Annales De Chirurgie Plastique Esthetique最新文献

{"title":"Les brûlures du front","authors":"D. Voulliaume,&nbsp;P. Curings,&nbsp;M. Vantomme,&nbsp;G. Henry,&nbsp;R. Bayoux,&nbsp;C. Barani","doi":"10.1016/j.anplas.2024.06.021","DOIUrl":"10.1016/j.anplas.2024.06.021","url":null,"abstract":"<div><div>Les brûlures graves du front sont rares ; un traitement chirurgical initial bien conduit limite par ailleurs l’apparition des séquelles. Les indications de réparation du front sont donc le fait de brûlures complexes souvent étendues aux unités adjacentes. Les techniques de réparation dépendent de la localisation et de la taille des lésions, de l’atteinte voisine associée, et de la capacité du patient à supporter la lourdeur du traitement. La prise en charge au stade aigu conditionne les séquelles ; l’excision-greffe dermoépidermique est le traitement de référence mais il ne donne de bons résultats que si les principes fondamentaux de la réparation sont respectés : délai d’intervention entre le 10^e et 15^e jour post-brûlure, prélèvement des greffes à l’extrémité céphalique ou à la partie supérieure du thorax et des bras, respect de l’unité frontale. La prise en charge des séquelles répond aux mêmes impératifs et nécessite en règle une expansion cutanée : expansion frontale pour réalisation de lambeaux cutanés s’il persiste assez de peau frontale disponible, expansion thoracique haute pour réalisation de greffes de peau totale si la cicatrice frontale est trop étendue. Les excellents résultats obtenus ne doivent cependant pas faire oublier les contraintes importantes liées à l’expansion cutanée. Les techniques alternatives sont peu nombreuses et donnent des résultats inconstants.</div></div><div><div>Severe burns on the forehead are rare; well-conducted initial surgical treatment also limits the occurrence of sequelae. Therefore, indications for repairing the forehead arise from complex burns often extending to adjacent units. Repair techniques depend on the location and size of the lesions, associated nearby damage, and the patient's ability to withstand the burden of treatment. Management at the acute stage determines the sequelae; excision-grafting is the standard treatment, but it yields good results only if the fundamental principles of repair are respected: intervention within the 10th and 15th days post-burn, graft harvesting from the cephalic extremity or the upper part of the thorax and arms, and respect for the frontal unit. Sequelae management follows the same imperatives and typically requires skin expansion: front expansion for skin flaps if enough frontal skin is still available, upper thorax expansion for full thickness skin grafts if the frontal scar is too extensive. However, the excellent results obtained should not conceal the significant constraints associated with skin expansion.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 570-579"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768057","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":"Le front traumatique","authors":"A. Paasche ,&nbsp;A. Destrez ,&nbsp;S. Dakpe ,&nbsp;S. Testelin ,&nbsp;B. Devauchelle","doi":"10.1016/j.anplas.2024.06.022","DOIUrl":"10.1016/j.anplas.2024.06.022","url":null,"abstract":"<div><div>Les lésions traumatiques du front sont fréquentes et souvent associées à des traumatismes crâniens. Dans tous les cas, l’enjeu neurologique est au premier plan, mais ces lésions présentent également des enjeux fonctionnels (pour la ventilation sinusienne et la fonction motrice frontale) et des enjeux esthétiques. Les fractures de la voûte crânienne frontale nécessitent des traitements différents en fonction de la présence d’une rhinoliquorrhée associée, d’une atteinte sinusienne ou de leur extension à la base du crâne ou au massif facial. Elles nécessitent parfois, de ce fait, une collaboration pluridisciplinaire. Elles peuvent, dans certains cas, être responsables de complications à long terme qui justifie un suivi prolongé dans le temps. De par les séquelles dont peuvent être responsables l’ensemble des traumatismes de la région frontale, la minutie de la prise en charge initiale est capitale.</div></div><div><div>Forehead traumatic injuries are frequently associated with head trauma. The primary concern in such cases is the neurological aspect, but these injuries also have significant functional (such as sinus ventilation and frontal movement) and aesthetic implications. Fractures of the frontal cranial vault differ based on the presence of associated rhinoliquorrhea, sinus involvement, or extension to the skull base or facial mass. Some cases could even require a multidisciplinary approach. Some fractures may lead to long-term complications, necessitating prolonged follow-up. Given the potential sequelae of all forehead injuries, meticulous initial management is crucial.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 559-569"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le front dans les déformations toulousaines du crâne","authors":"R.H. Khonsari","doi":"10.1016/j.anplas.2024.06.020","DOIUrl":"10.1016/j.anplas.2024.06.020","url":null,"abstract":"<div><div>La déformation artificielle du crâne est une pratique ubiquitaire qui consiste à utiliser des dispositifs externes pour modifier la forme de la tête des nouveau-nés. Les deux principaux types de déformation sont les déformations antéropostérieures (« têtes plates ») et les déformations circonférentielles (« têtes longues »). Les outils de déformation exercent principalement des forces mécaniques sur le front et l’occiput. La forme du front est ainsi au premier plan dans le diagnostic, la classification et la compréhension des motifs culturels motivant ces pratiques. Les déformations intentionnelles du crâne ont aujourd’hui disparu mais elles ont persisté jusqu’au début du vingtième siècle, notamment en France. De nombreuses données anthropologiques et historiques sont disponibles et permettent d’explorer l’origine, la nature, les motivations et les conséquences de ces pratiques dans notre pays.</div></div><div><div>Artificial skull deformations were performed in all cultures since Prehistoric times using external devices, to permanently modify the shape of the head of newborns. Two types of deformations are reported: (1) antero-posterior deformations (“flat heads”) and (2) circumferential deformations (“long heads”). Deformation devices exert mechanical forces on the forehead and the occiput: forehead shape is thus a major source of information for diagnosis, classification and on the culture significance of artificial skull deformations. France was the major European country for artificial skull deformations, and Toulouse was the epicenter of this practice. Numerous dry skulls and exceptional historical data are available to explore the origins, the mechanisms, the motivations, and the consequences of “Toulouse” artificial skull deformations.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 508-518"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632884","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":"Le front des craniosténoses","authors":"E. Arnaud ,&nbsp;R.H. Khonsari ,&nbsp;S. James ,&nbsp;G. Paternoster","doi":"10.1016/j.anplas.2024.06.027","DOIUrl":"10.1016/j.anplas.2024.06.027","url":null,"abstract":"<div><div>Le front est la partie crânienne de la face et représente une composante importante de l’esthétique faciale. Les déformations liées aux craniosténoses sont typiques par les modifications en hauteur, en largeur et en angulation du front. Les traitements chirurgicaux crâniofaciaux sont codifiés et basés sur une découpe osseuse frontale suivie de son repositionnement avec ostéosynthèse résorbable chez l’enfant. Les techniques ont peu changé depuis les descriptions princeps. Aujourd’hui, la distraction ou les ressorts permettent des remodelages précoces avec des morbidités faibles. Les séquelles sont essentiellement liées à des défauts de croissance à la jonction frontotemporale et sont corrigées le plus souvent par greffe de graisse autologue. L’existence de mutations génétiques associées à la craniosténose augmente le risque de reprise chirurgicale dans les six premières années de vie.</div></div><div><div>The forehead is the cranial part of the forehead, and represents an important component of facial esthetics. The deformations linked to craniosynostoses are characterized by modifications in height, width, and angulation. Their surgical correction during childhood is based on well-established techniques of remodeling using resorbable osteosynthesis. Today, distraction and springs allow less invasive procedures with good outcomes. Sequellae mainly correspond to hypotrophies of the temporal region, corrected with fat grafting. The presence of a mutation increases the risk of reoperation in the first six years of life.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 519-531"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Méningo-encéphalocèles sincipitaux : considérations cliniques et chirurgicales","authors":"F. Lauwers ,&nbsp;F.-E. Roux ,&nbsp;S. Boetto ,&nbsp;N. Oucheng ,&nbsp;F. Giroussens ,&nbsp;Z. Cavallier ,&nbsp;V. Poulet ,&nbsp;A. Prévost","doi":"10.1016/j.anplas.2024.07.008","DOIUrl":"10.1016/j.anplas.2024.07.008","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Les méningo-encéphalocèles (MEC) sincipitaux sont des malformations congénitales rares qui se manifestent par une hernie de tissu cérébral ou méningé à travers une ouverture dans l’étage antérieur de la base du crâne. Ces malformations touchent toujours l’os frontal, plus précisément la région glabellaire et l’angle naso-frontal. Une collaboration entre Médecins du Monde et le Children's Surgical Center de Phnom Penh a permis de prendre en charge plus de quatre cents cas sur vingt ans. Les patients n’ont généralement pas eu d’examens radiologiques, les stratégies chirurgicales étant basées sur les observations cliniques et peropératoires. Il existe plusieurs formes cliniques de MEC : naso-frontales, naso-ethmoïdales, et naso-orbitaires. La classification de Suwanwela de 1972 reste la plus pertinente. Les MEC naso-frontales sont souvent associés à une importante expansion cutanée sans déformation osseuse majeure, contrairement aux MEC naso-ethmoïdales, qui entraînent des déformations significatives et sont les plus fréquentes. Les MEC naso-orbitaires, plus rares, provoquent le plus souvent une augmentation du volume orbitaire. La nature du tissu hernié et le volume de la hernie sont déterminants pour la stratégie chirurgicale. La canthopexie, un élément clé de la reconstruction, doit être précise et répond à des règles strictes pour assurer un résultat esthétique. Le remodelage fronto-nasal finalise la réparation. La chirurgie des MEC suit des principes bien codifiés. Le contexte humanitaire influence la prise en charge, avec un accent sur la sécurité chirurgicale et la transmission des compétences. Le traitement repose sur une vision clinique plus que radiologique, même si les avancées en imagerie sont aujourd’hui disponibles au Cambodge. Le suivi à long terme, surtout chez les enfants, reste un défi à documenter pour évaluer les impacts sur la croissance et la stabilité des résultats chirurgicaux.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Sincipital meningoencephaloceles (MECs) are rare congenital malformations characterized by the herniation of brain or meningeal tissue through an opening in the anterior floor of the skull base. These malformations always affect the frontal bone, specifically the glabellar region and the naso-frontal angle. A collaboration between Médecins du Monde and the Children's Surgical Center in Phnom Penh has enabled the treatment of over four hundred cases over twenty years. Patients typically have not undergone radiological examinations, with surgical strategies based on clinical and intraoperative observations. There are several clinical forms of MECs: naso-frontal, naso-ethmoidal, and naso-orbital. The 1972 classification by Suwanwela remains the most relevant. Naso-frontal MECs are often associated with significant skin expansion without major bone deformity, unlike naso-ethmoidal MECs, which lead to significant deformities and are the most common. Naso-orbital MECs, being rarer, most frequently result in an increased orbital","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 545-553"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632906","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":"[Impact of the number of pregnancies on the venous outflow of DIEP flap in breast reconstruction: A clinical and CT-scan study].","authors":"I Hadji, G Roccaro, L Ferrero, F Pigneur, B Hersant, J-P Meningaud","doi":"10.1016/j.anplas.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.10.001","url":null,"abstract":"<p><strong>Introduction: </strong>The DIEP (deep inferior epigastric perforator) flap is the \"gold standard\" for breast reconstruction after cancer, giving better benefits on the quality of life. The most common complication is the venous congestion, because of the dominance of superficial venous outflow while the flap is drained by the deep epigastric vein. Pregnancy, by its physiological and vascular modifications, can reduce the risk of the venous congestion. Few studies explored the impact of pregnancy on the DIEP vascularization.</p><p><strong>Material and methods: </strong>We studied the preoperative CT-scans of 104 patients who benefited reconstruction surgery by DIEP from January 2011 until March 2022. The patients were separated into 5 groups according to number of pregnancies. For each CT-scan, a concomitant vein of deep epigastric artery diameter/SIEV diameter ratio was performed on each side, to assess the relation between pregnancy and the reduction of venous complications.</p><p><strong>Results: </strong>The results showed an increase of this ratio with the number of pregnancies. Patients with no pregnancy (G0) have the highest complication rate, with 41.7% of venous congestion case. On the other hand, in the group of four pregnancies or more (G4), the complication rate was significantly lower, at 10%, and none venous congestion was observed. These results suggest the beneficial effects of pregnancy on vascularization and especially on venous drainage in the DIEP flap.</p><p><strong>Conclusion: </strong>This study highlights the benefit effect of the number of pregnancies on the DIEP vascularization, especially for the reduction of the venous congestion risk. The ratio DIEV/SIEV may be a useful help to predict the risk of venous complications in nullparous patients. These results open to new studies to deepen the understanding of the physiological effects of the pregnancy on the breast reconstruction surgery.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513464","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":"Validating the porcine model for microsurgical perforator training: Can surgeons trained on pig perforator dissection successfully perform human DIEP flap procedures? A pilot study.","authors":"G A G Lombardo, A Stivala, R Cuomo, V Villani, A Nistor, F Rosatti","doi":"10.1016/j.anplas.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.008","url":null,"abstract":"<p><p>Autologous breast reconstruction, especially using the deep inferior epigastric artery perforator (DIEP) flap, is increasingly seen as a reliable, safe, and long-term alternative to implant-based reconstruction. Despite the recognized advantages of the DIEP flap for breast reconstruction, successful realization demands excellent anatomical knowledge, a thorough understanding of autologous breast reconstruction concepts and advanced microsurgical skills. Given that the porcine model is widely employed in microsurgical training, our study aims to assess this model using validated outcomes, with the objective of evaluating the enhancement in a surgeon's learning curve following training with this model. Forty DIEP flaps were harvested on 20 swines by a single surgeon in \"Pius Branzeu Center\" (Timisoara, RO) and \"Drazan Institute\" (University of veterinary of Brno, CZ) laboratories for microsurgical training in 6months (January 2015-June 2015). Then we analyzed data from 40 DIEP flaps harvested by the same surgeon on first 20 consecutive patients undergoing DIEP flap breast reconstruction. Perforator dissection time, surgeon-determined dissection difficulty score (DDS) and venous congestion rate were collected for each flap in porcine model and in patients, then compared and analyzed. The mean of DDS score analysis in first and second swines group dissection resulted as statistically significant (P-value 0.0001), while it was not statistically significant between those analyzed in the second group of swines dissected and patients (P-value 0.8037). Reduction in perforator dissection time between the two swines' groups and in venous congestion rates from the first swines groups to the second to the human group resulted statistically significant too (P-value respectively 0.0001 and 0.0079). The porcine model has been used for a long time together with other animal models for microsurgical training. Our study confirms and objective by validated scores that it is a valid and reliable model, comparable to the human one and which mimics the dissection of human perforating vessels.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513469","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":"Hand and wrist complete degloving: A case report and litterature review.","authors":"L Chouquet, Y Berkane, G Paleu, S Gandolfi, O Camuzard, E Lupon","doi":"10.1016/j.anplas.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.005","url":null,"abstract":"<p><strong>Introduction: </strong>Complete hand degloving injuries are traumatic avulsion injuries causing the skin to pull away from the underlying tissues and are most often caused by industrial machinery. We present the case of a degloving trauma of the whole fingers, hand, and wrist resulting in a \"watch hand\" by analogy with the \"ring finger\" and discuss alternatives and recommendations from the rare cases described of similar traumas.</p><p><strong>Case presentation: </strong>A 33-year-old manual worker, a non-smoker with no significant medical or surgical comorbidities, was admitted for a complete skin avulsion of the left hand and wrist following a work-related accident with a trommel-type industrial roller. Our approach covered the five fingers and the dorsal aspect of the hand and wrist with an artificial dermal matrix, while the palmar side of the hand and wrist was covered with a pedicled groin flap in emergency. At 15months, the patient's sensitivity was classified as S1 on the sensory evaluation scale, joint mobility was less than 30°, and the residual hand retained what we might call \"basic\" functions, i.e., a counterweight when carrying loads and the ability to pick up and hold a light object in the thumb-index grasp.</p><p><strong>Conclusion: </strong>Complete soft tissue hand defects are exceptional and require urgent treatment. If re-implantation is not possible, combining a dermal matrix with a pedicled flap is a simple salvage solution. The risks of vascular, infectious, and stiffening complications in these traumas are high and must be prevented. Patients must be warned of the severity of the trauma, the need for secondary surgeries to restore a policy-digital grip, and the poor functional results expected.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513466","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":"[Perioperative antibiotics in the management of hand infection].","authors":"L Takorabet, S Carmès, A Dorfmann, C Dumontier","doi":"10.1016/j.anplas.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.08.011","url":null,"abstract":"<p><strong>Purpose: </strong>There is no consensus on the utility of postoperative antibiotherapy in hand infections after surgical management. The aim of this study was to evaluate if the absence of postoperative antibiotic therapy was detrimental after surgical treatment.</p><p><strong>Methods: </strong>We included 287 patients operated on for a hand infection between January 2018 and October 2023. Preoperative or postoperative antibiotic prescription was collected for every patient. Patients cured for their infection with a single surgery were classified as \"simple evolution\", while patients requiring repetitive surgery or who had at least one complication directly linked to the initial infection (extension of infection or necrosis) were considered \"complicated\".</p><p><strong>Results: </strong>From a total of 287 patients, we included 188 paronychia, 40 phlegmons, 47 abscesses and 12 superinfected wounds. The revision surgery rate was 9.4%, and the complication rate was 27.2%. One hundred and seventeen (40.8%) patients received preoperative antibiotic therapy from emergency physicians or general practitioners, among whom a complication rate of 31.6% was observed. The causal link did not reach the significance threshold for the whole group of patients (P=0.079). However, preoperative antibiotic use in phlegmon patients was directly correlated with the occurrence of at least one complication (P=0.032). In all, 82.9% of patients did not require postoperative antibiotic therapy, 95% of whom had an uncomplicated course.</p><p><strong>Conclusions: </strong>Preoperative probabilistic antibiotic therapy is an independent risk factor for complications, particularly if given at a collected stage. Antibiotics should not be routinely prescribed postoperatively in a correct debridement is performed. We recommend that antibiotics be used only in very specific cases (osteitis, arthritis, necrosis and/or high-risk patients).</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301753","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":"Treatment of skin lesions related to pseudoxanthoma elasticum in plastic surgery.","authors":"T Beaussier, A Rouffet, M Dejean, C Deranque, L Martin, P Rousseau","doi":"10.1016/j.anplas.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.07.006","url":null,"abstract":"<p><strong>Background: </strong>Pseudoxanthoma elasticum (PXE) is a hereditary disorder of connective tissue characterized by progressive calcification and fragmentation of elastic fibers, which primarily affects the skin, retinal and arterial walls. Skin damage takes the form of yellow papules that can merge to create a cutaneous fold. This is accompanied by an excess of skin on the different sides of the neck and in the largest folds. These changes to the skin have a significant aesthetic, functional and psychological impact, especially among women.</p><p><strong>Patients and methods: </strong>We evaluated the treatment options in all patients with PXE of our University-Hospital. This group contains people who have been hospitalized for the assessment of their disease and applicants for surgical correction. The goal of the surgery was not the total removal of the lesions but instead a decrease in their size and a tightening of the skin.</p><p><strong>Results: </strong>In total, 250 patients were seen between 2007 and 2022. Surgical treatment was advised for 29 women and 1 man. The main interventions were based on standard techniques such as cervico-facial facelifts, brachioplasties and cruroplasties. The results obtained during postoperative follow-up consultations were rated satisfactory to very good, both aesthetically and functionally. There were no postoperative complications recorded: neither bruising nor scarring issues. Patients with PXE heal as normal.</p><p><strong>Conclusion: </strong>Surgical treatment for excess skin observed during PXE is poorly described. Yet, these excesses can be removed when they become troublesome by making use of and adapting the traditional methods of plastic surgery for tightening of the skin.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301761","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}