
  • 文章类型: Journal Article
    背景:在重建整形手术中,由于该领域的复杂性,对全面研究和系统评价的需求是显而易见的,影响支持特定程序的证据。尽管Chat-GPT的知识仅限于2021年9月,但其与研究的整合对于有效识别知识差距很有价值。因此,这个工具成为一个强大的资产,指导研究人员专注于在最必要的地方进行系统评价。
    方法:系统提示Chat-GPT3.5生成10个未发布的,关于乳房重建手术的创新研究课题,其次是10个额外的子主题。在PubMed中过滤结果以进行系统评价,并确定了新的想法。要评估Chat-GPT在生成改进响应方面的能力,使用Chat-GPT生成的搜索词进行了另外两次搜索.
    结果:Chat-GPT产生了83个新颖的想法,准确率为83%。在变性女性等主题中产生了广泛的新颖想法,产生10个想法,而无细胞真皮基质(ADM)产生了五个想法。Chat-GPT增加了产生的手稿总数,其中第一个增加了2.3、3.9和4.0倍,第二,和第三次审判,分别。虽然搜索结果对我们的手动搜索是准确的(准确率为95.2%),更多的手稿可能会稀释文章的质量,导致较少新颖的系统审查思路。
    结论:Chat-GPT在发现文献空白和提供对乳房重建手术缺乏研究领域的见解方面被证明是有价值的。虽然它显示高灵敏度,完善其特殊性势在必行。谨慎的做法包括评估已完成的工作并对所有涉及的组件进行全面审查。
    BACKGROUND: In reconstructive plastic surgery, the need for comprehensive research and systematic reviews is apparent due to the field\'s intricacies, influencing the evidence supporting specific procedures. Although Chat-GPT\'s knowledge is limited to September 2021, its integration into research proves valuable for efficiently identifying knowledge gaps. Therefore, this tool becomes a potent asset, directing researchers to focus on conducting systematic reviews where they are most necessary.
    METHODS: Chat-GPT 3.5 was prompted to generate 10 unpublished, innovative research topics on breast reconstruction surgery, followed by 10 additional subtopics. Results were filtered for systematic reviews in PubMed, and novel ideas were identified. To evaluate Chat-GPT\'s power in generating improved responses, two additional searches were conducted using search terms generated by Chat-GPT.
    RESULTS: Chat-GPT produced 83 novel ideas, leading to an accuracy rate of 83%. There was a wide range of novel ideas produced among topics such as transgender women, generating 10 ideas, whereas acellular dermal matrix (ADM) generated five ideas. Chat-GPT increased the total number of manuscripts generated by a factor of 2.3, 3.9, and 4.0 in the first, second, and third trials, respectively. While the search results were accurate to our manual searches (95.2% accuracy), the greater number of manuscripts potentially diluted the quality of articles, resulting in fewer novel systematic review ideas.
    CONCLUSIONS: Chat-GPT proves valuable in identifying gaps in the literature and offering insights into areas lacking research in breast reconstruction surgery. While it displays high sensitivity, refining its specificity is imperative. Prudent practice involves evaluating accomplished work and conducting a comprehensive review of all components involved.
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  • 文章类型: Journal Article
    几十年来,整形外科医生一直将重建梯子用作复杂创伤重建的标准目录,目的是修复身体结构和恢复功能。这包括不同的手术操作,如次要意图和直接组织闭合,以及更复杂的方法,如局部组织转移和游离皮瓣。重建梯代表了广泛已知的可实现的组织重建和伤口闭合的选项,其在底部横档放置最简单的重建方法并通过向上移动来加强复杂性。再生医学和外科手术构成了转化研究的快速发展领域,可以被微创手术策略所采用。目的是在体内再生细胞和组织,以便通过细胞的内在潜力重建正常功能,结合生物材料和适当的生化刺激。这些翻译程序的目的是创建能够支持生理细胞功能的适当微环境,以产生所需的细胞或组织并产生实质。基质,和血管成分的需求,最重要的是生产能够决定细胞命运的智能材料。智能技术已经发展起来,在经典的重建阶梯上提供额外的“梯级”,以整合更全面的,以患者为基础的方法,改善了结果。这篇评论介绍了整形外科领域重建阶梯的传统概念演变为一门新课程,旨在通过应用创新技术和生物活性分子来治疗各种外科疾病,实现软组织重建的优异成绩。
    Plastic surgeons have used the reconstructive ladder for many decades as a standard directory for complex trauma reconstruction with the goal of repairing body structures and restoring functionality. This consists of different surgical maneuvers, such as secondary intention and direct tissue closure, as well as more complex methods such as local tissue transfer and free flap. The reconstructive ladder represents widely known options achievable for tissue reconstruction and wound closure that puts at the bottom rung the simplest methods of reconstruction and strengthens the complexity by moving upward. Regenerative medicine and surgery constitute a quickly spreading area of translational research that can be employed by minimally invasive surgical strategies, with the aim of regenerating cells and tissues in vivo in order to reestablish normal function through the intrinsic potential of cells, in combination with biomaterials and appropriate biochemical stimuli. These translational procedures have the aim of creating an appropriate microenvironment capable of supporting the physiological cellular function to generate the desired cells or tissues and to generate parenchymal, stromal, and vascular components on demand, and above all to produce intelligent materials capable of determining the fate of cells. Smart technologies have been grown that give extra \"rungs\" on the classic reconstructive ladder to integrate a more holistic, patient-based approach with improved outcomes. This commentary presents the evolution of the traditional concept of the reconstructive ladder in the field of plastic surgery into a new course with the aim of achieving excellent results for soft tissue reconstruction by applying innovative technologies and biologically active molecules for a wide range of surgical diseases.
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  • 文章类型: Journal Article
    通常情况下,在任何创伤性事故中,发生硬组织损失以进行恢复性整形手术,因为有许多材料和方法用来恢复损失,这项研究揭示了使用一种这样的材料和方法,即由聚醚醚酮(PEEK)制造的3D打印面部植入物,并评估使用所述方法修复颌面部畸形后患者的满意度。
    一项研究样本,由10名面部畸形患者组成,在2020年至2021年之间在叙利亚拉塔基亚蒂斯林大学医院口腔颌面外科接受了颌面重建手术。所有患者都接受了计算机断层扫描(CT)扫描,然后进行了所需的面部植入物的设计,面部植入物的最终形式是由聚醚醚酮(PEEK)印刷而成的,然后进行了外科手术,我们在手术3个月后进行了检查,以1-5的量表评估满意度.
    10名患者的结果显示了良好的满意度,除了一例患者由于反复感染而不得不移除面部植入物,患者在手术后对药物治疗没有反应的迹象。
    这项研究表明,使用3D打印的PEEK面部植入物在治疗各种面部畸形的功能和美学方面非常合意。
    UNASSIGNED: it is generally the case in any traumatic accident where a loss in hard tissue occurs to preform restorative plastic surgery, as there are many materials and approaches used to restore the loss, this research sheds the light on the use of one such material and approach being 3D printed facial implants manufactured from PolyEther Ether Ketone (PEEK) and to evaluate the level of patients\' satisfaction following the use of said method in repairing maxillofacial deformities.
    UNASSIGNED: a research sample consisting of 10 patients with facial deformities underwent maxillofacial reconstructive surgery between 2020 and 2021 in the Department of Oral and Maxillofacial Surgery in the Tishreen University Hospital - Latakia - Syria. All patients underwent Computed Tomography (CT) scans, then the design of the required facial implant was carried out, the final form of the facial implant was printed from PolyEther Ether Ketone (PEEK), and then surgical work was performed, a check-up after 3 months of the surgical procedure was carried out to evaluate the level of satisfaction on a scale of 1-5.
    UNASSIGNED: The results from the 10 patients showed a good level of satisfaction except in one case where the facial implant had to be removed due to recurrent infection where the patient showed no signs of response to medicinal treatment following the surgery.
    UNASSIGNED: this research suggests that the use of 3D printed PEEK facial implants to be very agreeable in terms of functionality and aesthetics in treating various facial deformities.
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  • 文章类型: English Abstract
    The article presents a literature review, that analyzes the use of implantation materials in reconstructive plastic surgery of the larynx and trachea in patients with local and extended laryngeal-tracheal stenosis, including lumen obliteration. 48 literature sources were studied. The positive and negative aspects of biological and synthetic implant materials use have been determined. The choice of an implantation material that meets all the demands for the complete restoration of the respiratory tract determines the relevance of the problem raised.
    В обзоре литературы проведен анализ использования имплантационных материалов в реконструктивно-пластической хирургии гортани и трахеи у пациентов с ограниченными и протяженными гортанно-трахеальными стенозами, в том числе с облитерацией просвета. Изучено 53 источника литературы. Определены положительные и отрицательные стороны использования биологических и синтетических имплантационных материалов. Необходимость выбора имплантационного материала, удовлетворяющего всем необходимым критериям для полного восстановления респираторного тракта, определяет актуальность затронутой проблемы.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    Plastic surgeons around the globe are implementing projects that mix audit with medical research to ensure and improve the level of care offered to patients with cleft lip and palate. Drawing on recent literature on \"audit culture\" and the global growth of \"performance indicators\" as a form of governance, I demonstrate the conjugation of ethics and the production of numerical indicators in cleft treatment. By standardizing documentation, cleft treatment audit programs facilitate evidence-based medicine and a form of reflexive self-governance. However, the abstraction that accompanies standardization is amplified as corollary data practices travel. In emerging as the answer to improving treatment, these projects lock out the politico-economic factors that mediate medical care in resource poor settings. This danger is compounded by the tendency of numerical governance to replace political conversation with technocratic expertise.
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  • 文章类型: Journal Article
    Evaluation of effectiveness in reconstructive plastic surgery has become an increasingly important asset in comparing and choosing the most suitable medical procedure to handle facial disfigurement. Unfortunately, traditional methods to assess the results of surgical interventions are mostly qualitative and lack information about movement dynamics. Along with this, the few existing methodologies tailored to objectively quantify surgery results are not practical in the medical field due to constraints in terms of cost, complexity and poor suitability to clinical environment. These limitations enforce an urgent need for the creation of a new system to quantify facial movement and allow for an easy interpretation by medical experts. With this in mind, we present here a novel method capable of quantitatively and objectively assess complex facial movements, using a set of morphological, static and dynamic measurements. For this purpose, RGB-D cameras are used to acquire both color and depth images, and a modified block matching algorithm, combining depth and color information, was developed to track the position of anatomical landmarks of interest. The algorithms are integrated into a user-friendly graphical interface and the analysis outcomes are organized into an innovative medical tool, named facegram. This system was developed in close collaboration with plastic surgeons and the methods were validated using control subjects and patients with facial paralysis. The system was shown to provide useful and detailed quantitative information (static and dynamic) making it an appropriate solution for objective quantitative characterization of facial movement in a clinical environment.
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    文章类型: Journal Article
    As diverse as the causes of oropharyngeal dysphagia can be, as broad is the range of potential therapeutical approaches. In the past two decades, methods of plastic-reconstructive surgery, in particular microsurgically revascularised tissue transfer and minimally invasive, endoscopic techniques of every hue have substantially added to the portfolio of reconstructive surgery available for rehabilitating deglutition. Numerically, reconstructing the pharyngolaryngeal tract following resection of squamous-cell carcinomas in the oral cavity, the pharynx and the larynx has been gaining ground, as has functional deglutitive therapy performed to treat posttherapeutical sequelae. Dysphagia and malnutrition are closely interrelated. Every third patient hospitalised in Germany suffers from malnutrition; ENT tumour patients are not excluded. For patients presenting with advancing malnutrition, the mortality, the morbidity and the individual complication rate have all been observed to increase; also a longer duration of stay in hospital has been noted and a lesser individual toleration of treatment, diminished immunocompetence, impaired general physical and psychical condition and, thus, a less favourable prognosis on the whole. Therefore, in oncological patients, the dietotherapy will have to assume a key role in supportive treatment. It is just for patients, who are expected to go through a long process of deglutitive rehabilitation, that enteral nutrition through percutaneous endoscopically controlled gastrostomy (PEG) performed at an early stage can provide useful and efficient support to the therapeutic efforts. Nutrition and oncology are mutually influencing fields where, sooner or later, a change in paradigms will have to take place, i.e. gradually switching from therapy to prevention. While cancer causes malnutrition, feasible changes in feeding and nutrition-associated habits, including habitual drinking and smoking, might lower the incidence of cancer worldwide by 30 to 40% (American Institute of Cancer Research 1999).Esse oportet, ut vivas, non vivere ut edas. / Thou shouldst eat to live, not live to eat.Cicero 106 - 43 B.C.
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