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Ft innovative lawyers 09.10.14
Ius Laboris ranked for innovative client service by the Financial Times, Innovative Lawyers Report, 09 October 2014
Otoplasty: New Modification of the Mustardé technique
Title: Otoplasty: New Modification of the Mustardé technique
Author: Mohamed A.S.M. El-Rouby, MD,
Assistant Professor of Plastic surgery, Ain Shams University, Cairo, Egypt.
Abstract
Background: one of the most established techniques for management of protruding ears is the Mustardé technique (1). Many modifications had been published for this technique; however, all these modifications started by retro-auricular incision. We modify the Mustardé technique using three retroauricular microincisions to correct several deformities of the auricular cartilage in protruding ears.
Patients and Methods: 46 patients (7unilateral, 39 bilateral) (85 ears) who were candidates for this technique, their age (25 ± 2.8 years), 38 males, 8 females. The operation time, steps, follow up sessions (2 weeks, 3, 6 and 18 months) data was recorded. Preoperative and postoperative (1,18 months) photos were compared and analyzed by custom made computer program the evaluated the results.
Results: 42 patients achieve a natural appearance. extrusion of threads occurred in 8 ears. Asymmetrical ears were noticed in 4 patients and recurrence in 11 patients. These patients were revised by Mustardé technique with retro-auricular incisions. None of the patients developed retro-auricular scars.
Conclusion: this versatile modification allows for better asthenic results of otoplasty and minimizes complications of skin incision unless cartilage and/or skin resection is needed.
Efficacy of Injectable Collagenase in the treatment of Dupuytren’s contractur...
Efficacy of Injectable Collagenase in the treatment of Dupuytren’s contractur...Dr. Mohamed El-Rouby دكتور محمد الروبي
This study compared the efficacy of injectable collagenase versus partial fasciectomy in treating Dupuytren's contracture. 15 patients (33 rays) were divided into two groups: Group A underwent partial fasciectomy (26 rays) while Group B was treated with collagenase injections (7 rays). The collagenase treatment was found to be safe and effective, with contractures improving significantly and few complications. However, recurrence and failure rates were slightly higher compared to surgery. While collagenase injection is a good alternative to surgery, its higher cost should be considered, especially in developing countries.Wound Defect management
This document provides information about Mohamed Ahmed El-Rouby, an assistant professor of plastic and reconstructive surgery, and summarizes his expertise in wound closure techniques. It discusses direct closure for linear wounds, skin grafts or flaps for wide area wounds and skin loss, and re-implantation for amputations. Skin grafts are described as tissue transferred without its own blood supply, while flaps have an intact vascular supply. Factors like thickness, origin, adherence and revascularization processes are reviewed for grafts. Complications and various applications of grafts and flaps for nerves, fat, tendons, cartilage, bone and more are outlined.
Necrotizing fasciitis
Gangrene is the death of body tissue due to loss of blood supply. It is caused by infection or reduced blood flow and can be dry, wet, or gas gangrene. Dry gangrene develops slowly in tissues like the feet of diabetics. Wet gangrene occurs rapidly in moist tissues and causes swelling and odor. Gas gangrene is a medical emergency caused by soil bacteria that produce tissue-damaging gases. Treatment involves antibiotics, surgery to remove dead tissue, and sometimes amputation.
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This document discusses reconstruction of eyelid defects. It begins by describing the anatomy and functions of the eyelids. Eyelid defects can be anatomical, involving the structure of the eyelid, or functional, affecting eyelid movement. The objectives of reconstruction are to restore anatomical integrity, physiological function, and acceptable cosmetic appearance. Various surgical techniques are described for reconstructing different types and sizes of defects in the upper and lower eyelids. Key principles include documenting the defect, avoiding tension, and using similar tissue when possible. The timing, planning and postoperative care of reconstruction are also outlined.
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This document provides information on various topics related to wound management and suturing techniques. It begins with an introduction and contact information for Dr. Mohamed Ahmed El-Rouby. It then covers topics such as sterilization, wound classification, tetanus prophylaxis, wound healing, closure techniques, suture materials and types, and various suturing methods. Diagrams are provided to illustrate different suture patterns. The document aims to be a comprehensive reference on wound management and suturing.
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Ft innovative lawyers 09.10.14
Ius Laboris ranked for innovative client service by the Financial Times, Innovative Lawyers Report, 09 October 2014
Otoplasty: New Modification of the Mustardé technique
Title: Otoplasty: New Modification of the Mustardé technique
Author: Mohamed A.S.M. El-Rouby, MD,
Assistant Professor of Plastic surgery, Ain Shams University, Cairo, Egypt.
Abstract
Background: one of the most established techniques for management of protruding ears is the Mustardé technique (1). Many modifications had been published for this technique; however, all these modifications started by retro-auricular incision. We modify the Mustardé technique using three retroauricular microincisions to correct several deformities of the auricular cartilage in protruding ears.
Patients and Methods: 46 patients (7unilateral, 39 bilateral) (85 ears) who were candidates for this technique, their age (25 ± 2.8 years), 38 males, 8 females. The operation time, steps, follow up sessions (2 weeks, 3, 6 and 18 months) data was recorded. Preoperative and postoperative (1,18 months) photos were compared and analyzed by custom made computer program the evaluated the results.
Results: 42 patients achieve a natural appearance. extrusion of threads occurred in 8 ears. Asymmetrical ears were noticed in 4 patients and recurrence in 11 patients. These patients were revised by Mustardé technique with retro-auricular incisions. None of the patients developed retro-auricular scars.
Conclusion: this versatile modification allows for better asthenic results of otoplasty and minimizes complications of skin incision unless cartilage and/or skin resection is needed.
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This study compared the efficacy of injectable collagenase versus partial fasciectomy in treating Dupuytren's contracture. 15 patients (33 rays) were divided into two groups: Group A underwent partial fasciectomy (26 rays) while Group B was treated with collagenase injections (7 rays). The collagenase treatment was found to be safe and effective, with contractures improving significantly and few complications. However, recurrence and failure rates were slightly higher compared to surgery. While collagenase injection is a good alternative to surgery, its higher cost should be considered, especially in developing countries.Wound Defect management
This document provides information about Mohamed Ahmed El-Rouby, an assistant professor of plastic and reconstructive surgery, and summarizes his expertise in wound closure techniques. It discusses direct closure for linear wounds, skin grafts or flaps for wide area wounds and skin loss, and re-implantation for amputations. Skin grafts are described as tissue transferred without its own blood supply, while flaps have an intact vascular supply. Factors like thickness, origin, adherence and revascularization processes are reviewed for grafts. Complications and various applications of grafts and flaps for nerves, fat, tendons, cartilage, bone and more are outlined.
Necrotizing fasciitis
Gangrene is the death of body tissue due to loss of blood supply. It is caused by infection or reduced blood flow and can be dry, wet, or gas gangrene. Dry gangrene develops slowly in tissues like the feet of diabetics. Wet gangrene occurs rapidly in moist tissues and causes swelling and odor. Gas gangrene is a medical emergency caused by soil bacteria that produce tissue-damaging gases. Treatment involves antibiotics, surgery to remove dead tissue, and sometimes amputation.
Reconstruction of eyelids defects
This document discusses reconstruction of eyelid defects. It begins by describing the anatomy and functions of the eyelids. Eyelid defects can be anatomical, involving the structure of the eyelid, or functional, affecting eyelid movement. The objectives of reconstruction are to restore anatomical integrity, physiological function, and acceptable cosmetic appearance. Various surgical techniques are described for reconstructing different types and sizes of defects in the upper and lower eyelids. Key principles include documenting the defect, avoiding tension, and using similar tissue when possible. The timing, planning and postoperative care of reconstruction are also outlined.
Basic skills in medicine
This document provides information on various topics related to wound management and suturing techniques. It begins with an introduction and contact information for Dr. Mohamed Ahmed El-Rouby. It then covers topics such as sterilization, wound classification, tetanus prophylaxis, wound healing, closure techniques, suture materials and types, and various suturing methods. Diagrams are provided to illustrate different suture patterns. The document aims to be a comprehensive reference on wound management and suturing.
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Rhinoplasty - all You want to know about rhinoplasty or nose job
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Bone and cartilage healing
This document discusses bone structure, types, healing, and grafting. It describes that bone is composed of cells integrated into a rigid calcium framework. There are two main types of ossification - endochondral, where bone forms within cartilage templates in long bones, and membranous, where bone forms directly in flat bones. Fracture healing can occur directly through bony reconstruction or indirectly through soft and hard callus formation. Bone grafts are used for nonunions, defects, and augmentation, and work through osteogenesis, osteoinduction and osteoconduction. Autogenous grafts from sites like the iliac crest are commonly used but allografts and substitutes like BMP are also options.
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Rhytidectomy, also known as a face lift, has evolved over time from early procedures that were viewed negatively to becoming more accepted. The classic facelift technique developed in the 1950s, while newer deep plane techniques emerged in the 1990s. A thorough preoperative evaluation assesses medical history, expectations, and identifies asymmetries to plan the optimal procedure. The surgery involves incisions and redistribution of the superficial musculoaponeurotic system to improve contours, while minimizing risks like hematoma and nerve injury.
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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Aging upper face
- 4. 1 32