Navegando por Palavras-chave "Plastic Surgery"
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- ItemAcesso aberto (Open Access)Afetto- Alterações Faciais E Tratamento Portal De Informações(Universidade Federal de São Paulo (UNIFESP), 2018-08-17) Santos, Allan Da Costa [UNIFESP]; Gomes, Heitor Francisco De Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Craniofacial anomalies are a wide and diverse group of congenital deformities of the skull and facial bones. They present themselves as mild cases or stigmatizing abnormalities. Due to aesthetic and functional damages, affected individuals and their family members use the internet as a source of information. However, usually there is a lack of objective information available on the internet. The absence of reliable sources increases anxiety and fear about diagnosis and treatments. This thesis proposes the creation of a web portal that could provide clear, updated and accessible information. Moreover, this portal would localize referenced services distributed around the country. Objective: To design a website of reference in information about craniofacial anomalies. Methods: For the website’s development, the “Design Thinking” approach was used. It is divided in four phases: Discover, Define, Develop, and Deliver. In stage "Discover", interviews were made with lay and professional audiences about craniofacial anomalies. Suplementar reserch desk was done to support data. In stage "Define", the craniofacial anomalies that would be included in the website were chosen. In stage "Develop", a website’s sketch was performed using exercises of brainstorming about the theme. In the stage "Deliver" the website was released and tested as a source of easy information. Results: The website’s creation process, focused in easy and clear source of information for bearers of craniofacial anomalies, allowed the use of the “Design Thinking” approach. Conclusion: The website was named AFETTO (Portal of Craniofacial Anomalies) a tool that aims at bringing clear, objective and safe information for the general audience that wants to be instructed.
- ItemAcesso aberto (Open Access)Aplicativo Para Estratificação De Risco E Prevenção De Tromboembolismo Venoso Em Cirurgia Plástica(Universidade Federal de São Paulo (UNIFESP), 2018-08-16) Favarin, Eduardo [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Venous thromboembolism (VTE), defined as deep venous thrombosis and/or pulmonary embolism, is an important safety-related topic in patients undergoing surgical procedures. All preoperative patients should be carefully evaluated for risk factors for venous thromboembolism and preventive strategies should be adopted. Medical applications can be used to monitor patients, improve their treatment and assist doctors’ decision making. There are only two applications intended for plastic surgeons for VTE risk assessment but both only consider the risk factors of the patient and abstain from taking into account the procedure to be performed. Objective: To develop an a mobile-health application to assist surgeons in VTE risk stratification and prevention thrombotic events in plastic surgery. Method: The Design Thinking tool was used to create application with full participation of plastic surgeons enrolled in a professional master's degree in the four phases of the process: Discover, Define, Develop and Deliver. The application was made by a company contracted under the supervision of the author. To validate the project was used the patent method Canvas. Result: The VTE plastic surgery application was developed following Caprine Risk Assessment Score and guidelines issued by the American Society of Plastic Surgeons. It takes into account the procedure to be performed and the 39 risk factors considered by the Caprine score. Conclusion: The VTE plastic surgery application and is ready to be launched to be used by plastic surgeons aiming to prevent of VTE as a result of surgical procedures.
- ItemSomente MetadadadosEffects of Abdominoplasty on Female Sexuality: A Pilot Study(Wiley-Blackwell, 2012-03-01) Azevedo de Brito, Maria Jose [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Bussolaro, Rodolpho Alberto [UNIFESP]; Shinmyo, Lia Mayumi [UNIFESP]; Barbosa, Marcus Vinicius [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction. Changes in the pubic region resulting from abdominoplasty may have a psychosexual impact. Thus, it is important to study the influence of physical changes on the sexuality of patients after abdominoplasty. Aim. To evaluate the effects of the elevation of the mons pubis and consequent exposure of the clitoris in the vulvar commissure on the sexual functioning and sexual satisfaction of women who underwent abdominoplasty. Methods. Data were presented as mean +/- standard deviation. Nineteen women with a mean age of 35 +/- 7 years, mean body mass index of 23 +/- 2 kg/m(2) and who expressed a desire to undergo abdominoplasty were selected from consecutive patients attending the abdominal plastic surgery outpatient unit of a university hospital. Main Outcome Measures. Physical change (measured by the distance between the xiphoid process and vulvar commissure [xipho-vc]), sexual functioning, and sexual satisfaction (assessed with the Sexuality Assessment Scale), and body image (measured using the Body Shape Questionnaire [BSQ]) were evaluated preoperatively and 6 months after abdominoplasty. Results. There was a significant reduction (P = 0.0004; z = -3.53) in the xipho-vc distance 6 months after abdominoplasty compared with baseline (mean difference 3.63 +/- 2.79 cm), corresponding to an elevation of the mons pubis and consequent exposure of the clitoris. All patients reported a significant improvement in sexual functioning and sexual satisfaction 6 months after abdominoplasty when compared with baseline (P = 0.0001; z = -3.83). BSQ scores indicated an improvement in the patients' concerns about body shape (P = 0.0003; z = -3.58). Conclusion. Our results suggest that physical change and the new position of the clitoris may have a positive impact on sexuality. de Brito MJA, Nahas FX, Bussolaro RA, Shinmyo LM, Barbosa MVJ, and Ferreira LM. Effects of abdominoplasty on female sexuality: A pilot study. J Sex Med 2012; 9: 918-926.
- ItemAcesso aberto (Open Access)Impacto Do Sobrepeso E Da Obesidade Nas Complicações Em Cirurgias De Lipoaspiração: Revisão Sistemática(Universidade Federal de São Paulo (UNIFESP), 2018-07-26) Tavares, Marcelo Versiani [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Liposuction is the second most performed surgical procedure in plastic surgery worldwide, with almost 1.4 million / year, and the first in Brazil, with approximately 217 thousand / year. According to World Health Organization statistics, 39% of the population is overweight, and these rates are even higher in Brazil. Like any surgical procedure, this is not risk free, and patient safety is a major concern in the face of the growing demand for plastic surgeries and the high rates of overweight in the population. Objective: To carry out a systematic review of the impact of overweight and obesity on complications in liposuction surgeries. Methods: Electronic searches were performed at MEDLINE, LILACS and CENTRAL; there being no restriction of language, date and gender. Randomized, almost randomized clinical trials, as well as prospective and retrospective cohort studies were selected. Results: Applied to the database search strategy, 431 studies were identified, of which 393 were MEDLINE, 15 were LILACS and 23 CENTRAL. Twenty-one duplicate studies were excluded, leaving 410 studies. Twenty-three were selected for textual analysis, remaining only one. Conclusion: The data found are insufficient to affirm that overweight and obesity impact in complications in liposuction surgeries, it is necessary to carry out new clinical studies, in order to clarify the questioning.
- ItemAcesso aberto (Open Access)Litígio judicial entre paciente e cirurgião plástico em Minas Gerais(Universidade Federal de São Paulo (UNIFESP), 2017-04-07) Menezes, Jorge Antonio de [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Gomes, Heitor Francisco de Carvalho [UNIFESP]; http://lattes.cnpq.br/2266460253828291; http://lattes.cnpq.br/1619822351741819; http://lattes.cnpq.br/2877096920693550; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The number of complaints against physicians has increased in Brazil, especially in plastic surgery. This may be attributed to deterioration in the physician-patient relationship and patient dissatisfaction with the surgical outcome. Few studies on the causes of these lawsuits are available. OBJECTIVE: To determine the main causes of complaints regarding plastic surgery and evaluate the influence of the expert report on trial results. METHODS: Assessment of claims against plastic surgeons with a court decision rendered between April 2000 and March 2015 by the Court of Justice of Minas Gerais of second instance. RESULTS: The main complaint (31%) was dissatisfaction with the general surgical outcome, followed by unsightly scar (25%), and asymmetries (11%). Of the cases where the expert conclusions favored the physician, 64% were considered unfounded in the first and second instances; 23% were upheld in both instances; and 13% had the decision changed from well-founded to unfounded in the second instance. Of the cases where the expert conclusions favored the patient, 91% were upheld in both instances, and 9% had the decision changed from unfounded to well-founded in the second instance. Overall, 46% of cases were upheld and 43% were considered unfounded in both instances. Only 11% of cases had the decision changed from the first to the second instance. CONCLUSIONS: Most of patient complaints were related to events inherent to the surgical procedure, predicted as eventual complications. The expert conclusions were instrumental for the court decision in favor of or against the plastic surgeon. In most cases, the first instance decision was upheld at the second instance.
- ItemAcesso aberto (Open Access)Manual Para Implantação De Um Ambulatório De Cosmiatria Para Os Serviços Credenciados De Formação Em Cirurgia Plástica(Universidade Federal de São Paulo (UNIFESP), 2018-08-17) Santos, Leandro Menezes Lopes Dos [UNIFESP]; Haddad, Alessandra [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Cosmiatry is an area of medicine that aims to expand and extend procedures for maintaining the beauty and appearance of the skin and its appendix. In the majority of accredited training services in Plastic Surgery by the Brazilian Society of Plastic Surgery (SBCP) there are no specific outpatient clinics for attendance and training in Cosmiatry. Objective: To develop a Manual for the implantation of an Ambulatory of Cosmiatry for Accredited Training Services in Plastic Surgery in Brazil. Method: A review of the literature was made on the bases Scielo, Pubmed, Lilacs, selected articles on Cosmiatry. Researched as norms of the National Agency of Sanitary Surveillance (ANVISA) and of the Brazilian Association of Technical Norms (ABNT) for the implantation of medical outpatient clinics. A manual has been created with this data. A questionnaire was applied for method validation using a statistical method - Delphi methodology, together with a group of specialists. Results: Creation of a manual with the selection of contents validated by 7 judges, plastic surgeons with expertise in Cosmiatry, for the implementation of an outpatient clinic for teaching and training in this area. The manual was published in printed and electronic form. Conclusion: A manual was developed for implantation of a Cosmiatry outpatient clinic for Accredited Training Services in Plastic Surgery in Brazil.
- ItemAcesso aberto (Open Access)Melhorias No Atendimento Em Clínica Privada De Cirurgia Plástica, Com Foco No Paciente(Universidade Federal de São Paulo (UNIFESP), 2018-07-26) Coronel, Eugenio Alfonso Sempertegui [UNIFESP]; Gomes, Heitor Francisco De Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Medical textbooks, in general, neglect a very important aspect: the administration of a private clinic. That happens, in part, due to limitations in scoppus and ambition, and in another, by lack of official information on the subject. After years of professional training, many surgeons find themselves under capacitated, not only to deal with the daily commercial matters of the practice in their own clinics, but also, with their patients satisfaction. So, they do not become well succeeded. A constant and continuous ambition, in order to achieve excellence in business and marketing, should be a main part in all Plastic Surgery practice. Objetive: To improve the care in a established private Plastic Surgery clinic, with focus on the patient. Methods: The initial fases of the Design Thinking were used: Immersion and Ideation. After literature revision about management of business and surgical clinics, questionaries of the “Hero“ patients and of the clinic’s Staff were elaborated. Brainstorming meetings followe. Results: Many improvement suggestions were obtained, by means of the Design Thinking method, some of them were immediately incorporated. Conclusion: The Design Thinking, that foccus on patients’ experiences, allows the improvement in the care in a established private Plastic Surgery clinic.
- ItemSomente MetadadadosPercepção de segurança e conforto das pacientes submetidas à abdominoplastia com e sem o uso da cinta compressiva abdominal: ensaio clínico randomizado(Universidade Federal de São Paulo (UNIFESP), 2019-11-30) Aguiar, Leandro Do Couto [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The abdominal compression garment is widely used after abdominoplasty, but its use may increase the risk factors for thromboembolic phenomena. No studies were found that evaluated the real function of using the abdominal compressive elastic strap after abdominoplasty. There are only hypotheses that wearing this garment could reduce some types of complications. Likewise, its relationship with psychological comfort and the perception of safety for patients in the postoperative period was not established. Objective: the objective of this study is to evaluate the perception of safety and comfort of patients undergoing abdominoplasty with and without the use of the abdominal compression strap. Methods: Thirty-six female patients from the Abdominal Plastic Surgery Clinic of Hospital São Paulo, Federal University of São Paulo, underwent classic abdominoplasty. Before and after the 30-day postoperative period, the Brazilian Version of the Body Attitudes Questionnaire (BAQ) and a specific study questionnaire with 7 items related to the use of the abdominal compression garmentt were applied. Results: There were no distinct patterns of BAQ averages between groups during the evaluation moments (p = 0.268). Regarding the specific study questionnaire, evaluating the evolution of responses between pre and postoperative within the groups, a statistical difference was identified in the three questions directly related to the perception of safety and comfort with the use of the strap. Conclusion: Patients without compressive garment after abdominoplasty have a good perception of safety and comfort.
- ItemAcesso aberto (Open Access)Perfuração De Parede E Vísceras Abdominais Em Lipoaspiração(Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Souza, Gustavo Moreira Costa De [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Suction lipectomy is one of the most common surgical procedure in plastic surgery worldwide. Some of its complications can determine life threatening situations, as one can experience with the abdominal viscera perforation. Objective: Elaborate a review about perforation of the abdominal wall and abdominal viscera caused by suction lipectomy. Methods: A search in the scientific information services Pubmed, LILACS, SCIELO, COCHRANE and Google scholar was performed, with the choosen keys words and oficial terms related to the topic Results: The study selected 41 articles, among revisions, surveys, series and case reports. From this selection, 29 articles reported 61 cases about abdominal perforation during liposuction, 12 articles contributed with general information and recommendation about the clinical experience reported in this field. The mortality rate due to abdominal wall perforation during liposuction was 19,6%, and increased to 26,8%, when intestinal perforation was associated. The most common injury was the small bowel perforation. The anterior median abdominal wall was the most frequent muscularaponeurotic layer injured by the suction cannula. Perforation of hernia was reported only in one case in the entire series. Conclusion: A narrative review about the abdominal wall and abdominal viscera perforations during liposuction was performed. Little prevalence of the traditional risk factors was noticed. Important aspects of the clinical practice of liposuction were reinforced in the prevention and in the treatment of abdominal perforation after liposuction.
- ItemAcesso aberto (Open Access)Plasticonsent - Termo De Consentimento Informado Simplificado Online Em Cirurgia Plástica(Universidade Federal de São Paulo (UNIFESP), 2018-02-15) Sanjuan, Paulo Rodamilans [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The number of process against medical doctors in Brazil has increased, especially in plastic surgery. This increasing is attributed to a degeneration in the medical-patient relationship, considering the importance of the documentation focused in the informs and an informed consent that is clear and complete in order to avoid the information negligence. OBJECTIVE: develop a website that generate an informed consent, fast, practical and with individuality for each patient. METHOD: the five most common surgeries in Brazil were chosen, based on ISAPS (International Society of Aesthtic Plastic Surgery) data that are Lipoaspiration, Breast Augmentation, Blepharoplasty, Abdominoplasty and Rhinoplasty. The informed consents from wellknown plastic surgery departaments as well as the Brazilian, American and European Societies were reviewed. In Brazil, three plastic surgeons from each region (North, Northeast, Centerwest, South, Southeast) in a total of 15 with more than 10 years in practice had their terms studied in order to cover the country diversity and international tendency. RESULTS: An online platform was built with contente to generate informed consents in plastic surgery with many options for customization, increasing the informative power to the patient and conceding higher juridic support. CONCLUSION: The website Plasticonsent presentes as practical tool to create customized informed consent in plastic surgery.
- ItemSomente MetadadadosPrevalência da síndrome de burnout em residentes de cirurgia plástica no brasil.(Universidade Federal de São Paulo (UNIFESP), 2019-11-30) Lima, Edson Luiz De [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Plastic Surgery residency represents one of the most demanding training programs, with its residents undergoing constant stress and competition to prove their competence. As a result, this population may be more susceptible to Burnout Syndrome. Objective: Assess the prevalence of Burnout Syndrome among plastic surgery residents in Brazil. Methods: Primary, clinical, observational, descriptive, and cross-sectional study, conducted between November 2017 and February 2018. An online survey was conducted using a validated instrument, the Maslach Burnout Inventory, which, after due authorization, was sent to the residents of programs accredited by the Brazilian Society of Plastic Surgery and/or by the Ministry of Education. Burnout Syndrome was assessed by three dimensions (emotional exhaustion, depersonalization and personal accomplishment) and related to socio-demographic and occupational characteristics. Results: 68.5% (89/130) of plastic surgery residents obtained scores that were predictive of Burnout. Factors associated with Burnout Syndrome included: lack of leisure time (p=0.028), nights on call (p=0.042), having other jobs, in addition to the residency (p=0.009), worklife balance problems (p <0.001) and social and family relationship problems (p = 0.035). Conclusion: 68.5% of plastic surgery residents had symptoms of Burnout.
- ItemAcesso aberto (Open Access)Priori - Aplicativo De Gestão De Filas De Pacientes Para Cirurgia Plástica(Universidade Federal de São Paulo (UNIFESP), 2018-02-15) Guimaraes, Guilherme De Castro Greco [UNIFESP]; Gomes, Heitor Francisco De Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: In the Brazilian Health System - SUS, patients are treated in poorly structured institutions that doesn’t meet their psychosocial needs and health demands. They often have to wait in long queues and wait for elective surgeries , with no method of determining priorities and flow sequence for surgeries of these patients. Objective: Develop a patient management application for elective plastic surgery patients from Júlia Kubistchek Hospital (HJK). Method: For the development of the application, the methodology was used Design Thinking, which is divided into four phases: Discover, Define, Develop and Deliver. In the "Discover" phase, interviews and research desk were done; in the "Define" phase, queue priorities were determined; in the "Develop" phase, brainstorming sessions were held; and in the "Deliver" phase, the algorithm and application functionalities were developed. Results: A database was created and a priority algorithm to allocate patients, obeying the criteria of Brazilian legislation and the evidence obtained through Design Thinking. Developed an application for the desired functionality in collaboration with a technology company. Conclusion: PRIORI, an application to manage patient queues awaiting elective plastic surgeries in HJK, was developed.
- ItemSomente MetadadadosTranstorno dismórfico corporal e traços de personalidade em mulheres submetidas à mamoplastia de aumento.(Universidade Federal de São Paulo (UNIFESP), 2019-11-30) Pinto, Eduardo Rodrigues Sucupira [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The breast augmentation is one of the most performed aesthetic procedures in the world. Personality traits indicate the presence of psychological and social factors that together influence the experience of a plastic surgery procedure and may be risk factors for body dysmorphic disorder (BDD). Objective: To identify the BDD and personality traits in women submitted to breast augmentation. Methods: Thirty-six women with hypomasty (Sachini index <9 cm), mean age of 28.1 years (SD = 6.2), BMI ≤ 25Km / m2, without previous surgical procedures in the breasts, or associated pathologies, were included between March 2016 and May 2017. The Structured Clinical Interview (SCID-I), Big Five Inventory (IGFP-5), and Body Dysmorphic Symptoms Scale (BDSS) were applied preoperatively and after two and four months of mammoplasty. Results:The prevalence of preoperative BDD was 69.4% and after four months it decreased to 25%. BDD symptoms potentiated personality traits. Differences were observed for conscientiousness (p <0.001), BDD symptoms (BDSS) (p <0.001) and BDD diagnosis (SCID-I) (p <0.001) over time. Conclusion: Augmentation mammoplasty decreased BDD, psychosocial impairment and conscientiousness. Personality traits have been shown to be dynamic in intensity and overlap over time and associated with core symptoms of BDD, onset of body dissatisfaction, and demographic characteristics.