Acta chirurgiae plasticae最新文献

{"title":"Role of perforator flaps in leg and foot reconstruction.","authors":"T. El-Gammal, Y. Hassan, T. Raief, M. Elyounsi, M. Adel","doi":"10.21608/ejhm.2022.268097","DOIUrl":"https://doi.org/10.21608/ejhm.2022.268097","url":null,"abstract":"INTRODUCTION\u0000Lower extremity wounds have always been a challenge for the reconstructive surgeons. Free perforator flaps are considered to be the best option for this problem but require the complexity of microsurgery. So, pedicled perforator flaps have emerged as an alternative option.\u0000\u0000\u0000PATIENTS AND METHODS\u0000Prospective study was conducted in 40 patients with traumatic soft tissue defects in the leg and foot. The free flaps included the anterolateral thigh flap (ALT) and medial sural artery perforator flap (MSAP). In pedicled perforator flaps group, 10 cases were designed as propeller flaps while the other 10 flaps were designed as perforator plus flaps.\u0000\u0000\u0000RESULTS\u0000Free flaps were mainly used for large-sized defects; we had one case of partial flap loss and one case of complete flap necrosis.  MSAP flap was the first option for coverage of large-sized defects on foot and ankle as it is a thin and pliable flap, while ALT flap was used for coverage of larger defects on the leg. Pedicled perforator flaps were used mainly for small to medium-sized defects, especially in the lower third of the leg; we had three cases of flap loss in propeller flap design while we had no cases of flap loss in perforator plus flap.\u0000\u0000\u0000CONCLUSION\u0000Perforator flaps have become a reasonable solution for soft tissue defects of the lower extremity. Careful assessment of the dimensions, location, patient comorbidities, availability of surrounding soft tissue and presence of adequate perforators are mandatory for proper perforator flap selection.","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"65 1 1","pages":"20-27"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42008329","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":"Single-stage reconstruction of a large lower eyelid defect using a full-thickness bilamellar autograft","authors":"Cem Everoklioglu","doi":"10.48095/ccachp202293","DOIUrl":"https://doi.org/10.48095/ccachp202293","url":null,"abstract":"","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42765564","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 a questionnaire for a patient-reported outcome after nasal reconstruction.","authors":"D. Z, Křenková V, Hudcová L, Knoz M, Kubát M, Pink R","doi":"10.48095/ccachp202224","DOIUrl":"https://doi.org/10.48095/ccachp202224","url":null,"abstract":"INTRODUCTION\u0000Our face plays an important role in communication and social life. Defects of the face have a big impact on socializing and psychics of patients with its deformities. A good esthetic outcome is an important task of each reconstructive surgery. With a modern concept of nose reconstruction, it is possible to achieve a better esthetic and functional outcome than it was possible with one phase reconstructions before. There was a specific tool missing to measure patients reported outcome and objectively evaluate benefits of nose reconstruction from a patients point of view and get reliable feedback about the whole procedure.  The goal of this paper is to develop such a questionnaire.\u0000\u0000\u0000MATERIALS AND METHODS\u0000A pilot questionnaire was developed with literature input. The questionnaire was tested on five patients. Based on patients feedback and a review from a psychologist, the second version of the questionnaire was made. It was sent to 39 patients, who underwent nose reconstruction in the years 2016-2020. After two appeals, 34 completed questionnaires were sent back (87,2%). The final version of the questionnaire was developed after a thorough mathematic and statistical analysis of collected data.\u0000\u0000\u0000RESULTS\u0000The group of patients who completed the questionnaire consisted of 16 females (47%) and 18 males (53%). On average, the patients were 69 years old (17-88 years). The final questionnaire is structured into six categories from A to F: A - general information defining the patient and purpose for reconstruction, B - satisfaction with esthetic outcome, C - satisfaction with function and stability, D - satisfaction with medical treatment, E - social and psychological impact, F - overall satisfaction. Most of the questions use a 5-point rating scale.\u0000\u0000\u0000CONCLUSION\u0000The questionnaire enables the patients to provide feedback on particular aspects of the treatment and their overall satisfaction with the whole procedure and its outcome. With statistical analysis, it is possible to discover specific treatment aspects that have crucial impact on overall satisfaction with the whole procedure. A patient-reported outcome helps to improve the quality of provided health care and the quality of patient life.","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"64 1 1","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70559338","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":"Emergency evacuation low-pressure suction for the management of extravasation injuries - a case report.","authors":"Look Van L, Vissers G, Tondu T, Thiessen F","doi":"10.48095/ccachp202244","DOIUrl":"https://doi.org/10.48095/ccachp202244","url":null,"abstract":"BACKGROUND\u0000Extravasation is the movement of fluid outside its conduit into the extracellular tissue, possibly leading to a local inflammatory reaction, compartment syndrome, tissue necrosis, and full thickness skin loss at the affected area. To prevent these complications, early recognition, referral and treatment of an extravasation injury is of utter importance.\u0000\u0000\u0000CASE REPORT\u0000We present a case, illustrating an extravasation injury into the breast managed by a renovated surgical technique - emergency evacuation low-pressure suction (EELS). A 54-year-old woman attended the emergency department with 1.5 L of total parenteral nutrition leaked into her right breast via a central portal catheter. The patient was seen within 24 hours of the incident, and presented with a diffuse swollen, tender and erythematous right breast but no overlying skin necrosis. Dry EELS via two small stab incisions was performed to evacuate the extravasated total parenteral nutrition and to minimise the aspiration of healthy fat tissue of the breast. Only a few cases of extravasation injuries into the breast have been described and most cases involve chemotherapy extravasation from a central catheter. Presumably there is an underreporting of this complication in the literature.\u0000\u0000\u0000CONCLUSION\u0000This case-report promotes the use of aspiration in the management of diffusely spread extravasated injuries. EELS is a more appropriate term than liposuction, as there is no intention to evacuate healthy fat tissue. This new term is less confusing and might help medical staff and patients to better understand the treatment as it will break the affiliation with an aesthetic procedure. It is an effective and cosmetically satisfactory technique to treat early total parenteral nutrition extravasation injury at the level of the breast.","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"19 1","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70559256","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":"Superficial circumflex iliac artery perforator flap on extremity defects - case series.","authors":"Bajus A, Streit L","doi":"10.48095/ccachp202239","DOIUrl":"https://doi.org/10.48095/ccachp202239","url":null,"abstract":"BACKGROUND\u0000Reconstruction of upper and lower extremity defects can be challenging. Especially in distal parts, relatively thin flaps are needed not to interfere with the function or aesthetic appearance of the extremity. The superficial circumflex iliac artery perforator (SCIP) flap represents a powerful but still not so commonly used tool for this kind of reconstruction. In this article, we present several cases of the use of the SCIP flap for extremity defect coverage.\u0000\u0000\u0000CASE SERIES\u0000We present five cases (three men and two women) of upper or lower extremities defect coverage with a SCIP flap performed between January and June 2021 at our department. The mean age of the patients was 43 years (28-67 years). The body mass index was 28.6 on average. Two defects were located on hands and three defects on lower extremities. In three cases, the cause of the defect was trauma, and in the remaining two, it was a tumor resection. The mean thickness of the flap was 9.4 mm. We experienced no total flap loss and no revision surgery for ischemia or congestion was needed. One of the patients developed marginal flap necrosis, which was corrected by necrectomy and direct skin closure.\u0000\u0000\u0000CONCLUSION\u0000Our case series demonstrates the possible use of the SCIP flap in the reconstruction of upper and lower extremities. With its thinness, low donor-site morbidity, and ease of harvest, we recommend the SCIP flap to be considered as one of the primary reconstructive options for various extremities defects.","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"64 1 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70559450","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":"Efficacy of pedicled anterolateral thigh flap for reconstruction of regional defects - a record analysis.","authors":"Manjunath N K, Waiker V P, Shanthakumar S, K. M","doi":"10.48095/ccachp20226","DOIUrl":"https://doi.org/10.48095/ccachp20226","url":null,"abstract":"BACKGROUND\u0000The anterolateral thigh (ALT) flap was described as the fasciocutaneous flap. It can be harvested as a pedicled and/or free flap. Majority of the free flaps are harvested as a fasciocutaneous flap. Their use in head and neck reconstruction and limb trauma is well established. Apart from these advantages, this flap has various applications which are less utilized. ALT flap can be used as a myocutaneous flap along with vastus lateralis muscle. When muscle and fasciocutaneous flaps are required, both can be harvested as a chimeric flap which can cover two different regions of the wound. Moreover, harvest of the pedicled flap procedure is less time-consuming than that of a free flap. Since it has a long vascular pedicle, when used as pedicled flap, it can reach up to the gluteal region. To evaluate these less applied advantages of pedicled ALT flap, our study was undertaken. This study aimed to evaluate the efficiency of ALT flap in terms of the surface area of coverage, arc of rotation and the advantages of including vastus lateralis muscle as part of the flap.\u0000\u0000\u0000METHODS\u0000A retrospective record analysis of all pedicled ALT flap reconstruction of trochanteric, upper thigh, gluteal and flank regions from 2016 to 2018 was undertaken; 7 patients with 8 defects were included.\u0000\u0000\u0000RESULTS\u0000All the flaps healed successfully. There was no major necrosis of the flap and minor complications like wound gapping were found in three patients.\u0000\u0000\u0000CONCLUSION\u0000The ALT-vastus lateralis flap dimensions can be very large and can be easily harvested in a very short time. Vastus lateralis muscle harvested can be used to fill the defect or can be used as chimera to cover the defect. The use of muscle over long standing infective pressure sores can sterilize the wound bed and help in preventing recurrence. The vascularity of this flap is robust and highly reliable. Even after a maximum arc of rotation (up to 170°) all the flaps survived without any major complications.","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"64 1 1","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70559269","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":"Temporary skin closure in extremity soft tissue sarcoma - our indications.","authors":"Matějovská J,&nbsp;Christodoulou P,&nbsp;Šorelová V,&nbsp;Fridrichová M,&nbsp;Matějovský Z","doi":"10.48095/ccachp202269","DOIUrl":"https://doi.org/10.48095/ccachp202269","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial skin replacements were developed to cover defects in general surgery or after burns. Their main indication in oncologic surgery is secondary resection of appropriate margins in skin tumors after incomplete primary excision. This is contraindicated in sarcomas where only wide excision is indicated. The aim of the study is to show rare possible indications for temporary skin closure (TSC) in extremity soft tissue sarcomas (STS).</p><p><strong>Materials and methods: </strong>Out of 594 patients with extremity STS treated surgically at the Department of Orthopedics, University Hospital Bulovka, Prague, since 2014, we evaluated those with TSC concerning their indications.</p><p><strong>Results: </strong>TSC (Aquagel twice, Parasorb four times, and COM 30 five times) was used in 11 patients. Six cases were on the foot, three on the femur and two on the lower legs. Seven cases were high-grade sarcomas, two cases were synovial sarcomas, one case was low-grade myxofibrosarcoma and one case was low-grade malignant peripheral nerve sheath tumor. We covered tendons five times, bones four times and vessels once. Ten of the 11 cases were recurrent tumors with extensive reconstructions, an increased risk of infection or unclear final histology. Two-stage surgeries seem good indications to decrease the adverse effects of prolonged surgery on flap perfusion or patients status.</p><p><strong>Discussion: </strong>Not only the anesthesiologic, but also oncologic factors, potentiating the adverse effects of prolonged surgery on the patient and flaps, are discussed. The pros and cons of individual indications and their alternatives are compared.</p><p><strong>Conclusion: </strong>The indications for TSC in extremity STS are rare, but exist. TSC can be a good solution, enabling a safe two-stage reconstruction at a specialized plastic surgery unit, after an initial wide excision at a department of oncologic surgery. This can be a safer method concerning the perfusion of flaps and general status of an oncologic patient.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":" ","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40353539","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":"Single-incision endoscopic-assisted temporoparietal fascia harvest for single stage auricular reconstruction.","authors":"Nguyen H,&nbsp;Tran T T Huyen,&nbsp;Nguyen T T Hang","doi":"10.48095/ccachp202262","DOIUrl":"https://doi.org/10.48095/ccachp202262","url":null,"abstract":"<p><strong>Introduction: </strong>The temporoparietal fascia flaps (TPFF) have been widely used to cover the framework in auricular reconstructions. However, flap harvesting is mostly done by open surgery which may be easier but often results in bad scarring and hair loss. We would like to present a series of cases using endoscopic-assisted flap harvesting techniques with only one single cosmetic auricular incision.</p><p><strong>Patients and methods: </strong>Prospective studies from June 2018 to September 2021 on patients who underwent single-stage total auricular reconstruction using autologous costal cartilage and porous polyethylene (PPE) framework. Variables include age, gender, flap survivability as well as visual results and complications.</p><p><strong>Results: </strong>A total of 61 TPFFs were harvested to cover 15 autologous costal cartilages and 46 PPE frameworks in 60 patients (one patient had operation on both sides). TPFF harvests are performed by endoscopic techniques with one single auricular incision. There was no flap necrosis, no bleeding and no cases required framework removal. Only 7/61 (11.5%) ears had small framework exposure which resolved on their own or only required local skin flap coverage and 1 ear had frontal nerve injury.</p><p><strong>Conclusion: </strong>Single-stage auricular reconstruction is a difficult surgery, yet greatly beneficial to young children. Through a single-incision endoscopic technique, we can obtain sufficiently large high-survivability TPFFs ensuring full coverage of the autologous costal cartilage or PPE framework. This method is reliable, and reproducible with advanced training. After reviewing the literature, we can state that our report probably includes the largest endoscopic-assisted TPFF harvesting series and the first to implement single-incision endoscopic technique in auricular reconstructions.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":" ","pages":"62-68"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40353538","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":"Salvage of a large exposed cranial implant on irradiated necrosed scalp using free latissimus dorsi and forehead flaps - a case report.","authors":"Taliat G,&nbsp;Kumar M K,&nbsp;Shivalingappa S","doi":"10.48095/ccachp202289","DOIUrl":"https://doi.org/10.48095/ccachp202289","url":null,"abstract":"<p><p>Scalp necrosis following a cranioplasty and subsequent exposure of the implant is a dreaded complication and needs to be treated promptly. Conventionally, implant removal is often advised to prevent delayed infection. We present a case of a scalp necrosis following cranioplasty using a titanium mesh for a patient who had undergone glioma excision and radiation therapy. Using a latissimus dorsi free muscle flap, we salvaged the implant. Patient had a persistent dural leak which was addressed by a pedicled extended forehead flap and suction drain under the latissimus dorsi flap. We successfully stopped the cerebrospinal fluid leak and covered the defect adequately concluding that muscle flaps are very useful to salvage exposed implants.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":" ","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351475","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":"Bilateral latissimus dorsi for breast reconstruction in one stage.","authors":"Dražan L,&nbsp;Knoz M,&nbsp;Streit L,&nbsp;Cheimaris A","doi":"10.48095/ccachp202282","DOIUrl":"https://doi.org/10.48095/ccachp202282","url":null,"abstract":"<p><p>The authors present a technique of bilateral breast reconstruction in case series of 5 patients, allowing simultaneous harvest of both latissimus dorsi myocutaneous flaps. Three patients underwent bilateral immediate reconstruction after prophylactic mastectomy. One patient underwent a delayed reconstruction, in 1 patient latissimus dorsi myocutaneous flap was used after prophylactic mastectomy and reconstruction with implants followed by bilateral necrosis of the skin flaps. The described technique enables safe breast reconstruction in one procedure. The average reconstruction time was about 4 hours, which represents bilateral latissimus dorsi procedure to the centre of the breast reconstructions range, between the reconstructions with double free tissue transfer and the breast implants.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":" ","pages":"82-85"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351473","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}