Markevičiūtė, Medeinė Šilenė

Amniono membrana - biologinė medžiaga, gaunama iš žmogaus placentos, dėl savo unikalių regeneracinių savybių pastaraisiais metais vis dažniau taikoma gydant žaizdas.

Vascular malformations are very difficult to treat and usually require a multidisciplinary approach. We report a case of a giant facial and scalp vascular malformation resection and large defect reconstruction with the use of artificial dermis and hair follicle transplantation. In total, 3 surgeries were performed with in-between periods of 6 weeks. Firstly, the giant malformation was resected, and the defect was reconstructed using a dermal matrix and expander implantation. During the second surgery, expander was reintroduced, skin flaps were readvanced and hair follicle transplantation to the dermal matrix zone was performed for enhancing reepithelization and wound contraction by second-intention healing. During the third surgery the tissue expander was removed and skin grafts were placed in small non-transplanted areas. This strategy resulted in complete defect reepithelization without the need of skin grafting and a good aesthetic (with hair growth) and functional results were obtained, however, further studies are necessary.

Tyrimo tikslai. Įvertinti pacientų, sergančių odos melanoma (OM), pasiskirstymą pagal lytį, naviko histologinį tipą, lokalizaciją. Nustatyti OM išplitimą po pirminio chirurginio naviko pašalinimo į sarginius limfmazgius, priklausomai nuo naviko dydžio. Išanalizuoti sergamumą OM 2018-2022 m. laikotarpiu. Metodai. Atliktas retrospektyvusis tyrimas, analizuojant pacientų, kuriems atliktos chirurginės intervencijos ir diagnozuota invazinė OM, duomenis. Rezultatai. Analizuoti 527 pacientų (329 moterys ir 198 vyrai) duomenys. Dažniausiai OM moterims diagnozuota kojose (21,8 proc.), liemens srityje (19,5 proc.), vyrams - liemens srityje (21,1 proc.). Labiausiai paplitęs histologinis tipas - paviršiumi plintanti melanoma (45 proc.). Sarginio limfmazgio biopsija (SLB) atlikta 359 tiriamiesiems, 107 diagnozuotos sarginio limfmazgio metastazės, kurių skaičius augo didėjant naviko storiui. Dažniausiai nustatoma I stadijos (51,2 proc.) OM, rečiausiai - IV (5,5 proc). 2018-2022 m. laikotarpiu I stadijos atvejų dažnis svyravo nuo 48,8 proc. iki 52,9 proc., о IV - nuo 3,7 рос. iki 6,7 proc. Išvada. SLB - tai svarbiausias OM prognostinis rodiklis, gerinantis ligos kontrolę ir bendrą pacientų išgyvenamumą.

Objectives. Invasive facial procedures can cause anxiety, discomfort and pain that nondrug methods and local anaesthetics might not fully relieve. To maintain periprocedural comfort and while avoiding systemic anaesthesia risks, noninvasive conscious sedation, using benzodiazepines like midazolam or bromazepam, can be used. The purpose of the research was to determine which premedication is most effective in blepharoplasty. Materials and methods. A retrospective study involved 85 female patients who underwent blepharoplasty at the Hospital of Lithuanian University of Health Sciences in 2023. The study participants did not exhibit any co-morbidities or harmful habits. The study groups comprised Group 1 (n=45), who received oral midazolam, and Group 2 (n=40), who administered oral bromazepam. Descriptive statistics included means (±) and median (Mdn) values (min-max). Statistical analyses employed the Mann-Whitney U and unpaired t-test. Results. No statistically significant differences were observed in demographic parameters between groups, with a mean age of 57.61 ± 8.154 and BMI of 26.58 ± 4.362. Patients in Group 1 reported significantly higher levels of preoperative anxiety (Mdn=4) compared to Group 2 (Mdn=2) (U=531, p=0.0069). However, there was no statistically significant difference between Group 1 (Mdn=2, (0–6)) and Group 2 (Mdn = 1, (0–4)) regarding anxiety during surgery (p=0.9785). Concerning postoperative anxiety, significantly more patients experienced it in Group 1 (Mdn=2, (0–6)) than in Group 2 (Mdn=0, (0–3)) (U=380, p<0.0001). The majority of participants in both Group 1 (63.64%) and Group 2 (58.33%) reported that “the surgical procedure exceeded their expectations” (p=0.6281). Conclusions. In comparison to midazolam, bromazepam demonstrates a superior reduction in both preoperative and postoperative anxiety. While there were no significant differences in anxiety during surgery, the overall findings suggest that bromazepam may be considered a more effective premedication option in blepharoplasty.

Objectives. During minor surgeries under local anaesthesia, anaesthetic injections are often the most painful aspect. To alleviate this, the use of topical anaesthetic cream EMLA is considered. However, its efficacy for periocular injections lacks strong evidence. This study aims to assess the effectiveness of additional premedication with oral Ultracod and EMLA in reducing pain and improving postoperative comfort. Materials and methods. A retrospective study involved 80 female patients who underwent blepharoplasty at the Hospital of Lithuanian University of Health Sciences in 2023. The study participants did not exhibit any co-morbidities or harmful habits. The study groups comprised Group A (GA) (n=40), receiving oral midazolam and Group B (GB) (n=40), administered preoperative EMLA eyelid ointment, oral midazolam and Ultracod tablets. Statistical analyses employed the Mann-Whitney U and chi-squared test. Results. No statistically significant differences were observed in demographic parameters between groups, with a mean age of 51.89 ± 4.543 and BMI of 28.43 ± 5.469. There was no statistically significant difference between GA (Mdn=2) and GB (Mdn=2) in pain during anaesthetic injection. Statistically significantly patients felt less pain in GB (Mdn=0) than in GA (Mdn=1) (U=515.5, p=0.0056) during surgery. Significantly higher postoperative pain was experienced in GA (Mdn=2.5) compared to GB (Mdn=1) (U=367, p<0.0001). Among patients who reported postoperative pain in both groups, with no significant difference, it was experienced only on the day of surgery and started 1-2 h after blepharoplasty. Conclusions. The additional premedication with Ultracod and EMLA has been found to reduce pain during and after surgery. Although there was no difference in pain at the time of injection, we can assume that additional premedication with Ultracod and EMLA is effective for blepharoplasty.

Background and aim of the study. Blepharoplasty is a common cosmetic procedure, often performed under local anaesthesia for efficiency and safety. Premedication, including sedatives and analgesics, aims to improve patient comfort and experience during surgery. This study evaluates various premedication protocols’ effects on intraoperative and postoperative pain and anxiety levels in blepharoplasty. Methods and materials. In this retrospective study of 98 female blepharoplasty patients across three clinical settings in 2023, including the Lithuanian University of Health Sciences Hospital, Vilnius University Hospital, and a private clinic. Three groups were analyzed: the control group (CG) with no premedication, Group A receiving oral benzodiazepines, and Group B receiving a combination of oral benzodiazepines, EMLA eyelid ointment, and oral Ultracod tablets. Data normality was assessed using the Shapiro-Wilk test, and statistical analyses employed Mann- Whitney, Kruskal-Wallis, and ANOVA tests (p < 0.05). Results. No significant demographic differences were found among the three groups, with a median age of 53 years (range: 37-70) and a mean BMI of 27.36 ± 4.678. ANOVA revealed significant differences in pain during anaesthetic injections (p = 0.0107), with CG experiencing higher pain than Group A and B. Group differences persisted throughout the operation (p = 0.0039), with CG showing higher pain than Group B. Preoperative anxiety levels differed significantly (p = 0.024), with CG having higher anxiety than Group A. However, no significant differences were found in postoperative pain (p = 0.6837) or anxiety during the operation (p = 0.0922). Conclusions. Premedication effectively reduces injection-related discomfort. The combination of benzodiazepines, EMLA eyelid ointment, and Ultracod tablets is most effective in reducing pain during surgery, albeit with increased postoperative anxiety. Benzodiazepines alone are effective in reducing both pre-and postoperative anxiety. However, premedication does not significantly affect postoperative pain and anxiety during the operation levels in blepharoplasty patients.

Introduction Upper blepharoplasty (BP), whether carried out for cosmetic enhancements or to address functional issues, stands out as one of the most prevalent facial surgical procedures [1]. According to the literature, it was determined that 38% of patients experience high levels of preoperative anxiety before eyelid surgery [2]. Anxiety has the potential to negatively impact both the medical and psychological outcomes of the procedure [3]. Enhancing the patient experience can be achieved through the application of noninvasive sedation by utilizing oral benzodiazepines, a fundamental element of conventional perioperative anxiolysis [4,5]. At present, there is a lack of studies comparing the rationale for premedication with control groups in performing facial aesthetic surgeries, such as blepharoplasty. [...].

Introduction The eyes and eyelids are crucial for facial aesthetics and non-verbal communication. Blepharoplasty (BP) can address various eyelid issues, providing functional and cosmetic benefits [1]. Research using the FACE-Q questionnaire, a patient-reported outcome measure, revealed high patient satisfaction and substantial improvements in appearance, psychological well-being, and aging appraisal post - blepharoplasty [2,3]. Currently, there is a restricted comparison of attitudes towards upper eyelid (UE) surgery between paying and non-paying patients. [...].

The periorbital area undergoes transformative changes with age, influencing both aesthetic appearance and functional aspects of the eyelids. Age-related alterations involve volume loss, shifts in eyelid crease position, drooping eyebrows, reduced skin elasticity, and the presence of dermatochalasis. Dermatochalasis, characterized by redundant upper eyelid skin folds, poses aesthetic and functional challenges, impacting visual acuity and eyelid elevation efficiency. Upper blepharoplasty addresses these age-related changes. Despite the elective nature of upper lepharoplasty, the procedure can evoke preoperative anxiety and discomfort. Various premedication strategies, including benzodiazepines, aim to alleviate anxiety and enhance the overall patient experience. However, ongoing debates persist regarding the optimal strategy for implementation. The study aims to contribute insights into the effectiveness of different premedication approaches in optimizing patient comfort during and after upper blepharoplasty.

Temos aktualumas Didėjantis pacientų su negyjančiomis žaizdomis skaičius tampa vis didesne ekonomine ir socialine našta sveikatos sistemai. Tradiciniai tvarsčiai rodo neblogus rezultatus gydant nekomplikuotas žaizdas, tačiau sudėtingas žaizdos gijimo procesas neretai tampa iššūkiu, kai bekintančios žaizdos gydymas tradiciniais tvarsčiais tampa nebeefektyvus, žaizdos gijimo laikas prailgėja, išauga žaizdos gydymo kaina. Stebint poreikį pritaikyti tvarstį efektyviam žaizdos gijimui vykdoma nuolatinė pažanga kuriant modernius tvarsčius. Idealaus tvarsčio visoms žaizdoms dar nėra, tačiau iki šiol sukurti šiuolaikiniai tvarsčiai leidžia prisitaikyti prie žaizdos, sumažinti žaizdos gijimo laiką ir bendrą žaizdos gydymo kainą. Darbo tikslas (-ai) Apžvelgti mokslinėje literatūroje aprašomų šiuolaikinių tvarsčių pritaikymą gydant įvairaus pobūdžio žaizdas. Tyrimo metodai Apžvelgti ir apibendrinti mokslinėje literatūroje aprašomų šiuolaikinių tvarsčių pritaikymą gydant įvairaus pobūdžio žaizdas. [...].