Abdominoplasty is an aesthetic surgical procedure that restores abdominal contouring. Repeated pregnancy usually leads to lower abdominal skin redundancy and excess fat accumulation. Delivery via Cesarean section adds weakness to the lower abdominal wall muscles and yields a lower transverse Cesarean scar. Recently and in some cultures, abdominoplasty is requested at the same time of Cesarean delivery. Those women usually want to get the benefit of undergoing the abdominoplasty combined with Cesarean delivery in the same setting, thus avoiding a future surgery. This study was designed to evaluate the aesthetic outcome of combined abdominoplasty with Cesarean delivery. The study included 50 pregnant women from February 2008 to December 2009 with an average follow up period of 6 months. Nine patients (18%) developed wound infection; three of them (9%) developed wound dehiscence. Six patients (12%) developed lower abdominal skin necrosis; three of them (6%) were treated conservatively and healed by secondary intention, while surgical debridement and secondary sutures were needed in the other three patients (6%). Residual abdominal skin redundancy in 9 patients (18%), outward bulging of the abdomen and lack of waist definition in 16 patients (32%), and outward bulging of the umbilicus in 12 patients (24%) were the reported unaesthetic results. The results were compared with results of 80 abdominoplasties in nonpregnant women. The study concluded that abdominoplasty combined with Cesarean delivery carries a higher incidence of complications and does not give the desired aesthetic outcome. The authors do not recommend this practice.

IntroductionThe issue of conserving the ovaries at hysterectomy in premenopausal women with benign gynecologic disease has been the subject of considerable controversy. Some clinicians prefer prophylactic oophorectomy in premenopausal women during hysterectomy to prevent future development of malignant changes in conserved ovaries. Other clinicians prefer to conserve apparently normal ovaries, because bilateral oophorectomy in premenopausal women results in an abrupt imbalance, sudden onset of menopausal symptoms, decreased libido, increased cardiovascular risk and osteoporosis.Material and methodsTwo hundred and twenty multipara women (who had completed their families), with benign uterine pathology were included in this prospective study for abdominal hysterectomy with bilateral ovarian preservation. Pre-operative vaginal ultrasound, Doppler studies, diagnostic hysteroscopy and endometrial biopsy were done followed by laboratory studies including Anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol for all studied women. Doppler studies, AMH, FSH and estradiol were repeated 6 and 12 months post-operative for assessment of the ovarian function and ovarian blood supply after hysterectomy.ResultsPre-operative AMH, FSH and estradiol of the studied women were statistically insignificant compared to AMH, FSH and estradiol 6 and 12 months post-operative. Twelve months post-operative right and left ovarian volumes (6.92 ± 0.18 and 6.85 ± 0.19 cm3, respectively) were significantly larger than pre-operative right and left ovarian volumes (6.19 ± 0.22 and 5.86 ± 0.23 cm3, respectively), and, 12 months post-operative right and left ovarian pulsatility indices (2.92 ± 0.15 and 2.96 ± 0.16 cm/s, respectively) were significantly lower than pre-operative right and left ovarian pulsatility indices (3.45 ± 0.19 and 3.36 ± 0.2 cm/s, respectively). Eight (3.6%) cases of the studied women developed an ovarian cyst 6 months after hysterectomy, 3 were spontaneously resolved and the remaining 5 (2.27%) cases underwent exploratory laparotomy.ConclusionsThere is no evidence of ovarian dysfunction affecting conserved ovaries one year after hysterectomy in premenopausal women as evident by AMH, FSH and estradiol. Furthermore, an increased ovarian volume and reduced ovarian pulsatility indices indicate a possible increase in ovarian blood supply, and preserved non-compromised ovarian function.

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Hydration characteristics of tricalcium aluminate and gypsum mixture with a mole ratio of 1 : 1 in the presence and absence of sodium salt of naphthalene formaldehyde sulfonic acid polycondensate (NFS) at 30 and 508C were investigated. Different ratios of NFS were used, namely 0, 1, and 3% by weight. The water-to-solid ratio used was 10.Hydration was carried out for various time intervals from 0 . 5 h and up to 90 days. The results of combined water content, X-ray diffraction and scanning electron microscopy indicate that NFS retards the formation of ettringite and accelerates its transformation to monosulfate at early hydration ages. The extent of transformation is inversely proportional to the ratio of NFS.

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