Papers by Sergio Sepúlveda
Revista de cirugía
Background: The adequate plastic surgeons training demand a constant review and assessment of the... more Background: The adequate plastic surgeons training demand a constant review and assessment of the training programs of residents. It has been 8 years since the first survey made to Plastic Surgery graduates of the University of Chile about the program training. Aim: Collect the opinion of Plastic Surgery graduates of the University of Chile between the years 2011-2017, in order to compare the results with previous generations. Materials and Method: A survey of 28 questions was conducted which evaluated general aspects of the residence, specific rotations of the resident, practical activities, theoretical activities and economic and research aspects. Results: There has been 21 graduates between 2011-2017, a survey response was obtained in 16 of them, 100% of the respondents approved the training program, 63% of respondents consider the duration of the program is insufficient. The best-evaluated rotation of the program was HCUCH according to 56% of graduates. The areas of best training perceived were body contour surgery and breast aesthetic surgery, respectively. Conclusion: Plastic surgery training program approval is still high in graduates; nevertheless the opinion about the needing for a more extensive program is kept. The analysis collected from this survey is an excellent tool to identify aspects of the training program can be improved.
Journal of Pain Research
This study aimed to compare the effects of ketamine and ketamine associated with magnesium on opi... more This study aimed to compare the effects of ketamine and ketamine associated with magnesium on opioid consumption and pain scores in patients undergoing abdominoplasty and/or liposuction compared to standard treatment. Patients and Methods: A total of 63 patients were included and randomized as follows: 21 patients in the Control group, 20 patients in the Ketamine group (Ket), and 22 patients in the Ketamine-magnesium group (KetMag). The KetMag group received an IV bolus of 0.3 mg/ kg of ketamine and 50 mg/kg magnesium, followed by continuous infusion of ketamine (0.15 mg/kg/h) and magnesium (10 mg/kg/h) until extubation. The Ket group received the same bolus and infusion of ketamine, together with a bolus and continuous infusion of placebo instead of magnesium. The Control group received saline instead of ketamine and magnesium. The groups were compared in morphine consumption during the first 12h, bodypostoperative pain and disability scale until the 90th day, the time until the first morphine request on the PCA pump, pain scores, and the adverse effects related to the use of study drugs. Results: The KetMag group had a lower morphine consumption by almost 50% during the first 12h than the Control and the Ket groups. In addition, the KetMag group required the first dose of morphine later than the other two groups. There were no differences in the adverse effects of the proposed treatments. Finally, multiple linear regression and a nonlinear approach analysis indicated that the Control group experienced a higher degree of pain and increased morphine consumption per hour than Ket and KetMag groups. Conclusion: Co-administration of intraoperative ketamine plus magnesium and ketamine alone are an effective and easy regime for reducing pain and opioid consumption in the postoperative period.
Revista chilena de infectología
Revista chilena de cirugía
Lower Body Lift: Integral management of the lower trunk in patients with massive weight loss. Cas... more Lower Body Lift: Integral management of the lower trunk in patients with massive weight loss. Case series and description of the Surgical Technique Introduction: Obesity is a public health problem; bariatric surgery is an effective treatment to weight loss. Skin surplus and adiposity can produce physical and psychological problems. The management of these patients requires large cutaneous resections. The Lower Body Lift is an integral strategy that allows to handle abdominal, gluteal and proximal thigh area. Objective: Present a series of patients with massive weight loss using the Lower Body Lift and expose the surgical technique. Materials and Method: Cohort of patients managed with Lower Body Lift by plastic surgeons of a university clinical hospital, between January 2013 and June 2016. A descriptive analysis of the series was realized. And the surgical technique is exposed. Results: Of a total of 97 lower body contour procedures in patients with massive weight loss, 17 (17.52%) were Lower Body Lift. 14 (82.35%) were women, with a mean age of 39.2 ± 11.2 years. On average, the patients had a weight loss of 41.4 ± 14.9 kg, with the BMI at the time of the intervention of 26.02 ± 6.17 kg/m 2. Conclusions: Patients with massive weight loss have a large cutaneous surplus that may require extensive resections to achieve satisfactory contour correction. Our patients had a weight loss of about 40 Kg prior to surgery, reaching almost normal BMI. The Lower Body Lift technique successfully corrects the aftermath of massive weight loss, with associated low complications.
Revista chilena de cirugía
Introduction: Massive weight loss in obese, has beneficial health effects, however patients usual... more Introduction: Massive weight loss in obese, has beneficial health effects, however patients usually presents excessive adiposity and redundant skin, that generates physical and psychological problems. The body contouring surgery helps to modify the contour of the body to achieve aesthetic harmony. There are few national studies that describe the epidemiology of body contour surgery in patients with massive weight loss. Objectives: Describes a series of patients with massive weight loss with body contour surgery and its complications. Materials and Methods: A prospective series of patients with body contouring surgery with a history of low body mass, between January 2013 and June 2016, in a university hospital. Patients with incomplete information or operated at another center were excluded. Descriptive statistics was used. Results: 120 patients with body contouring surgery and low weight mass were included. Age of 38.4 ± 10.4 years, 105 (87.5%) were women. 110 (91.67%) were bariatric patients. BMI of 26.56 ± 3.26 kg/m 2 and a weight loss of 39.06 ± 14.17 Kg were reached previous the contouring surgery. The most frequent surgery was the standard abdominoplasty 79 (65.83%), followed by mastopexy with implants 21 (17.5%). 1 (0.83%) presented major complication and 33 (27.5%) had a minor complication during the postoperative period. Discussion: This series presents results similar to other authors, with a lower rate of postoperative complications. Conclusion: The Body contouring surgery are safe procedures, which provides a solution to the bodily sequels after massive weight loss according to our experience.
Aesthetic Surgery Journal
Background: Body contouring surgery (BCS) is becoming increasing popular for aesthetic and recons... more Background: Body contouring surgery (BCS) is becoming increasing popular for aesthetic and reconstructive purposes, particularly among patients with massive weight loss (MWL). However, data on quality of life (QoL) following the surgery are limited, especially long-term QoL. Objectives: The authors evaluated the effect of BCS on QoL and the durability of this effect over time. Methods: QoL was measured with the Body-QoL ® instrument at 3 time points among consecutively treated patients: the day before BCS, 1 to 9 months postoperatively (short term), and 1 to 2.7 years postoperatively (long term). Total Body-QoL scores were compiled, as were scores for the instrument's main domains: body satisfaction, sex life, self-esteem and social performance, and physical symptoms. Scores were examined for the entire study population and separately for the cosmetic and MWL cohorts. Results: Fifty-seven of the 112 patients participated in the short-term assessment and 84 in the long-term assessment. Total Body-QoL scores increased significantly (P < 0.0001), from 44.0 ± 14.1 preoperatively to 85.5 ± 17.5 short-term postoperatively and to 84.4 ± 12.7 long-term postoperatively. Scores for the 2 postoperative assessments did not differ significantly. Similar results were observed for scores on each separate domain. Although preoperative scores were lower for the MWL cohort than the cosmetic cohort (33.9 ± 15.6 vs 46.1 ± 12.8; P = 0.0002), they improved substantially after BCS, approaching scores for the cosmetic cohort. Conclusions: QoL increases significantly after BCS. This favorable outcome remained stable throughout long-term follow-up and was true for the cosmetic and MWL cohorts.
Revista Chilena de Cirugía, 2017
Revista Chilena de Cirugía, 2016
Revista Chilena de Cirugía, 2016
Revista chilena de cirugía, 2016
effects of breast reduction surgery on the quality life background: The results of breast reducti... more effects of breast reduction surgery on the quality life background: The results of breast reduction surgery are usually reported in terms of anthropometric assessments. However the impact of surgery in quality of life is seldom informed. aim: To assess the effects of breast reduction surgery on the quality of life of patients. material and methods: The "Breast-Q Reduction and Mastopexy Module" was prospectively applied to all women subjected to breast reduction surgery in a University Hospital during one year. results: Twenty women answered the survey in the preoperative period and 20 in the postoperative period. The most commonly cutaneous pattern employed that the inverted T in 10 women, followed by the Wise pattern in six patients. The most commonly used pedicles were superior in 10 patients, followed by superomedial in seven patients. Mean excision weight was 923 g (range 150-2850). Mean Breast Q score improved from 45 to 65%. Satisfaction with breast appearance improved from 31 to 83%, self-esteem from 39 to 80%, sexuality from 50 to 81% and physical symptoms decreased from 48 to 16%. There was a significant association between the magnitude of excision and improvement in physical symptoms. conclusions: Quality of life improves notably in women after breast reduction surgery.
Revista Médica Clínica Las Condes, 2016
Aesthetic Plastic Surgery, 2015
To develop a new patient-reported outcome instrument (PRO) to measure body-related satisfaction q... more To develop a new patient-reported outcome instrument (PRO) to measure body-related satisfaction quality of life (QoL). Standard 3-phase PRO design was followed; in the first phase, a qualitative design was used in 45 patients to develop a conceptual framework and to create preliminary scale domains and items. In phase 2, large-scale population testing on 1340 subjects was performed to reduce items and domains. In phase 3, final testing of the developed instrument on 34 patients was performed. Statistics used include Factor, RASCH, and multivariate regression analysis. Psychometric properties measured were internal reliability, item-rest, item-test, and test-retest correlations. The PRO-developed instrument is composed of four domains (satisfaction with the abdomen, sex life, self-esteem and social life, and physical symptoms) and 20 items in total. The score can range from 20 (worst) to 100 (best). Responsiveness was 100 %, internal reliability 93.3 %, and test-retest concordance 97.7 %. Body image-related QoL was superior in men than women (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and decreased with increasing age (p = 0.004) and BMI (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Post-bariatric body contouring patients score lower than cosmetic patients in all domains…
Revista chilena de cirugía, 2015
development and testing of an instrument to assess body shape related quality of life background:... more development and testing of an instrument to assess body shape related quality of life background: The assessment of patient satisfaction and quality of life after body remodeling surgery is important. aim: To develop and assess a self-report instrument to evaluate the results of bariatric and body remodeling surgery. material and methods: A three phase methodology was used. In phase 1, literature was reviewed and in depth interviews to patients were carried out, creating a preliminary instrument that was applied to 1,340 patients in phase 2. In phase 3, the final assessment of the instrument was performed, applying it to 34 patients. The psychometric properties of the in instrument were evaluated. results: The instrument has four domains (satisfaction with abdomen, sexual life, self-esteem and social life and psychological symptoms) and 20 items. Its score ranges from 20 (worst) to 100 (better). Response rate was 100%, internal reliability was 93% and test-re test concordance was 98%. Body shape related quality of life was significantly higher in men than in women. It decreases with age and with increasing body mass index. Patients subjected to bariatric surgery had lower scores than patients subjected to esthetic surgery. In the postoperative period, the score improved by 21.9 ± 16.9 points. conclusions: The instrument developed can reliably measure quality of life associated with body shape.
Revista chilena de cirugía, 2011
Revista chilena de cirugía, 2014
Coupler ® venous mechanic microanastomosis. An important technological contribution to microvascu... more Coupler ® venous mechanic microanastomosis. An important technological contribution to microvascular surgery Aim: The aim of the present paper is to show the experience of the Plastic Surgery Division at the University of Chile Clinical Hospital, with the Coupler ® anastomotic device (Synovis Corp, Birmingham, AL) for venous microanastomoses in patients undergoing reconstructive microsurgery. Material and Methods: A retrospective review of 48 consecutive patients with free flaps between March 2009 and in February 2013. All microsurgical venous anastomoses were performed with the Coupler ® device and the arterial anastomoses with interrupted or continuous 9-0 or 10-0 nylon sutures. The collected data were: personal and medical patient information, location of the defect, flap used, vessels diameter, arterial anastomoses, Coupler ® used, time of anastomosis, postoperative complications, arterial and venous thrombosis. Results: A total of 48 free flaps were performed for reconstruction of lower extremity (n = 25, 52.1%); head-neck (n = 15, 31%); breast (n = 5, 10.4%
Revista chilena de cirugía, 2011
Radial forearm fl aps. Experience in ten patients Background: Radial forearm fl ap is extraordina... more Radial forearm fl aps. Experience in ten patients Background: Radial forearm fl ap is extraordinarily versatile thanks to its irrigation by the radial artery and its minor pedicles. It provides assorted alternatives for the reconstruction of proximal or distal defects of the arm and can be used as a free fl ap in head, neck, posterior trunk region, lower limb, esophagus and penis. It allows the incorporation of bone, tendons, nerves and muscle for complex lesion repair. Aim: To report our experience with radial forearm fl ap. Patients and Methods: Ten patients aged 20 to 65 years (four women) are reported. The lesions repaired were traumatic in four, infectious in three, secondary to tumors in two (a squamous intra oral adenocarcinoma in both patients) and vascular in one patient. Results: No patient had a partial or total loss of the fl ap. Five patients required complementary dermo epidermic grafts in a second intervention. Mean hospital stay was 30 days. All patients reported a favorable degree of satisfaction with the procedure. Conclusions: Radial forearm fl aps are a good alternative for the repair of a great variety of lesions.
Aesthetic Plastic Surgery, 2014
Background This study aimed to design a new patientreported outcome (PRO) instrument to measure p... more Background This study aimed to design a new patientreported outcome (PRO) instrument to measure patient satisfaction after body-contouring procedures such as liposculpture, abdominoplasty, body-lift, thigh-lift, and arm-lift. Methods Phase 1a involved an extensive literature review, 16 in-depth patient interviews, and expert focus groups with 5 plastic surgeons to develop a conceptual framework for the outcomes deemed important for body image and preliminary PRO instruments. In phase 1b, the preliminary instrument was tested with a second independent sample of 29 patients with whom simple interviews were additionally performed. In the second sample, scale reliability was calculated. Results In phase 1a, the domains identified for the conceptual framework included clothing and body image, sexual and affective life, self-image and self-esteem, social relationships, and physical symptoms. In phase 1b, the scale internal consistency was 91.5 %. Conclusions When psychometric evaluation is completed, the Body-Shape-Related Quality of Life instrument and its subscales will provide a reliable tool for plastic surgeons, researchers, and patients to use in measuring the impact and effectiveness of body-contouring procedures from the patient's perspective. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-B Keywords Body contouring surgery Á Tummy tuck Á Suction assisted Lipectomy Á Patient reported outcomes Á Quality of life Á Massive weight loss
Revista chilena de cirugía, 2013
Validation of the Spanish version of the breast Q reduction and mastopexy module xxxx Background:... more Validation of the Spanish version of the breast Q reduction and mastopexy module xxxx Background: The Breast Q Reduction and Mastopexy Module evaluate breast related quality of life from the perspective of the patients. Body self-image, social performance, sexuality and physical symptoms are assessed. Aim: To translate the Breast Q Reduction and Mastopexy Module to Spanish and validate the translated version to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research institute were used and the survey was applied to six patients aged 29 ± 6 years with 14 ± 2 years of studies. The internal stability of the test was assessed using Cronbach alpha. Results: The mean body mass index of the patients was 25 ± 1 kg/m 2. The internal stability of the scale was 97%. The scores of the test in the preoperative period ranged from 74 to 125 points. Conclusions: The Breast Q Reduction and Mastopexy Module is a valid instrument to assess the results of reductive mammoplasty among Spanish speaking patients.
Revista chilena de cirugía, 2014
Proyecto académico sin fines de lucro, desarrollado bajo la iniciativa de acceso abierto
Revista chilena de cirugía, 2013
Proyecto académico sin fines de lucro, desarrollado bajo la iniciativa de acceso abierto
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Papers by Sergio Sepúlveda