Journal of plastic and reconstructive surgery最新文献

{"title":"Pedicled SCIA and SIEA Mega Groin Flap-A Staged Reconstructive Approach for Large Forearm Defects.","authors":"Yu-Ming Lai, Jonathan T W Au Eong, Bien-Keem Tan","doi":"10.53045/jprs.2022-0052","DOIUrl":"10.53045/jprs.2022-0052","url":null,"abstract":"<p><strong>Objective: </strong>The pedicled combined superficial circumflex iliac artery and superficial inferior epigastric artery flap has a large vascular territory ideal for coverage of crush-degloving injuries of the upper extremity. We describe our technique of creating a bipedicled flap through a staged inset, first at the wrist and subsequently progressing up the forearm. This process allows primary thinning of the entire flap while facilitating a safe transfer of the flap.</p><p><strong>Methods: </strong>Three patients with crush-degloving injury of the forearm associated with open fractures of the radius and ulnar bones had their defects reconstructed using the aforementioned flap. Patient 3 also had avulsion of the ulnar artery and crush injury of the median and ulnar nerves. Patients 1 and 2 underwent flap delay and training for 1 week prior to inset. Patient 3 did not undergo delay due to the broad-based nature of the flap. The maximal flap size was 25 × 15 cm. The flap was raised thinly until the sufficient length was obtained for the first-stage inset. Over 2 weeks, further elevation and staged inset were performed to maintain uniform thinness and thereby maximize coverage.</p><p><strong>Results: </strong>Complete flap division was accomplished in 3 weeks. All flaps survived with no marginal flap necrosis. Donor sites were closed directly (n = 2) or skin grafted (n = 1).</p><p><strong>Conclusions: </strong>Staged insetting created a bipedicled construct, which allowed primary thinning of the base and bridging portion, thereby allowing maximal use of the entire flap. Maximising the flap was possible because our technique maintained a bipedicled circulation throughout the entire inset process.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"64-70"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660114","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":"Fundamentals for Supermicrosurgical Lymphaticovenular Anastomosis: Part 1 Comprehensive Review of Anastomosis Techniques and Proposal for a Flowchart Algorithm.","authors":"Guido Gabriele, Simone Benedetti, Flavia Cascino, Antonino Ungaro, Paolo Gennaro","doi":"10.53045/jprs.2023-0017","DOIUrl":"10.53045/jprs.2023-0017","url":null,"abstract":"<p><p>Supermicrosurgical lymphaticovenular anastomosis represents an established procedure for lymphedema treatment, the effectiveness of which has been well documented in international literature. Nevertheless, currently, no standards for supermicrosurgical lymphaticovenular anastomosis have been established regarding the type, location, and number of anastomoses so that the approach to surgical scenarios still depends on the surgeons' preference and ability. A comprehensive literature search for articles involving supermicrosurgical lymphaticovenular anastomosis techniques was performed on the PubMed/Medline/SCOPUS databases. Results, including the names of the technique and their characteristics, such as indications, surgical time, and configuration of the vessels, are reported. Each technique included was then performed five times, and for each of them, patency was tested intraoperatively and 30 days after surgery. Moreover, an efficacy score was assigned, taking into consideration the number of lymphatic vessels anastomosed, the average time for anastomosis, and the difficulty of each technique. A total of 148 articles resulted from the literature search. In total, 16 papers met the criteria for inclusion as defined in the methods and were included in the review as a \"supermicrosurgical lymphaticovenular anastomosis technique.\" Efficacy scores ranged from 0.21 to 1, intraoperative patency ranged from 80% to 100%, and the 30-days patency test ranged from 60% to 100%. To perform effective anastomoses and aim to maximize the results of supermicrosurgical lymphaticovenular anastomosis, a modern microsurgeon should be trained to recognize and manage the most common vessel configurations, performing the most adequate one of the several techniques described. Further studies are required to validate and compare the use of the supermicrosurgical lymphaticovenular anastomosis techniques reviewed.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660131","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":"Retrospective Evaluation of an Oral Propranolol Delivery Strategy in 25 Cases of Infantile Hemangioma.","authors":"Shinichi Ashizawa, Takanobu Kan, Shunsuke Takahagi, Mikio Kawai, Sayuri Toda, Yasumasa Iwasaki, Shuhei Karakawa, Michihiro Hide, Akio Tanaka","doi":"10.53045/jprs.2023-0016","DOIUrl":"10.53045/jprs.2023-0016","url":null,"abstract":"<p><strong>Objectives: </strong>The majority of infantile hemangiomas shrink on their own, but when there is a chance of functional impairment, ulceration, or aesthetic issues, an active therapeutic intervention is needed. Propranolol is effective in treating infantile hemangiomas in recent years, although little information is known regarding the consequences of long-term oral administration of propranolol for treating infantile hemangioma or regarding when to stop propranolol treatment. We looked back at the therapeutic effectiveness, sequelae, and side effects of propranolol in actual clinical settings for infantile hemangiomas.</p><p><strong>Methods: </strong>The study comprised 25 patients under the age of 6 months who had propranolol treatment for infantile hemangiomas in our department between April 2011 and May 2021.</p><p><strong>Results: </strong>At one month and 6 months following the commencement of treatment, propranolol treatment was successful in 72% and 96% of patients, respectively. In 84% of patients, there were cutaneous sequelae. Only one patient with sequelae of hair loss required early surgery because of a cosmetic problem. There were substantial side effects in one case, but these were not related to the propranolol dose.</p><p><strong>Conclusions: </strong>This study found that the effect of propranolol did not differ depending on the kind of infantile hemangiomas, although propranolol was expected to be extremely helpful for head lesions regardless of site. A degree of sequelae remained in many cases following propranolol therapy, whereas the subcutaneous type was less likely to develop sequelae with propranolol treatment.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660259","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}