Annales De Chirurgie Plastique Esthetique最新文献

{"title":"Chirurgie pour tumeurs phyllodes du sein : la dénomination d’une tumeur phyllode géante est-elle justifiée ?","authors":"A.K.A. Amavi , D. Lamboni , T. Dossouvi , A. Sakiye , A. Alassani , A. Adabra","doi":"10.1016/j.anplas.2024.10.003","DOIUrl":"10.1016/j.anplas.2024.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>En Afrique, très peu de publication se sont intéressés aux tumeurs phyllodes (TP). Le but de notre étude est décrire les particularités chirurgicales des TP du sein opérées.</div></div><div><h3>Patientes et méthode</h3><div>Étude rétrospective et descriptive portant sur 11 cas de TP opérées du 1<sup>er</sup> janvier 2015 au 31 mars 2023 à la clinique médicochirurgicales du centre hospitalier universitaire Sylvanus Olympio (CHU SO) de Lomé. Les patientes avaient bénéficié d’une échographie mammaire associée ou non à la mammographie et une biopsie au « tru cut ». Nous avons pris en compte les données épidémiologiques, cliniques et thérapeutiques. Le suivi des patientes était régulier à 1 mois, à 3 mois et tous les 6 mois.</div></div><div><h3>Résultats</h3><div>La fréquence des TP était de 4,9 % des tumeurs mammaires opérées. L’âge moyen était de 29 ans (extrême 18 ans et 61 ans). La tranche d’âge de 20 à 30 ans était la plus représentée dans 5 cas. L’autopalpation d’un nodule du sein, la douleur mammaire et la peur d’avoir un cancer ont été noté respectivement dans 11 cas, dans 4 cas et dans 2 cas. Le délai moyen d’admission était de 8 mois (extrêmes 6 mois à 18 mois). La taille tumorale moyenne était 6,4<!--> <!-->cm (extrême 3<!--> <!-->cm et 11<!--> <!-->cm). La chirurgie était conservatrice dans 10 cas et mastectomie dans 1 cas avec une résection R1. Nous avons noté une nécrose de la plaque aréole et mamelon. Les types histologiques étaient bénignes (3), intermédiaires (6) et malignes (2). La résection R1 avait noté une récidive locale, puis métastatique et décès survenue à 16 mois.</div></div><div><h3>Conclusion</h3><div>Les TP étaient qualifiées de géante (taille supérieure à 5<!--> <!-->cm). Il n’y a pas de technique prédéfinie à appliquer. La chirurgie conservatrice est notre préférence tout respectant une marge Ro, un sein restant esthétique et une rançon cicatricielle moindre.</div></div><div><h3>Introduction</h3><div>In Africa, rare publications have focused on phyllodes tumors (PTs). The aim of our study is to describe the special feature of PTs surgery.</div></div><div><h3>Patients and method</h3><div>Retrospective and descriptive study of 11 cases of PT operated from January 1, 2015 to March 31, 2023 at the medical-surgical clinic in Teaching Hospital Center of Sylvanus Olympio of Lome. The patients had a breast ultrasonography with or without mammography and core needle biopsy. Epidemiological, clinical and therapeutic data were record. The follow up was regularly at 1 month, 3 months and every 6 months.</div></div><div><h3>Results</h3><div>The PT was 4.9% of breast tumors operated on. The mean age was 29<!--> <!-->years (range 18 to 61). The 20–30 age group was the most represented in 5 cases. Self-examination of a breast nodule, breast pain, and fear of cancer were noted in 11, 4, and 2 cases, respectively. The mean time to admission was 8 months (range 6 to 18). The mean tumor size was 6.4<!--> <!-->","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 85-89"},"PeriodicalIF":0.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast sensibility after reconstruction: Comparison of different methods","authors":"T. Mernier, K. Serror, M. Goutard, M. Chaouat, D. Boccara","doi":"10.1016/j.anplas.2024.11.003","DOIUrl":"10.1016/j.anplas.2024.11.003","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Sensibility of the breast area is a key factor in quality-of-life evaluation after breast reconstruction (BR). Breast sensation can be assessed using numerous tools that are already largely described in the literature, including the Semmes Weinstein filaments which remain the most frequently used. Although different reconstruction techniques are available, post-BR sensitivity is rarely described. The aim of this study was to evaluate post-BR sensibility of the breast according to each reconstruction technique.</div></div><div><h3>Material and methods</h3><div>Fifteen patients were included in each group, i.e. 90 patients in total: before BR, Latissimus Dorsi (LD) flap with implant, LD flap with fat grafting, exclusive fat grafting, Deep Inferior Epigastric Perforator (DIEP) flap, implant. A single evaluator assessed the sensibility with Semmes Weinstein filaments testing 7 zones on both sides. The native breast was considered as control. Various potential confounding factors were collected.</div></div><div><h3>Results</h3><div>Patients who benefited from BR with fat grafting alone had a significantly better sensation of the reconstructed breast compared to the other groups (DIEP flap (<em>P</em> <!--><<!--> <!-->0.0001), LD flap<!--> <!-->+<!--> <!-->implant (<em>P</em> <!-->=<!--> <!-->0.0013), LD flap with fat grafting (<em>P</em> <!-->=<!--> <!-->0.0073), implant (<em>P</em> <!-->=<!--> <!-->0.00315)). Comparing those results to the ones obtained in the group before reconstruction, only the fat grafting and DIEP flap groups showed a difference, the fat grafting group (<em>P</em> <!-->=<!--> <!-->0.0061) had higher sensibility whereas DIEP flaps were less sensitive (<em>P</em> <!-->=<!--> <!-->0.00233).</div></div><div><h3>Conclusion</h3><div>We compared mammary sensibility depending on the BR technique used. Our study is the first comparing breast sensitivity among all major breast reconstruction methods. Fat grafting resulted in better breast sensitivity in delayed breast reconstruction than implant or flap-based BR.</div></div><div><h3>Contexte et objectifs</h3><div>La sensibilité est un élément important mais sous-estimé, dans l’évaluation de la qualité de vie après une reconstruction mammaire (RM). La sensibilité du sein peut être évaluée à l’aide de nombreux outils déjà largement décrits dans la littérature, dont les filaments de Semmes Weinstein, qui restent les plus fréquemment utilisés. Il existe depuis longtemps de nombreuses techniques de reconstruction, mais la sensibilité post-RM est rarement évaluée. L’objectif de cette étude était d’évaluer la sensibilité mammaire post-RM en fonction de chaque technique de reconstruction.</div></div><div><h3>Matériel et méthodes</h3><div>Quinze patientes ont été incluses dans chaque groupe, soit un total de 90 patientes: avant RM, lambeau de grand dorsal avec implant, lambeau de grand dorsal avec greffe de graisse, greffe de graisse exclusive, DIEP, ","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 127-139"},"PeriodicalIF":0.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined ultrasound imaging/neurophysiological evaluation for surgical planning in upper limb traumatic nerve injuries with concomitant vascular damage: Two emblematic cases and a review of litterature.","authors":"A Gagliardo, M Tripoli, B Corradino, C Gagliardo, V Di Stefano, F Rosatti, G Rimmaudo, A Cordova, F Brighina, F Toia","doi":"10.1016/j.anplas.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries and penetrating traumas of the upper limb are at high risk of combined neurovascular lesion, due to anatomical proximity of main vessels and nerves. Occasionally, post-traumatic pseudoaneurysms or thrombi can develop in the site of trauma or surgery; these vascular complications represent a real urgency and require an accurate and timely diagnosis. The neurophysiological investigation still represents the gold standard for quantification, localization of nerve injuries and outcome prediction.</p><p><strong>Methods: </strong>We reviewed a database of cases of upper limb trauma from the last two years with concomitant vascular and nervous damage evaluated using a combined ultrasound imaging/neurophysiological approach. Furthermore, among these, we have selected two emblematic cases of proximal upper limb injury with late-onset of vascular complications which came to our attention almost a month after trauma. Compound motor action potentials (CMAP) and sensory nerve action potentials (SNAP) were recorded by superficial electrodes and compared with the contralateral electrodes to estimate the percentage of affected fibres and possible recovery. Maximal cross-sectional area (CSA) of each nerve in the traumatic site and in the typical entrapment zones was recorded measuring at the inner hyperechogenic part of each nerve. Finally, a literature review was conducted.</p><p><strong>Results: </strong>Our study confirms the importance of the use of electrophysiology in the diagnostic process of post-traumatic nerve injuries, with a diagnostic accuracy that increases significantly if associated with ultrasonography possibly integrated by Doppler.</p><p><strong>Conclusions: </strong>The results reported in this study are very encouraging in the combined use of neurophysiology and ultrasonography in the approach to upper limb trauma with concomitant vascular and nervous damage; larger-scale studies are desirable to strengthen results.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status and perspectives in the treatment of facial lipoatrophy in HIV-positive patients in 2024.","authors":"L Tilhet, M Rouanet, A-S Henry, A Pop, Y Claudic, W Saraoui, H Nachaoui, W Hu","doi":"10.1016/j.anplas.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.10.006","url":null,"abstract":"<p><p>Facial lipoatrophy, a sign of normal aging, also occurs due to lipodystrophy from metabolic disorders affecting lipogenesis. It can be hereditary or acquired, localized or generalized. In HIV patients, prolonged antiretroviral therapy (ART) is a major cause, affecting around 55% of patients with 47% experiencing facial lipoatrophy. The exact changes in adipose tissue in HIV patients are unclear. Atrophic areas show immature adipose tissue, inflammation, and increased apoptosis. NRTIs cause mitochondrial toxicity, leading to energy depletion and adipocyte apoptosis. PIs disrupt protein expression related to adipocyte metabolism, causing apoptosis and metabolic issues. Lipoatrophy leads to fat loss in the cheeks, temporal, and sub-zygomatic regions, resulting in a cachectic appearance. Despite severe lipoatrophy, Bichat's fat pad often remains unaffected. Various scales assess lipodystrophy severity: James Scale, Fontdevilla Scale, Funk Scale, Facial Lipoatrophy Scale. Facial lipoatrophy significantly impacts patients' quality of life, leading to poor body image and depression. The MOS-HIV and ABCD questionnaires assess the impact on quality of life. Several therapeutic options are described: antiretroviral switch, growth hormone, glitazones, excision and suturing, human cadaveric dermis and Fascia, dermafat, fillers, lipofilling, implants and flaps.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary cleft lip rhinoplasty. Our experience of two decades","authors":"C. Macni,&nbsp;S. Tomczak,&nbsp;M. Abellan Lopez,&nbsp;C. Philandrianos,&nbsp;B. Bertrand,&nbsp;D. Casanova","doi":"10.1016/j.anplas.2024.10.009","DOIUrl":"10.1016/j.anplas.2024.10.009","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Patients who underwent cleft lip surgery in childhood may develop nasal malformation later in life. Various procedures have been described to correct these malformations. This study aims to describe our surgical approach and assess the morphometric outcomes of secondary cleft-lip rhinoplasty performed at the plastic surgery department in Marseille between 2002 and 2022. We conducted an analysis of surgical procedures and nasal morphometrics results by measuring pre- and postoperative images. Both surgical procedures and nasal morphometric analyses have been performed. This study included 43 patients, with 70% presenting unilateral cleft lip and 30% bilateral cleft-lip. An open approach was performed in 90% of cases. Regarding the surgical steps, a tip rhinoplasty, tip reinforcement, and crus lateral reinforcement by cartilage grafting was performed in 98%, 96%, and 32% of cases. A septal extension graft, a columellar strut, and a “tongue in groove” technique were performed in 54%, 33%, and 4% of cases, respectively, to reinforce the tip. Cartilage harvested from the nasal septum, ribs, and ear was utilized in 44%, 23%, and 20% of cases. An osteotomy, septoplasty associated with a spreader-flap, alar base reduction, and alar to triangular cartilage fixation were performed in 67%, 79%, 16%, and 16% of cases. All pre- and postoperative nasal morphometrics measurements have demonstrated a statistical significant improvement in nasal morphology following surgery. An open approach rhinoplasty, facilitating alar cartilage dissection and reinforcement by septal, rib, or ear cartilage is crucial to preserve postoperative outcomes. Our technique enables favorable mid-term results on secondary cleft-lip rhinoplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Les patients opérés d’une fente labiopalatine dans leur enfance vont présenter déformations nasales pouvant s’aggraver durant la croissance faciale. Diverses procédures ont été décrites pour corriger ces malformations. Cette étude a pour but de décrire notre approche chirurgicale et d’évaluer les résultats morphométriques des rhinoplasties secondaires de fentes labiales ou labiopalatines réalisées dans le service de chirurgie plastique de Marseille entre 2002 et 2022. Nous avons analysé les procédures chirurgicales et les résultats morphométriques en mesurant les images pré- et postopératoires. L’analyse des procédures chirurgicales et résultats morphométriques nasaux ont été réalisés. Cette étude a porté sur 43 patients, dont 70 % présentaient une fente labiale unilatérale et 30 % une fente labiale bilatérale. Une approche ouverte a été réalisée dans 90 % des cas. En ce qui concerne les étapes chirurgicales, une rhinoplastie de la pointe, un renforcement de la pointe et un renforcement des crus latéraux par greffe de cartilage ont été réalisés dans 98 %, 96 % et 32 % des cas. Un greffon d’extension septale, un strut columellaire et une technique de « tongue in groove » ont été réalisées dans 54 %, 33 % et 4 % des ","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 119-126"},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of a septic femoral triangle using a vertical pedicled DIEP flap: Response to the article \"Reconstruction of a septic femoral triangle fistula with a pedicled DIEP flap: A case report and mini-review\".","authors":"T Dinahet, M Bordet, U Huvelle, A Mojallal, F Boucher, G Henry","doi":"10.1016/j.anplas.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.10.008","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signes cliniques de brûlure cutanée thermique à la phase aiguë chez les patients à peau noire. Résultats d’une étude prospective de 214 sujets brûlés","authors":"K. Kibadi","doi":"10.1016/j.anplas.2024.10.005","DOIUrl":"10.1016/j.anplas.2024.10.005","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Dans la littérature, nous ne retrouvons pas d’étude publiée sur les signes cliniques de brûlure cutanée thermique en phase aiguë chez les patients à peau noire. La présente étude qui comble cette lacune, rapporte pour la toute première fois les résultats des observations cliniques auprès de 214 sujets brûlés à peau noire. Il s’agissait d’une étude prospective qui collectait les signes cliniques de brûlure à la phase aiguë. Ont été inclus dans cette étude tout brûlé à peau noire ayant consulté en phase aiguë sans traitement local initial et dont la brûlure datait de moins de 4&lt;!--&gt; &lt;!--&gt;heures. Elle a couvert une période de 13 ans, allant du 1&lt;sup&gt;er&lt;/sup&gt; janvier 2011 au 31 décembre 2023. Le sexe masculin (54,6 %) et les enfants âgés de 5 ans et moins ont été les plus touchés (46,3 %). Les liquides bouillants constituaient l’agent causal le plus commun (67,4 %). Les brûlures de 20 % et plus de la surface corporelle représentaient la grande proportion (39,1 %) suivies de celles entre 10 et 19 % (35,5 %). Tous les 214 patients inclus dans l’étude présentaient au moins une brûlure du premier degré et il existait plusieurs degrés associés. Les brûlures du deuxième degré, dans leur ensemble, étaient aussi parmi les plus rencontrées, soit 89,1 % de cas. Chez nos patients brûlés à peau noire, nous avons observé quelques différences cliniques dans l’évaluation de la profondeur des brûlures avec la description rapportée dans la littérature. L’érythème décrit dans la brûlure du premier degré sur peau « blanche » se traduisait chez le patient brûlé à peau noire par un aspect foncé, plus foncé ou grisâtre de la peau ; et le derme pour les brûlures du deuxième et troisième degré apparaissait plus blanc chez les patients à peau noire comparativement aux patients à « peau blanche ». La sémiologie de brûlure cutanée thermique à la phase aiguë devrait être revisitée et adaptée à la couleur de la peau du patient.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;In the literature, we do not find any published study on the clinical signs of thermal skin burns in the acute phase in black-skinned patients. The present study, which fills this gap, reports for the very first time the results of clinical observations in 214 black-skinned burn victims. This was a prospective study that collected the clinical signs of burns in the acute phase. This study included all burn patients with black skin who consulted in the acute phase without initial local treatment and whose burn was less than 4&lt;!--&gt; &lt;!--&gt;hours old. It covered a period of 13 years, from January 1st, 2011 to December 31st, 2023. Males (54.6%) and children aged 5 years and under were the most affected (46.3%). Boiling liquids were the most common causative agent (67.4%). Burns of 20% or more of the body surface area represented the largest proportion (39.1%) followed by those between 10 and 19% (35.5%). All 214 patients included in the study had at least one first-degree burn and there were several associated degrees. Second-degre","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 112-118"},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction de l’aponévrose musculaire de la zone donneuse du lambeau antérolatéral de cuisse par plaque synthétique : technique et bénéfice","authors":"D. Boccara,&nbsp;K. Serror,&nbsp;M. Chaouat","doi":"10.1016/j.anplas.2024.11.001","DOIUrl":"10.1016/j.anplas.2024.11.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Le lambeau antérolatéral de cuisse est, dans certains cas prélevé, avec une partie de l’aponévrose du muscle quadriceps ce qui peut entraîner des hernies musculaires, ou des adhérences au niveau du site donneur. Les études rapportent entre 11 et 32 % de survenue de hernies musculaires et entre 8 et 26 % de faiblesse persistante de la zone donneuse. Il n’y a pas de données dans la littérature scientifique présentant de technique chirurgicale de prévention des hernies musculaires au niveau du site donneur du lambeau antérolatéral de cuisse. L’objectif de notre étude est de décrire notre technique de mise en place d’une plaque synthétique en cas d’impossibilité de fermeture de l’aponévrose lors de la levée d’un lambeau antérolatéral de cuisse afin de limiter le risque de survenue de hernies musculaires postopératoires et d’en analyser les bénéfices.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Matériel et méthode&lt;/h3&gt;&lt;div&gt;Dans le cadre d’une étude prospective, nous présentons ici notre technique de reconstruction de l’aponévrose par pose de plaque synthétique non résorbable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Vingt-deux patients ont bénéficié de la pose d’une plaque pour la reconstruction du défect aponévrotique qui était de 9,6&lt;!--&gt; &lt;!--&gt;cm en moyenne. Un an après l’intervention aucun ne présentait de hernie musculaire ni adhérence au niveau du site donneur.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Présents dans 11 à 32 % selon les études, les hernies musculaires et adhérences cicatricielles sont disgracieuses et invalidantes pour les patients. S’il paraît difficile de quantifier le bénéfice en termes de force musculaire la reconstruction de l’aponévrose prévient efficacement de ce type de complications. Lorsque le défect est supérieur à 8&lt;!--&gt; &lt;!--&gt;cm, il nous semble indispensable de reconstruire l’aponévrose lors de la levée afin de prévenir la survenue de hernie ou d’adhérence du site donneur. Bien que ne retentissant pas sur la fonction du membre, la hernie musculaire est au moins gênante esthétiquement et mériterait d’être prévenue de façon systématique.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;La reconstruction de l’aponévrose musculaire de la zone donneuse du lambeau antérolatéral de cuisse par une plaque synthétique non résorbable en cas de défect supérieur à 8&lt;!--&gt; &lt;!--&gt;cm permet de prévenir la survenue d’hernies musculaires et d’adhérences sources de complications esthétiques et fonctionnelles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The anterolateral thigh flap is sometimes harvested with a portion of the quadriceps muscle fascia, which can lead to muscle hernias or adhesions at the donor site. Studies report an 11 to 32% incidence of muscle hernias and an 8 to 26% incidence of persistent weakness at the donor site. There is no data in the scientific literature presenting a surgical technique for the prevention of muscle hernias at the donor site of the anterolateral thigh flap. The objective of our study is to describe our tec","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 148-152"},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allotransplantations de tissus composites en France : mise au point","authors":"E. Lupon ,&nbsp;Y. Berkane ,&nbsp;J. Cornacchini ,&nbsp;C.L. Cetrulo ,&nbsp;H. Oubari ,&nbsp;A. Sicard ,&nbsp;A.G. Lellouch ,&nbsp;O. Camuzard","doi":"10.1016/j.anplas.2024.10.007","DOIUrl":"10.1016/j.anplas.2024.10.007","url":null,"abstract":"<div><div>Les allotransplantations de tissus composites (ATC) regroupent les transplantations de face, de membre supérieur, de trachée, de pénis, de paroi abdominale et, plus récemment, d’utérus. Elles offrent des possibilités de reconstruction uniques pour pallier les limites des techniques traditionnelles de reconstruction. À la différence des greffes d’organes solides (cœur, foie, rein, poumon.), l’ATC n’intervient généralement pas en contexte de pronostic vital engagé mais vise à améliorer la qualité de la vie au prix d’une contrainte majeure freinant son expansion : la nécessité d’un traitement immunosuppresseur à vie. Cependant, l’ATC est considérée comme l’une des cinq innovations les plus importantes de l’ère moderne de la discipline, et une enquête mondiale menée auprès des plasticiens a confirmé que des changements majeurs dans la chirurgie réparatrice seront liés aux ATC à l’avenir. La France a été pionnière dans ce type de transplantation en réalisant avec succès la première ATC, la première double greffe de main, la première greffe de face, la première retransplantation de face et la première transplantation bilatérale au niveau de l’épaule et du bras et continue de démontrer des prouesses chirurgicales sans précédents. Cette activité continue de s’étendre sur le territoire avec des programmes d’ATC actifs, notamment dans les domaines des membres supérieures, de la face, de l’utérus et du pénis. Cet article vise à apporter une mise au point sur les avancées cliniques réalisés en France dans le domaine des allogreffes de tissus composites.</div></div><div><div>Vascularized composite allografts (VCA) encompass the face, upper limb, trachea, penis, abdominal wall, and, more recently, uterus transplants. They offer unique reconstructive possibilities to overcome the limitations of traditional reconstructive techniques. Unlike solid organ transplants (heart, liver, kidney, lung, etc.), VCA is not generally performed in a life-threatening situation but aims to improve quality of life, at the cost of a major constraint to its expansion: the need for lifelong immunosuppressive treatment. Nevertheless, VCA is considered one of the five most important innovations of the modern era of the discipline, and a worldwide survey of plastic surgeons has confirmed that significant changes in reconstructive surgery will be related to VCA in the future. France pioneered this type of transplantation by successfully performing the first VCA (unilateral hand transplant), the first double hand transplant, the first face transplant, the first face retransplant, and the first bilateral shoulder and arm transplant, and continues to demonstrate unprecedented surgical prowess. This activity continues to expand across the country, with active VCA programs notably in the upper limb, face, uterus and penis. This article aims to provide an update on the clinical advances made in France in the field of composite tissue allografts.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 140-147"},"PeriodicalIF":0.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The critique of an artificial intelligence tool in the assessment of peripheral facial paralysis].","authors":"H Kerleau, L Perrin, K Marcotte, S Martineau","doi":"10.1016/j.anplas.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.11.002","url":null,"abstract":"<p><p>Peripheral facial palsy (PFP) is an alteration in the functioning of some facial muscles following an injury to the facial nerve. This pathology has functional and aesthetic consequences that impact the quality of life of patients. Their care is essential and begins with an accurate assessment. Currently, scoring scales such as Sunnybrook Facial Grading System (SFGS) or House-Brackmann Grading System (HBGS) are used, based on clinician judgment. However, these evaluation methods can be subject to a certain degree of subjectivity. Recent advances in technology have led to increased interest in artificial intelligence (AI). AI could make it possible to develop an objective, automated and quantitative assessment tool, applicable in a clinical setting. This approach aims to reduce the subjectivity induced by current evaluation. We conducted a retrospective study of 38 patients with moderate-severe to total PFPs. The objective of the study is to identify the benefits and limitations of Emotrics+, a facial metrics tool based on AI, in order to determine whether the tool is applicable in the clinic. This protocol took place at two different time periods (14days and 1year post-PFP) using the SFGS scale and the Emotrics+ software. We evaluated the inter-rater and intra-rater reliability in order to determine the reliability and the reproducibility of the two tools. Then, we established a correlation between the two tools to determine if Emotrics+ followed SFGS's trend. Our currents results do not support the immediate applicability of this software. However, with appropriates adjustments, Emotrics+ has a certain potential.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}