1,721,030 research outputs found
Use of the Spare-Part Strategy to Reconstruct the External Auditory Canal After Subtotal Auriculectomy for Basal Cell Carcinoma
Full text linkAfter removal of an infiltrative BCC of the
auditory meatus, a soft tissue defect of the temporal-mastoid area with bone exposure, needed reconstruction. Several options have been taken into account and a simple yet
effective solution has been found following the spare-parts
principle. The ear lobe, preserved during cancer removal,
was split and used as a thin skin flap. Adequate coverage of
the bone exposure and resurfacing of the external auditory
canal was obtained with minimal donor site morbidity and
a short surgery in a fragile patient with several comorbidities. The spare-parts strategy can provide successful
solution to difficult reconstructive cases regardless of the
anatomical area
Defining the Inframammary Fold by Liposuction: An Essential Tool in Aesthetic Shaping of the Reconstructed Breast. Technique and Long-term Results in a Series of Patients
Full text linkAbstract
Background A good inframammary fold (IMF) definition
and position is essential to achieve a satisfactory and natural
result in breast surgery. This structure can be damaged,
especially during mastectomies. Multiple methods are
reported in the literature to restore IMF or improve its
definition. In this study, we present the results achieved in a
series of patients treated with subdermal liposuction.
Methods We report on all our patients who underwent IMF
liposuction between January 2016 and June 2020. Subdermal
liposuction was performed with a blunt 3 mm
cannula along the new IMF to promote skin retraction and
adherence between skin and fascia. Results were evaluated
subjectively by the patients and objectively by 8 individuals
not involved with the treatment.
Results We performed IMF liposuction in 88 breasts (69
patients), aged 21–74 (mean 52) years for 82 implant-based
reconstructions, 2 tuberous breasts, and 4 contralateral
breast augmentations. Mean follow-up was 28 months
(6–64). Subjective results: the overall result evaluated with
the VAS scale reached 86.6/100. All the 22 patients
interviewed judged as well defined the new inframammary
fold. Objective results: in 83% of cases the definition of the
inframammary fold was judged as good or excellent, while
symmetry with contralateral IMF, natural appearance, and
overall aesthetic outcome were judged as good.
Conclusion Based on our long-term satisfactory results,
we recommend the technique of subdermal liposuction to
improve the definition of IMF in breast reconstruction after
mastectomy and other breast procedures. It is effective,
easy to perform, minimally invasive, and durable
Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence
No full textBackground. Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension. Methods and Results. We describe a case of a 56-year-old man with stomal recurrence after total laryngectomy treated by the use of a tubed anterolateral thigh (ALT) flap to elongate the shortened trachea and simultaneously cover the cervical skin defect. Conclusions. The ALT can be accepted as an ideal free-flap choice for stomal recurrence, because it has maximal reconstructive capacity and produces minimal donor-site morbidity. © 2009 Wiley Periodicals, Inc
Gracilis muscle transposition for the treatment of recurrent rectovaginal and pouch-vaginal fistula: is Crohn's disease a risk factor for failure? A prospective cohort study
No full textBACKGROUND:
The surgical management of rectovaginal fistulae associated with Crohn's disease is often frustrated by poor results regardless of the different techniques. The outcomes of the gracilis muscle transposition (GMT) for the treatment of recurrent Crohn's-associated fistulae are still debated. The aim of the study is to determine whether the success rate of GMT is similar in Crohn's disease patients and in a control group.
MATERIALS AND METHODS:
All patients undergoing GMT for rectovaginal or pouch-vaginal fistula were collected from a prospectively maintained database (2005-2016). The primary study outcome was the comparison of the success rate of GMT in Crohn's disease and control group patients.
RESULTS:
Twenty-one patients with a rectovaginal fistula due to Crohn's disease (8, 38.1%) or other etiologies (13, 61.9%) were included. The groups had similar characteristics and postoperative outcomes. After a median follow-up time of 81 and 57 months (p 0.34), the success rate of GMT was 75% in patients with Crohn's disease and 68.4% in control group (p 0.6). The median time to recurrence was 3.5 months (1-12). The success rate in patients who had more than two previous attempts of repair was lower regardless of the etiology (50 vs 79.4%, p 0.1).
CONCLUSION:
GMT is associated with a high success rate, especially in Crohn's disease-related rectovaginal fistula. In consideration of the low morbidity rate and the fact that an increasing number of previous local operations might be associated with failure, the procedure should be considered as a first line of treatment for recurrent rectovaginal fistulae
Aesthetical outcome after breast reconstruction using deep inferior epigastric perforator flap: Personal techniques
No full textBackground: Now-a-days, deep inferior epigastric perforator (DIEP) flap breast reconstruction is widespread throughout the world. The aesthetical result is very important in breast reconstruction and its improvement is mandatory for plastic surgeons. Materials and Methods: The most frequent problems, we have observed in breast reconstruction with DIEP flap are breast asymmetry in terms of volume and shape, the bulkiness of the inferior lateral quadrant of the new breast, the loss of volume of the upper pole and the lack of projection of the inferior pole. We proposed our personal techniques to improve the aesthetical result in DIEP flap breast reconstruction. Our experience consists of more than 220 DIEP flap breast reconstructions. Results: The methods mentioned for improving the aesthetics of the reconstructed breast reported good results in all cases. Conclusion: The aim of our work is to describe our personal techniques in order to correct the mentioned problems and improve the final aesthetical outcome in DIEP flap breast reconstruction
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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