Browsing by Author "Vulović, Dejan (24400428000)"

Introduction. The umbilicus (omphalos; the navel; belly button; tummy button) is important in a medical and psychosocial context. Umbilical tumors are rare and can be benign or malignant, primary or secondary. The most common are malignant metastatic tumors, especially The Sister Mary Joseph Nodule, an eponym for the umbilical metastasis of intra-abdominal malignant tumors. Primary melanoma of the umbilicus is very rare, there is few literature data about it and its incidence is not well known. Therefore, the aim of this study was to present a patient with a rare localization of the primary skin melanoma, that was, also, of atypical form, large and involved the whole umbilicus and surrounding skin. Case Report. In this report, the patient had nodular red tumor which involved the whole umbilicus. Tumor had rapid growth. In the differential diagnosis, the tumor most by resembled a pyogenic granuloma. After the surgery, the histopathological finding showed the primary nodular skin melanoma (Clark V, Breslow 10 mm, positive for: vimentim S - 100 protein, melan - A and HMB - 45, and negative for EMA, with moderately high proliferative activity). Conclussion. According to literature data, this is 27th case of the primary melanoma of the umbilicus since 1916 when it was first reported. By presenting this rare clinical case, we emphasize that any skin lesion that is removed, must be sent to a histopathologic analysis. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Medico-legal aspect of physical disfigurements has been subject of few scientific researches. The aim of this study was to establish a standardized instrument for forensic evaluation of all kinds of physical disfigurements, which has not existed until now. Methods. The research was conducted in 3 phases: the first one – drafting a list of disfigurements; the second phase – evaluation of the draft of the disfigurement list provided by 11 experts (plastic surgery lecturers) by the use of the Delphy method; the third one during which 51 medical doctors, members of Serbian Association of Plastic, Reconstructive and Aesthetic Surgery were evaluating the list of disfigurements. Results. Totally 176 individual physical disfigurements were described in the first phase of research. In the second phase, 217 disfigurements were established which were classified into 5 degrees of severity 0 – none/very small, 1 – small, 2 – medium, 3 – large, 4 – very large disfigurements. In the third phase, 217 disfigurements were evaluated. Conclusion. The first 4-point ordinal scale was established, rating 217 disfigurements, which showed high level of compatibility in practice and which can be used as an instrument for standardization of disfigurements in giving of forensic expertise. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Most surgeons, at the end of corrective rhinoplasty, use endonasal tamponade and external splinting, primarily because of hemostasis and immobilization. Possible complications of this surgery are various. Pain, nose edema, palpebral swelling and ecchymosis, are the most common and usual. The aim of our study was to evaluate the incidence of nonaesthetic complications and the efficiency of corrective rhinoplasty without the use of tamponade and external splint. Methods. One hundred and fiftyone patients, who underwent primary corrective rhinoplasty without endonasal tamponade and without an external splint, were analyzed at the Clinical Centre “Kragujevac” in Kragujevac, Serbia, in the period 1999-May 2016. The surgeries were done by the same surgeon. Instead of a splint, sterile skin adhesive tapes were used. Study was prospective, consecutive case-series type. We analyzed the possible complications and subjective estimates of the patients who underwent primary corrective rhinoplasty in described fashion. In assessing postoparative pain, the visual analogue scale (VAS) in a range of 1 to 5 was used. Palpebral swelling and ecchymosis, were estimated 24h after surgery, by the Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) scale ranging from 0 to 5. The degree of restriction of nasal respiration was evaluated by the scale 1-4. The overall comfort of patients in the postoperative period was evaluated according to a scale: good, no opinion, bad. The patient satisfaction with the aesthetic result was analyzed on 7th and 30th day after surgery, by a scale from 1 (very satisfied) to 5 (very dissatisfied). Results. There were 151 patients aged between 18-47 years. Females were more frequent (72.18%). Most of the patients (40.39%) had moderate pain. None of the patients had neither severe nor the worst pain and 59 patients had no pain at all. Eyelid edema and periorbital ecchymosis were moderate in all patients (100%). The other complications did not occur, apart from one (0.66%) unilateral epistaxis, on postoperative day 10. Most of the patients (52.97%), immediately after surgery, could freely breathe through the nose. The general impression of the patient comfort after surgery was mainly good (74.17%). The majority of patients (52.28%), were satisfied with aesthetic result after 7 days, and 52.32% after 1 month. There were very satisfied patients: on day 7 - 27.15% and on day 30 - 39.73%. Conclusion. We concluded that the rhinoplasty without using tamponade and immobilization was safe, comfortable and economical. The degree of pain, edema and ecchymosis were low, as well as the incidence of other complications. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. 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.