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Equipping your facial plastic clinic for office-based procedures

World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第3期9卷 206-211页

作者： Arman Saeedi Danielle F.Eytan Department of Otolaryngology-Head and Neck Surgery Division of Facial Plastic and Reconstructive SurgeryNew York University Grossman School of MedicineNew YorkNew YorkUSA

Office-based procedures can be a fulfilling part of the facial plastic practice with the right tools,personnel,and preparation.Equipping the clinic for office-based procedures has several unique considerations that ultimately impact its success.It is important to strategize preemptively regarding what treatments will be offered and the respective equipment that will allow the safe,cost-effective,and high-quality delivery of those treatments.Most procedures in the office-based setting are cosmetic in nature and there are often overlapping treatment modalities that target similar outcomes.Patient selection and counseling is a crucial step in preparing for office-based procedures in the effort to maximize patient satisfaction.Nearly all the most common facial plastic procedures can be delivered in the office-based based setting under local anesthesia and moderate sedation,depending on the expertise of the surgeon.To enable these and other categories of treatments,there are certain expensive pieces of technology that one might consider for their office-based practice and other fundamental supplies that are necessary for almost all practices.Though the initial investment in equipment can be costly,this article also discusses more affordable alternatives or third-party sales of devices and equipment.The field of facial plastic surgery is very dynamic and having both peer and mentorship networks is invaluable in navigating some of the financial decisions discussed herein.This article also briefly covers personnel,training,and accreditation considerations.

关键词： ambulatory surgical procedures equipment medical practice management

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High-Performance Macrotia Surgery

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Modern Plastic Surgery 2022年第4期12卷 61-75页

作者： Marcelo Souza Assis Gabriel Rosas Leila Souto Miranda Department of Plastic Surgery Orelhinha Institute Campinas Brazil Department of Anesthesia Orelhinha Institute Campinas Brazil Orelhinha Institute Campinas Brazil

Many articles report that macrotia is a rare ear deformity, but this is not the reality that we encounter in our service. In accordance with anthropometric studies of the ears, we consider that an aesthetically normal ear measures 6.0 cm in length on the vertical axis and 3.7 cm on the horizontal axis in boys, with ear growth maturing at 13 years of age, and 5.91 cm in length on the vertical axis and 3.37 cm on the horizontal axis, with ear growth maturing at age 12 in girls. When the measurements exceed these averages, we consider that the patient has macrotia. The authors describe a new technique of surgical correction of macrotia that results in an average reduction of 1.7 cm on the vertical axis and 0.8 cm on the diagonal axis with an average surgical time of forty-five minutes, fast learning curve, and little scarring. This technique also allows it to be combined with otoplasty and correction of the lobe length. Because of these items we call the technique High-Performance Macrotia Surgery. Level IV: Evidence is obtained from multiple time series with or without the intervention, such as case studies.

关键词： Ear Acquired Ear Deformities Ear Cartilage ambulatory surgical procedures Macrotia Plastic Surgery

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Inguinal Hernia Repair with Local Anesthesia in the Outpatient—10 Year Experience

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International Journal of Clinical Medicine 2014年第12期5卷 644-649页

作者： Flavio Antonio de Sa Ribeiro Baltazar de Araujo Fernandes Joao Pedro de Araujo Simoes Correa Surgery of UNIFESO TeresopolisBrazil Hospital Federal de Bonsucesso Rio de JaneiroBrazil General Surgery Service Hospital Geral de BonsucessoRio de JaneiroBrazil

Objective: To demonstrate the feasibility of inguinal hernia repair with local anesthesia in an out-patient regime, with safety, efficacy and short learning curve. Methods: We prospectively evaluated 1186 patients undergoing inguinal hernia repair under local anesthesia on an outpatient basis between November 2004 and March 2014. Of the total number of hernias surgically treated in this period, 755 were operated on the right, 394 on the left and 37 bilateral. We used clinical, surgical and psychosocial criteria for inclusion in the procedure. The parameters for exclusion were complex, irreducible or recurrent hernia, obesity (BMI greater than 30 kg/m2), patient’s refusal and psychiatric disorder. All patients underwent elective surgery and were analyzed regarding surgical outcome, complications and hospital stay. Results: All operations were completed successfully. In no case there was a need to change the anesthetic method. surgical time was similar to that conducted with other methods of anesthesia and there were no cases of adverse effects of local anesthetics. Intra-operative complications amounted to approximately 2.64%. There was no need for hospital admissions greater than 24 hours. Conclusion: The procedure is feasible and causes no perioperative significant pain, is safe, can be performed by residents under supervision, has satisfactory patient acceptance and complications similar to those observed in a conventional herniorrhaphy, allowing lower time and cost of hospitalization and faster access to treatment.

关键词： Inguinal Hernia/Surgery Local Anesthesia ambulatory surgical procedures

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