@article{JakubietzJakubietzSchmidtetal.2021, author = {Jakubietz, Michael Georg and Jakubietz, Danni Felicitas and Schmidt, Karsten and Jakubietz, Rafael Gregor}, title = {Blepharoplastik bei asiatischen Augen}, series = {Journal f{\"u}r {\"A}sthetische Chirurgie}, volume = {14}, journal = {Journal f{\"u}r {\"A}sthetische Chirurgie}, number = {4}, issn = {1867-4313}, doi = {10.1007/s12631-021-00276-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270189}, pages = {161-165}, year = {2021}, abstract = {Die operative Verj{\"u}ngung des Auges stellt einen der am h{\"a}ufigsten nachgefragten Eingriffe im {\"a}sthetischen Spektrum dar. Die multikulturelle Bev{\"o}lkerungsstruktur bedingt, dass auch „asiatisch" imponierende Augen behandelt werden. „Asiatische" Augen sind aber nicht nur bei Asiaten anzutreffen, sondern in unterschiedlicher Auspr{\"a}gung auch bei Patienten aus dem Nahen und Mittleren Osten. Das asiatische Auge stellt in Bezug auf Verj{\"u}ngungsm{\"o}glichkeiten eine eigene Entit{\"a}t dar. W{\"a}hrend die klassische „Korrektur" des asiatischen Auges eine etablierte und durch eine Vielzahl von verschiedenen Techniken mit vorhersehbaren Ergebnissen verbundene Methode ist, ist eine „verj{\"u}ngende" Blepharoplastik des asiatischen Auges komplexer zu bewerten [1, 3, 5, 10]. Die Operationsmethoden f{\"u}r das „asiatische" Auge sind f{\"u}r j{\"u}ngere Patienten intendiert, bei denen es {\"u}berwiegend um die Korrektur des Epikanthus geht. Diese Techniken ziehen eine gew{\"u}nschte Ver{\"a}nderung des periorbitalen Erscheinungsbildes nach sich, wobei das asiatische Aussehen teilweise zugunsten eines vermehrt „europ{\"a}ischen" Aussehens beeinflusst wird. Fraglich bleibt, ob eine Ver{\"a}nderung zu einem europ{\"a}ischen Aussehen hin auch bei einem alternden Patienten einer Verj{\"u}ngung gleichkommt. Prinzipiell imponiert ein derart operiertes asiatisches Auge „k{\"u}nstlich", eine Tatsache die bei alternden Patienten als noch st{\"o}render als der Alterungsprozess selbst empfunden werden d{\"u}rfte. Daher ist der Wunsch nach einer Verj{\"u}ngung ohne Verlust des typischen asiatischen Erscheinungsbildes des Auges chirurgisch nicht mit der klassischen Technik bei Europ{\"a}ern umzusetzen. W{\"a}hrend die Behandlung durch eine klassische Blepharoplastik ein unnat{\"u}rliches Aussehen zur Folge hat, kann unter Respektierung der asiatischen anatomischen Besonderheiten eine nat{\"u}rlich wirkende Verj{\"u}ngung erreicht werden.}, language = {en} } @article{JakuscheitSchaeferRoedigetal.2021, author = {Jakuscheit, Axel and Schaefer, Nina and Roedig, Johannes and Luedemann, Martin and Hertzberg-Boelch, Sebastian Philipp von and Weissenberger, Manuel and Schmidt, Karsten and Holzapfel, Boris Michael and Rudert, Maximilian}, title = {Modifiable individual risks of perioperative blood transfusions and acute postoperative complications in total hip and knee arthroplasty}, series = {Journal of Personalized Medicine}, volume = {11}, journal = {Journal of Personalized Medicine}, number = {11}, issn = {2075-4426}, doi = {10.3390/jpm11111223}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250290}, year = {2021}, abstract = {Background: The primary aim of this study was to identify modifiable patient-related predictors of blood transfusions and perioperative complications in total hip and knee arthroplasty. Individual predictor-adjusted risks can be used to define preoperative treatment thresholds. Methods: We performed this retrospective monocentric study in orthopaedic patients who underwent primary total knee or hip arthroplasty. Multivariate logistic regression models were used to assess the predictive value of patient-related characteristics. Predictor-adjusted individual risks of blood transfusions and the occurrence of any perioperative adverse event were calculated for potentially modifiable risk factors. Results: 3754 patients were included in this study. The overall blood transfusion and complication rates were 4.8\% and 6.4\%, respectively. Haemoglobin concentration (Hb, p < 0.001), low body mass index (BMI, p < 0.001) and estimated glomerular filtration rate (eGFR, p = 0.004) were the strongest potentially modifiable predictors of a blood transfusion. EGFR (p = 0.001) was the strongest potentially modifiable predictor of a complication. Predictor-adjusted risks of blood transfusions and acute postoperative complications were calculated for Hb and eGFR. Hb = 12.5 g/dL, BMI = 17.6 kg/m\(^2\), and eGFR = 54 min/mL were associated, respectively, with a 10\% risk of a blood transfusion, eGFR = 59 mL/min was associated with a 10\% risk of a complication. Conclusion: The individual risks for blood transfusions and acute postoperative complications are strongly increased in patients with a low preoperative Hb, low BMI or low eGFR. We recommend aiming at a preoperative Hb ≥ 13g/dL, an eGFR ≥ 60 mL/min and to avoid a low BMI. Future studies must show if a preoperative increase of eGFR and BMI is feasible and truly beneficial.}, language = {en} } @article{SchmidtJakubietzGilbertetal.2021, author = {Schmidt, Karsten and Jakubietz, Michael Georg and Gilbert, Fabian and Fenwick, Annabel and Meffert, Reiner Heribert and Jakubietz, Rafael Gregor}, title = {Muscle cuff in distal pedicled adipofascial sural artery flaps: a retrospective case control study}, series = {PRS Global Open}, volume = {9}, journal = {PRS Global Open}, number = {3}, doi = {10.1097/GOX.0000000000003464}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259875}, year = {2021}, abstract = {Background: Amputation after open tibial fracture occurs in 3\% of cases. The rate increases when flap reconstruction is required. The standard care involves microsurgical tissue transfer although the pedicled reverse sural artery adipofascial flap (PRSAF) is a local alternative in patients endangered by a prolonged operative time. Incorporation of a gastrocnemius muscle cuff in this flap can be used to fill dead space and increase healing potential. Literature shows superior survival rates for both PRSAF and inclusion of a muscle cuff in comparison with the cutaneous version. The aim of the study was to compare the outcome of the PRSAF and the musculoadipofascial version (PRSMAF). We hypothesize that the PRSMAF provides similar lap viability and flap-related complication rates as does the adipofascial version. The muscle component may reduce the long-term osteomyelitis rate. Methods: Patients were evaluated retrospectively after reconstruction with either PRSAF or PRSMAF. Preoperative osteomyelitis, flap survival, complications and osteomyelitis clearance were analyzed. Results: The study shows preliminary results supporting the potential use of the PRSMAF. We compare either 23 PRSMAF or 20 PRSAF flaps. We found no statistically significant differences in flap survival or in complication rate. Conclusions: Although the anatomical situation may sometimes dictate the use of a free flap, a technically less-complicated option may in some cases offer a viable alternative. This study shows that the PRSMAF can serve as an alternative for complex bone defects in the limb, though it does not provide statistical improvement to the PRSAF.}, language = {en} }