Dr Michael Bell: A Surgeon With Boundless Ingenuity

Dr Michael Bell was born in Kingston, Ontario, on October 14, 1944. He was always a curious child who exhibited a tendency toward innovation and experimentation. Dr Bell was accepted into the MD program at the University of Toronto graduating in 1969 before completing his plastic surgery residency there. Dr Bell accepted a position bringing hand and microsurgery expertise to the University of Ottawa in 1976. He pioneered the widespread use of local anesthetic for surgery and developed an innovative relationship with Leonard Lee of Lee Valley tools. Canica Design created several surgical products, including an enhanced design on the traditional scalpel handle and wound closure devices. Dr Bell had a passion for making improvements to enable surgeons to advance patient care. He encourages a philosophy of critical thinking that contributes to continued design in plastic surgery. Dr Bell continues to design and craft new devices with alumni of the Lee Valley Tools team.

The effect of body mass index and wound irrigation on outcome after bilateral breast reduction

Thirty patients undergoing bilateral breast reduction by inferior pedicle technique were entered into a prospective, randomized study to determine the effect of unilateral saline wound irrigation and body mass index (BMI) on outcome. Each patient was assessed at 1, 4, and 8 weeks after surgery for wound dehiscence, infection, fat necrosis, and breast comfort by means of a visual analog pain score. The mean patient age was 33 years; mean weight, 67.7 kg; mean BMI, 26.3; and mean weight of breast tissue excised per patient, 1270 g. In 60 breasts there were 13 cases of minor wound breakdown, all of which had healed by 8 weeks postoperatively. Wound irrigation had no significant effect on the rate of T-junction breakdown or on postoperative pain. BMI was associated significantly with wound breakdown (BMI > 26.3, 33% wound breakdown rate; BMI < 26.3, 10% wound breakdown rate; P < 0.05, chi2 test). Patients with a high BMI are more likely to have delayed healing after breast reduction.

A comparison of two methods of infiltration in breast reduction surgery

The superwet technique has been shown in previous studies to dramatically reduce blood loss in breast reduction surgery, compared with standard infiltration. A retrospective chart review of 303 consecutive patients undergoing bilateral breast reduction surgery was undertaken to demonstrate additional differences in complication rate, operative time, or sponge use in the operating room. In this series, 132 consecutive patients received standard infiltration along incision lines (25 cc per breast of 1:100,000 epinephrine), and 171 patients received superwet infiltration with 240 cc per breast of 1:1,000,000 epinephrine. The average operative time was significantly reduced in the superwet group, from 78.5 minutes to 70.7 minutes (p < 0.01 level). The average number of sponges used intraoperatively was also decreased significantly (p < 0.01), from 26 to 20 sponges. Complication rates were equally low in both groups, demonstrating the safety of the superwet technique. In addition to limiting blood loss, the superwet infiltration effectively reduces operative time and sponge use without increasing complications in breast reduction surgery.