Novel Injection Techniques
Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh in Adapting Dermal Fillers in Clinical Practice, 2022
Dissection is the part of the procedure that results in tissue destruction. Unwanted events occur during this step. In some critical parts of the face – the forehead, for example – even the advancement of the cannula by hand is not free of risk. A more rigid cannula sometimes cannot follow the curved surfaces and might change its plane more toward the superficial or deeper layer where vessels or nerves can be encountered. The latter can cause a substantial amount of pain and should be avoided (Figures 4.3 and 4.4). However, a flexible cannula can advance more unpredictably into the facial soft tissues, posing an equal risk to the patient. It is not easy to make direct injection on the forehead even, complete and within a single layer. With these concerns, using saline instead of these instruments for the part of dissection is a wise idea (Figures 4.5 and 4.6a–d).
The Origin and Nature of Pathology
Jeremy R. Jass in Understanding Pathology, 2020
The two types of dissection, anatomical and pathological, continued side by side into the eighteenth century, but it was anatomical dissection that represented the central pillar of medical knowledge and took pride of place in medical school education. The concept of dissection being the final punishment of the poor and wicked was perpetuated in this century by the English painter William Hogarth (1697–1764) in a series of engravings entitled The Four Stages of Cruelty. In engraving 3 Tom Nero is caught murdering his mistress. After his death by hanging, his body is shown in engraving 4 being ceremoniously dissected at the Royal College of Physicians, the somewhat disinterested President taking the role of the traditional anatomist. Nero’s heart is greedily consumed by a dog (Burke & Caldwell, 1968).
Crisis or renaissance?
Caragh Brosnan, Bryan S. Turner in Handbook of the Sociology of Medical Education, 2009
As we have seen, dissection was historically viewed as a supreme tradition that developed in students a detailed understanding of the structures and functions of the human body. But in the late 1990s and the early twenty-first century, proponents of living anatomy began to champion the use of more live and virtual methods of learning (McLachlan et al. 2004; McLachlan and Regan de Bere 2004). This emerged for several reasons. On a practical level, many of the objections levelled at cadaveric dissection were based on quite straightforward disadvantages: dissection is labour intensive and requires skilled anatomy tutors; cadavers are expensive and donated corpses scarce; dead bodies may carry disease (CJD, HIV, hepatitis and tuberculosis), their tissues are dead and therefore unlike living tissues; and the student experience is generally aesthetically unpleasant and stress provoking (Aziz et al. 2002).
Do we really need cadavers anymore to learn anatomy in undergraduate medicine?
Published in Medical Teacher, 2018
P. G. McMenamin, J. McLachlan, A. Wilson, J. M. McBride, J. Pickering, D. J. R. Evans, A. Winkelmann
Our recently published meta-analysis on anatomy laboratory pedagogies (Wilson et al. 2018) is a key evidence-based study, which lays the groundwork for many of the arguments to follow. In summary, the meta-analysis conducted 4 sub-analyses that investigated dissection vs prosection, dissection vs. models/modeling, dissection vs digital media, and dissection vs hybrid approaches. The overall goal of this study was to understand the effectiveness of dissection compared to these other approaches. Upon reviewing over 3000 records, a total of 27 studies were included in the final analysis. Across those 27 studies (which included over 7000 participants), the meta-analysis detected no effect on learner performance. In other words, students’ short-term knowledge gains in anatomy were equivalent regardless of being exposed to dissecting cadavers or not.
Operative repair of three ascending aortic dissections in one day at Baylor University Medical Center
Published in Baylor University Medical Center Proceedings, 2022
Charles Stewart Roberts, Lauren Zammerilla Westcott
Patient 1 had a known ascending aortic aneurysm, which had previously measured 4.1 cm by echocardiography. In this patient, the entry tear was in the aortic arch and hemopericardium was present. Patient 2 had a previous aortic dissection in the descending thoracic aorta, which had been treated by an endograft. In this patient, the acute entry tear was in the ascending aorta, and hemopericardium was also present. Patient 3 appeared to have a healed dissection in the ascending aorta, perhaps 4 months before admission by history, together with a new acute entry tear in the ascending aorta, but no hemopericardium. Aortic regurgitation was assessed by transesophageal echocardiogram and noted to be absent in patient 1 and moderate in patients 2 and 3. All three dissections were type A as defined by the Society for Vascular Surgery and the Society of Thoracic Surgeons (Figure 1).4
Role of Intraoperative Nerve Monitoring in Postoperative Muscle and Nerve Function of Patients Undergoing Modified Radical Mastectomy
Published in Journal of Investigative Surgery, 2021
Serhat Tokgöz, Ebru Karaca Umay, Kerim Bora Yilmaz, Muzaffer Akkoca, Melih Akinci, Cem Azili, Mehmet Saydam, Yasin Ucar, Şener Balas
As a result, knowledge of the surgical anatomy of the axillary region and preservation of these nerves during cautious dissection in axillary lymph node dissection is useful for preserving muscle functions and preventing morbidity. However, our study showed that morbidity might develop despite careful dissection. Furthermore, this study showed that nerve and muscle functions were significantly preserved using an objective method such as IONM, which has a significant role in preserving the PMM, the main structure of the chest wall. Our nerve monitoring technique is simple and more reliable for low-volume centers than the exposure technique with the angle according to the lateral thoracic vein, which was defined by Anthony et al. [29] or through the surgical technique suggested by Zin et al. [30].
Related Knowledge Centers
- Anatomy
- Cadaver
- Forensic Medicine
- Blood Vessel
- Pathology
- Autopsy
- Formaldehyde
- Morgue
- Computational Anatomy
- Nerve