Eplasty最新文献

{"title":"Nipple Areola Complex Reconstruction: An 8-Year Experience With Modified Technique and Systematic Review.","authors":"Michael Rice, Giulia Colavitti, Philippa Jackson, Sherif Wilson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nipple areola complex reconstruction is often the last procedure offered to patients undergoing breast reconstruction. Although comparatively minor, this final step creates the focal point of the breast while signifying the end of an often long and difficult journey for patient and surgeon. The literature demonstrates that nipple areolar complex (NAC) reconstruction conveys a positive impact on overall body image while defining the final aesthetic outcome. This paper presents a novel technique for NAC reconstruction developed at a UK tertiary referral center. It is supported by a systematic review of the current literature.</p><p><strong>Methods: </strong>Between 2014 and 2022, a new technique was used to reconstruct the NAC using a modification of the C-V flap with a full-thickness skin graft (FTSG) and later nipple tattoo, if required. Patients were followed up in clinic noting complications, satisfaction, and need for revision surgery. The study was completed by conducting a systematic review of the literature assessing areolar reconstruction with skin grafts, according to PRISMA guidelines.</p><p><strong>Discussion: </strong>This technique provides excellent results in terms of patient satisfaction and objective outcomes (complication rate, need for revision procedures, and loss of projection requiring further surgery). This literature review reflects alternative techniques and highlights the advantages of using a modified C-V flap with FTSG, in terms of morbidity and patient satisfaction.</p><p><strong>Conclusions: </strong>NAC reconstruction is the \"cherry on top\" at the end of the breast reconstructive journey. This paper advocates a technique that is reproducible, with minimal complications, excellent outcomes, and long-standing results.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e36"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pigtail-Assisted Distal Canalicular Repair in a Child: An Innovative Technique for Bicanalicular Intubation With Single Monocanalicular Stent.","authors":"Gautam Lokdarshi, Abdul Shameer Shamanzil","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Repair of medial canthus injury involving canaliculus is an emergency indication for canalicular intubation to restore lacrimal drainage. Herein, the author has described an innovative but simple technique for this reconstruction.</p><p><strong>Method and result: </strong>A small, blunt pigtail probe was gently passed through the opposite canaliculus in a rotational manner. A silicon stent was threaded inside canaliculi by reverse rotation of the pigtail in an atraumatic way. The technique was used on 4 pediatric cases without any postoperative complication or epiphora.</p><p><strong>Conclusions: </strong>This technique of intubation is simple, cheap, and useful in canalicular emergencies, including \"distal\" canaliculus lacerations.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e34"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closed Incision Negative Pressure Therapy Versus Standard of Care Over Closed Abdominal Incisions in the Reduction of Surgical Site Complications: A Systematic Review and Meta-Analysis of Comparative Studies.","authors":"Christopher Mantyh, Ronald Silverman, Ashley Collinsworth, Christine Bongards, Leah Griffin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Surgical site complications (SSCs) pose a significant risk to patients, potentially leading to severe consequences or even loss of life. While previous research has shown that closed incision negative pressure therapy (ciNPT) can reduce wound complications in various surgical fields, its effectiveness in abdominal incisions remains uncertain. To address this gap, a systematic review and meta-analysis were conducted to assess the impact of ciNPT on postsurgical outcomes and health care utilization in patients undergoing open abdominal surgeries.</p><p><strong>Methods: </strong>A systematic literature search using PubMed, EMBASE, and QUOSA was performed for publications written in English, comparing ciNPT with standard of care dressings for patients undergoing abdominal surgical procedures between January 2005 and August 2021. Characteristics of study participants, surgical procedures, dressings used, duration of treatment, postsurgical outcomes, and follow-up data were extracted. Meta-analyses were performed using random-effects models. Dichotomous outcomes were summarized using risk ratios and continuous outcomes were assessed using mean differences.</p><p><strong>Results: </strong>The literature search identified 22 studies for inclusion in the analysis. Significant reductions in relative risk (RR) of SSC (RR: 0.568, <i>P</i> = .003), surgical site infection (SSI) (RR: 0.512, <i>P</i> < .001), superficial SSI (RR: 0.373, <i>P</i> < .001), deep SSI (RR: 0.368, <i>P</i> =.033), and dehiscence (RR: 0.581, <i>P</i> = .042) were associated with ciNPT use. ciNPT use was also associated with a reduced risk of readmission and a 2.6-day reduction in hospital length of stay (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>These findings indicate that use of ciNPT in patients undergoing open abdominal procedures can help reduce SSCs and associated hospital length of stay as well as readmissions.A previous version of this abstract was presented at the 2023 Conference of the European Wound Management Association (EWMA) in Milan, Italy and posted online at the site listed below. EWMA permits abstracts to be republished with the complete manuscript. https://journals.cambridgemedia.com.au/application/files/9116/8920/7316/JWM_Abstracts_LR.pdf.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e33"},"PeriodicalIF":0.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Perspectives on the Use of Allograft Skin.","authors":"Stephen M Milner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA16"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin Grafting of the Dorsum of the Hand.","authors":"Stephen M Milner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA15"},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Hematoma After Feminizing Augmentation Mammoplasty Mimicking Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).","authors":"Kazuki Ueno, Yasuhiro Sakata, Mari Kawaji, Miwako Miyasaka, Shinichi Asamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report the case of an Asian transgender patient with late hematoma after feminizing mammoplasty. Bilateral silicone breast implants were inserted into the patient 25 years previously. The right breast gradually became swollen without any specific cause, along with erythema and pain. Positron emission tomography showed right axillary lymphadenopathy. The mass and the axillary lymph node were surgically removed. Pathologic examination of the excised specimen revealed only hematoma formation and inflammatory granulation. At follow-up at 6 months postoperatively there was no reformation of hematoma. The presented symptoms are similar to those of breast implant-associated anaplastic large cell lymphoma, so there can be difficulty in differentiating between these 2 complications. We compared the clinical characteristics between our case of late hematoma and reported breast implant-associated anaplastic large cell lymphoma after feminizing mammoplasty. Life-threatening breast implant-associated anaplastic large cell lymphoma should be ruled out from late hematoma according to the National Comprehensive Cancer Network screening guidelines.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postsurgical Pyoderma Gangrenosum After Penile Inversion Vaginoplasty: Case With Review of Diagnostic and Management Strategies.","authors":"Michael M Talanker, Jessica R Nye, David T Mitchell, Daniel J Freet","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Postsurgical pyoderma gangrenosum (PSPG) is a highly uncommon and unpredictable wound healing complication. Rapid progression of ulcers at incisions can cause unfettered dehiscence. Most commonly, PSPG involves breast procedures; however, in this work, we detail a case of a patient who developed PSPG 10 days postoperatively after penile inversion vaginoplasty.</p><p><strong>Methods: </strong>The patient in this case underwent a penile inversion vaginoplasty with orchiectomy in the standard fashion. She had no risk factors for PSPG. Following an uncomplicated hospital stay, the patient developed difficulty with pain control and increasing serous drainage on the 10th postoperative day. On readmission, the patient was found to have developed large, mildly purulent ulcers throughout the perineal wound edges. On exam under anesthesia, the neovaginal canal was found to be patent and intact. The dehisced portions of the incisions were left open and redressed with occlusive bismuth-petrolatum dressing. Dermatology was promptly consulted with suspicion for PSPG. The patient was started on an 18-day prednisone taper with cyclosporine, along with doxycycline and ciprofloxacin.</p><p><strong>Results: </strong>After 5 days of immunosuppressive treatment, the ulcers visibly converted to healthy granulation tissue and were no longer actively purulent. Following another washout, the dehisced wound edges were reapproximated. At follow-up, the patient had no evidence of PSPG recurrence and continued dilating on schedule. Our patient recovered from PSPG without further complications and a satisfactory aesthetic result.</p><p><strong>Conclusions: </strong>This unique case highlights the importance of prompt dermatological consultation, immunosuppression, and avoidance of further pathergy in the setting of suspicion for PSPG.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Difference in Abdominal Wall Muscle Strength, Endurance, and Motor Control Following Bilateral DIEP and TRAM Flaps for Breast Reconstruction?","authors":"Amra Olafson, Nicole K Le, Lokesh Coomar, Grace Jacobs, Paul Smith, Nazanin Khakpour, Ambuj Kumar, Douglas Haladay, Deniz Dayicioglu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Abdominal donor site complications in bilateral pedicled transverse rectus abdominis muscle (TRAM) have been a concern when compared with bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction. This study aimed to assess the strength, endurance, and motor control in patients undergoing DIEP and TRAM flaps.</p><p><strong>Methods: </strong>A prospective, cohort study was performed at a single institution including patients who underwent pedicled TRAM and DIEP flap reconstruction after mastectomy from August 2017 to August 2018. Patients underwent pre- and postoperative testing involving rectus abdominis, prone plank, side bridge, and trunk flexor tests. Descriptive analyses and multivariate linear regressions were performed.</p><p><strong>Results: </strong>The final analysis included a total of 9 patients, 4 of whom underwent TRAM flap reconstruction while 5 underwent DIEP flap reconstruction. The tests were not statistically significant between the TRAM versus DIEP groups, including rectus abdominis mean time decrease (0.25 vs 0.60 sec, <i>P</i> = .51), prone plank time increase (1.38 vs 1.38 sec, <i>P</i> = .51), right side bridge time increase (7.54 sec vs 32.15 sec, <i>P</i> = 1.00), left side bridge time increase (2.14 vs 44.5 sec, <i>P</i> = .37), and trunk flexor time decrease (4.68 vs 1.68 sec, <i>P</i> = .44). Overall complications were similar between the 2 groups.</p><p><strong>Conclusions: </strong>No significant difference in abdominal donor site morbidity was found when comparing the 2 groups. This article provides a point of conversation with patients when discussing available reconstruction options.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e30"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Lymphedema in Patients With Advanced Cancer Receiving Palliative Care: A Single-Center Experience.","authors":"Keisuke Shimbo, Haruka Kawamoto, Isao Koshima","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema can develop during the progression of neoplastic diseases and is a devastating complication in patients with cancer receiving palliative care. This study aimed to investigate the course of treatment for lymphedema in patients receiving palliative care to assess posttreatment outcomes.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study reviewed the maintained database of patients with lymphedema who presented to our department from January 2015 through December 2022. A combination of skin care, compression therapy, and lymphaticovenular anastomosis was used to treat lymphedema in patients with cancer receiving palliative care. The upper or lower extremity lymphedema indices, calculated based on 5 upper or 4 lower extremity circumferences and body mass index, were compared at the first and last visits.</p><p><strong>Results: </strong>Of the 202 patients with lymphedema, 38 patients with 45 affected limbs (upper extremities: 11 patients, 12 limbs; lower extremities: 27 patients, 33 limbs) were included in the analysis. There were no significant changes in edema based on the upper or lower extremity lymphedema indices in the upper (<i>P</i> = .931) or lower extremities (<i>P</i> = .767) between the first and last visits. No pain relief was observed after the treatment. In the treatment differences, the rate of change in edema was -3.6 ± 10.8% for the compression garment and +5.7 ± 11.5% for the lymphaticovenular anastomosis, showing no significant difference (<i>P</i> = .157).</p><p><strong>Conclusions: </strong>All treatments had limited therapeutic effects, such as reduced edema and pain relief, and there were no significant differences between them.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e29"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Cohort Analysis on the Use of Hydrolyzed Collagen Powder in Back Reconstruction Following Spinal Instrumentation.","authors":"Darren Sultan, Paige Goote, Connor Crowley, Victor Moon, Armen K Kasabian, Denis Knobel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nearly half a million interbody fusions are estimated to be performed in the US each year, many of which involve complex reconstruction. The ability to limit seroma formation is vital to a seamless postoperative recovery.</p><p><strong>Methods: </strong>A retrospective review was performed for patients undergoing fusion procedures along with flap reconstruction over a period of 20 months. Cohorts reflect a temporal practice shift where use of hydrolyzed collagen powder (HCP) was initiated for hypothesized seroma prevention. Outcomes and associated metrics were used for intergroup comparison.</p><p><strong>Results: </strong>The study included 76 patients, of whom 47 were treated with HCP and 29 were not. Control patients had significantly fewer postoperative seromas than experimental ones (6.9% vs 27.7%; <i>P</i> = .03). The cohorts had no significant differences in time until final drain removal or in number of spinal levels involved (7.8 vs 7.1 days; <i>P</i> = .33, 8.5 vs 8.4 levels; <i>P</i> = .90). Rates of wound dehiscence, hematoma, or infection did not differ significantly between control and experimental patients (3.4% vs 12.8%, <i>P</i> = .17; 0% vs 0%; and 6.9% vs 10.6%, <i>P</i> = .58, respectively).</p><p><strong>Conclusions: </strong>The use of HCP led to a 4-fold increase in postoperative seromas in patients undergoing spinal fusion with flap reconstruction. This was regardless of all analyzed demographic and procedural factors, with the exception of age, whereby control patients were found to be on average slightly younger than experimental counterparts.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}