The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Stephen Sprigle - One of the best experts on this subject based on the ideXlab platform.
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Buttock tissue response to loading in men with spinal cord injury
PLOS ONE, 2018Co-Authors: Sharon Eve Sonenblum, Stephen SprigleAbstract:Objective/Background Despite the fact that most people with a spinal cord injury who use a wheelchair for mobility are considered at-risk for pressure ulcer (PrU) development, there still exists a spectrum of risk amongst this group. Efforts to differentiate risk level would benefit from clinical tools that can measure or predict the Buttocks response to loading. Therefore, the goal of this study was to identify how tissue compliance and blood flow were impacted by clinically-measurable risk factors in young men with SCI. Methods Blood flow at the ischial tuberosity was measured using laser Doppler flowmetry while the seated Buttock was unloaded, and loaded at lower (40–60 mmHg) and high (>200 mmHg) loads. Tissue compliance of the Buttock was measured using the Myotonometer while subject were lifted in a Guldmann Net. Results Across 28 participants, blood flow was significantly reduced at high loads, while no consistent, significant changes were found at lower loads. At 40–60 mmHg, blood flow decreased in participants with a pressure ulcer history and lower BMI, but stayed the same or increased in most other participants. The Buttock displaced an average of 9.3 mm (2.7 mm) at 4.2 N, which represented 82% (7%) of maximum displacement. BMI was related to the amount of Buttock tissue displacement while smoking status explained some of the variation in the percent of max displacement. Conclusion Wide variability in tissue compliance and blood flow responses across a relatively homogeneous population indicate that differences in biomechanical risk may provide an explanation for the spectrum of PrU risk among persons with SCI.
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effects of wheelchair cushions and pressure relief maneuvers on ischial interface pressure and blood flow in people with spinal cord injury
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: Sharon Eve Sonenblum, Teddie E Vonk, Thomas W J Janssen, Stephen SprigleAbstract:Abstract Objective To investigate the effectiveness and interactions of 2 methods of pressure ulcer prevention, wheelchair cushions and pressure relief maneuvers, on interface pressure (IP) and blood flow of the Buttocks. Design Within-subject repeated measures. Setting Rehabilitation center. Participants Wheelchair users with a spinal cord injury or disorder (N=17). Interventions Participants performed 3 forward leans and 2 sideward leans with different degrees of lean while seated on each of 3 different wheelchair cushions. Main Outcome Measures IP measured with a custom sensor and blood flow measured with laser Doppler flowmetry were collected at the ischial tuberosity. Results Pressure relief maneuvers had a significant main effect on the ischial IP ( P P Conclusions The results of the study highlight the importance of positioning wheelchair users in a manner that facilitates in-seat movement. Regardless of the cushion being used, the pressure relief maneuvers resulted in very large reductions in IPs and significant increases in Buttock blood flow. Only the small frontward lean was shown to be ineffective in reducing pressure or increasing blood flow. Because these pressure relief maneuvers involved postural changes that can occur during functional activities, these pressure relief maneuvers can become a part of volitional pressure relief and functional weight shifts. Therefore, clinical instruction should cover both as a means to impart sitting behaviors that may lead to better tissue health.
Sharon Eve Sonenblum - One of the best experts on this subject based on the ideXlab platform.
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Buttock tissue response to loading in men with spinal cord injury
PLOS ONE, 2018Co-Authors: Sharon Eve Sonenblum, Stephen SprigleAbstract:Objective/Background Despite the fact that most people with a spinal cord injury who use a wheelchair for mobility are considered at-risk for pressure ulcer (PrU) development, there still exists a spectrum of risk amongst this group. Efforts to differentiate risk level would benefit from clinical tools that can measure or predict the Buttocks response to loading. Therefore, the goal of this study was to identify how tissue compliance and blood flow were impacted by clinically-measurable risk factors in young men with SCI. Methods Blood flow at the ischial tuberosity was measured using laser Doppler flowmetry while the seated Buttock was unloaded, and loaded at lower (40–60 mmHg) and high (>200 mmHg) loads. Tissue compliance of the Buttock was measured using the Myotonometer while subject were lifted in a Guldmann Net. Results Across 28 participants, blood flow was significantly reduced at high loads, while no consistent, significant changes were found at lower loads. At 40–60 mmHg, blood flow decreased in participants with a pressure ulcer history and lower BMI, but stayed the same or increased in most other participants. The Buttock displaced an average of 9.3 mm (2.7 mm) at 4.2 N, which represented 82% (7%) of maximum displacement. BMI was related to the amount of Buttock tissue displacement while smoking status explained some of the variation in the percent of max displacement. Conclusion Wide variability in tissue compliance and blood flow responses across a relatively homogeneous population indicate that differences in biomechanical risk may provide an explanation for the spectrum of PrU risk among persons with SCI.
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effects of wheelchair cushions and pressure relief maneuvers on ischial interface pressure and blood flow in people with spinal cord injury
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: Sharon Eve Sonenblum, Teddie E Vonk, Thomas W J Janssen, Stephen SprigleAbstract:Abstract Objective To investigate the effectiveness and interactions of 2 methods of pressure ulcer prevention, wheelchair cushions and pressure relief maneuvers, on interface pressure (IP) and blood flow of the Buttocks. Design Within-subject repeated measures. Setting Rehabilitation center. Participants Wheelchair users with a spinal cord injury or disorder (N=17). Interventions Participants performed 3 forward leans and 2 sideward leans with different degrees of lean while seated on each of 3 different wheelchair cushions. Main Outcome Measures IP measured with a custom sensor and blood flow measured with laser Doppler flowmetry were collected at the ischial tuberosity. Results Pressure relief maneuvers had a significant main effect on the ischial IP ( P P Conclusions The results of the study highlight the importance of positioning wheelchair users in a manner that facilitates in-seat movement. Regardless of the cushion being used, the pressure relief maneuvers resulted in very large reductions in IPs and significant increases in Buttock blood flow. Only the small frontward lean was shown to be ineffective in reducing pressure or increasing blood flow. Because these pressure relief maneuvers involved postural changes that can occur during functional activities, these pressure relief maneuvers can become a part of volitional pressure relief and functional weight shifts. Therefore, clinical instruction should cover both as a means to impart sitting behaviors that may lead to better tissue health.
Simon G. Talbot - One of the best experts on this subject based on the ideXlab platform.
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Silicone-induced granuloma after Buttock augmentation
Plastic and Reconstructive Surgery - Global Open, 2016Co-Authors: Mansher Singh, Michael S Calderwood, Isaac H Solomon, Simon G. TalbotAbstract:Liquid silicone is inexpensive, minimally antigenic, and likely noncarcinogenic. Its simplicity of use has made it popular as a soft-tissue filler in some parts of the world for patients seeking rapid soft-tissue augmentation of the face, breast, and Buttocks. However, multiple reports describe the complications of silicone injections such as cellulitis, abscess, ulceration, and foreign body migration. We present an unusual complication of granulomatous reaction secondary to silicone injection for Buttock augmentation, with a literature review of this entity and treatment options. Our patient was a 54-year-old woman who underwent bilateral Buttock augmentation in the Dominican Republic using percutaneous injection of liquid silicone. She presented to our facility 1 year after this procedure with pain and inflammation of both Buttocks. She was diagnosed with multiple silicone granulomas. Her symptoms completely resolved with a 3-week course of minocycline. Granulomatous reactions to silicone may occur months to years after the silicone injection. The incidence of such complications may be increased when nonmedical-grade silicone is used, and hence, when these procedures are performed in developing countries. Tetracycline antibiotics, especially minocycline, may be used to achieve sustained remission.
M Batt - One of the best experts on this subject based on the ideXlab platform.
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percutaneous angioplasty of the superior gluteal artery for Buttock claudication a report of seven cases and literature review
Journal of Vascular Surgery, 2006Co-Authors: M Batt, Jean Baque, P J Bouillanne, Reda Hassenkhodja, Pierre Haudebourg, Benjamin TheveninAbstract:Background Buttock claudication due to stenosis or occlusion of the superior gluteal artery is infrequent. The recent development of noninvasive gluteal duplex scanning, combined with aortoiliac angiography using oblique projections and the availability of low-profile devices for percutaneous transluminal angioplasty (PTA), led us to review our recent experience concerning the diagnosis and mid-term results of PTA for superior gluteal artery stenosis or occlusion. Methods The files of all patients who had been treated in our department by PTA for superior gluteal artery stenosis or occlusion with Buttock claudication were analyzed retrospectively, and any associated arterial lesions, morbidity, restenosis, or recurrent Buttock claudication were noted. Outcomes were compared with published reports. Results Retrospective review identified six patients (5 men, 1 woman; mean age, 64 years) with seven cases of Buttock claudication (1 bilateral localization) who had undergone PTA within the past 2 years. There was no case of isolated Buttock claudication. Buttock claudication was associated with impotence, thigh claudication, or calf claudication in seven cases. Gluteal duplex scans were performed for three of the patients diagnosed with two stenoses and one occlusion. Aortoiliac angiography revealed five superior gluteal artery stenoses and two occlusions. PTA without stenting was successful in all cases, without morbidity or mortality. During a mean follow-up of 13 months, restenosis occurred in one patient. A repeat PTA without stenting was successful, with resolution of the Buttock claudication. Conclusions Buttock claudication due to superior gluteal artery stenosis is probably underestimated when gluteal duplex scanning and aortoiliac angiography with oblique projections are not performed. PTA gives good results, and the procedure can be repeated should restenosis occur.
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Buttock claudication from isolated stenosis of the gluteal artery
Journal of Vascular Surgery, 1997Co-Authors: M Batt, Reda Hassenkhodja, Thierry Desjardin, Andre Rogopoulos, Pierre Le BasAbstract:Buttock claudication is usually caused by proximal arterial obstruction in the aorta or the common iliac artery. We report an unusual case of Buttock claudication caused by isolated stenosis of the superior gluteal artery diagnosed by angiography. Both physical examination and noninvasive vascular explorations had been unremarkable. Twenty-six months after undergoing treatment by percutaneous transluminal angioplasty, the patient has no symptoms. Buttock claudication related to unilateral stenosis of the superior gluteal artery as observed in this case can be successfully managed by percutaneous transluminal angioplasty.
Loren J Borud - One of the best experts on this subject based on the ideXlab platform.
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autologous gluteal augmentation after massive weight loss aesthetic analysis and role of the superior gluteal artery perforator flap
Plastic and Reconstructive Surgery, 2007Co-Authors: Amy S Colwell, Loren J BorudAbstract:Background: Anatomical features that make the Buttocks attractive include adequate volume, projection, and a defined infragluteal fold. The gluteal region in patients with massive weight loss after gastric bypass is characterized by excessive skin and exaggerated fat loss. Lower body lift procedures remove excess skin and lift sagging Buttock tissue, but they typically result in further gluteal flattening. Procedures designed to augment the inferomedial aspect of the gluteal region restore projection and help define the infragluteal crease. The authors describe their technique of lower body lift with gluteal autologous augmentation using the superior gluteal artery perforator flap. Methods: Eighteen consecutive patients with massive weight loss after gastric bypass had lower body lifts with autoaugmentation performed by one surgeon. Superior gluteal artery perforator flaps were designed within the lower body lift markings, raised lateral to medial, and transferred to the inferomedial quadrant of the Buttocks. Results: Patients with a median age of 41 years (range, 24 to 56 years) had lower body lifts 2.8 years (range, 1.2 to 4.9 years) after gastric bypass after losing an average of 141 pounds (range, 92 to 272 pounds). Median body mass index decreased from 49 to 29 at the time of contouring. The autoaugmentation procedure added approximately 60 minutes to the overall Buttock lift procedure time; there were no intraoperative complications. Postoperatively, patients were surveyed anonymously and reported noting substantial improvement in the volume and contour of the Buttocks. Conclusions: Superior gluteal artery perforator flaps can be transferred reliably during lower body lifts to add volume and projection to the Buttocks. Key anatomical landmarks for vascular anatomy and aesthetic design are emphasized.
