Methaemoglobinemia after Liposuction under Tumescent Local Anaesthesia - Diagnostic Value of Pulse Oximetry.

Background: Tumescent local anaesthesia with prilocain can lead to clinically significant methemoglobin levels. New generation multiple wavelength pulse oximeters (e. g.

Improvements in patients with lipedema 4, 8 and 12 years after liposuction.

Background: Long-term results following liposuction in patients with lipedema were available only for an average period of 8 years.

Objective: To find out whether the improvements persist for a further 4 years.

Methods: In 60 patients with lipedema a single-centre study with a mail questionnaire - often in combination with clinical controls - was performed after an average period of 12 years following liposuction(s).

Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia: Results of an International Consensus Conference.

Background: Lipedema is a chronic, progressive disorder of subcutaneous adipose tissue that usually affects the lower extremities of women. Also known as "two-body syndrome," the fat accumulations in lipedema are unsightly and painful. The disorder is well-known in Europe but is largely unrecognized and underdiagnosed in the United States.

S1-Leitlinie Lipödem.

Die vorliegende überarbeitete Leitlinie zum Lipödem wurde unter der Federführung der Deutschen Gesellschaft für Phlebologie (DGP) erstellt und finanziert. Die Inhalte beruhen auf einer systematischen Literaturrecherche und dem Konsens von acht medizinischen Fachgesellschaften und Berufsverbänden. Die Leitlinie beinhaltet Empfehlungen zu Diagnostik und Therapie des Lipödems.

S1 guidelines: Lipedema.

The present, revised guidelines on lipedema were developed under the auspices of and funded by the German Society of Phlebology (DGP). The recommendations are based on a systematic literature search and the consensus of eight medical societies and working groups. The guidelines contain recommendations with respect to diagnosis and management of lipedema.

Long-term benefit of liposuction in patients with lipoedema: a follow-up study after an average of 4 and 8 years.

Background: Long-term results following liposuction in patients with lipoedema are available only for an average period of 4 years.

Objective: To find out whether the improvement of complaints persists for a further 4 years.

Methods: In a single-centre study, 85 patients with lipoedema had already been examined after 4 years.

Evaluation and application of a high performance liquid chromatographic method for prilocaine analysis in human plasma.

Background: Prilocaine, a local anesthetic of the amide type, is frequently applied in substantial doses during tumescent liposuction. Although it cannot be excluded that the subcutaneously infiltrated narcotic may enter the circulation and trigger adverse systemic reactions, prilocaine plasma levels have rarely been measured during routine tumescent surgery. We established and evaluated a high performance liquid chromatography (HPLC) method for analysis of this narcotic and used it to measure the drug in plasma samples drawn in the course of tumescent liposuction with prilocaine local anesthesia.

Liposuction - a surgical procedure in dermatology.

Liposuction is an integral part of the wide range of surgical procedures in dermatology. Dermatologists established tumescent local anesthesia in combination with the use of micro-cannulas; especially dermatologists from Germany and Austria actively designed and developed these new techniques. In this position paper, we discuss the history, various interdisciplinary aspects, the significance, and the treatment indications for this procedure as well as its role within dermatologic training programs and research.

Tumescent liposuction in lipoedema yields good long-term results.

Background: Lipoedema is a painful disease in women with circumscribed increased subcutaneous fatty tissue, oedema, pain and bruising. Whereas conservative methods with combined decongestive therapy (manual lymphatic drainage, compression garments) have been well established over the past 50years, surgical therapy with tumescent liposuction has only been used for about 10years and long-term results are unknown.

Objectives: To determine the efficacy of liposuction concerning appearance (body shape) and associated complaints after a long-term period.

Tumescent liposuction: a new and successful therapy for lipedema.

Background: Lipedema is a rare and painful disease in women. Until recently, it could be treated only by conservative methods (combined physical therapy).

Objective: To determine the efficacy and safety of surgery (liposuction) concerning appearance and associated complaints.

[Lipoedema--current status, new perspectives].

Because of the lifelong and often progressive course and the mental trauma to the patients, lipoedema is an important dermatologic disorder. Complex physical therapy programs were introduced as a standard therapy years ago and can achieve an impressive oedema reduction. Liposuction in tumescent local anesthesia with vibrating microcannulas has proved to be a new effective treatment.

[10 years "Doctors in Aid of Children with Skin Diseases in Africa"--personal impressions].

Within the scientific establishment of dermatology, it is difficult to initiate or to support basic dermatology services in Third World countries. The author describes his experiences over 10 years in backing a community-based health care project in western Kenya. The problems with supporting tropical dermatology in Germany are also discussed.

Changes of fascia and muscles before and 12 months after successful treatment of recalcitrant venous leg ulcers by shave therapy.

Background: In chronic venous insufficiency (CVI) III typical changes of skin, subcutaneous tissue, fascia and muscle can be found. It was believed, that the thickening of the fascia is irreversible and it has been postulated that the degeneration of muscles is causative for the persistence of recalcitrant leg ulcers.

Patients And Methods: By computed tomography (CT) and magnetic resonance imaging (MRI) 8 patients with therapy resistant venous ulcers were examined.

[Autologous fat grafting].

Autologous fat grafting is a standard method for soft tissue augmentation. The method is commonly used for volume restoration of the ageing face. Furthermore, atrophic scars, lipodystrophy and scleroderma en coup de sabre can be treated.

Resistance to activated protein C due to factor V Leiden mutation: high prevalence in patients with post-thrombotic leg ulcers.

Background: Activated protein C (APC) resistance is the most frequently diagnosed heritable thrombophilic defect predisposing to thrombosis.

Objectives: To determine the prevalence of APC resistance due to factor V Leiden mutation in patients with leg ulcers.

Methods: Within a 2-year-period 100 consecutive patients with leg ulcers were examined for factor V Leiden mutation.

Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system.

Background: Following an epidemiological study on skin diseases in 5780 pupils from 13 schools in rural western Kenya in 1993, a dermatology project within the primary health care system was established in 1994 by the German non-government organization (NGO) 'Doctors in Aid of Children with Skin Diseases in Africa'. Within this project trained community health workers carried out regular visits to schools and nurseries and treated children with hydrocortisone acetate 1% cream for dermatitis, gentian violet 1% solution for bacterial skin infections, Whitfield's ointment for dermatophytoses and benzylbenzoate emulsion 25% for scabies.

Objectives: To assess the impact of this intervention.

[Dermatology in the primary health care system. Long-term outcome of a self-help project with children in rural Kenya].

Background And Objective: In spite of the importance of skin diseases in Africa south of the Sahara, dermatology is insufficiently represented within the established primary health care systems. Aim of this study was to find out whether an integrated dermatology project could reduce the prevalence of dermatoses.

Patients/methods: Since 1994 trained community health workers have carried out regular weekly visits to schools and nurseries in 10 communities in rural western Kenya.

Surgical removal of ulcer and lipodermatosclerosis followed by split-skin grafting (shave therapy) yields good long-term results in "non-healing" venous leg ulcers.

The purpose of this study was to evaluate the long-term effects of shave therapy in non-healing venous leg ulcers. Forty-one patients with 75 recalcitrant leg ulcers caused by primary deep vein incompetence or post-thrombotic syndrome were operated by shave therapy (removal of ulcer and surrounding lipodermatosclerosis with a Schink skin-grafting knife and covering of the wounds with meshed split-thickness skin grafts). After an average follow-up period of 2 years and 5 months all patients were evaluated for long-term results.

[Increased prevalence of APC-resistance (factor V Leiden mutation) in patients with postthrombotic syndrome].

Background And Objective: APC resistance (Factor V Leiden mutation) is the most often diagnosed hereditary thrombolytic defect. Data about the prevalence in patients with leg ulcers, especially postthrombosis, are limited of this defect.

Patients/methods: APC resistance was determined in 100 patients with venous leg ulcers.