Punch Set Surgical

Revising Scars In Hair Transplant Repair

Prior to revising a scar, it is important to take a careful patient history and find out specifically what, if anything went wrong with previous surgeries. It is presumptuous to think that just because a patient has scarring, the next procedure will make it better. One should carefully review the surgical history and, if possible, speak with the original surgeon to see if there are any techniques that could be improved upon, or problems that occurred which might be avoided in future procedures.

The cause of an unacceptable scar may be due to poor healing intrinsic to the patient, such as the tendency to form keloids. It might also be caused by a genetic predisposition to poor healing because of connective tissue defects, such as Ehlers-Danlos Syndrome. Genetic or drug induced coagulopathies, or medications that interfere with healing can also result in unacceptable scars. In addition, scarring may be caused by complications such as a post-operative infection or simply from the patient not following post-op instructions, such as smoking or performing strenuous exercise too soon after the surgery.

As emphasized in the preceding discussion, a depleted donor supply is the major limitation to a successful repair. The inability to harvest additional hair is caused by two main factors. The first factor is the physical limit set by the combination of low donor density and poor scalp mobility. When donor density is low, a larger strip must be harvested to obtain an adequate amount of hair. A tight scalp, however, limits the size of the strip that can be removed. After multiple procedures, attempting to harvest additional hair is no longer worth the risk of a possible widened scar. Every hair transplant procedure simultaneously decreases donor density and scalp laxity, but poorly executed surgery does this to a greater degree and decreases the supply without making proportionate cosmetic improvements in the recipient scalp.

The second factor is the visibility of the donor scars. Once the donor scars are to the point of near visibility, the ability to harvest additional hair is severely limited, as further surgery would make the patient's previous transplant surgery apparent. An important point to keep in mind in judging how much additional hair is available, is that coverage of donor scarring is more closely related to the amount of donor hair present than to the degree of scarring. Therefore, any process that removes hair along with the scar will run the risk of making the donor scarring more visible. The reason is that when scar and hair are both removed, the closure will further stretch the scalp and decrease the density of the remaining hair. This may prevent it from covering other scars that have not been excised or thin out the appearance of the donor fringe to an unacceptable degree.

Techniques, such as Follicular Unit Extraction, where follicular units are harvested directly from the donor area without a linear excision can be useful when the scalp is very tight. The usefulness of this technique is limited, however, as significant donor scarring makes removing hair without transection difficult and a donor zone of low density limits the amount of hair that can be removed without the area becoming too transparent.

Repair of Open Donor Scars -

The most common type of donor scar revision is the excision of the round scars (produced by the open donor technique) during routine, single-strip harvesting in subsequent hair transplant sessions. This is most easily accomplished when the old hair transplant scars lie directly in line with the proposed new strip. Although a relatively simple procedure, the following points should be kept in mind when excising open donor scars.

1. Healed open donor scalp often has decreased mobility when the tissue is bound down to the underlying fascia. It results from punches that are too deep and necessitates that the surgeon remove a narrower than normal strip.

2. Wound edges tend to be more friable than normal scalp. To prevent the edges from tearing during suturing, a thinner strip should be planned to minimize wound tension.

3. Finally, avoid excising open donor scars that are placed too low. This can cause the greatest problem, as the new linear excision will be subject to stretch from the underlying movement of the neck muscles. This can result in a stretched scar that is much worse in appearance than the original open donor scars.

Repair of Linear Scars -

Removing unacceptable linear scars by re-excision should be considered when scarring is well localized and the cosmetic benefit from its removal will be more than offset by the decreased density of the surrounding hair. Because of the importance of the surrounding area for camouflage, success in decreasing the size of an existing scar depends as much upon the choice of the scar as upon the actual surgical technique used to repair it.

A number of surgical techniques have the tendency to produce poor donor scars. An understanding of how these techniques may contribute to poor wound healing provides insight into how the repair may best be accomplished. The more common problems are:

* Deep donor incisions
* Wide donor strips
* Suturing with large bites
* Poor wound edge approximation
* Non-contour incisions
* Donor incisions placed too low
* Donor incisions placed too high

About the Author

Dr. Bernstein is Clinical Professor of Dermatology and is recognized worldwide for pioneering Follicular Unit Hair Transplantation. Dr. Bernstein's hair restoration center in Manhattan performs hair transplant repair and other hair restoration procedures. To read more publications on balding and hair loss, visit http://www.bernsteinmedical.com/.

Swine Flu: The New Pandemic

Brought to you by cheap health insurance

Everyone's all abuzz with panic nowadays it seems. That's mostly because after SARS and bird flu, another new strain of virus has managed to rear its head. The H1N1 influenza virus, more popularly known as the Swine Flu, exploded on to the global scene last April via a large-scale infection in Mexico City. 

I think everyone's seen the images on CNN a thousand time. Surgical-masked Mexicans crowding the hospitals with worrisome shots of full hospital beds.The Center for Disease Control and the World Health Organization raised their alert levels in hopes of catching and cutting off the infection at the bud, but it seems that cases have been reported all over the world. It seems that the current fatalities from disease are from Mexico but everyone is just expecting for the other shoe to drop.

To understand all of this panic, you need to have a little background. Influenza, or more popularly known as the flu, is probably one of the most infectious diseases out there. Airborne and highly contagious, it could spread like wildfire all across the world. Now you're asking what's the matter with a few people getting a bit of sniffles? That's because this isn't your ordinary flu. 

A lot of the flu viruses we are exposed to have been in the human system for hundreds of years. We've managed to build an immunity to these strains. The big problem that's got everyone running scared is the idea that a flu strain has crossed species. This is what happened with the bird flu and now, with the H1N1. The pigs and birds have also built up resistances to these diseases, however, since humans are not used to them, these strains of flu have a very large potential of being fatal.

The last time a large-scale flu epidemic raged around the world, electricity was just coming into vogue and cars were all Model Ts. The Spanish Flu Epidemic of 1918 literally set the bar for every modern disease in terms of casualties. Fifty to a hundred million people worldwide died over a period of two years from 1918 to 1920 as the disease spread worldwide. Following on the heels of the Great War, it was a one-two punch that killed an entire generation of young men and women. What everyone's afraid of is this: the 1918 epidemic was a subtype of the H1N1 flu virus, the same virus that seems to have crossed over and become a real threat to humans.

This is why the CDC is keeping a close watch on Mexico and hoping all of the subsidiary cases worldwide aren't indications of the beginning of some worldwide epidemic. The good news about this is that the disease is treatable. Medicine and vaccine production alerts have been sent out by the CDC and most pharmaceutical companies have started churning out oseltamivir and zanamivir.

The problem with that is the demand may outstrip the supply depending on the Swine Flu's virulence. More common antiviral drugs are also available but they're not exactly definitive cures. They serve to weaken the symptoms and give you a fighting chance and prevent some of the worse flu symptoms like diarrhea and vomiting.

So as the world waits and watches the situation in Mexico, it would be a good idea to take a few precautions. Regular hand washes and vitamins can help make sure you avoid the initial infection of the H1N1 Virus. Avoiding pork's not needed though. Swine Flu can't be transmitted through food. Remember to just a take a few preventive measures and you can come through clean and healthy.

For more please see Why You Need To Get An Online Medical Insurance Quote and health insurance names.

Set of tools for a blind child?

I'm 15. When I was twelve, a mentally unstable boy punched me in my left eye. I lost 100% of the vision in that eye. Now I have cancer in my right eye. I'll be able to keep the eye but the surgical removal of the tumor is going to deprive me of all of my vision in that eye as well. I need to learn brail, I need a brail keyboard, but I can't find a complete set of all this stuff online anywhere.

Since you are school age, your parents should be working with your school to make sure you acquire the skills of blindness--braille, orientation and mobility, assistive technology. Once you leave school, you would qualify for rehabilitation through your state service. There is a coordinator in each state for a pool of federal money set aside for educational materials. These people are generally also an excellent resource for parents and schools. A list is at:

http://www.aph.org/fedquotpgm/trustees.html

As everyone has different needs, you won't find a "set" of anything for sale!

Surgical Ward - ''Face Crushing-Skull Smashing-Life Destroying Punch Of Death''