Browsing by Author "Djordjević, Boban (36090844000)"

Introduction. Complex defects of skull bones with different etiology, still present the challenge in reconstructive surgery. The goldstandard for cranioplasty is the autologous calvarial bone graft removed during surgery which cannot be always applied, especially in gunshot wounds for sometimes complete bone destruction. Autologous reconstruction with split calvarial, rib bones or iliac bone graft is also possible. Materials routinely used for reconstructions like titanium mesh, polymethyl metacrylate (PMMA), and other have numerous dis-advantages and limitations. Case report. We presented a patient with gunshot injury to the head with residual large bone defect in the frontal region, with involvement of the skull base, and open frontal sinus. After conservative treatment, six months after the injury, reconstruction of the residual bone defect was performed. The chosen material was computer-designed PEEK-OPTIMA® implant, manufactured on the basis of MSCT scan. This material has not been used in this region so far. The postoperative and follow-up period of the next 12 months passed without surgical complications, neurological deficit, with satisfactory functional and aesthetic results. Conclusion. Implanted bone replacement was designed and manufactured precisely according to the skull defect, and we found it suitable for the treatment of complex defects of the cranium. Early results are in favor of this cranioplasty method over standardized materials. Therefore, this material is expected to become a method of choice for reconstructive surgery of bony defects of the face and skull especially in complex cases. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. Complications of breast augmentation, as one of the most common cosmetic surgery, may be different. Besides usual early, local postoperative complicatons, the most common late complication is capsular contracture. As a specific complication of skin functions after this operation only disturbance of sensibility is described. Since the skin has other functions as well, and because there are no literature data available, the aim of this research was measuring the skin temperature before and after surgery. Methods. A prospective intervential study was done in 49 adult women. Bilateral augmentative mammaplasty was performed for breast hypoplasia or on the personal request of a patient with autrophic breasts. Measuring the temperature of the breast skin was done in two points, before the operation, and seven days and three months after surgery. The temperature measurement was done by the infrared thermometer (Pyrometer TROTEC BP21). Statistically significant difference was determined using the t-test for related samples. Differences were considered statistically significant if p was less than 0.05. Eta squared coefficient was use to determine the import size and according to the Cohen criteria everything over 10:14 signified a major impact. The data were analyzed by the IBP SPSS Statistics v20. Results. In a majority of patients the breasts were hypoplastic (69.39%). The most commonly used implants were 275–500 mL volume (46.94%), and the least common implants were over 500 mL (16.33%). In a little less than 2/3 of the patients submammary incision was used (61.22%). In a majority of patients (67.35%) the prosthesis were placed subglandularly. The average value of the temperature before the operation at the point 1 was 34.49ºC, seven days after surgery 34.81ºC, and three months after surgery 34.10ºC; and at the point 2: 34.60 ºC, 34.91ºC and 34.19ºC in the same time intervals. In relation to the size of the breasts before operation and the size of the implant manufacturer, the localization of the incision and placement of the localization of the prosthesis, no statistically significant differences in the temperature of the skin of the breast before and after surgery was observed. Conclusion. Our results on the change of skin temperature after the breast augmentation could be significant preoperative information for the patients. Apstrakt Uvod/Cilj. Komplikacije augmentacije grudi, kao jedne od najčešćih estetskih operacija, su moguće i različite. Osim uobičajenih ranih, lokalnih postoperativnih komplikacija, najčešća kasna komplikacija je kapsularna kontraktura. Kao specifična komplikacija poremećaja funkcije kože posle ove operacije opisan je samo poremećaj senzibiliteta. S obzirom na to da koža ima i druge funkcije, kao i zbog toga što ne postoje podaci u literaturi, cilj istraživanja bio je merenje temperature kože dojke pre i posle operacije. Metode. Urađena je prospektivna intervencijska studija kod 49 punoletnih žena koje nisu rađale. Bilateralna augmentaciona mamoplastika je rađena zbog hipoplazije dojki ili na lični zahtev pacijenta sa eutrofičnim dojkama. Merenje temperature kože dojke je rađeno u dve tačke, pre operacije, sedam dana posle operacije i tri meseca posle operacije. Merenje temperature je učinjeno infracrvenim termometrom (Pyrometer BP21 TROTEC). Statistička značajnost razlike je određena korišćenjem t-testa za vezane uzorke. Razlike su smatrane statistički značajnim ukoliko je p < 0,05. Koeficijent eta kvadrat određivao je veličinu uticaja i prema kriterijumu Cohena, sve preko 0,14 označavalo je veliki uticaj. Dobijeni su analizirani programom IBM SPSS Statistics v20. Rezultati. Kod većine ispitanica dojke su bile hipoplastične (69,39%). Najčešće su korišćeni implantati zapremine 275–500 mL (46,94%), a najređe implantati zapremine preko 500 mL (16,33%). Kod nešto manje od 2/3 pacijenata primenjen je submamarni rez (61,22%). Kod većine pacijenata (67,35%), proteza je plasirana subglandularno. Prosečna vrednost temperature pre operacije u tački 1 bila je 34,49°C, sedam dana nakon operacije 34,81°C, a tri meseca nakon operacije 34,10°C, a u tački 2: 34,60°C, 34,91°C i 34,19°C u istim vremenskim intervalima. U odnosu na veličinu dojki pre operacije, veličinu i proizvođača implantata, lokalizaciju incizije i lokalizaciju plasiranja proteze, nisu nađene statistički značajne razlike u temperaturi kože dojke pre i posle operacije. Zaključak. Naši rezultati o promeni temperature kože dojke posle augmentacije mogli bi da imaju značaj u preoperativnom informisanju pacijenta. © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Total knee arthroplasty in patients with rheumatoid arthritis is an effective method of eliminating pain and improving functional status, but it is associated with a number of unique challenges. The aim of this study was to evaluate the clinical and radiographic outcomes of total knee arthroplasty, as well as patient satisfaction, in this series of patients with rheumatoid arthritis. Methods. Between January 2001 and 2012, 108 total knee arthroplasties in 78 patients with rheumatoid arthritis were performed, utilizing a posteriorstabilized prostheses. The average age of the patients was 58 ± 12.4 years, and 88% were females. Median follow-up of patients was 80 months with interquartile range of 34 months (min-max: 36-132 months). Results. Average Knee Society score improved from preoperative 18 ± 11.4 to postoperative 83 ± 3.5, and Functional Knee Society score from 21 ± 9.9 to 50 ± 5. 9. Western Ontario and McMaster Universities Arthritis (WOMAC) knee injury and osteopaedic outcome scores improved from 23 ± 6.4 to 69 ± 4.6 postoperatively. In 25 (23.14%) knees radiolucent lines of less than 2 mm were found and they were not progressive. Survival rate excluding deep infection was 99.1%. Conclusion. Total knee arthroplasty is an effective procedure of treatment of damaged knee joint in patients with rheumatoid arthritis. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.