Skip to main content
Erschienen in: Aesthetic Plastic Surgery 5/2022

25.05.2022 | Original Article

Efficacy of Topical Losartan in Management of Mammoplasty and Abdominoplasty Scars: A Randomized, Double-Blind Clinical Trial

verfasst von: Behzad Khodaei, Maryam Nasimi, Ehsan Nassireslami, Simin Seyedpour, Javad Rahmati, Shahriar Haddady Abianeh, Farhad Motavalli Khiavi

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Annually, millions of people suffer from skin scars’ psychological and physical disadvantages. Pathologic scars prevention is challenging and requires developing feasible and effective therapeutic strategies. Regarding promising results of losartan (an angiotensin 1 receptor inhibitor) on skin scar in preclinical studies, we aimed to assess the losartan ointment’s impact on surgical scars in a clinical setting.

Material and Method

Twenty-four patients with surgical wounds were enrolled from Razi hospital’s plastic and reconstructive surgery department. The patients were trained to apply ointments 14–18 days post-surgery on the determined scar side, twice a day for 6 months. Two dermatologists independently evaluated scar formation at 3 and 6-month follow-ups using the Vancouver Scar Scale (VSS) score.

Result

Twenty-four female patients with cosmetic surgeries were included. The mean VSS score of losartan-treated sides was 7.1 ± 2.06 (at month 3) and 5.21 ± 1.71 (at month 6) that significantly were different from placebo-treated sides (9.77 ± 1.55 and 8.31 ± 1.88 at 3 and 6 months, respectively) (P value < 0.001 and < 0.001, respectively, for months 3 and 6). The subset analysis demonstrated a significant improvement in height (P value < 0.001 at 3 and 6 months), pliability (P value  < 0.001 at 3 and 6 months), and vascularity (P value < 0.001 at 3 and 6 months) subsets at losartan compared to placebo-treated side. Losartan ointment was well tolerated with no complication.

Conclusion

Losartan ointment successfully improved scar formation in mammoplasty and abdominoplasty patients. The losartan preventive effect should be confirmed in future large-scale studies with long-term follow-ups.

Level of Evidence II

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.
Literatur
1.
Zurück zum Zitat Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG (2011) Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med 17:113–125PubMedCrossRef Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG (2011) Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med 17:113–125PubMedCrossRef
3.
Zurück zum Zitat Xue M, Jackson CJ (2015) Extracellular matrix reorganization during wound healing and its impact on abnormal scarring. Adv Wound Care 4:119–136CrossRef Xue M, Jackson CJ (2015) Extracellular matrix reorganization during wound healing and its impact on abnormal scarring. Adv Wound Care 4:119–136CrossRef
4.
Zurück zum Zitat Koese O, Waseem A (2008) Keloids and hypertrophic scars: Are they two different sides of the same coin? Dermatol Surg 34:336–346 Koese O, Waseem A (2008) Keloids and hypertrophic scars: Are they two different sides of the same coin? Dermatol Surg 34:336–346
6.
Zurück zum Zitat Lawrence JW, Fauerbach JA, Heinberg L, Doctor M (2004) The clinical research award: visible vs hidden scars and their relation to body esteem. J Burn Care Rehabil 25:25–32PubMedCrossRef Lawrence JW, Fauerbach JA, Heinberg L, Doctor M (2004) The clinical research award: visible vs hidden scars and their relation to body esteem. J Burn Care Rehabil 25:25–32PubMedCrossRef
7.
Zurück zum Zitat Wang F, Li X, Wang X, Jiang X (2020) Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. Int Wound J 17:765–773PubMedPubMedCentralCrossRef Wang F, Li X, Wang X, Jiang X (2020) Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. Int Wound J 17:765–773PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Demir CY, Ersoz ME, Erten R, Kocak OF, Sultanoglu Y, Basbugan Y (2018) Comparison of enalapril, candesartan and intralesional triamcinolone in reducing hypertrophic scar development: an experimental study. Aesthetic Plast Surg 42:352–361PubMedCrossRef Demir CY, Ersoz ME, Erten R, Kocak OF, Sultanoglu Y, Basbugan Y (2018) Comparison of enalapril, candesartan and intralesional triamcinolone in reducing hypertrophic scar development: an experimental study. Aesthetic Plast Surg 42:352–361PubMedCrossRef
9.
Zurück zum Zitat Iannello S, Milazzo P, Bordonaro F, Belfiore F (2006) Low-dose enalapril in the treatment of surgical cutaneous hypertrophic scar and keloid-two case reports and literature review. Medscape Gen Med 8:60 Iannello S, Milazzo P, Bordonaro F, Belfiore F (2006) Low-dose enalapril in the treatment of surgical cutaneous hypertrophic scar and keloid-two case reports and literature review. Medscape Gen Med 8:60
10.
Zurück zum Zitat Ramos RM, Burland M, Silva JB, Burman LM, Gelain MS, Debom LM, Bec JM, Alirezai M, Uebel CO, Valmier J (2019) Photobiomodulation improved the first stages of wound healing process after abdominoplasty: an experimental, double-blinded, non-randomized clinical trial. Aesthetic Plast Surg 43:147–154PubMedCrossRef Ramos RM, Burland M, Silva JB, Burman LM, Gelain MS, Debom LM, Bec JM, Alirezai M, Uebel CO, Valmier J (2019) Photobiomodulation improved the first stages of wound healing process after abdominoplasty: an experimental, double-blinded, non-randomized clinical trial. Aesthetic Plast Surg 43:147–154PubMedCrossRef
11.
Zurück zum Zitat Abedini R, Rayeni NM, Abianeh SH, Rahmati J, Teymourpour A, Nasimi M (2020) Botulinum toxin type A injection for mammoplasty and abdominoplasty scar management: a split-scar double-blinded randomized controlled study. Aesthetic Plast Surg 44:2270–2276PubMedCrossRef Abedini R, Rayeni NM, Abianeh SH, Rahmati J, Teymourpour A, Nasimi M (2020) Botulinum toxin type A injection for mammoplasty and abdominoplasty scar management: a split-scar double-blinded randomized controlled study. Aesthetic Plast Surg 44:2270–2276PubMedCrossRef
12.
Zurück zum Zitat Hedayatyanfard K, Haddadi NS, Ziai SA, Karim H, Niazi F, Steckelings UM, Habibi B, Modarressi A, Dehpour AR (2020) The renin-angiotensin system in cutaneous hypertrophic scar and keloid formation. Exp Dermatol 29:902–909PubMedCrossRef Hedayatyanfard K, Haddadi NS, Ziai SA, Karim H, Niazi F, Steckelings UM, Habibi B, Modarressi A, Dehpour AR (2020) The renin-angiotensin system in cutaneous hypertrophic scar and keloid formation. Exp Dermatol 29:902–909PubMedCrossRef
13.
Zurück zum Zitat Mohammadi AA, Parand A, Kardeh S, Janati M, Mohammadi S (2018) Efficacy of topical enalapril in treatment of hypertrophic scars. World J Plast Surg 7:326–331PubMedPubMedCentralCrossRef Mohammadi AA, Parand A, Kardeh S, Janati M, Mohammadi S (2018) Efficacy of topical enalapril in treatment of hypertrophic scars. World J Plast Surg 7:326–331PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Tang HT, Cheng DS, Jia YT, Ben DF, Ma B, Lv KY, Wei D, Sheng ZY, Xia ZF (2009) Angiotensin II induces type I collagen gene expression in human dermal fibroblasts through an AP-1/TGF-beta1-dependent pathway. Biochem Biophys Res Commun 385:418–423PubMedCrossRef Tang HT, Cheng DS, Jia YT, Ben DF, Ma B, Lv KY, Wei D, Sheng ZY, Xia ZF (2009) Angiotensin II induces type I collagen gene expression in human dermal fibroblasts through an AP-1/TGF-beta1-dependent pathway. Biochem Biophys Res Commun 385:418–423PubMedCrossRef
15.
Zurück zum Zitat Tan WQ, Fang QQ, Shen XZ, Giani JF, Zhao TV, Shi P, Zhang LY, Khan Z, Li Y, Li L, Xu JH, Bernstein EA, Bernstein KE (2018) Angiotensin-converting enzyme inhibitor works as a scar formation inhibitor by down-regulating Smad and TGF-β-activated kinase 1 (TAK1) pathways in mice. Br J Pharmacol 175:4239–4252PubMedPubMedCentralCrossRef Tan WQ, Fang QQ, Shen XZ, Giani JF, Zhao TV, Shi P, Zhang LY, Khan Z, Li Y, Li L, Xu JH, Bernstein EA, Bernstein KE (2018) Angiotensin-converting enzyme inhibitor works as a scar formation inhibitor by down-regulating Smad and TGF-β-activated kinase 1 (TAK1) pathways in mice. Br J Pharmacol 175:4239–4252PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Niazi F, Hooshyar SH, Hedayatyanfard K, Ziai SA, Doroodgar F, Niazi S, Habibi B, Asadirad A (2018) Detection of angiotensin II and AT(1) receptor concentrations in keloid and hypertrophic scar. J. Clin. Aesthet. Dermatol. 11:36–39PubMedPubMedCentral Niazi F, Hooshyar SH, Hedayatyanfard K, Ziai SA, Doroodgar F, Niazi S, Habibi B, Asadirad A (2018) Detection of angiotensin II and AT(1) receptor concentrations in keloid and hypertrophic scar. J. Clin. Aesthet. Dermatol. 11:36–39PubMedPubMedCentral
17.
Zurück zum Zitat Zheng B, Fang QQ, Wang XF, Shi BH, Zhao WY, Chen CY, Zhang MX, Zhang LY, Hu YY, Shi P, Ma L, Tan WQ (2019) The effect of topical ramipril and losartan cream in inhibiting scar formation. Biomed Pharmacother 118:109394PubMedCrossRef Zheng B, Fang QQ, Wang XF, Shi BH, Zhao WY, Chen CY, Zhang MX, Zhang LY, Hu YY, Shi P, Ma L, Tan WQ (2019) The effect of topical ramipril and losartan cream in inhibiting scar formation. Biomed Pharmacother 118:109394PubMedCrossRef
18.
Zurück zum Zitat Murphy A, LeVatte T, Boudreau C, Midgen C, Gratzer P, Marshall J, Bezuhly M (2019) Angiotensin II type I receptor blockade is associated with decreased cutaneous scar formation in a rat model. Plast Reconstr Surg 144:803e–813ePubMedCrossRef Murphy A, LeVatte T, Boudreau C, Midgen C, Gratzer P, Marshall J, Bezuhly M (2019) Angiotensin II type I receptor blockade is associated with decreased cutaneous scar formation in a rat model. Plast Reconstr Surg 144:803e–813ePubMedCrossRef
19.
Zurück zum Zitat Uzun H, Bitik O, Hekimoğlu R, Atilla P, Kaykçoğlu AU (2013) Angiotensin-converting enzyme inhibitor enalapril reduces formation of hypertrophic scars in a rabbit ear wounding model. Plast Reconstr Surg 132:361e–371ePubMedCrossRef Uzun H, Bitik O, Hekimoğlu R, Atilla P, Kaykçoğlu AU (2013) Angiotensin-converting enzyme inhibitor enalapril reduces formation of hypertrophic scars in a rabbit ear wounding model. Plast Reconstr Surg 132:361e–371ePubMedCrossRef
20.
Zurück zum Zitat Fang QQ, Wang XF, Zhao WY, Ding SL, Shi BH, Xia Y, Yang H, Wu LH, Li CY, Tan WQ (2018) Angiotensin-converting enzyme inhibitor reduces scar formation by inhibiting both canonical and noncanonical TGF-β1 pathways. Sci Rep 8:3332PubMedPubMedCentralCrossRef Fang QQ, Wang XF, Zhao WY, Ding SL, Shi BH, Xia Y, Yang H, Wu LH, Li CY, Tan WQ (2018) Angiotensin-converting enzyme inhibitor reduces scar formation by inhibiting both canonical and noncanonical TGF-β1 pathways. Sci Rep 8:3332PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Ehanire T, Ren L, Bond J, Medina M, Li G, Bashirov L, Chen L, Kokosis G, Ibrahim M, Selim A, Blobe GC, Levinson H (2015) Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction. J Mol Med (Berl) 93:289–302CrossRef Ehanire T, Ren L, Bond J, Medina M, Li G, Bashirov L, Chen L, Kokosis G, Ibrahim M, Selim A, Blobe GC, Levinson H (2015) Angiotensin II stimulates canonical TGF-β signaling pathway through angiotensin type 1 receptor to induce granulation tissue contraction. J Mol Med (Berl) 93:289–302CrossRef
22.
Zurück zum Zitat Hedayatyanfard K, Ziai SA, Niazi F, Habibi I, Habibi B, Moravvej H (2018) Losartan ointment relieves hypertrophic scars and keloid: a pilot study. Wound Repair Regen 26:340–343PubMedCrossRef Hedayatyanfard K, Ziai SA, Niazi F, Habibi I, Habibi B, Moravvej H (2018) Losartan ointment relieves hypertrophic scars and keloid: a pilot study. Wound Repair Regen 26:340–343PubMedCrossRef
23.
Zurück zum Zitat Ulrich D, Ulrich F, Unglaub F, Piatkowski A, Pallua N (2010) Matrix metalloproteinases and tissue inhibitors of metalloproteinases in patients with different types of scars and keloids. J Plast Reconstr Aesthet Surg 63:1015–1021PubMedCrossRef Ulrich D, Ulrich F, Unglaub F, Piatkowski A, Pallua N (2010) Matrix metalloproteinases and tissue inhibitors of metalloproteinases in patients with different types of scars and keloids. J Plast Reconstr Aesthet Surg 63:1015–1021PubMedCrossRef
24.
Zurück zum Zitat Min LJ, Cui TX, Yahata Y, Yamasaki K, Shiuchi T, Liu HW, Chen R, Li JM, Okumura M, Jinno T, Wu L, Iwai M, Nahmias C, Hashimoto K, Horiuchi M (2004) Regulation of collagen synthesis in mouse skin fibroblasts by distinct angiotensin II receptor subtypes. Endocrinology 145:253–260PubMedCrossRef Min LJ, Cui TX, Yahata Y, Yamasaki K, Shiuchi T, Liu HW, Chen R, Li JM, Okumura M, Jinno T, Wu L, Iwai M, Nahmias C, Hashimoto K, Horiuchi M (2004) Regulation of collagen synthesis in mouse skin fibroblasts by distinct angiotensin II receptor subtypes. Endocrinology 145:253–260PubMedCrossRef
25.
Zurück zum Zitat Ren M, Hao S, Yang C, Zhu P, Chen L, Lin D, Li N, Yan L (2013) Angiotensin II regulates collagen metabolism through modulating tissue inhibitor of metalloproteinase-1 in diabetic skin tissues. Diab Vasc Dis Res 10:426–435PubMedCrossRef Ren M, Hao S, Yang C, Zhu P, Chen L, Lin D, Li N, Yan L (2013) Angiotensin II regulates collagen metabolism through modulating tissue inhibitor of metalloproteinase-1 in diabetic skin tissues. Diab Vasc Dis Res 10:426–435PubMedCrossRef
26.
Zurück zum Zitat Colwell AS, Phan TT, Kong W, Longaker MT, Lorenz PH (2005) Hypertrophic scar fibroblasts have increased connective tissue growth factor expression after transforming growth factor-beta stimulation. Plast Reconstr Surg 116:1387–1390 (discussion 1391-1382)PubMedCrossRef Colwell AS, Phan TT, Kong W, Longaker MT, Lorenz PH (2005) Hypertrophic scar fibroblasts have increased connective tissue growth factor expression after transforming growth factor-beta stimulation. Plast Reconstr Surg 116:1387–1390 (discussion 1391-1382)PubMedCrossRef
27.
Zurück zum Zitat Amadeu T, Braune A, Mandarim-de-Lacerda C, Porto LC, Desmoulière A, Costa A (2003) Vascularization pattern in hypertrophic scars and keloids: a stereological analysis. Pathol Res Pract 199:469–473PubMedCrossRef Amadeu T, Braune A, Mandarim-de-Lacerda C, Porto LC, Desmoulière A, Costa A (2003) Vascularization pattern in hypertrophic scars and keloids: a stereological analysis. Pathol Res Pract 199:469–473PubMedCrossRef
28.
Zurück zum Zitat Gira AK, Brown LF, Washington CV, Cohen C, Arbiser JL (2004) Keloids demonstrate high-level epidermal expression of vascular endothelial growth factor. J Am Acad Dermatol 50:850–853PubMedCrossRef Gira AK, Brown LF, Washington CV, Cohen C, Arbiser JL (2004) Keloids demonstrate high-level epidermal expression of vascular endothelial growth factor. J Am Acad Dermatol 50:850–853PubMedCrossRef
29.
Zurück zum Zitat Kurosaka M, Suzuki T, Hosono K, Kamata Y, Fukamizu A, Kitasato H, Fujita Y, Majima M (2009) Reduced angiogenesis and delay in wound healing in angiotensin II type 1a receptor-deficient mice. Biomed Pharmacother 63:627–634PubMedCrossRef Kurosaka M, Suzuki T, Hosono K, Kamata Y, Fukamizu A, Kitasato H, Fujita Y, Majima M (2009) Reduced angiogenesis and delay in wound healing in angiotensin II type 1a receptor-deficient mice. Biomed Pharmacother 63:627–634PubMedCrossRef
30.
Zurück zum Zitat Karnik SS, Unal H, Kemp JR, Tirupula KC, Eguchi S, Vanderheyden PM, Thomas WG (2015) International union of basic and clinical pharmacology. XCIX. angiotensin receptors: interpreters of pathophysiological angiotensinergic stimuli. Pharmacol Rev 67:754–819PubMedPubMedCentralCrossRef Karnik SS, Unal H, Kemp JR, Tirupula KC, Eguchi S, Vanderheyden PM, Thomas WG (2015) International union of basic and clinical pharmacology. XCIX. angiotensin receptors: interpreters of pathophysiological angiotensinergic stimuli. Pharmacol Rev 67:754–819PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Takeda H, Katagata Y, Hozumi Y, Kondo S (2004) Effects of angiotensin II receptor signaling during skin wound healing. Am J Pathol 165:1653–1662PubMedPubMedCentralCrossRef Takeda H, Katagata Y, Hozumi Y, Kondo S (2004) Effects of angiotensin II receptor signaling during skin wound healing. Am J Pathol 165:1653–1662PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Akershoek JJJ, Brouwer KM, Vlig M, Boekema B, Beelen RHJ, Middelkoop E, Ulrich MMW (2018) Early intervention by captopril does not improve wound healing of partial thickness burn wounds in a rat model. Burns 44:429–435PubMedPubMedCentralCrossRef Akershoek JJJ, Brouwer KM, Vlig M, Boekema B, Beelen RHJ, Middelkoop E, Ulrich MMW (2018) Early intervention by captopril does not improve wound healing of partial thickness burn wounds in a rat model. Burns 44:429–435PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Yahata Y, Shirakata Y, Tokumaru S, Yang L, Dai X, Tohyama M, Tsuda T, Sayama K, Iwai M, Horiuchi M, Hashimoto K (2006) A novel function of angiotensin II in skin wound healing. Induction of fibroblast and keratinocyte migration by angiotensin II via heparin-binding epidermal growth factor (EGF)-like growth factor-mediated EGF receptor transactivation. J Biol Chem 281:13209–13216PubMedCrossRef Yahata Y, Shirakata Y, Tokumaru S, Yang L, Dai X, Tohyama M, Tsuda T, Sayama K, Iwai M, Horiuchi M, Hashimoto K (2006) A novel function of angiotensin II in skin wound healing. Induction of fibroblast and keratinocyte migration by angiotensin II via heparin-binding epidermal growth factor (EGF)-like growth factor-mediated EGF receptor transactivation. J Biol Chem 281:13209–13216PubMedCrossRef
34.
Zurück zum Zitat Criss CN, Gao Y, De Silva G, Yang J, Anderson JM, Novitsky YW, Soltanian H, Rosen MJ (2015) The effects of Losartan on abdominal wall fascial healing. Hernia 19:645–650PubMedCrossRef Criss CN, Gao Y, De Silva G, Yang J, Anderson JM, Novitsky YW, Soltanian H, Rosen MJ (2015) The effects of Losartan on abdominal wall fascial healing. Hernia 19:645–650PubMedCrossRef
Metadaten
Titel
Efficacy of Topical Losartan in Management of Mammoplasty and Abdominoplasty Scars: A Randomized, Double-Blind Clinical Trial
verfasst von
Behzad Khodaei
Maryam Nasimi
Ehsan Nassireslami
Simin Seyedpour
Javad Rahmati
Shahriar Haddady Abianeh
Farhad Motavalli Khiavi
Publikationsdatum
25.05.2022
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2022
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-022-02935-2

Weitere Artikel der Ausgabe 5/2022

Aesthetic Plastic Surgery 5/2022 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.