Postoperative wound manipulation after self-mutilation in borderline personality disorder—a plastic reconstructive challenge

Postoperative wound manipulation after self-mutilation in borderline personality disorder—a... Borderline personality disorder (BPD) is a mental illness with a prevalence of 1.5% in Western countries. One of the major characteristics of patients with BPD is self-mutilation of any kind. These patients are especially often seen in our clinic since our institution is collaborating with the department of psychiatry that offers supra-regional specialist inpatient hospital treatment of BPD. Types of self-manipulation are various and include slashing and cutting, burning or freezing, bonebreaking, hitting or incorporation of foreign objects. Due to the difficult-to-treat primary disorder, more wound manipulation or self-injury may occur when tensions continue, even after adequate plastic reconstructive surgical treatment and during hospitalization, which represents a challenge for the plastic reconstructive strategy. We describe special problems associated with plasticreconstructive surgery in the light of BPD and self-mutilation and present our algorithm with a series of recommendations for the treatment of such patients as well as three illustrative case reports. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Postoperative wound manipulation after self-mutilation in borderline personality disorder—a plastic reconstructive challenge

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Publisher
Springer-Verlag
Copyright
Copyright © 2012 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-011-0548-3
Publisher site
See Article on Publisher Site

Abstract

Borderline personality disorder (BPD) is a mental illness with a prevalence of 1.5% in Western countries. One of the major characteristics of patients with BPD is self-mutilation of any kind. These patients are especially often seen in our clinic since our institution is collaborating with the department of psychiatry that offers supra-regional specialist inpatient hospital treatment of BPD. Types of self-manipulation are various and include slashing and cutting, burning or freezing, bonebreaking, hitting or incorporation of foreign objects. Due to the difficult-to-treat primary disorder, more wound manipulation or self-injury may occur when tensions continue, even after adequate plastic reconstructive surgical treatment and during hospitalization, which represents a challenge for the plastic reconstructive strategy. We describe special problems associated with plasticreconstructive surgery in the light of BPD and self-mutilation and present our algorithm with a series of recommendations for the treatment of such patients as well as three illustrative case reports.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Mar 1, 2012

References

  • The validity of DSM-IV passive–aggressive (negativistic) personality disorder
    Rotenstein, OH; McDermut, W; Bergman, A; Young, D; Zimmerman, M; Chelminski, I
  • Sensory sensitivity, attachment experiences, and rejection responses among adults with borderline and avoidant features
    Meyer, B; Ajchenbrenner, M; Bowles, DP
  • Self-mutilation and eating disorders
    Favazza, AR; DeRosear, L; Conterio, K
  • A comparison of life events between suicidal adolescents with major depression and borderline personality disorder
    Horesh, N; Sever, J; Apter, A

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