Acta chirurgiae plasticae最新文献

{"title":"Gas Gangrene Following Posterior Tibial Tendon Transfer of a 34-Year-Old Patient - a Case Report.","authors":"Lodin J,&nbsp;Humhej I,&nbsp;Táborská J,&nbsp;Sameš M","doi":"10.48095/ccachp202118","DOIUrl":"https://doi.org/10.48095/ccachp202118","url":null,"abstract":"<p><p>Gas gangrene is a rare and potentially fatal surgical complication, most often associated with contaminated traumatic wounds or more rarely following cases of abdominal surgery. The following article describes a case of gas gangrene in the right lower limb of a 34-year-old patient following an elective posterior tibial tendon transfer. The surgery was performed in bloodless fashion, utilizing a surgical tourniquet. Fifteen months prior to the procedure, the patient was attacked by a wild boar, resulting in a tear of the upper calf with complete transection of the right common fibular nerve. The patient underwent a total of three acute surgical procedures, of which the third resulted in below knee amputation. The patient then underwent a final corrective procedure and was fitted with a suitable leg prosthesis. In the discussion, three possible pathophysiological mechanisms of gas gangrene development are described - iatrogenic inoculation of bacteria during injection of local anesthetics for conduction anesthesia, iatrogenic inoculation of bacteria during the posterior tibial tendon transfer and activation of latent clostridial spores within the original wound caused by the wild boar. We consider the third mechanism most likely, as boar tusks contaminated with soil and debris are a more likely source of clostridial spores, than sterile surgical instruments. Furthermore, it is likely the surgical tourniquet played a key role in activating latent spores within the patient wound, as changes in tissue oxygen levels are a common cause of spore activation. Thus, we suggest caution in utilizing bloodless operating fields in elective cases with a history of open contaminated wounds, as the iatrogenic hypoxia can potentially activate sporulent bacteria within the patients wound.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39031212","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":"Three-dimensional navigation in maxillofacial surgery - the way to minimize surgical stress and improve accuracy in fibula free flap and Eagles syndrome surgical procedures.","authors":"Ladislav Czakó,&nbsp;Michal Vavro,&nbsp;Bronislava Dvoranová,&nbsp;Marek Soviš,&nbsp;Kristián Šimko,&nbsp;Andrej Thurzo,&nbsp;Branislav Gális,&nbsp;František Sándor","doi":"10.48095/ccachp2021145","DOIUrl":"https://doi.org/10.48095/ccachp2021145","url":null,"abstract":"<p><strong>Background: </strong>Surgical navigation with three-dimensional (3D) printing techniques presents two major advantages: First, from a technical aspect, it facilitates orientation in target anatomical structures resulting in improvement of the accuracy of surgery. Moreover, it shortens the time of complex surgical interventions by preparing the exact position of customized autologous grafts with fixation devices. Second, from a clinical point of view, it also lessens the impact of surgical stress to adjacent tissues by decreasing the duration of surgery.</p><p><strong>Material and methods: </strong>Two maxillofacial procedures were evaluated in this study using 3D navigation and planning approach - resection of the styloid process due to Eagles syndrome and microvascular mandibular reconstruction with the fibula free flap. All patients who underwent these procedures were divided into two groups (with or without 3D navigation).</p><p><strong>Results: </strong>In the Eagles syndrome group procedure independent t-test showed  significant difference in the operating time between group 1 (M = 148; SD = 0) and group 2 (M = 78; SD = 4.24) t (1) = 13.472; P = 0.047. There was no significant difference in the duration of postoperative hospitalization (2 days), which was equal in all patient groups. Regarding the fibula free flap procedure, the independent t-test revealed significant difference in operating time with (M = 8: 40 : 25; SD = 0 : 58 : 07) and without 3D printing guides (M = 10 : 43 : 15; SD = 3 : 04 : 32) t (14)=2.133, P = 0.051. Similarly, there was no significant difference between groups (group 1 M = 15.5; SD = 0,71; group 2 M = 13; SD = 1,63) in the duration of postoperative hospitalization time t (4) =1,98; P = 0.119.</p><p><strong>Conclusion: </strong>In summary, reduction in operation time in Eagles syndrome and in microvascular mandibular reconstruction with the fibula free flap group mitigates the surgical stress on target tissues enabling faster tissue healing and quicker recovery.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 3","pages":"145-149"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651949","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":"Fourniers gangrene secondary to males circumcision - a case report and review of the literature.","authors":"Massimiliano Tripoli,&nbsp;Emanuele Cammarata,&nbsp;Cordova","doi":"10.48095/ccachp202196","DOIUrl":"https://doi.org/10.48095/ccachp202196","url":null,"abstract":"<p><strong>Background: </strong>Fournier&#39;s gangrene is necrotizing fasciitis of the genitalia, perineal and perianal region associated with a significant mortality rate. The potentially fatal disease is caused both by aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier&#39;s gangrene cases is idiopathic or derived from perineal and genital skin infections. Early surgical debridement of necrotic tissues and antibiotics are fundamental.</p><p><strong>Case: </strong>We report a rare case of Fourniers gangrene of a 57-year-old man secondary to circumcision. The patient presented due to painful swelling of the scrotum and perineum associated with high-grade fever. The patient received broad-spectrum antibiotics and underwent immediate surgical debridement; a total of five other debridements were performed during the recovery until the wounds healed. On a second recovery phase, we performed a penile reconstruction with full thickness skin graft with satisfactory cosmetic and functional results.</p><p><strong>Conclusion: </strong>FG remains an urgent condition associated with a high mortality rate, requiring immediate treatment. More statistical reports and standard guidelines are necessary to improve the rate of its survival.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 3","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651943","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":"Reconstructive and esthetic breast surgery after solid organ transplantation - a systematic review, proposal of a novel protocol and case presentations.","authors":"Robertino B. Basso,&nbsp;Maria Eugenia Salto,&nbsp;Horacio F. Mayer","doi":"10.48095/ccachp2021102","DOIUrl":"https://doi.org/10.48095/ccachp2021102","url":null,"abstract":"<p><strong>Introduction: </strong>Great advancements in solid organ transplantation (SOT) have allowed patients to have better chances to survive longer and enjoy a quality life after surgery. This increasing number of SOTs and improved long-term survival rates lead to an increasing demand for plastic, esthetic and reconstructive breast procedures.</p><p><strong>Material and methods: </strong>A literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and using searching terms related to esthetic and reconstructive breast surgery was conducted across three databases: PubMed, Scopus and Google Scholar. Included articles were analyzed to extract data points of interest including patient age, type of surgery, organ transplanted, underlying conditions associated with organ transplantation, follow-up, immunosuppressive drugs and their side effects, perioperative management and complications related to the breast plastic procedures in SOT recipients.</p><p><strong>Results: </strong>A total of 1,298 articles were retrieved from the mentioned electronic databases. Eight full articles were finally included in this systematic review. In these articles, a total of 41 cases of breast plastic surgery after solid organ transplantation were reported. Procedures were esthetic in nature in 26.83% of cases (11 of 41 cases) and reconstructive in 73.17% of them (30 of 41 cases). No deaths were reported.</p><p><strong>Conclusions: </strong>Although esthetic and reconstructive breast surgery could be performed safely in SOT recipients, the dosage of immunosuppression and patient&#39;s overall health status with regard to the length and extent of the planned procedure should always be taken into account. From the literature data analysis, it is not possible to draw a statistical conclusion that the complication rate of surgery in immunosuppressed post-transplant patients is the same as in normal, not immunosuppressed population. Further and more valid clinical studies are warranted.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 3","pages":"102-112"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651944","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":"Pyoderma gangrenosum: a rare complication of reduction mammaplasty - a case report.","authors":"Michaela Široká,&nbsp;Kateřina Kiss,&nbsp;Aleš Fibír","doi":"10.48095/ccachp202169","DOIUrl":"https://doi.org/10.48095/ccachp202169","url":null,"abstract":"<p><strong>Background: </strong>Pyoderma gangrenosum (PG) is a rare non-infectious inflammatory disease of unknown etiology that affects the skin and mucous membranes. The occurrence of pyoderma gangrenosum after a reduction mammoplasty is a very rare complication, which at first glance may seem like an infectious complication; in reality, however, it is an inflammatory disease.</p><p><strong>Case: </strong>This case report describes a rare postoperative complication - pyoderma gangrenosum and its appropriate treatment in our patient who underwent reduction mammoplasty.</p><p><strong>Conclusion: </strong>Early detection of this complication is essential for the patients recovery because the primary surgical treatment can lead to worsening of the condition and is therefore contraindicated in such a case. Pyoderma gangrenosum must be treated conservatively with corticosteroids.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 2","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320605","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":"Platelet-rich plasma improves esthetic postoperative outcomes of maxillofacial surgical procedures.","authors":"Yuliya Menchisheva,&nbsp;Ulmeken Mirzakulova,&nbsp;Dildora Usupova,&nbsp;Gulzhan Yermukhanova,&nbsp;Zhanagul Rysbayeva","doi":"10.48095/ccachp2021118","DOIUrl":"https://doi.org/10.48095/ccachp2021118","url":null,"abstract":"<p><strong>Background: </strong>Postoperative facial scars after plastic and reconstructive surgery are visible results that can seriously affect the quality of life of recovering patients. Currently, platelet-rich plasma (PRP) is widely used in medicine to improve tissue regeneration.</p><p><strong>Purpose: </strong>To analyze the esthetic outcomes of using PRP in the late postoperative period of maxillofacial surgical interventions.</p><p><strong>Material and methods: </strong>A total of 100 patients aged 18-60 years who were undergoing plastic and reconstructive surgery in the maxillofacial region were included in this study. The patients were randomly divided in two groups. Fifty patients in the treatment group received PRP injections at the time of surgery. Patients in the control group did not receive any injections. PRP was injected intradermally after suturing the wound. Evaluation of treatment outcomes was carried out by planimetry, the Image J programme during 1 month after surgery and by the Patient and Observer Scar Assessment Scale 30 and 90 days after the surgical procedure. The Dermatological Quality of Life Index was used to assess the negative impact of treatment outcomes on various aspects of the patients life.</p><p><strong>Results: </strong>The change of scar width was twice less pronounced in the treatment group. The patients in the treatment group were more satisfied with the results of the treatment and had a higher quality of life. The treatment group exhibited less scaring at all time points than the control group 3 months after surgery.</p><p><strong>Conclusions: </strong>The use of PRP had a pronounced beneficial therapeutic effect in influencing the esthetic outcomes of surgical interventions.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 3","pages":"118-126"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651946","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":"Negative pressure therapy in the orofacial region in oncological patients - two case reports.","authors":"Júlia Belobradová,&nbsp;Oldřich Res,&nbsp;Jiří Stránský,&nbsp;Zuzana Čermáková,&nbsp;Tomáš Blažek,&nbsp;Pavel Hurník,&nbsp;Jan Štembírek","doi":"10.48095/ccachp202173","DOIUrl":"https://doi.org/10.48095/ccachp202173","url":null,"abstract":"<p><strong>Background: </strong>Chronic wounds and their problematic healing is a widely discussed topic in all branches of medicine. In recent years, vacuum therapy appears to be a very successful non-invasive method supporting the healing of these wounds. The aim of this paper is to demonstrate the possibility of utilizing a vacuum system in the orofacial area where other conservative and surgical procedures have failed.</p><p><strong>Cases: </strong>The case reports demonstrate the use of vacuum therapy in non-healing postoperative wounds in cancer patients.</p><p><strong>Conclusion: </strong>Vacuum therapy has limited use in the orofacial area, but based on our experience, we can conclude that it has a very positive effect on the healing of chronic wounds. Thanks to this treatment, it was possible to reduce the frequency of dressings and significantly shorten the length of hospital stay. Despite these advantages, however, it is necessary to adhere to the conditions for the application of vacuum treatment.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 2","pages":"73-77"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320606","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 Extensive Chest Wall Defects Using Light-Weight Condensed Polytetrafl uoroethylene Mesh - Case Reports.","authors":"Šín P,&nbsp;Hokynková A,&nbsp;Peňázová P,&nbsp;Horváth T,&nbsp;Rotschein P,&nbsp;Holoubek J","doi":"10.48095/ccachp202130","DOIUrl":"https://doi.org/10.48095/ccachp202130","url":null,"abstract":"<p><p>Tumors of the chest wall require extensive surgical intervention, which includes radical resection of the tumor mass followed by reconstruction of the defect. The depth of the defects may vary from a shallow one to a deep defect with exposure of the internal organs. In reconstruction of the chest wall, it is important to ensure the stability of the chest. Advanced synthetic biomaterials in combination with flap surgery are nowadays used as a treatment method of choice. The main advantage of biomaterials is easy manipulation, good fixation and a porous membrane. They are generally well tolerated by the patient. Flap surgery including regional flaps, pedicled flaps and free flap transfer are used for final closure of a deep defect. Shallow defects may be covered by autologous split-thickness skin graft transplantation. We present a series of case reports where we used light-weight condensed polytetrafluoroethylene (cPTFE) Omyra® Mesh TX B. Braun in combination with flap surgery for reconstruction of the chest wall. Different flaps for closure of the defects were used. In all cases the reconstruction of the chest wall was sufficient. One of the keys to success is a good cooperation between the oncosurgeon and the plastic surgeon.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 1","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39018162","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":"Presence of circulating tumor cells in a patient with multiple invasive basal cell carcinoma - a case report.","authors":"Kateřina Kiss,&nbsp;Imrich Kiss,&nbsp;Katarína Kološtová,&nbsp;Eliška Pospíšilová,&nbsp;Michaela Široká,&nbsp;Aleš Fibír","doi":"10.48095/ccachp202164","DOIUrl":"https://doi.org/10.48095/ccachp202164","url":null,"abstract":"<p><strong>Background: </strong>Basal cell carcinoma (BCC) is the most frequent skin cancer worldwide, however, its metastatic spreading is extremely rare.</p><p><strong>Case: </strong>We present a case of advanced BCC with rapid growth of new tumor lesions in a patient who was later diagnosed with Gorlin syndrome. Due to the advanced disease stage, the patient was examined for circulating tumor cells (CTCs), which are used as a prognostic marker in some metastatic malignancies. To date, no studies have been found that could assess the BCC tumor and the presence of CTCs in peripheral blood. CTCs were obtained after each surgical excision and during systemic oncological therapy from the peripheral venous blood by size-based isolation method (Metacell®) and cultured in vitro for 7 days. CTCs were enriched by size-based separation and examined using vital fluorescence microscopy. Cytomorphological comparison of CTCs with cells from the tumor lesions was provided. In the course of the treatment, the CTCs count in the blood decreased after surgical removal of the tumorous mass, but finally, the sustained and persisting decrease in CTCs was achieved with a hedgehog pathway inhibitor treatment.</p><p><strong>Conclusion: </strong>The detection of CTCs points a systematic disease behavior in this case.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 2","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320604","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":"Moriarty's sign - predictor of skin graft take.","authors":"P V Veena,&nbsp;S Shanthakumar,&nbsp;M Kumaraswamy,&nbsp;O Udayashankar","doi":"10.48095/ccachp2021166","DOIUrl":"https://doi.org/10.48095/ccachp2021166","url":null,"abstract":"<p><strong>Background: </strong>Resurfacing wound beds with split skin graft is the most common procedure in plastic surgery. Association of more pain in the donor site than in the recipient site has been used as a predictor of successful graft take by Stark in 1962 who termed it Moriartys sign.</p><p><strong>Purpose: </strong>The aim of the study was: 1) to predict the successful take of skin graft by eliciting Moriartys sign; 2) to decide the day of first graft inspection based on Moriartys sign.</p><p><strong>Methods: </strong>The authors hereby present a prospective study in 100 patients who underwent wound resurfacing with split thickness skin graft at the Department of Plastic Surgery in a tertiary care center between January 2014 and June 2015. The area with more pain, absence of pain or equivocal response at the graft donor site was recorded on the visual analog scale for 10 days.</p><p><strong>Results: </strong>In this study, 80 patients had positive Moriartys sign, 12 patients had equivocal responses and 8 patients showed a negative sign. Patients with positive Moriartys sign underwent their first graft inspection on 10th postoperative day and showed 100% graft take. Twelve patients with equivocal response underwent first graft inspection on 5th day and had 70-80% graft take.  In 8 patients, with negative Moriartys sign first graft inspection done on 3rd day, the graft take was &lt; 50%.</p><p><strong>Conclusion: </strong>The study demonstrates that Moriartys sign is a reliable clinical predictor of split thickness skin graft take and may be useful as a guide to determine the day of first graft inspection. It is an effective method even for junior members of the surgical and nursing team to monitor parameters in relation to this sign. It can be practiced in a smaller group of hospitals, too. Hence, the authors recommend to integrate this clinical assessment in routine practice.</p>","PeriodicalId":7098,"journal":{"name":"Acta chirurgiae plasticae","volume":"63 4","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39831716","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}