Acta chirurgiae plasticae最新文献

{"title":"Taylor's flap reconstruction following abdominoperineal resection for advanced hidradenitis suppurativa - a case series and literature review.","authors":"I Ben Ayad, F Château","doi":"10.48095/ccachp2025245","DOIUrl":"10.48095/ccachp2025245","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disorder primarily affecting intertriginous regions. In advanced stages, it can lead to extensive scarring, sinus tract formation, and significant impairment in quality of life. While early-stage disease may respond to medical management, severe and refractory cases often require subsequent radical surgical intervention. This report presents two cases of extensive perineal HS managed through abdominoperineal resection followed by reconstruction with a pedicled oblique rectus abdominis myocutaneous flap (Taylor's flap).</p><p><strong>Case presentation: </strong>Two patients, a 49-year-old man and a 67-year-old woman, presented with long-standing, relapsing perineal HS unresponsive to conservative therapies. Both were active smokers with significant disease burden. After multidisciplinary evaluation, each underwent abdominoperineal resection followed by reconstruction using a pedicled Taylor's flap. Additional procedures included excision of inguinal lesions with split-thickness skin grafting. Postoperative complications included venous congestion of the flap, partial dehiscence, and one case of uncomplicated eventration. All complications were managed successfully. Despite these issues, both patients recovered well and remained disease-free at 3.5 and 2.5 years of follow-up, respectively.</p><p><strong>Conclusion: </strong>In highly selected patients with severe, refractory HS, abdominoperineal resection combined with Taylor's flap reconstruction can be a successful salvage strategy. While postoperative complications can occur, they are manageable with appropriate care. These cases underscore the importance of a multidisciplinary approach and demonstrate that radical surgery may be curative in advanced HS when conservative measures fail.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 4","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715664","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":"The middle-aged women's attitudes towards (anti-ageing) cosmetic services in the Czech Republic.","authors":"M Honelová, T Doseděl","doi":"10.48095/ccachp202513","DOIUrl":"https://doi.org/10.48095/ccachp202513","url":null,"abstract":"<p><p>Cosmetic/aesthetic surgery has increased in popularity, reflecting the increased consumer demand. Modern women feel compelled to meet near-impossible standards of beauty. Most of those who undergo cosmetic/aesthetic surgery are (middle-aged) women. Women are often under pressure to meet near-impossible standards of beauty. This study examined cosmetic/aesthetic surgery attitudes and perceptions among 516 Czech middle-aged women. It assessed the perception and attitudes towards cosmetic/aesthetic procedures of middle-aged Czech women and determined the possible factors influencing their level of acceptance through a quantitative survey. The research findings are based on an online questionnaire survey. Based on our analyses, we revealed that acceptance and attitudes towards cosmetic/aesthetic surgery among women can be influenced by the variables such as marital status, place of living, fear of ageing, the importance of physical appearance, occupational status, and partner's influence. This study provided a first general look at the situation around cosmetic/aesthetic surgery in the context of the Czech Republic. However, to gain a more comprehensive understanding of the acceptance and attitudes towards cosmetic/aesthetic surgery in the Czech Republic, further research should be conducted across the country to assess the attitudes of the wider population (for example, different age groups).</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 1","pages":"13-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482864","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":"Varied presentation of female external genitalia - a record analysis.","authors":"K N Manjunath, P Nagwani, P Sanmati, M S Venkatesh, S Chilikuri S","doi":"10.48095/ccachp202599","DOIUrl":"10.48095/ccachp202599","url":null,"abstract":"<p><p>Ambiguous genitalia, a cluster of varied presentations classified as disorders of sexual development (DSD), involves a spectrum of manifestations affecting both internal and external genital organs. Diagnosing and treating these disorders is complex and requires a multidisciplinary approach. This article aims to explore the complexities and challenges of diagnosing and managing DSD. These cases highlight the importance of genetic, phenotypic, and biochemical evaluations in achieving accurate diagnosis and treatment plans, which may include surgical interventions and psychological support. The cases presented include individuals with 46,XY and 46,XX DSD, highlighting conditions such as MRKH syndrome, recto-vaginal fistula, and persistent urogenital sinus, androgen insensitivity syndrome each with unique clinical presentations and treatment challenges. Treatment options, such as McIndoe vaginoplasty, and considerations regarding psychological counselling and legal gender assignment further complicate the management of DSD, emphasizing the need for a comprehensive, individualized care approach.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 2","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084920","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":"Free advancement ipsilateral medial plantar artery flap to encompass the entire plantar aspect of the foot - a case report and comprehensive review.","authors":"Z Q Lin Wu, B López-Masramón, V Andreu-Solà, J P Barret","doi":"10.48095/ccachp2025132","DOIUrl":"https://doi.org/10.48095/ccachp2025132","url":null,"abstract":"<p><p>Sarcomas affecting weight-bearing areas of the foot are a rare disease and represent a reconstructive challenge. The medial plantar artery (MPA) flap offers an optimal \"like with like\" reconstructive option for the sole. However, it has certain limitations such as the limited reach of the vascular pedicle, vascular impairment associated with retrograde flow flap or the morbidity of using contralateral foot as a free flap donor site. We present a case of a 30-year-old male with left sole forefoot defect after sarcoma excision. Because of the previous excision surgery along with the wish to avoid morbidity in the contralateral foot, reverse flow MPA flap and contralateral free MPA flap were ruled out. Reconstruction using an ipsilateral anterograde flow MPA flap with pedicle extension using a grater saphenous vein loop to advance the flap and reach the defect was proposed. After 9 months of reconstruction, the patient achieved full weight-bearing and ambulated normally without any complications. We propose this method of elongating the pedicle of the MPA flap as an optimal procedure, capable of encompassing mid-size defects in the entire sole of the foot. This approach reduces the morbidity associated with using the contralateral foot and avoids sacrificing other vascular axis in the affected foot for use as a recipient vessel. Although complications of the harvesting site are known, we believe that MPA flap is still the best option for reconstructing the weight bearing area.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 2","pages":"132-136"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084803","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":"Digital retractile keloid in a context of spontaneous keloids - a case report.","authors":"G Belmaati Cherkaoui, M Tajir, A Daoudi, A A Oufkir","doi":"10.48095/ccachp2025260","DOIUrl":"10.48095/ccachp2025260","url":null,"abstract":"<p><p>We report the extremely rare case of a digital and plantar retractile keloid in a 32-year-old patient with a history of spontaneous keloids. Since childhood, she has developed hypertrophic scars following minor trauma, extending beyond the original wound margins. She currently presents a left IV-V syndactyly and a complete flexion contracture of the fifth finger (Tubiana stage IV), as well as a retraction of the right hallux, resulting in functional impairment. The goal of surgical treatment is to restore extension. Retractile keloids occurring in the context of spontaneous keloids are unusual. Their exact pathophysiology remains poorly understood, and curative treatments are currently disappointing. The primary objective of surgery is functional restoration.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 4","pages":"260-263"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715630","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":"Surgical site infection after breast reconstruction with silicone implant - a retrospective analysis of risk factors.","authors":"B Englcová, J Kulhánek, Z Dvořák, D Erhart","doi":"10.48095/ccachp2025172","DOIUrl":"10.48095/ccachp2025172","url":null,"abstract":"<p><strong>Introduction: </strong>Breast reconstruction using a silicone implant after mastectomy is a common part of the comprehensive treatment of breast cancer patients. One of the most serious complications is implant infection, which can significantly affect the surgical outcome as well as the patient's quality of life. The aim of this study was to analyse the incidence of infectious complications following breast reconstruction with a silicone implant. The study also sought to identify major risk factors, assess possible preventive measures, and compare the findings with data available in the scientific literature. Special attention was paid to immediate versus delayed reconstruction following mastectomy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from 17 patients who had surgery at Na Františku Hospital in Prague in 2024. Both clinical and surgical variables were evaluated, including the timing of reconstruction (immediate or delayed), incidence of infection, and microbiological findings in relation to the presence of risk factors (smoking, diabetes mellitus, radiotherapy, coagulopathy), reoperation, fat transfer prior to surgery, and length of hospitalization. The distal end of the Redon drain was sent for microbiological examination.</p><p><strong>Results: </strong>Infection occurred in 7 out of 17 patients, with a higher incidence observed in cases of immediate reconstruction. The most common pathogens identified were Staphylococcus epidermidis and Staphylococcus capitis. The average length of hospitalization was 9.8 days (a median of 8 days). The most frequent complicating factors were immediate reconstruction, smoking (including IQOS), radiotherapy, and diabetes mellitus. A positive impact on reconstruction outcomes was observed in patients who had fat transfer prior to implant placement, which appeared to have a protective effect. Reoperation was required in 5 patients, and in 3 of these cases, implant removal was ultimately necessary.</p><p><strong>Conclusion: </strong>The importance of identifying risk factors for planning reconstruction and preventing complications was confirmed. Smoking, diabetes mellitus, and radiotherapy are significant risk factors for implant-related infections. Fat transfer prior to implant-based reconstruction may serve as a protective factor.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 3","pages":"172-179"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043546","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":"Brachioplasty after massive weight loss: analyzing wound healing and risk factors for dehiscence.","authors":"C D Rojas Gutiérrez, P Carvallo Maiocco, E Zúñiga Garza, M Guitián González, J Said Haro Cruz, F S Herrán Motta, E Camacho Quintero","doi":"10.48095/ccachp2025160","DOIUrl":"10.48095/ccachp2025160","url":null,"abstract":"<p><strong>Background: </strong>Brachioplasty in the post-bariatric patient deserves special attention since a not negligible number of wound complications is reported in the literature. In this study, the authors present unique risk factors for wound dehiscence and delayed wound healing based on retrospective data in post-bariatric patients who underwent brachioplasty alone or with other procedures.</p><p><strong>Methods: </strong>A total 31 patients who underwent brachioplasty alone or combined with other procedures between 2017-2022 were included. Data analyzed encompassed demographic information, biometric data, type of brachioplasty if performed alone or in combination with other procedures, days to epithelization/closure, and its management.</p><p><strong>Results: </strong>A total of 15 patients (48.38%) experienced surgical wound dehiscence, the majority (66%) being minor wound dehiscence. Subjects who underwent concomitant arm liposuction with brachioplasty showed a higher degree of dehiscence (P = 0.021) and more days to epithelialization/closure (P = 0.10). Fifty-seven percent of patients who underwent a combined procedure showed some degree of dehiscence, as well as more days to epithelialization/closure (41 vs 15.75 days). Brachioplasty and mastopexy as combined procedures demonstrated more days to epithelialization/closure (P = 0.05).</p><p><strong>Conclusions: </strong>Brachioplasty in the post-bariatric population is deemed safe and effective; nevertheless, it carries an increased risk of wound dehiscence and delayed wound healing when combined with liposuction and other procedures. The plastic surgeon needs to become familiar with variables that increase the risk of this complication, all of which can be anticipated in preoperative planning.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 3","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043624","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":"Extensive keloid scar of the left auricle - combined treatment of excision followed by brachytherapy: a case report.","authors":"J Fau, P Vítek, K Procházková, P Kurial, T Votruba, P Vodička, V Mařík","doi":"10.48095/ccachp2025264","DOIUrl":"10.48095/ccachp2025264","url":null,"abstract":"<p><p>Treatment of keloids is still challenging due to their tendency to frequent recurrences and the lack of universally accepted treatment protocols. Initial approaches to the treatment of keloids include conservative strategies such as intralesional steroid injections, the use of occlusive dressings, compression therapy, silicone gel or sheeting, and laser treatment. In case of the failure of conservative treatment or if the keloid is extensive or a good surgical result is expected, more aggressive methods can be used. These include surgical removal of the keloid, which itself carries a very high probability of recurrence. In these more complex cases, the combination of surgery and postoperative radiotherapy often leads to a satisfactory outcome. Even in rare cases, definitive radiotherapy is used without prior surgical excision. In this case report, we would like to present our experience with the treatment of extensive keloid scars of the left auricle.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"67 4","pages":"264-267"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715645","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":"Development of aesthetic surgery in the Czech Republic - the situation before the COVID pandemic, during the pandemic, and expected changes in the practice of aesthetic surgery in the post-COVID period.","authors":"M Honelová, M Nováková, L Vidovićová","doi":"10.48095/ccachp202434","DOIUrl":"https://doi.org/10.48095/ccachp202434","url":null,"abstract":"","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"66 1","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847133","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":"Transposition of Stensen's duct in severe salivary duct stenosis -  a case report.","authors":"M Vavro, B Dvoranová, D Med, N Gurčíková, L Czakó","doi":"10.48095/ccachp2024167","DOIUrl":"10.48095/ccachp2024167","url":null,"abstract":"<p><p>This case report presents interventional sialendoscopy treatment in a patient with chronic parotitis based on sialolithiasis and later Stensen's duct stenosis. After sialendoscopic sialolith removal, stricture of Stensen's duct in the distal part developed, with megaduct formation. On MRI, the parotid gland parenchyma was without present pathology. A transoral approach was chosen. Stensen's duct dissection, transposition, sialendoscopy of the proximal duct, and stenting were performed. After surgery, the patient's state improved, no more episodes of swelling were experienced. The stent was removed after 3 weeks. Six weeks after surgery, the neostoma stays functional with clear saliva secretion.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"66 4","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655842","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}