现代整形外科(英文)最新文献

{"title":"Trillium Flap for Postmastectomy Neo-Nipple Reconstruction (A Novel Technique)","authors":"Ahmed Alsayed","doi":"10.4236/mps.2020.101002","DOIUrl":"https://doi.org/10.4236/mps.2020.101002","url":null,"abstract":"Introduction: Breast cancer cases, mastectomy and following reconstruction procedures are growing in numbers. Despite being lifesaving, mastectomies have a destructive psychological impact on the patients. On the other hand, breast reconstruction improves psychological damages within the same population. Various techniques for nipple reconstruction were described in literature. Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. Objectives: To come up with an innovative design for reconstructing a neo-nipple post mastectomy, that is superior to other popular flaps. Results: The Trillium flap design has less visible and easily camouflaged scars, is geometry-based, specific, well-detailed and flexible to produce a tailored nipple with any desired height and diameter and ensures the flaps good vascularity and the neo-nipple projection sustainability. Conclusion: Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. The results shown in the study are for experimental procedures done on human tissue samples of excised flaps from abdominoplasties and brachioplasties. Further application on actual cases is needed with monitoring of neo-nipple projection sustainability on the long term.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70497755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Single Vein Anastomosis versus Double Venous Anastomosis in ALT Perforator Flap in Foot and Leg Reconstruction","authors":"M. Abdelaal, A. Gaber","doi":"10.4236/mps.2019.94009","DOIUrl":"https://doi.org/10.4236/mps.2019.94009","url":null,"abstract":"Introduction: Single or double venous anastomosis in free flap in general and ALT, in particular, is still a matter of debate between micro vascular surgeons. In this study, we will present our experience in single vein anastomosis versus double venous anastomosis in ALT perforator flap used in leg and foot reconstruction as regarding flap outcome, complications, operation time and the need for re-exploration. Patient and Methods: We retrospectively evaluate 60 patients with post traumatic foot and leg defects in the period between January 2014 and January 2018 where free ALT flap was done. The patients were divided into two groups, Group 1 where single vein anastomosis was done and Group 2 where double venous anastomosis was done; we utilize the deep venous system for the anastomosis in all cases. Results: Complete flap survival noticed in 56 cases (93.3%), defect size ranged from 70 to 200 cm (mean 126.35 ± 33.78). There was no difference between the 2 groups as regarding Flap survival, hospital stay, flap complications, donner site morbidity and vascular insufficiency. There is statistically significant difference between both groups as regarding Ischemia time, Operation time, and overall re-exploration rate. Conclusions: Our study suggests that the use of a single venous anastomosis in the venous drainage of anterolateral thigh free flaps is as safe and feasible as the two veins anastomoses.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48140076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Complications Following Implant-Based Breast Reconstruction Using Triple Antibiotic Solution versus Low Concentration Chlorhexidine Gluconate Solution","authors":"T. Merceron, Udayan Betarbet, A. Hart, Nusaiba F Baker, G. Carlson, A. Losken","doi":"10.4236/mps.2019.94010","DOIUrl":"https://doi.org/10.4236/mps.2019.94010","url":null,"abstract":"Background: Prevention of infection and capsular contracture remains a primary goal of implant-based breast reconstruction (IBBR). Previous studies have demonstrated improved outcomes with the use of triple-antibiotic solution (TAS) for breast pocket irrigation, but ready-to-use products have recently gained popularity. The purpose of this study is to compare outcomes following IBBR between TAS and low-concentration chlorhexidine gluconate (CHG) solutions. Methods: This is a retrospective analysis of 690 consecutive patients undergoing IBBR from 2008-2017. The TAS (n = 346) irrigation solution was composed of 1 g cefazolin, 80 mg gentamicin and 50,000 U bacitracin diluted in 500 mL of normal saline; the CHG (n = 344) irrigation solution was the commercially-available product Irrisept (0.05% chlorhexidine gluconate in sterile water, Irrimax Corporation, Lawrenceville, GA). Comparisons were made between demographic and clinical variables. Complications were recorded and statistical analysis, including multivariate regression analysis, was performed. Results: The TAS group underwent significantly more skin-sparing mastectomies, adjuvant chemotherapy/radiation and less direct-to-implant reconstruction than the CHG group. The CHG group experienced a significantly lower incidence of total complications (22.4% vs. 31.8%, p = 0.006), minor complications (8.7% vs. 16.5%, p = 0.003), infection (6.4% vs. 12.7%, p = 0.006) and seroma (2.6% vs. 6.9%, p = 0.011). There was a significantly increased rate of delayed wound healing in the CHG group. Multivariate analysis showed that the use of CHG solution significantly decreased the odds of any complication by 1.6-fold (OR 0.637, 95% CI 0.414 - 0.977) and the odds of infection by 2.4-fold (OR 0.420, 95% CI 0.218 - 0.809). There were no statistically significant differences in rates of capsular contracture or other complications. Conclusions: The use of CHG as a pocket irrigant in post-mastectomy breast reconstruction is a reasonable alternative to other solutions, in efforts to minimize prosthetic based complications.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44512853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vectra 3D Imaging for Quantitative Volumetric Analysis of the Efficacy of Propranolol in Infantile Hemangioma","authors":"Reina Kitabata, Noriko Aramaki-Hattori, H. Fukushima, J. Maeda, Tomoki Kiuchi, Marie Aoki, K. Kishi","doi":"10.4236/MPS.2019.93006","DOIUrl":"https://doi.org/10.4236/MPS.2019.93006","url":null,"abstract":"Infantile hemangioma (IH) is a common tumor in infants. After the proliferative phase, hemangiomas regress, but sometimes leave scars. Propranolol is now the recommended first-line oral therapy for IH. To evaluate the effectiveness of oral propranolol administration, we measured quantitative changes in an IH by digital camera and Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Although digital cameras are very simple, changes in color tones occur with time, lesions are evaluated in two dimensions, and changes in the thickness of the hemangioma are difficult to evaluate. Therefore, we investigated the feasibility of 3D photography to quantify volumes in IH during oral propranolol treatment.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44516711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four Cousins with Hypospadias, Is It Familial or Environmental? (Case Report)","authors":"Mohamed Elsayed Mohamed Mohamed, Mina Senada, M. Hassan, Y. Abdalazeem","doi":"10.4236/MPS.2019.93008","DOIUrl":"https://doi.org/10.4236/MPS.2019.93008","url":null,"abstract":"Hypospadias is one of the most common birth defects. However, its etiology remains largely unknown. Genetic and also intrauterine environmental factors have a principal role in causing familial hypospadias. Hypospadias repair is done through several techniques, one of which is Snodgrass technique which has many advantages. The 4 cousins underwent repair with no complications during 6 months follow up period. Methods: Urethroplasty using Snodgrass hypospadias repair of 4 cousins with positive parental consanguinity and absent family history of hypospadias. Results: 4 cousins underwent Snodgrass (Tubularized incised plate urethroplasty) with no complications after 6 months follow up. Conclusion: Although there is high heritability of hypospadias that also aggregates within second- and third-degree relatives, environmental factors may play a principal role in causing familial hypospadias. Hypospadias repair has a long learning curve. The continuous auditing should be done to improve the results.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46217237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Body Modeling: A Practical Theoretical Experience in Plastic Surgery","authors":"J. Resende, Issacar de Oliveira Costa, Pedro Fernando Huertas Granobles, Rolando Arturo Romero Balcazar, Guilherme Bahia de Carvalho, Hugo Rojas Perdomo, Edmar Moreira Lisbôa, Mohamad Youssef Mohsen, Álváro Sanchez Vargas, Nébia Maria Almeida de Figueiredo","doi":"10.4236/MPS.2019.93007","DOIUrl":"https://doi.org/10.4236/MPS.2019.93007","url":null,"abstract":"This research is an active pedagogical experience with surgeons who are specialized in reconstructive plastic surgery and nursing. The guiding questions were the statements of each Surgeon’s clients and what they think about them. Modeling the imaginary bodies of the patients and identify what they built in their minds, highlighting topics and the discussion about the practice made in clay modeling. Eight bodies were modeled, with six bodies with all the senses and two incomplete bodies with only the regions of the breasts and buttocks. It was concluded that there are diverse issues emerging such as gender, ethics, care, spirituality and dream as the fulfillment of the wishes of the patients. Where in the body can these surgeons act to improve the patients’ physical and quality of life? There is an important theme when we are generally welcoming women into an anamnesis that considers their body as a whole, but what is their expectation for each patient? This paper showed the importance of the preoperative evaluation of this whole, for the indication of repairs or contraindications of procedures that aim to improve the physical of the patients, with possible bodily surgical modifications as a form of modeling through liposuction, grafting or excision with lipectomy and withdrawal of excess skin to mitigate the effects of the transformations that deform the physical and end up harming the human relationship, especially women. This is a qualitative method showing the meanings of the bodies of the women represented in the modeling by the Surgeons. However, some surgeons stand out by the look of their practice, as greater sensitivity looking at the body as a whole, spiritual and emotional. They need to use their skills as surgical art and gift, to try to achieve a means, but not an end.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46768726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of Chest Wall after Extensive Chest Wall Necrosis Caused by Transcatheter Arterial Embolization of Bilateral Internal Mammary Arteries Injured by Cardiopulmonary Resuscitation—A Case Report","authors":"Ayako Kamitomo, Minoru Hayashi, Ryohei Tokunaka, Y. Yoshida, S. Tatsuta, Y. Sasaki","doi":"10.4236/MPS.2019.92005","DOIUrl":"https://doi.org/10.4236/MPS.2019.92005","url":null,"abstract":"Transcatheter Arterial Embolization (TAE) is known to be effective for controlling severe hemorrhage caused by iatrogenic or blunt trauma. Out of more than 100 cases of TAE performed in our hospital, we have treated some cases of skin or muscle necrosis that resulted from embolization of the main arteries. In this study, we report the case of a patient with significant chest wall necrosis after TAE of the bilateral internal mammary arteries (IMAs). A 66-year-old male was transported to our hospital for loss of consciousness while playing golf. Cardiopulmonary resuscitation (CPR) was performed for cardiac arrest, which resulted in several rib fractures and mediastinal hematoma due to bilateral mammary artery injuries. Immediate TAE embolization was performed because of continuous hemorrhage. He was referred to our department 16 days after embolization due to the presentation of chest wall necrosis. Heart, lungs and diaphragm were exposed after surgical debridement under systemic anesthesia. We performed several operations to reconstruct the anterior chest wall. His spontaneous respiration returned, and is now controlled with a tracheostomy tube. Complete epithelialization was achieved, and he was transferred to another hospital for further rehabilitation. To the best of our knowledge, this is the first report of chest wall necrosis resulting from TAE of IMAs. Arterial embolization can cause widespread necrosis of bone, muscle and skin. Although treatment required an extended period, we managed to reconstruct the chest wall with multidisciplinary strategies.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44100810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Cold Atmospheric Pressure Plasma on Accelerating Acute Wound Healing: A Comparative Study among 4 Different Treatment Groups","authors":"A. Nishijima, T. Fujimoto, T. Hirata, J. Nishijima","doi":"10.4236/MPS.2019.91004","DOIUrl":"https://doi.org/10.4236/MPS.2019.91004","url":null,"abstract":"Cold atmospheric pressure plasma (CAP) has been expected to be effective for wound healing among plasma medicines and has been attracting attention. The aim of this retrospective clinical study was to evaluate and compare the effects of CAP on acute wounds created by a fractional CO2 (FXCO2) laser on four treatment groups. Methods: This study was conducted between September 2017 and November 2018. Radiated surface wounds were created using a FXCO2 laser on four identically-sized regions on the medial side of the left forearm of 12 healthy volunteer subjects, for a total of 48 treatment regions. Each region was then randomly assigned to one of four groups: 1) no treatment (control group), 2) irradiated CAP for 60 seconds (plasma group), 3) topical application of ointment containing betamethasone valerate (steroid group), or 4) two to three sprays of basic fibroblast growth factor (bFGF group). The primary outcome of the skin was the change in absolute values of lightness index (L*), redness index (a*I) of L*a*b color space, arithmetical mean roughness (Ra), and mean melanin concentration. The secondary outcome was the clinical condition of the wounds, including inflammation, crust formation, and hyper/hypo-pigmentation on the recovering skin surface relative to the surrounding intact skin. Each item was evaluated at post-treatment 0, 1, 3, 7, 14, 28 days and 1 year. Results: Although no significant difference was observed among all groups, the CAP group exhibited more rapid recovery regarding a*I and Ra. No side-effects were observed in the CAP group. Conclusion: CAP is considered to accelerate healing of irradiated wounds via anti-inflammatory activity. Our study confirmed the effectiveness and safety of CAP which is devoid of side-effects of conventional therapies, and may aid in future development of medical plasma therapies.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45821558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gigantomastia in Female Workers: “Public Health Cases”","authors":"J. Resende, Alban Moura, A. Mariano, Hellen Karynne Silva, Hingryd Lorenna Silva, I. Campos, Luis Clayton Fernandes de Lima, M. Gabriel, Wiuller Oliveira Silverio","doi":"10.4236/MPS.2019.91001","DOIUrl":"https://doi.org/10.4236/MPS.2019.91001","url":null,"abstract":"In this manuscript the authors have studied gigantomastia in female workers. After this weight loss, they perform mammary reduction and, after a year, the patients were referred to the bariatric team. All patients stayed for one year at the Obesity Workshop to learn about the dangers and benefits of weight loss, breast reduction and the possibilities of a more healthy body and future repairing plastics. After all these procedures, they observe an adequate psychological preparation. The patients felt more comfortable and happy with the smaller breasts, operated by using the Resende technique.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70498017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanofat and Platelet Rich Plasma to Enhance Recovery and Minimize Risk of Recurrence after Endoscopic Carpal Tunnel Release","authors":"M. Fitzmaurice","doi":"10.4236/MPS.2019.91002","DOIUrl":"https://doi.org/10.4236/MPS.2019.91002","url":null,"abstract":"Carpal tunnel release is one of the most common and surgery procedures performed. Complications and recurrence of the condition can occur up to 20% of cases. We describe a technique of utilizing the nanofat and platelet rich plasma to successfully enhance healing and minimize risk of recurrence after endoscopic carpal tunnel release. This patient had exceptionally fast recovery, resuming work in one day and excellent grip strength and a full functioning level at his two-week follow-up. After one year he continues to demonstrate a complete resolution of symptoms and full function without any evidence of recurrence or complications.","PeriodicalId":70402,"journal":{"name":"现代整形外科(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70498088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}