DESCRYPTION :

Dupuytren contracture: occurs due to cramping and then scarring of the palmar aponeurosis, which leads to a contracture of the fingers.
Causes: genetic factors; trauma; neuropathies, including those caused by diabetes mellitus, epilepsy, or alcoholism. There may be a small nodule or thickening of the fourth and fifth digits of the hand.

PROCEDURES :

anesthesia : local, best results with decreased blood flow through the hand
procedure:fasciotomy (incision of the scarred aponeurosis); fasciectomy (complete resection of the aponeurosis); partial resection of the aponeurosis; multiple Z surgery; V-Y surgery
Layered stitches, drainage, splint

POST OPERATIVE CARE :

The drain is removed 1 day after surgery, the stitches in 7-10 days, and the splint in 7-14 days. After removal of the splint, the patient may bend the fingers. The fingers should not be stretched, and therefore the hand may not be straigthened, until 3 weeks after the procedure.

POSSIBLE SLIDE EFFECTS:

hematomas, infections, edema, recurrence

COST:

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PROCEDURES :

anesthesia : local
procedure:resection of a ganglionic cyst

COST:

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DESCRYPTION :

Carpal tunnel syndrome is caused by compression of the median nerve and is due to metabolic processes, trauma, or infection.

INDYCATIONS :

Surgical treatment is indicated when conservative treatment is not sufficientto decrease symptoms (including numbness, paresthesias, color changes, and easily breaking delicate nails).

PURPOSE :

The volume of the carpal tunnel is increased by a decrease in the tension of the transverse ligament and its elongations.

PROCEDURES :

anesthesia : local
procedure:open decompression of the carpal tunnel is performed by an incision paralle to the palm's 'life line'. The transverse ligament is cut along with associated tendon aponeuroses. The median nerve must be visualized along the entire length of the canal and all adhesions must be incised.
Pain due to carpal tunnel syndrome is relieved immediately after the procedure. The patient may continue experiencing numbness and muscle strength loss, although these recede partially over 1-2 years.

POST OPERATIVE CARE :

s1st and 2nd postoperative day - elastic bandages are used to help straighten the wrist naturally
2nd and 3rd postoperative day - gentle, functional motion
Stitches are removed approximately after 10 days. Symptoms of carpal tunnel syndrome are mostly relieved by 4-6 weeks.

POSSIBLE SLIDE EFFECTS:

hematomas, infections, edema, median nerve damage

COST:

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PROCEDURES :

anesthesia : local, general, or epidural; deep vein thrombosis prophylaxis
procedure: classical surgery (stripping), laser surgery, or cryosurgical surgical procedure involving the removal of the main surface veins, ligation or cauterization of the perforating veins, and removal of varicosed branches of the tibialis vein. Klapp stitches are used. In the case of small varicosities, we obliterate the vessels using pharmacotherapy

POST OPERATIVE CARE :

Postoperative pain often requires intravenous painkiller administration in the first 24 hours. Compressive stockings must be worn for 1-3 months prophylactically after the surgery. Stitches are removed 10-14 days after the procedure.

POSSIBLE SIDE-efects:

hematomas, infections

LENGTS OF TIME PATIENT MUST REMAIN AFTER THE PROCEDURE:

1 day

TIME NEED FOR RECUPERATION:

Depending on the extent of the surgery, recuperation can take 10-14 days. Edema and bruising is almost always present. After the procedure, the limbs must be bandaged or compressive stockings must be worn for approximately 2 weeks (compressive bandages for a total of 1-3 months). The limbs must be elevated when the patient is in bed.

REQUIRED TEST :

bleeding time, clotting time, blood morphology, EKG, To determine the cause of the varicosities a Doppler ultrasound of lower limb veins is required.

CONTRAINDICATIONS:

uncontrolled hypertension, uncontrolled diabetes mellitus, coagulopathies, vascular hemorrhagic diathesis, infections in the treated area

COST:

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PURPOSE :

Removal of umbilical, post-operative, inguinal, and scrotal hernias, as well as those through the linea alba.

INDICATIONS:

Flabby skin in the arm and/or thigh areas due to weight loss or aging; reduction of this skin is resistant to physical therapy and/or exercise.

PROCEDURES :

anesthesia : local, general, or epidural
procedure: classical plastic surgery using the patients own tissue (skin) or synthetic implants (mesh).

POST OPERATIVE CARE :

Pain associated with the procedure often requires intravenous painkiller in the first 24-hour postoperative period. A compression bandage must be worn for 1-3 months after the surgery. Stitches are removed 10-14 days postoperatively.

POSSIBLE SIDE-efects:

Bleeding, hematomas, edema, infection, recurrence

LENGTS OF TIME PATIENT MUST REMAIN AFTER THE PROCEDURE:

1 day

TIME NEED FOR RECUPERATION:

Depending on the location and size of the hernia, recuperation can take 10-14 days. The patient can resume full normal function (including recreational sports) after approximately 3 months.

REQUIRED TEST :

bleeding time, clotting time, blood morphology, EKG, For large abdominal hernias, an abdominal ultrasound is indicated.

CONTRAINDICATIONS:

uncontrolled hypertension, uncontrolled diabetes mellitus, coagulopathies, vascular hemorrhagic diathesis, infections in the treated area.

COST:

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PROCEDURES :

anesthesia: local
procedure: Esthetically displeasing scars of the face and other body areas are removed using plastic methods to decrease skin tension, redirect the scar, and to create conditions for the formation of a new, cosmetically pleasing scar.

COST:

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PROCEDURES :

Derangements of wound healing can lead to overgrown, large scars and keloids

A keloid is a type of scar involving an overgrowth of fibrous tissue at the site of a healed skin injury.

Keloids are most frequently associated with:

  • burns,
  • surgical procedures,
  • vaccinations,
  • insect bites
  • tattoos

Keloids can occur anywhere, but seen more frequently in areas of increased skin tension, such as the neck, upper chest and shoulders.

Treatment includes :

  • conservative (creams containing oils from onion; compression bandages),
  • surgical (steroid injections; cryotherapy; laser therapy),
  • psychotherapy
  • a combination of the above-listed methods

Keloids often pose a serious clinical and cosmetic problems, which can have a negative effect on the patient's psyche.

COST:

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PROCEDURES :

anesthesia : local or general
procedure: Resection of moles in the region of the head are undertaken under sterile conditions used during oncological surgeries - using appropriate margins within healthy tissue and histopathologic evaluation of resected tissue to confirm the diagnosis and demonstrate if margins are clear fo disease. The histopathologic evaluation is performed in the Department of Pathology in Poznan University of Medical Sciences.
Wounds are covered by skin patches or skin transplants from various body regions (post-auricular, clavicular, shoulder, internal thigh).

COST:

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PROCEDURES :

We have at our disposition a dermatoscope and video-dermatoscope, which allow us to evaluated moles and qualify them for removal. We use a so-named ABCD dermatoscope, which allows us to determine the following:

A - asymmetry,
B - border,
C - color,
D - diameter and distringuishing characteristics

Each of the abovementioned characteristics is scored, and calculations allow us to determine the Total Dermatoscopic Score. A TDS value of 4.75-5.45 is an indicator for prophylactic removal of the mole, while a TDS value of over 5.45 often indicates a malignant color change that requires surgical resection of the mole.

Particularly affected person include those with the so-called atypical mole syndrome, characterized by tens or more moles, of which at least one mole is over 8mm in diameter, and at least one mole has atypical characteristics (according to ABCD, above).

The procedure is performed with maintenace of sterility as in oncologic procedures and the wound is stitched (if necessary) and dressed for good cosmetic effect. All excised moles are examined hisptopathologically.

COST:

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