Publications (Scientific Papers/Write-ups)

Dr. William Nimle Mol has been an author to 17 Original Scientific Papers, regarding SCLEROTHERAPY and various other aspects of Plastic, Reconstructive & Cosmetic Surgery & Vascular Anomalies. The references are as follows:

1. 2017: Special Techniques in Plastic Surgery to Conceal Scars. PIH e-Med Journal 2017;11(1):01-06.

2. 2017: 'Pinch' & 'Displacement' Tests. PIH e-Med Journal 2017;8(1):01-05.

3. 2013: Efficacy of percutaneous ethanol sclerotherapy for venous malformation in lower extremities: a retrospective review of 21 cases. Euro J Plast Surg 2013;36(2):161-4.

4. 2010: Percutaneous sclerotherapy for arteriovenous malformations of the face in the outpatient clinic. ACTA OTORHINOLARYNGOLOGICA ITALICA 2010;30:149-152.

5. 2009: Efficacy of polidocanol sclerotherapy for capillary malformation with masked venous malformation. Dermatologic Surgery 2009;35(1):161-4.

6. 2008: Merkel cell carcinoma of the face: an analysis of 16 cases in the Japanese. Journal of Plastic, Reconstructive & Aesthetic Surgery 2008, Aug 1 (Epub ahead of print) PMID: 18676193.

7. 2008: Simvastatin inhibits growth via apoptosis and the induction of cell cycle arrest in human melanoma cells Melanoma Research 2008;18(2):85-94.

8. 2008: Salvage of cartilage framework exposure in microtia reconstruction using a mastoid fascial flap. Journal of Plastic, Reconstructive & Aesthetic Surgery 2008;61(1): s110-3. E-pub 2007 March 9.

9. 2008: Double innervation occurs in the facial mimetic muscles after facial-hypoglossal end-to-side neural repair: rat model for neural supercharge concept. Journal of Plastic, Reconstructive & Aesthetic Surgery 2008;61(3):257-64.

10. 2007: Evaluation of the sclerotherapeutic efficacy of ethanol, polidocanol, a OK-4nd32 using an in vitro model. Dermatologic Surgery 2007;33(12):1452-9.

11. 2007: Use of absolute ethanol & 1% polidocanol for the treatment of vascular malformations at our institute. Papua New Guinea journal of science, technology and engineering 2007;1(Epub only).

12. 2007: New grading system for patients with Treacher Collins syndrome.The Journal of Craniofacial Surgery 2007;18(1):113-9.

13. 2007: Modification of thoracoscopy in pectus excavatum: insertion of both thoracoscope and introducer through a single incision to maximize visualisation. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 2007;41(4):189-92.

14. 2006: Percutaneous sclerotherapy using polidocanol for haemangioma and vascular malformations Japanese journal of interventional radiology 2006; 21(4): 403-407.

15. 2006: Surgical management of ischial and perineal pressure ulcers with urethrocutaneous fistulae. Journal of Wound Care 2006;15(2):55-7.

16. 2006: P6: A study on blood flow in pedicled jejunum after supercharge using a dog model - which is more important for survival of distal (oral) end of pedicle jejunum, artery or vein? Plastic and Reconstructive Surgery 2006;118 (4):89-90 posters: scientific posters: pdf only.

17. 2004: A new technique of microvascular suturing: the chopstick rest technique. British Journal of Plastic Surgery 2004;57:567-571.

A NEW CONCEPT IN PUBLICATION OF CLINICAL PAPERS

The New Pacific International Hospital (PIH) in Port Moresby has commenced publishing short clinical papers to exchange vital and relevant information among clinicians. Generally speaking clinicians are busy dealing with patients and they usually do not find time to read and publish papers (being academic). Nevertheless, it is important that a clinician should read and upgrade his/her knowledge and at the same time report interesting clinical findings/observations or cases. In standard journals, the format of reporting is lengthy and to make matters worse, the process of submission and reviewing are sometimes discouraging, especially to the novice.

Dr. Venkita Suresh (Senior Cardiologist) and team members of PIH, has introduced a simple way of reporting interesting clinical findings: The PIH E-Med Journal. The Journal is based on the concept of 'A Picture Speaks A Thousand Words'. Clear photos, diagrams and tables are recommended with very few wordings to convey the main message.

In this journal, Dr. Mol explains the clinical examination technique of 'Pinch' and 'Displacement' Tests to come up with a preliminary diagnosis of any subcutaneous tissue level masses (lumps, bumps, cysts & swellings) before ordering radiologic and laboratory tests.

LOOK OUT FOR OUR NEW PUBLICATION IN THE NEW PIH e-MED JOURNAL IN NOVEMBER 2017 (IT WILL ALSO BE POSTED/UPLOADED TO THIS BLOG): 

'SPECIAL TECHNIQUES IN PLASTIC SURGERY TO CONCEAL SCARS'

Permanent Removal of Facial Hair or Body Hair

WE NOW HAVE A HAND-HELD, PERMANENT LASER, HAIR REMOVER!

It is painless. However, you may only feel a bit of heat and slight swelling for 3 days, is expected. Takes less time and is less complex, compared to 'Vector' below and Waxing (common temporary hair removal method in Papua New Guinea)!

Our Cases of Permanent Laser Hair Removal will be posted on this section soon!

There are 2 methods for hair removal:

1. Temporary

-Shaving using a razor blade or electrical shavers
-Trimming using scissors or electrical trimmers
-Plucking
-Waxing (same as plucking except that large areas are covered in 1 attempt)
-'Veet' (hair dissolving cream) etc.

Plucking and waxing removes hair from closer to the follicle or root, thereby stimulating more & thicker hair growth. Removal with cream such as 'Veet', dissolves hair at the shaft above the skin, the same as shaving and trimming. Over time the hair may become thin and less obvious, with the use of 'Veet' or any other hair dissolving cream.

2. Permanent

-Electrolysis (With or Without Needle)
-Laser

Needle electrolysis is the most common and reliable method in the world today. After numbing & cleaning the skin, a tiny needle is passed alongside the hair shaft, down to the follicle and then the switch is put on to pass a tiny current to the follicle. If done properly it is painless, safe and reliable. There is a newer tweezers type of electrolysis, where no needle is used instead, the current is passed down to the follicle using a highly conductive gel. This is a new machine & may not be reliable.

Laser is concentrated light, once absorbed the energy is converted to heat to destroy the follicle. Darker materials absorb more heat. It works better for light skin people with darker hair. The light energy is only absorbed by the hair shaft, preserving the skin. Dark skin people will have burns. Laser is associated with a lot of pain, redness & swelling following the procedure.

Up until now, there is no reliable cream or lotion for permanent hair removal designed yet.

Body Piercing

Body piercing has been a tradition and a culture among our Melanesian tribes. They have used sharp bamboos, turtle shells etc.. for piercing. Even, nowadays, improper techniques can lead to infections and hypertrophic scars and keloids, especially on the ear lobes. The piercing gun provided by many pharmacies around the country, can cause problems. This is because the pierce is blunt, therefore, it can cause a lot of pain, bleeding and swelling. Because of the bluntness, the skin edges where the pierce penetrates is very irregular. This irregular skin edges has a high tendency for hypertrophic scars and keloid formation. It is better to do piercing under sterile (clean) conditions and to use an anaesthetic cream to numb the skin, as well as to use a sharp instrument to create an opening prior to the insertion of the blunt pierce. These precautions may prevent the formation of keloids.

Lip Reduction

In Melanesians, the size of the upper and lower lips are naturally large. Sometimes they are large because of some trauma or growth below it. In Caucasians the lips are usually thin or small, so they usually request for lip enlargement. Fillers (substances that are injected below the skin) are injected for lip enlargement. For lip reduction in the Melanesian, a small incision is done on the oral side to remove the excess lip skin. The scar is well hidden on the oral side. There is minimal blood loss and the patient can go home the same day. Slight swelling may last for 2-3 days. The patient is allowed to eat soft foods and rinse the mouth with warm salt water, immediately after the operation. Normal feeding can resume after 3 days. The thread or sutures will stay and resolve or disappear into the skin after 2-3 weeks. The risk of infection is low for any minor wounds within the oral mucosa.

Sclerotherapy (Scarless Surgery)

We use Sclerotherapy to treat mainly the Vascular Malformations (Congenital Abnormally Formed Blood Vessels). However, recently, we are using it to treat other Cystic Lesions (fluid filled sac causing a swelling or bulge) as well.

The Vascular Malformation includes:

Lymphatic Malformation 

(Congenital Abnormal Lymphatic Vessels that Do Not Connect to a Main Branch and Ends Blindly, Forming a Cyst of Lymphatic Fluid. Macrocystic means one or two large cysts while Microcystic means many small cysts)

Venous Malformation 

(Congenital Abnormal Veins that Do Not Drain Blood Effectively But Pools Blood and Dilates Over Time)

Arterio-Venous Malformation 

(Congenital Abnormal Connection Between Arteries and Veins, Without Any Capillaries in Between. The Direct High Pressure from Arteries is Transmitted to the Veins Causing Them to Engorge and Dilate With Arterial Blood, Over Time)

Plunging Ranula: One of Other Cystic Lesions Treated by Sclerotherapy, Recently.

(Cysts Forming as a Result of Blocked Salivary Gland Ducts and Extending into the Neck, from the Mouth)

*Refer to the Section on Plunging Ranula for the results of the New Minimally Invasive Treatment for Plunging Ranula (or Click on this Phrase).

Sclerotherapy is a method whereby agents that irritate the vessel walls are injected to cause the vessels to harden & obliterate over time. Thus, cutting off the blood supply to the diseased part to cure it. This technique is done through an injection needle, therefore no scar is left on the skin & there is less complications such as blood loss & the recovery time is short.

Sclerotherapy is used to treat:
1. cystic lesions (fluid filled swellings)
2. vascular malformations & hemangiomas (swellings that are composed of blood vessels)
3. uncontrollable bleeding sites after trauma or surgery
4. cancers (to cut off blood supply to tumors)
5. to cut off nerve supply to control abnormal muscle movements or excessive pain
6. hemorrhoids (anal swellings that are composed of veins)

Dr. Mol is the only person in PNG specializing in the art & technique of sclerotherapy. He has obtained a PhD on sclerotherapy while studying plastic surgery at Hokkaido University, Japan. He has elucidated the mechanism of action (how they work or induce sclerosis) of 3 commonly used sclerosants (agents that induce sclerosis or hardening of vessels).

We are now extending our Sclerotherapy technique to treat Mandibular Bone Cysts.