Michael Sg Bell's research while affiliated with Dalhousie University and other places

Publications (25)

Article
Full-text available
Wide-awake flexor tendon repair in tourniquet-free unsedated patients permits intraoperative Total Active Movement examination (iTAMe) of the freshly repaired flexor tendon. This technique has permitted the intraoperative observation of tendon repair gapping induced by active movement when the core suture is tied too loosely. The gap can be repaire...
Article
End-to-end neurorrhaphy remains the gold standard for transected nerve repair. However, the current dogma is that to be successful, nerve repairs must be tension free. Therefore, nerve gaps are most commonly repaired with grafts. While there is evidence that nerves can regenerate successfully after initial approximation under a tensile force, the a...
Article
Postoperative infection in liposuction patients may be exceedingly difficult to clinically appreciate because of the skin edema, colour changes and even blistering that can occur. The authors outline such a case with practical advice about establishing an accurate and precise diagnosis of an early septic process.
Article
Silicone breast implants have a finite life span and may need changing over the lifetime of the patient. The experience with removing first- and second-generation implants is frustrating, because thick capsules often form, in association with rupture and spread of the silicone gel into the surrounding tissue. Different techniques have been employed...
Article
The authors present a case of a surgical wound that was inappropriately packed to the extent that a significant and major deterioration occurred in the expected healing by secondary intention. This is intended to alert surgeons to the fact that careful supervision is required of such seemingly simple and straightforward tasks as the topical treatme...
Article
Atraumatic stabilization of delicate eyelid skin for visualization and control in the removal of skin and fat is a critical factor in achieving goods results in blepharoplasty. This traditionally requires an experienced and attentive surgical assistant. Doing these procedures without assistance is easily achieved by the adaptation of devices in th...
Article
Postoperative infection in liposuction patients may be exceedingly difficult to clinically appreciate because of the skin edema, colour changes and even blistering that can occur. The authors outline such a case with practical advice about establishing an accurate and precise diagnosis of an early septic process.
Article
Full-text available
The authors present a case of a surgical wound that was inappropriately packed to the extent that a significant and major deterioration occurred in the expected healing by secondary intention. This is intended to alert surgeons to the fact that careful supervision is required of such seemingly simple and straightforward tasks as the topical treatme...
Article
Full-text available
In damage-control surgery, definitive abdominal closure may not be possible for several days or weeks after laparotomy until the patient has stabilized. We present 23 patients treated with the Canica ABRA dynamic wound closure system that re-approximated open abdomens with silicone elastomers placed transfascially across the wound. This study aimed...
Article
Established nonexpanding hematomas can be successfully treated with minimal morbidity using standard liposucstion techniques at the bedside or in an outpatient setting under local anesthesia. The authors presents a series of eight patients and discuss current concepts of dealing with this common and distressing surgical complication.
Article
To examine prospectively the incidence of digital infarction and phentolamine rescue in a large series of patients in whom local anesthesia with adrenaline was injected electively into the hand and fingers. There continues to be a commonly held belief that epinephrine injection is contraindicated in the finger despite a lack of valid evidence to su...
Article
Unassisted hand surgery is being undertaken by necessity for both elective and emergency cases, due to hospital resource restrictions. The authors outline the principles of local anesthesia, surgeon-controlled tourniquet techniques, and a number of new instruments which allow a surgeon to work in comfort and safety, unassisted. The traditional surg...
Article
Surgical soft tissue debridement of an inflamed or necrotic wound can be a challenging, time-consuming exercise, often with disproportionate blood loss. Suction-assisted curettage is a safe, simple and effective technique for these common, frustrating problems.

Citations

... Compared with the common postoperative complications after liposuction, TSS is very rare and relatively unknown to most plastic surgeons. During the past 30 years, only a few pieces of literature on TSS associated with liposuction have been reported [14][15][16][17]. TSS is a life-threatening infection characterized by a rapid progression of the disease. ...
... Trigger finger release has exhibited high success rates ranging from 94-100% (Lim et al., 2007;Stahl et al., 1997;Stefanich and Peimer, 1989). Multiple types of skin incision have been described for trigger finger release, including transverse, longitudinal, oblique, and a checkmark pattern (Bell, 2009;Bonnici and Spencer, 1988;Ryzewicz and Wolf, 2006;Turowski et al., 1997). Although training bias may influence a surgeon's choice of incision, it is unclear whether incision type affects scar quality, patient-reported outcomes, or complication rates. ...
... In particular, surgery with local anesthesia does not provide adequate hemostasis in the interdigital space and may cause tissue edema that will likely prevent surgical exposure. Anesthetic techniques controlled with a tourniquet, such as regional intravenous anesthesia, may be preferred to provide adequate hemostasis and a comfortable and safe surgical intervention in these patients [40][41][42]. ...
... When applied to an acute model, this strategy showed outcomes to be as good or better than a nerve repaired using an autograft (Howarth et al., 2019). This corroborates extensive previous research showing benefits of end-to-end repairs (Bhatia et al., 2017), that tension increases the rate of axon growth (Bray, 1984;Pfister et al, 2004), and positive outcomes from alternate peripheral nerve lengthening strategies in acute injury models (Saijilafu et al., 2006;Yousef et al., 2015;McDonald and Bell, 2010). In the acute model, long nerve gaps were readily bridged, without the structural and kinematic changes associated with chronic injury. ...
... In 2009, Bell et al. recommended the use of a 60 ml Toomey syringe connected to suction tubing in order to bluntly grasp the capsule during en bloc capsular removal and reduce intracapsular silicone volume in order to prevent accidental silicone extravasation during removal. 3 We propose this adapted technique to rapidly remove all silicone from the implant capsule. ...
... WALANT has been used in hand surgeries (3,4) as well as procedures involving foot and ankle (1,2). This anaesthetic technique has fewer risks and side effects compared to conventional sedation or general anaesthesia technique. ...
... More recently, many plastic surgeons consequently advocate a no-touch technique to minimize skin/parenchyma contamination and complications. [9][10][11][12][13][14] This is generally accomplished with a device composed of a nylon sleeve with a hydrophilic inner coating. 12 This present article describes a low-cost sleeve adapted to insert smooth, nanotextured, and texturized SGI. ...
... At particular risk are elderly patients with multiple comorbidities and those who may be taking medications such as anticoagulants [1][2][3]. Effective treatment of subcutaneous hematomas is important in order to avoid complications including skin necrosis, infection, scarring, hyperpigmentation, tissue edema, and prolonged recovery [1][2][3][4][5]. Hematoma evacuation may be done using a surgical approach, in which the hematoma is evacuated under general or regional anesthesia followed by treatment with a skin graft or skin substitute [3,5]. ...
... In the literature, the abdominal re-approximation anchor (ABRA) and the vacuum and mesh mediated fascial traction (VACM) have been described as effective dynamic closure procedures [13,14,18,25,26]. Both techniques exert a dynamic horizontal traction on the fascia, which can be reapproximated at bedside (ABRA) or in repeated abdominal explorations (ABRA/VACM). ...
... In a multicenter prospective study of 3,100 cases of hand and finger procedures using epinephrine, Lalonde et al 11 reported no incidence of phentolamine rescue or digital necrosis. ...