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Upper Eyelid Myocutaneous Flap and External Tarsorrhaphy, Two Combined Minimally Invasive Techniques in the Functional and Cosmetic Correction of Cicatricial Ectropion of the Lower Eyelid: An Experience of Two Clinical Cases Follow in Short Term
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作者 Julls Celestin Apouakone Elie Fazaa +3 位作者 Loubna El Hajj Greta Lipa Sophie Cassier Eric Dunet modern plastic surgery 2025年第1期21-31,共11页
Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulc... Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions. 展开更多
关键词 ECTROPION Scar FLAP EYELID Tarsorrhaphy
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A Plastic Surgery Mission: Personal Experience in Improving Outcomes
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作者 Mohamed Elsayed Mohamed Mohamed modern plastic surgery 2025年第1期32-43,共12页
Background: Missions organized by international societies and humanitarian organizations play a significant role in saving many patients’ lives and improving their quality of life, despite the surrounding frustrating... Background: Missions organized by international societies and humanitarian organizations play a significant role in saving many patients’ lives and improving their quality of life, despite the surrounding frustrating conditions. Methods: A team of plastic surgery volunteers was sent to Yemen by the KSHARC. Results: A successful mission was performed on 62 patients who underwent surgery, with more than 900 patients examined and receiving appropriate medications. Conclusion: Missions in disaster-affected areas are of great importance. The role of missions and humanitarian organizations should be empowered. 展开更多
关键词 MISSIONS Humanitarian Organizations Plastic Surgery Natural Disasters Wars
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A Study on the Mechanisms by Which AGEs and RAG Promote Wound Healing in Patients with Second-Degree Burns undergoing Eschar Grinding Combined with Drug Therapy
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作者 Weijie He Zhi Liu +5 位作者 Lujun Yang Sitian Xie Zhan Ouyang Yao Lin Fuhua Huang Shijie Tang modern plastic surgery 2025年第1期1-20,共20页
Objective: To evaluate the improvement effect of combined treatment of eschar abrasion, nanosilver dressing, and mussel mucin spray on wound healing in patients with second-degree burns, and to explore their effects o... Objective: To evaluate the improvement effect of combined treatment of eschar abrasion, nanosilver dressing, and mussel mucin spray on wound healing in patients with second-degree burns, and to explore their effects on the expression level of (advanced glycation end products) AGEs in wound tissue, so as to provide a basis for the application of AGEs expression level in wound tissue in the future clinical treatment of second-degree burns. Methods: Patients with second-degree burns admitted to the Department of Burns and Plastic Surgery of the Second Affiliated Hospital of Shantou University Medical College from July 2023 to July 2024 were selected as the research subjects. This study was a non-double-blind study, and both patients and researchers were aware of the treatment methods. They were randomly divided into Group A (control group) and Group B (study group). According to the order of their visits, the patients were numbered in advance;then the seed number was taken, and 70 random numbers were generated on the computer using SAS, the first 35 corresponding to group A, and the last 35 corresponding to group B;the random numbers were arranged from small to large, and the rank of the random numbers was the patient number;finally, the patient numbers were arranged from small to large, and the corresponding groups were the grouping scheme. 1) Wound healing time: The wound healing was observed every day, and the wound healing time was calculated when the wound was completely epithelialized. 2) Wound healing: The wound healing area was measured 1, 7, and 14 days after treatment, and transparent paper was used to record combined with a computer-assisted imaging system. Wound healing rate = wound healing area (cm2)/total wound area before treatment (cm2) × 100%. The time for complete wound healing was recorded in the two groups of patients. 3) Pain: The pain was evaluated at 1, 7, and 14 days after treatment using the visual analogue scale (VAS). The higher the score, the more severe the pain. 4) Scar condition: Scar formation was evaluated 1, 3, and 6 months after wound healing using the VAS scale, with a total score of 15 points. The higher the score, the more severe the scar. 5) Detect the expression of AGEs in wound tissue. Results: The wound healed 14.03 ± 2.28 days after eschar removal, with a cure rate of 97.8%. No infection occurred in the wound after eschar removal in all patients. The wound healing time ranged from 9 to 23 days, with an average healing time of 28.41 ± 1.45 days. The healing quality was satisfactory. The Vancouver Scar Scale scored the wound healing scar as 0.81 ± 0.73 points. Western blot was used to detect the expression of AGEs, (receptor for advanced glycation end products) RAGE, and protein in the wound tissue. Results After 7, 14, and 28 days of medication, the wounds of diabetic patients healed well. The drug treatment efficacy and hydroxyproline content showed an upward trend, and the expression levels of AGEs, RAGE, and HIF-1a proteins showed a downward trend. Compared with day 0, the hydroxyproline content of the wound granulation tissue on days 7, 14, and 28 was significantly increased (P< 0.01), and the expression levels of AGEs, RAGE, and HIF-1α proteins were significantly downregulated (P< 0.05 or P< 0.01). Conclusion: Monitoring the expression levels of AGEs and RAGE can reflect the wound-healing effect of patients with second-degree burns, and the prognosis of the wound is closely related to the expression levels of AGEs, RAGE, and scab abrasion. In the treatment of second-degree burn wounds, scab abrasion can grasp the level of necrotic scab removal, can achieve “relatively accurate” removal of necrotic tissue, maximally protect the ecological tissue between wounds and retaining normal tissue, and can play a positive role in promoting the healing process of burn wounds;at the same time, nanosilver dressings have good antibacterial properties and high safety, and mussel mucin has anti-inflammatory and antioxidant activities and the characteristics of blocking nerve endings, which can effectively relieve the burning, stinging, and itching of sensitive skin and effectively promote wound healing. 展开更多
关键词 AGES RAG DERMABRASION Second Degree Burns
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Abdominoplasty, Liposuction and Brazilian Butt Lift (BBL) in Kinshasa in the Democratic Republic of Congo. My Experience in This Aesthetic Plastic Surgery with Black African Women in a Low-Income Country
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作者 Anatole Kibadi-Kapay modern plastic surgery 2024年第3期36-50,共15页
Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my ... Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my experience and the challenges of this aesthetic plastic surgery among black African women. Material and Methods: A retrospective study was conducted about the abdominoplasties, liposuctions and Brazilian butt lift (BBL) which I operated in public and private hospitals at Kinshasa (Democratic Republic of Congo) in black African women. It covers a period of 13 years, going from December 1, 2010 to December 1, 2023. For this study, I had at least 6 months period (to Juin 1, 2024) to assess the occurrence of early and late postoperative complications. Results: I performed 84 abdominoplasties, 144 liposuctions and 23 Brazilian butt lifts (BBL). The average age at the time of abdominoplasty was 44 years with extremes ranging from 26 to 55 years and a concentration of cases (60.7%) in the age group of 40 to 49 years. The age group of 20 to 29 years old represented the lowest rate of requests for abdominoplasty (4.7%). Patients with a BMI of 30 to 2 were the majority (61.9%), followed by those between 25 to 2 (29.7%). 67.8% of patients were obese (BMI ≥ 30 kg/m2). The average age at the time of liposuction was 41 years with extremes ranging from 21 years to 69 years;and more than half of cases (68%) in the age group between 30 and 49 years. As for Brazilian butt lift (BBL), the average age was 33 years with extremes ranging from 24 to 42 years and a concentration of patients (91.3%) between 20 and 39 years. The immediate postoperative complications of abdominoplasties observed were: seroma in 7% of cases, hematoma and partial infection of the surgical site in 5% of cases. Pathological scars (hypertrophic, keloid) after abdominoplasties were observed in 9% of cases. The most common complication of liposuction was contour deformity. I observed 16 patients (11.1%) with soft-tissue depressions or elevations, skin panniculus or folds. For Brazalian Butt Lift (BBL), complications like asymmetry for 2 patients (8.9%), contour irregularities for 2 patients (8.9%), and excessive fat removal for 6 patients (26%), had observed. I have not recorded any cases of death or pulmonary embolism. Conclusion: I perform aesthetic plastic surgery procedures in black African women with a high socioeconomic standard of living compared to the average of the general population. The renunciation of planned surgery is motivated by the impossibility of paying the cost of the operation as well as by popular and religious perceptions regarding cosmetic surgery. The results of these aesthetic plastic surgery procedures carried out are very satisfactory for them. The challenges to overcome are mainly threefold: the unforeseeable complications of these cosmetic plastic surgery procedures, popular and religious perceptions of cosmetic surgery as well as the poverty of the population. 展开更多
关键词 ABDOMINOPLASTY LIPOSUCTION Brazilian butt lift (BBL) Black African Women KINSHASA Democratic Republic of Congo
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Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman
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作者 Taif Alsafy Joe Jacob +10 位作者 Anish Thadathil Elias Ahmed Salah El Din Salim Mohammed Ghawas Majid Tariq Saud Albusaidi Ahmed Al Jabri Al Anood Al Hadhrami Mutazz Obeid Al Khaldi Moath Abdelhamid Shummo Karim Mohamed Haridi Aml Eid Saleh Said Al-Busaidi modern plastic surgery 2024年第1期9-14,共6页
Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 5... Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique. 展开更多
关键词 BURNS Burn Units Burn Management Delayed Grafting Major Burns Treatment Efficacy
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Using Mustardé Flap for Reconstruction of a Traumatic Facial Injury: Case Report
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作者 Francisco de León Gálvez Luis Fernando Montenegro Carrillo modern plastic surgery 2024年第4期51-56,共6页
Flaps become the first option when primary closure is not possible, using them to reduce the tension in the closure, as well as improving the texture and color, which ends in having a better aesthetic outcome. The Mus... Flaps become the first option when primary closure is not possible, using them to reduce the tension in the closure, as well as improving the texture and color, which ends in having a better aesthetic outcome. The Mustardé flap is a flap used for the cheek and lower eye lid defects. We present a 26-year-old male with an avulsive wound in the right maxillary region, with no bone injuries, taken to the operative room performing a Mustardé Flap for reconstruction of the defect area. Patient completed a 7-day antibiotic regimen, using non-steroid anti-inflammatories for pain, wound cleaning and flap hydration with mineral oil, subsequently having an adequate clinical and aesthetic evolution. Conclusion: The Mustardé flap can be a useful pedicled flap for the reconstruction of full-thickness defects. 展开更多
关键词 AESTHETIC Color DEFECT FLAP Mustardé PATIENT
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Prevalence of Bacterial and Fungal Infected Chronic Leg Ulcers at a Teaching Hospital in Ghana
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作者 Janet Pereko George Aryee +3 位作者 Warigbani Pieterson Albert Paintsil Zainab Nina Schumacher Japheth A. Opintan modern plastic surgery 2024年第4期87-98,共12页
Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and se... Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and serious complications such as tissue necrosis and osteomyelitis, can result without the timely control of infections. Recent studies have also reported an increase in the association of fungal infections with chronic non-healing ulcers. Aim: To determine the prevalence of bacterial and fungal infections among patients reporting with chronic leg ulcers in participants without co-morbidities. Methods: A prospective cross-sectional study was conducted among patients with chronic leg ulcers at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital (NRPS/BC-KBTH) and those who consented were enrolled. Characteristics of the wound as well as micro-organisms cultured from wound swabs were recorded. Results: A total of 50 participants were enrolled for the study with the mean (SD) age of 40.7 (10.7) years. Eighty percent of the participants presented with post traumatic leg ulcers with 80% being artisans and traders in the age group 31 - 50 years. There was no statistically significant association between sex and the organism cultured for post traumatic and cellulitis (p-value > 0.05). The prevalence of bacterial and fungal infection was 79.3% and 20.7% respectively. Pseudomonas species was the most isolated bacteria (61.5%) while Aspergillus niger was the most isolated fungi (41%). Conclusion: From this study, fungal infections should be included in managing chronic leg ulcers, especially among artisans, famers and gardeners even though there was a significantly higher burden of bacterial infections. 展开更多
关键词 Chronic Leg Ulcers (CLUs) Microbial Infections Fungal Infections Pseudomonas Species Burn Surgery
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Complications Associated with Autologous Fat Transfer: Case Report and Literature Review
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作者 Bryan Armando Morales Eslava Carlos Emiliano García Cordova Antoine Arturo Lagunes Gasca modern plastic surgery 2024年第1期1-8,共8页
Undoubtedly, since its appearance, the interest and use of autologous fat transfer (AFT) as a breast reconstruction technique have been increasing, becoming one of the main surgical alternatives for aesthetic breast a... Undoubtedly, since its appearance, the interest and use of autologous fat transfer (AFT) as a breast reconstruction technique have been increasing, becoming one of the main surgical alternatives for aesthetic breast augmentation. This increase in its popularity has led to the development of new technologies to increase its efficacy and safety, however, it has inherently implied the inadequate use of this procedure, mainly when performed by unqualified medical personnel. We present the case of a patient with complications following a breast AFT for aesthetic purposes, performed by a general practitioner without a specialty in plastic and reconstructive surgery. 展开更多
关键词 BREAST Breast Reconstruction Breast Surgery Autologous Fat Transfer Intramammary Abscess
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Principles and Techniques of Post-Traumatic Rhinoplasty: A Review of the Literature
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作者 Maroua Berrezouk Fiqhi Mohammed Kamal +2 位作者 Samir Maidam Mohamed Lakouichmi Abdeljalil Abouchadi modern plastic surgery 2024年第4期74-86,共13页
Post-traumatic rhinoplasty is the surgical treatment of the complex functional and aesthetic sequelae of nasal trauma. Correcting a post-traumatic nose is a challenging task, requiring the surgeon to employ a range of... Post-traumatic rhinoplasty is the surgical treatment of the complex functional and aesthetic sequelae of nasal trauma. Correcting a post-traumatic nose is a challenging task, requiring the surgeon to employ a range of techniques and grafts to adequately address the deformities observed. The results of our research show that restoring pre-traumatic form and function remains complex, although many guidelines have been established to refine and optimize the management of the after-effects of nasal trauma. But it is achievable with the right techniques. The objective of our review is to highlight the various post-traumatic nasal sequelae, describe the fundamental principles in the field of post-traumatic rhinoplasty and provide the surgeon with the various existing surgical techniques and strategies so that he or she can make an appropriate choice for the patient. 展开更多
关键词 Nasal Trauma SEQUELAE Post-Traumatic Rhinoplasty Deviation Saddle Nose
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Body Contour in the Post-Bariatric Male Patient
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作者 Erick Zúñiga-Garza Israel Salgado-Adame +3 位作者 Claudio D. Rojas-Gutiérrez Laura María Rodríguez-Barrios Guillermo Álvarez-Sánchez Eduardo Camacho-Quintero modern plastic surgery 2024年第2期15-22,共8页
Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric recon... Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric reconstructive procedures have increased. Therefore, the clinical approach and understanding of the body contour of this population have become more relevant. The goal of post-bariatric reconstruction is to enhance the male silhouette through removal of skin and adipose tissue excess, and abdominal rectus diastasis repair. Material and Methods: We conducted a retrospective study at the Plastic and Reconstructive Surgery Department of the National Medical Center “20 de Noviembre”. All male patients referred to our department to start a post-bariatric reconstruction protocol from January 2018 to December 2022 were included in this study. Results: In total, 15 patients who underwent corporal contouring procedures were included;median age was 49.2 years with minimum of 33 years, and a maximum of 57 years. Median Body mass index was 28.4 kg/m<sup>2</sup> with minimum of 22 kg/m<sup>2</sup> and maximum of 38 kg/m<sup>2</sup>. All patients were treated 18 months after their bariatric surgery. All patients underwent an abdominoplasty as a body contouring procedure. 4 (26.7%) patients presented complications related to the surgery. Conclusion: We described a comprehensive and systematic approach to massive weight loss for male patients, suggesting an abdominal marking based on the patient’s clinical features and the expected results avoiding feminization of the abdominal body contour. 展开更多
关键词 Massive Weight Loss Post-Bariatric MALE ABDOMINOPLASTY CONTOURING
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Poland Syndrome: Breast Reconstruction Outcomes in 10 Years (2013-2023)
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作者 Fernando Isaac Recio-España Cuahutémoc Márquez-Espriella +8 位作者 Rodrigo Dávila-Díaz Marco A. Cuervo-Vergara Gabriel Barrera García Priscila Campollo-López Alfredo Chama-Naranjo Omar Pérez-Benítez Erika Barlandas-Quintana Mauro Garibaldi-Bernot Eduardo Poblano-Olivares modern plastic surgery 2024年第4期99-107,共9页
Summary: Poland syndrome is a rare congenital anomaly characterized by the partial or complete absence of the pectoralis major muscle and a wide spectrum of thoracic anomalies, predominantly on the ipsilateral side. T... Summary: Poland syndrome is a rare congenital anomaly characterized by the partial or complete absence of the pectoralis major muscle and a wide spectrum of thoracic anomalies, predominantly on the ipsilateral side. These anomalies include hypoplasia or aplasia of the breast and its components, hypotrophy of subcutaneous fat, and absence of axillary hair, as well as hand deformities that can range from syndactyly to ectrodactyly. The aim of this study was to gather information about patients diagnosed with Poland syndrome at the Central South High Specialty Hospital of Petróleos Mexicanos over a period of 10 years and to identify their reconstructive algorithm. Materials and Methods: A retrospective, observational, and descriptive study was conducted to identify the population diagnosed with Poland syndrome at the “Central South High Specialty Hospital of Petróleos Mexicanos” during the period from 2013 to 2023. Results: The database of patients with Poland syndrome from 2013 to 2023 was analyzed, identifying a total of 8 patients with this diagnosis. Of these, 7 were women (90%) and 1 was a man (10%). The left side was more frequently affected (80%) compared to the right side (20%). The average reconstructive process required two surgical stages, mainly consisting of breast expander reconstruction (first stage) and replacement of the expander with an implant (second stage). Conclusions: Despite being a rare congenital condition, the volume of patients treated at the Central South High Specialty Hospital allows for improved diagnosis and contributes to their reconstructive process. The lack of diagnosis in the male population is notable, likely due to the absence of adequate screening. 展开更多
关键词 Poland Syndrome Breast Reconstruction Poland Tissue Expander Breast Reconstruction
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Donor-Site Morbidity Following Harvest of Autologous Costal Cartilage in Microtia Reconstruction
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作者 Surendra Jung Basnet Khushboo Gurung +1 位作者 Satya Raj Paudel Qingguo Zhang modern plastic surgery 2024年第4期57-73,共17页
Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest... Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest for microtia reconstruction from March 2008-March 2009 were included. Anterior chest wall deformity was evaluated with chest topography, and scar quality at baseline and at 6-months follow-up, and final outcomes analyzed with SPSS. Results: In 70 patients, 52 (74%) were male, 18 (26%) were female, and altogether 40 (57%) patients developed deformity. At 6-month follow-up, the incidence of anterior chest wall deformity was highest at 80% in Block-III, and least at 0% in Block-I. The 6 - 10 years age group was the largest group at 84% (21), and also with highest incidence of deformity in association to Block-IV harvest at 83%. The incidence of donor-site deformity was higher in female gender at 66%, and 54% in males. But in the sub-group, male had higher incidence of deformity at 75% in both Block-III, and Block-IV when compared to the respective females. The 120 - 135 cm height group had the highest deformity at 67% with Block-IV costal cartilages harvested. At the three measurement points: 1) xiphisternum, 2) intersecting points between PSL and LCM, and 3) intersecting points between MCL and LCM, significant differences (mean) were observed in chest circumference from baseline to 6-month follow-up, and between the left and right chest hemi-circumference (postoperatively). Acceptable donor-site scar was observed in all but 3% (2) developed hypertrophic scar. Conclusion: The development of chest wall deformity was observed when more than one costal cartilage was harvested, particularly the 6th (complete), 7th, 8th block. Therefore, to minimize the deformity, we recommend harvesting only the necessary amount of cartilage, and at the lowest level possible to avoid injury of costochondral junction. Additionally, age, height, gender and chest development are equally important factors which influence donor-site deformity in microtia reconstruction. 展开更多
关键词 Chest Wall Autologous Costal Cartilage DEFORMITY MICROTIA
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Traumatic Lower Extremity Reconstruction in a Patient with Significant Vascular Comorbidities
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作者 Natalia Da Fonte Richard Winters modern plastic surgery 2024年第4期113-121,共9页
Limb salvage after devastating traumatic injuries, cancer extirpation, and intrinsic disease is a complex decision-making process. Although several scoring and evaluation tools have been created to attempt to apply al... Limb salvage after devastating traumatic injuries, cancer extirpation, and intrinsic disease is a complex decision-making process. Although several scoring and evaluation tools have been created to attempt to apply algorithmic decision-making to the process, thoughtful clinical decision-making remains the most important standard. When limb salvage is deemed appropriate, selection of a tissue flap for limb reconstruction is dependent on the size and location of the defect, patient comorbidities, nicotine dependence, mechanism of injury to the limb, patient lifestyle, occupation, and ambulatory status. This case involves a male trauma patient with significant comorbidities and a large lower extremity wound requiring multiple operations to attempt limb reconstruction with a rectus abdominis free flap. This patient’s complex injury and comorbidities made the risk of flap failure high, illustrating that the importance of patient- and case-specific factors cannot be overstated when planning for a limb reconstruction. This extreme resort of limb reconstruction, where limb loss is the only other option and a likely consequence of even heroic efforts, is aptly called “limb salvage”. 展开更多
关键词 Free Flap Limb Reconstruction Limb Salvage
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Expanding the Use of Nipple-Sparing Mastectomies in Obese Patients Undergoing Staged Implant-Based Reconstruction
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作者 Mallory A. Rowley Prashant K. Upadhyaya modern plastic surgery 2024年第3期23-35,共13页
Background: Advantages of various mastectomy techniques include skin reduction and favorable aesthetics in Wise-pattern closures, and less visible scars in nipple-sparing mastectomies (NSM). This study compares postop... Background: Advantages of various mastectomy techniques include skin reduction and favorable aesthetics in Wise-pattern closures, and less visible scars in nipple-sparing mastectomies (NSM). This study compares postoperative complication profiles between Wise-pattern and nipple-sparing mastectomies in the obese population. Methods: A retrospective chart review of obese patients (BMI ≥ 30) who underwent staged breast reconstruction following Wise-pattern and nipple-sparing mastectomies at our institution between February 2016 and January 2020 was conducted. Complications between cohorts were analyzed using the independent samples t-test (2-sided) and the χ2 test. Results: A total of 232 breasts (163 Wise-pattern, 69 NSM) were re-constructed in 123 obese female patients (85 Wise-pattern, 38 NSM). Complication rates in both the Wise-pattern and NSM patient cohorts were similar following stage 1 (Wise-pattern: 30.7%, NSM: 39.1%, p = 0.212) and stage 2 (Wise-pattern: 16.6%, NSM: 15.9%, p = 0.907) of reconstruction. No statistically significant differences in rates of infection, dehiscence, seroma, hematoma or malposition of tissue expander (TE)/implant following stage 1 or stage 2 were found between cohorts. Conclusions: There were no significant differences in postoperative complication rates between the Wise-pattern and NSM cohorts of obese patients. NSM can be a viable surgical option in carefully selected obese patients and offer the advantage of concealed scarring. 展开更多
关键词 MASTECTOMY Breast Reconstruction Nipple-Sparing
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Unusual Anterolateral Fascio Cutaneous Tight Flap for Extremity Soft Tissue Reconstruction
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作者 Eurico Cleto Ribeiro de Campos Pedro Afonso Kono +5 位作者 Elder Dalazoana Filho Melquesedeque dos Santos Matheus Von Jelita Salina Marcelo Augusto de Souza Leandro Cavalcante Lipinski Guataçara Salles Junior modern plastic surgery 2024年第4期108-112,共5页
Soft tissue sarcoma is rare neoplasms that affect mainly the extremities. Surgery is the mean treatment and the resection results in extensive muscle and skin loss. The anterolateral tight flap is a good option for sa... Soft tissue sarcoma is rare neoplasms that affect mainly the extremities. Surgery is the mean treatment and the resection results in extensive muscle and skin loss. The anterolateral tight flap is a good option for sarcomas arising in knees, superior third of legs and the medial face of thigh. The anatomy knowledge and the multidisciplinary approach is very important for a successful reconstruction. The authors report a successful case treated with the anterolateral tight flap and a literature review. 展开更多
关键词 Soft Tissue Sarcoma Anterolateral Tight Flap Reconstruction
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Anatomy of Free Flap Failures: Dissection of a Series 被引量:3
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作者 Steven P. Davison Mark W. Clemens Andrew L. Kochuba modern plastic surgery 2013年第3期89-95,共7页
Introduction: Free flap success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap failures were attributed to the surgeon’s inexperience and technique. However, ther... Introduction: Free flap success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap failures were attributed to the surgeon’s inexperience and technique. However, there are factors beyond the surgical anastomosis that contribute to flap failure. The purpose of this study is to review each case of total flap loss in detail to develop a better understanding of complications. Methods: A retrospective study was performed over eleven years in a single surgeon’s practice, a predominantly head and neck reconstructive practice. All charts were independently reviewed. In patients who sustained total flap loss, a review was conducted of patient comorbidites, anesthesia records, perioperative and follow-up notes. Results: A total of 514 free flaps were performed. 76% (392) of these flaps were for head and neck reconstruction. There were 22 total flap losses (4%) and 26 partial flap losses (5%). Of the 22 total flap losses, four flaps were avulsed, five flaps were in patients later found to have coagulation disorders (homozygous mutations of the MTHFR gene and factor V Leiden), four patients were exposed to neosynephrine, two patients remained hypotensive perioperatively, and four delayed flap losses were attributed to pseudomonal infection. Five losses were technical or related to flap inexperience. Several representative case scenarios are illustrated. Conclusion: Careful review of free flap failures indicates that a thorough workup (particularly coagulation disorders), flap selection, surgeon to anesthesia communication, proper securing of the flap, and postoperative patient blood pressure and infection control have a greater part to play in this new era of anastomotic success. 展开更多
关键词 Free FLAPS FLAP Loss Head and Neck Reconstruction COAGULOPATHY MTHFR Factor V LEIDEN
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A Long Term Review of Surgically Treated Enlarged Breasts 被引量:2
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作者 Pius Agbenorku modern plastic surgery 2013年第4期113-119,共7页
Introduction: Breast hypertrophy (excessive enlargement of breast), a condition though rare, is well pronounced in some females. Surgery either by reduction mammaplasty or sub-cutaneous mastectomy is often employed in... Introduction: Breast hypertrophy (excessive enlargement of breast), a condition though rare, is well pronounced in some females. Surgery either by reduction mammaplasty or sub-cutaneous mastectomy is often employed in treatment of this condition. Aim: This study seeks to find out the long term level of satisfaction of the surgery on these persons after about 10 - 12 years after treatment. Materials and Methods: From January 1994 to December 2000, the Komfo Anokye Teaching Hospital (KATH) carried out surgeries on 43 females who presented with several degrees of breast hypertrophy. Patients were asked to answer questionnaires on their condition pre-operatively and post-operatively during the long term review process. Results: Thirty-four (79.1%) patients out of the 43 were available for the review with the patients stating there was much (100%) improvement in terms of the pain they felt in the neck, upper and lower back regions. There was no re-occurrence of the condition in any of the patients;29 (85.3%) stated they were satisfied and that their new breast size(s) was/were excellent for them. Conclusion: The pre-operative complications experienced by these patients were resolved hence this surgical procedure was good and the quality of life of these persons had been improved. 展开更多
关键词 Breast HYPERTROPHY Reduction MAMMAPLASTY Sub-Cutaneous MASTECTOMY Quality of Life Satisfaction
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Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report 被引量:2
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作者 Medhat E. Habib Christoph H. Reuter modern plastic surgery 2012年第2期35-38,共4页
We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thickness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the han... We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thickness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the hand was found avascular with loss of vital structures and full thickness burns. As a salvage procedure the hand was embedded in the subcutaneous tissue of the abdomen for 4 weeks and after that elevated as an inferiorly based flap on the bilateral superficial inferior epigastric arteries. Two weeks later the hand was freed by division of the base of the flap bilaterally. The details and description of the injury, the procedure and the outcome are discussed. 展开更多
关键词 Hand BURN Mutilating Degloving Injury SUPERFICIAL INFERIOR Epigastric Artery FLAP
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Cranioplasty after Decompressive Craniectomy Caused an Intracerebral Hemorrhage: A Case Report 被引量:1
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作者 Takayuki Okumoto Tomito Oji Kazuo Kishi modern plastic surgery 2015年第3期28-33,共6页
Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain,... Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain, and the brain can become dilated. Although some cases with complications induced by cranioplasty, such as intracranial hematoma, have been reported, no clinical cases with intracerebral hemorrhage after rigid reconstruction have been reported. This case report describes a 39-year-old man with a skull defect following clipping with simultaneous decompressive craniectomy for a subarachnoid hemorrhage. About 25 months later, cranioplasty using a custom-made hydroxyapatite (HAP) ceramic implant was performed. Immediately after the operation, intracerebral hemorrhage was detected on the opposite side by computed tomography (CT). However, there were no physical or neurological findings, the hematoma was completely absorbed within 3 weeks postoperatively, and the skull retained a good shape. This case suggests that rigid reconstruction of a skull defect can influence intracranial conditions, and early postoperative CT is important to detect complications. 展开更多
关键词 CRANIOPLASTY RIGID Reconstruction SKULL Defect INTRACEREBRAL HEMORRHAGE Decompressive CRANIECTOMY
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Management of Diabetic Foot Ulcers Using Negative Pressure with Locally Available Materials 被引量:1
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作者 Joseph Yorke Joseph Akpaloo Pius Agbenorku modern plastic surgery 2013年第3期84-88,共5页
Introduction: Diabetic ulcers are one of the main causes of morbidity and hospitalisation and thereby affecting the quality of life of persons suffering from the condition. The aim of the study was to assess the level... Introduction: Diabetic ulcers are one of the main causes of morbidity and hospitalisation and thereby affecting the quality of life of persons suffering from the condition. The aim of the study was to assess the level of satisfaction of persons who underwent treatment for diabetic ulcers using negative pressure produced from locally available materials. Materials and Methods: Creating negative pressure using locally available materials such as sterilized foam, tubes with diameter between 0.5 and 0.8 cm, transparent adhesive plaster and a suction machine. Results: Thirty-seven patients were enrolled in the current study;70.3% (n = 26) were known diabetic patients on regular treatment while 29.7% (n = 11) were diagnosed when they presented for the first time with ulcers. Patients were made to grade their level of satisfaction with therapy involving these locally used materials. Out of the 37 patients, 35 (94.6%) stated their therapy was excellent while 1 (2.7%) said the therapy was good;therapy was discontinued in one patient (2.7%) who had some complication. Conclusion: Desirable outcomes were obtained when patients were treated using negative pressure wound therapy (NPWT) produced using locally manufactured materials. Patients were able to pay for the therapy since the cost was reasonably low. 展开更多
关键词 DIABETIC ULCERS NEGATIVE Pressure Therapy COST LOCALLY Manufactured MATERIALS
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