Indian Journal of Plastic Surgery最新文献

{"title":"Outcomes of Deep Inferior Epigastric Artery Perforator (DIEP) Flap in Indian Population-A Prospective Single-Institute Study.","authors":"Annika Marwah, Ashok Basur Chandrappa, Srikanth Vasudevan, Ananteshwar Y N Yelambalase Rao, Dinkar Sreekumar, Pooja Shetty, Serena Bharathkar, Somashekhar Sp","doi":"10.1055/s-0044-1781445","DOIUrl":"10.1055/s-0044-1781445","url":null,"abstract":"<p><p><b>Introduction</b>  Breast reconstruction has become integral part of breast cancer treatment. Deep inferior epigastric perforator (DIEP)-based flap is considered the gold standard in autologous breast reconstruction. <b>Aims and Objectives</b>  The aim of this study was to evaluate the patient satisfaction and the incidence of complications in DIEP flaps in an Indian setup for breast reconstruction. <b>Materials and Methods</b>  This is a prospective, nonrandomized study at a single institute-Manipal Hospitals, Old Airport Road, Bangalore. Eligible patients were women aged between 28 and 60 years with primary breast cancer requiring mastectomy and radiotherapy, who consented for DIEP flap reconstruction. <b>Results</b>  The study includes subjects who had autologous breast reconstruction after mastectomy with DIEP flap between January 2019 and August 2021 that included 31 patients with a minimum follow-up of 2 years. Four flaps were turbocharged and 17 flaps were superdrained primarily. The average operative time for the whole procedure by adopting a two-team approach is 353.8 ± 43.793 minutes. About 94.1% patients had excellent aesthetic score results. Six patients developed mastectomy flap necrosis, one had fat necrosis that was managed conservatively, whereas one patient had donor site re-exploration for hematoma. We had no DIEP flap necrosis, seroma, flap site hematoma, or flap failure. Physical well-being module of Breast-Q indicated an average of 83 points, psychosocial well-being module indicated 80 points, whereas sexual scores reverted an average of 77 points. Among satisfaction module, aesthetic outcomes for breast showed an average of 94 points, whereas the donor site had 96 points. Satisfaction with information, surgeon, medical staff each gained more than 87 points. <b>Conclusion</b>  Breast reconstruction with DIEP flap yields good aesthetic outcomes and quality of life in Indian population. The incidence of fat necrosis, flap and donor site complications is less over time and will enhance the patient satisfaction score further.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"106-115"},"PeriodicalIF":0.8,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grading Congenital Anomalies of the Hand for Defining Outcomes and Improved Patient Communication: A Practical Approach.","authors":"Devi Prasad Mohapatra, Satyaswarup Tripathy, Biswajit Mishra","doi":"10.1055/s-0044-1781444","DOIUrl":"10.1055/s-0044-1781444","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"159-161"},"PeriodicalIF":0.8,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cadaveric Study on Perforator Anatomy of the Medial Sural Artery Perforator Flap.","authors":"Helen Mary Titus, Sarath Radhakrishnapillai Sreedevi, Sabu Chaniveliyil Parameswaran, Lekshmi Malathi","doi":"10.1055/s-0044-1782201","DOIUrl":"10.1055/s-0044-1782201","url":null,"abstract":"<p><p><b>Background</b>  The medial sural artery perforator (MSAP) flap was described by Cavadas et al in 2001. The aim of this study was to analyze the flap characteristics in the regional population and was planned as a cadaveric dissection study. <b>Methods</b>  Thirty-three legs of fresh cadavers were studied for perforator characteristics, length, and origin of pedicle and skin paddle thickness. Observations were documented and analyzed. <b>Results</b>  Seventeen right legs (51.5%) and sixteen left legs (48.5%) were studied. Twenty-five pedicles originated from popliteal artery (86.2%) and four (13.8%) from the common sural trunk. No perforators were seen in four legs. The mean number of perforators is 2 (0-6). The mean distance of perforator from midpoint of popliteal fossa was 10.7 cm (8-13 cm) and from posterior midline it was 3.2 cm. The mean size of the perforator was 1.1 ± 0.8 mm (0.8-1.5 mm). The mean pedicle length was 9.3 ± 1.3 cm. The mean flap thickness was 4.3 ± 0.7 mm (3.0-5.5 mm). There was no correlation for flap or perforator characteristics with side of leg. <b>Conclusion</b>  This study concludes that MSAP is a good flap in terms of perforator characteristics, pedicle length, and flap thickness, when a medium sized thin flap with long pedicle is needed. The location of perforator on calf varies in different population. Being a perforator flap, anatomical variability is common and should be thought of while choosing this flap.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"140-146"},"PeriodicalIF":0.8,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Volume Assessment of Reconstructed Breast Using Three-Dimensional Measurement: How Do DIEP and LD Flap Change Immediately after Surgery?","authors":"Hiroki Utsunomiya, Ryutaro Tanaka, Shuryo Akamine, Taro Kusano, Tomoaki Kuroki, Koichi Kadomatsu","doi":"10.1055/s-0044-1781447","DOIUrl":"10.1055/s-0044-1781447","url":null,"abstract":"<p><p><b>Background</b>  The deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD) flaps are two widely used autologous breast reconstructions. Despite studies on flap-volume changes, the time of the first measurement is not immediately after surgery. Therefore, this study aimed to investigate the change in volume over time from the immediate postoperative period using a three-dimensional (3D) scanner. <b>Methods</b>  Patients who underwent breast reconstruction with a DIEP or LD flap between October 2019 and December 2020 at Showa University Koto Toyosu Hospital were included. The Kinect 3D scanner was used to measure the reconstructed and healthy breast volumes immediately after surgery and at 1, 3, 6, and 12 months. The control group was the healthy side, and the volumes obtained at each time point and ratios (to the immediate postoperative period) were calculated and analyzed using a linear mixed model. <b>Results</b>  Of the 25 patients and 26 breasts examined, the postoperative increase in volume ratios was statistically significant in the DIEP flap group, except for the sixth month, but decreased significantly in the LD group. Compared with the control group, the volume ratio was significantly higher up to 3 months in the DIEP flap group and decreased significantly after 3 months in the LD flap group. <b>Conclusions</b>  The volume of the LD flap continued to decrease immediately after surgery, whereas the volume of the DIEP flap increased by 10% up to 1M. Therefore, this increase in volume should be taken into consideration in studies where the initial measurements were not taken immediately after surgery.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"99-105"},"PeriodicalIF":0.8,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Sea Amputation of a Russian Engineer's Hand, Successful Medical Evacuation by Indian Coastguards and Replantation in Mangalore City: 19-Year Survival.","authors":"Dinesh Kadam, Trivikrama Padur Tantry","doi":"10.1055/s-0044-1780528","DOIUrl":"10.1055/s-0044-1780528","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 1","pages":"74-76"},"PeriodicalIF":0.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Cell Tumor of the Tendon Sheath of the Hand: Analysis of Factors Impacting Recurrence.","authors":"Pavan Venkateswar Kolisetty, Sheikh Sarfraz Ali, Imran Ahmad, Indrajith K Sudhy, Om Prakash, Y Ranga Kishore","doi":"10.1055/s-0044-1779657","DOIUrl":"10.1055/s-0044-1779657","url":null,"abstract":"<p><p><b>Background</b>  Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence. <b>Methods</b>  A retrospective analysis was done in cases of GCTTS operated on between 2015 and 2021. The patients were invited for follow-up for a minimum of 2 years, and the patient files were reviewed. Further data were collected at follow-up including recurrence, range of movement, sensation, skin necrosis, scarring, and digital neuropathy. A data analysis was done. The correlation between the proposed risk factors and recurrence was calculated with the Pearson correlation coefficient. A <i>p</i> -value of less than 0.05 was considered statistically significant. <b>Results</b>  During the 6 years, 48 patients were operated on. Recurrence was observed in eight patients (16%) at an average of 38.7 months from the time of surgery. Of the risk factors, tumors with satellite nodules and tumor adjacency to joint correlated significantly with recurrence. No complications were observed during follow-up. <b>Conclusion</b>  GCTTS of the hand has a high propensity to recur. The presence of satellite nodules and proximity to interphalangeal joints are two important risk factors for recurrence. Magnification during surgery ensures complete excision of the tumor and reduces the chance of recurrence.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"123-128"},"PeriodicalIF":0.8,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single Staged Reconstruction of Upper Eyelid and Eyelashes.","authors":"Taruna Singh, Madhubari Vathulya, Anand Agrawal, Ridima Behl, Anupam Singh","doi":"10.1055/s-0044-1779656","DOIUrl":"10.1055/s-0044-1779656","url":null,"abstract":"<p><p>The upper eyelid is a complex structural part of the face that plays an important role in protecting the cornea from drying and damage to preserve vision. The eyelashes are an essential part of the upper eyelid and help in protecting the eyes from dust, foreign bodies, and sweat. Being a part of the face, which is the most noticeable part of the body, both structures hold an important role in reconstructive procedures. Reconstruction of both structures simultaneously is tricky but helps reduce the number of procedures required in achieving an aesthetically acceptable eye. Our techniques describe the use of the paramedian forehead flap with an anterior hairline to reconstruct the upper eyelid and eyelashes in a single stage in a posttraumatic near-total upper eyelid defect with a favorable outcome. Depending on the parting of the patient's hair, the anterior hairline of one side can be included in the distal edge of the flap while raising, which can be inset so that the direction and orientation of the eyelashes perfectly match. Our technique refurbishes an established technique for eyelid reconstruction to include eyelash reconstruction at the same time, thus saving time and resources without any inconvenience to the patient.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"152-155"},"PeriodicalIF":0.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel, Simple, and Reliable Technique to Monitor Free Gracilis Flap.","authors":"Madhu Periasamy, Vamseedharan Muthukumar, Hari Venkatramani, S Raja Sabapathy","doi":"10.1055/s-0044-1779659","DOIUrl":"10.1055/s-0044-1779659","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"162-164"},"PeriodicalIF":0.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fronto-Orbitary Arteriovenous Malformation Reconstruction with Latissimus Dorsi Free Flap and Anterior Serratus Fascia Anastomosed to the Nutrient Vessels of the Lesion.","authors":"Ana Trapero, Alberto Pérez-García, Pedro Alvedro Ruiz, Belén Andresen Lorca, Alessandro Thione","doi":"10.1055/s-0044-1779475","DOIUrl":"10.1055/s-0044-1779475","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"156-158"},"PeriodicalIF":0.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Elliot's Modification of Moberg's Flap and Our Improvisation.","authors":"Anand Prasath Jayachandiran, Suresh Rajendran, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Manoj Ananthappan","doi":"10.1055/s-0044-1779658","DOIUrl":"10.1055/s-0044-1779658","url":null,"abstract":"<p><p>Thumb tip injuries constitute one of the most common hand injuries. There are various reconstructive options for thumb tip injuries. We present our series of thumb tip injuries reconstructed using Elliot's modification of the Moberg flap, which provides like-for-like tissue. We also present our flap improvisation, which can be useful in the armamentarium of plastic surgeons. <b>Background</b>  Moberg described the advancement flap for thumb defects in 1964, which was modified by O'Brien in which the proximal part of the flap is incised and advanced. Although it is a popular flap, it has the disadvantage of interphalangeal (IP) joint flexion deformity. Among the various modifications of the Moberg flap, Elliot's flap provided more tissue with minimal donor site morbidity and no usage of skin grafts or first web skin. <b>Methods</b>  We retrospectively analyzed the patients who underwent reconstruction of thumb defects by Elliot's modified Moberg's flap. The size of the defect, etiology, and IP joint movement were analyzed. Two patients underwent our improvised flap where a daughter flap was elevated within Elliot's flap. <b>Results</b>  Between January 2021 and September 2023, 12 patients underwent reconstruction by Elliot's flap. All flaps settled well. There was no IP joint deformity. Two patients had scar hypertrophy that was managed conservatively. <b>Conclusion</b>  Elliot's modification of the Moberg flap is a very useful but underutilized flap for thumb tip injuries that provides like tissue with sensation and with little donor site morbidity. It can be used for <i>thumb tip defects of up to 3 cm</i> . It is possible to incorporate a second V-Y flap in patients for whom additional movement is required for tension-free closure.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"116-122"},"PeriodicalIF":0.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}