1,721,024 research outputs found
New applications of the anterior intercostal artery perforator flap for prosthetic breast reconstruction in the setting of postoperative radiotherapy
Full text linkBackground:Several studies have reported preliminary experiences with the anterior intercostal artery perforator (AICAP) flap for treating partial breast defects or breast implant exposure following reconstruction. As radiotherapy is commonly administered for breast cancer, some patients may present with heavily damaged skin flaps and chronic radiodermatitis. We describe new applications of a de-epithelialized AICAP flap, used in combination with an implant, for breast reconstruction when other treatment options are unavailable.Methods:A retrospective study was conducted, including all patients who underwent implant-based breast reconstruction with the aid of an AICAP flap. A literature review was also performed.Results:Between November 2022 and August 2023, four pedicled AICAP flaps were harvested in four patients. The indications were breast implant coverage in cases of chronic dermatitis of the mastectomy skin flaps (two unilateral flaps) and inferolateral coverage of partially submuscular expanders for immediate breast reconstruction (two unilateral flaps). All four flaps were based on one perforator. The mean harvesting time was 40 minutes. Complete flap survival was achieved, with no complications at the donor site.Conclusions:The AICAP flap is a safe and reliable technique for difficult cases of breast reconstruction when no other options are available. Moreover, this technique can easily provide additional coverage for the breast implant when needed
Long-term result of bilateral pectoralis major muscle advancement flap in median sternotomy wound infections
No full textNational Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy: Two-Stage Implant-Based Breast Reconstruction
No full textWe read your article “National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy” and found the data on immediate breast reconstruction (IBR) that you pointed out really interesting. It is very newsworthy how IBR practice has developed since 2004 in both radiated and nonradiated patients. It is even more significant to note that since 2008, implants surpassed autologous reconstruction as the most common IBR method despite the possibility of postmastectomy radiotherapy (PMRT). The clinical practice at our unit follows the trend you havedescribed. However, we noticed that PMRT could cause some difficulties in heterologous IBR as biomaterial alterations or capsular contracture
Breast Animation Deformity: A Retrospective Study on Long-Term and Patient-Reported Breast-Q Outcomes
No full textBackground We evaluated the aesthetic outcomes and quality of life of patients who underwent neurotomy of the lateral and medial branch of the pectoralis nerve for animation deformity after breast reconstruction. Material and Methods Health-related quality of life questionnaire and cosmetic outcome evaluation were conducted using the preoperative and the postoperative BREAST-Q modules for reconstructive surgery. An external author also assessed the general aesthetic outcome before and after surgery. Results Sixty-two patients with animation deformity after breast reconstruction were enrolled: 43 in group 1 (second-stage breast reconstruction), 10 in group 2 (permanent breast prosthesis), and 9 in group 3 (Baker III-IV capsular contraction). Patients scored high level of satisfaction with outcome concerning all aspects of the survey. Overall satisfaction with breast was significantly increased after surgery in all the 3 groups, whereas physical well-being was improved in group 1 and group 3 and psychosocial well-being was improved in group 1. General outcome evaluation by an external author, compared with the preoperative condition, also showed significant improvement. Conclusions Section of the lateral and medial branches of the pectoralis nerve represents an easy and reproducible technique, associated with low morbidity and very good results in terms of patient satisfaction, comfort, and hospitalization
Is body-contouring surgery a right for massive weight loss patients? A survey through the European Union National Health Systems
No full textBackground: Obesity is pandemic nowadays, and hanging skin with consequent functional and psychological impairments is a common price to pay for massive weight loss. Plastic surgery in postbariatric patients represents a fundamental step to regain possession of a positive self-image. The authors aimed to investigate how EU countries’ National Health System (NHS) behaves regarding reimbursements for body-contouring procedures after massive weight loss. Methods: A 1-item survey was sent to contacts found on the NHS official Web sites of 27 EU countries. The question focused on postbariatric surgery practice and investigated the accessibility criteria for NHS coverage concerning body-contouring procedures after massive weight loss. Results: Responses were collected between January 2020 and February 2020. Response rate was 65%, and access criteria to NHS coverage for postbariatric surgery presented great variation across EU countries. Only one country presented an NHS with no coverage for postbariatric surgeries. Conclusions: Despite the conspicuous variability found among the EU NHS, none of them admit reimbursement in cases of merely aesthetic procedures: postbariatric patients need to display functional or health impairments due to the extensive weight loss. The results of the current study describe a complex situation among EU countries, but a common lead towards postbariatric patients’ care shows off. The ultimate goal of bariatric patient’s healing should be full restoration of physical and psychological well-being. NHS of EU countries are facing this increasing request in various ways, and more studies should be performed in order to understand which is the best approach. Level of evidence: Not ratable
Management of microanastomosis in patients affected by vessel diseases
Full text linkIn the last 10 years with the advances in microsurgery of techniques and materials the indications for free tissue transfer have considerably been increased. But, there are still some limitations and drawbacks. Among risk factors associated with flap failure, atherosclerosis can affect both the flap and the recipient vessels of free microvascular tissue transfers. The purpose of this paper is to discuss about the pathogenesis of Monckeberg's sclerosis, and the topics that must be taken into consideration when performing microsurgery in these patients
Fibroepithelioma of Pinkus: variant of basal cell carcinoma or trichoblastoma? Case report
No full textINTRODUCTION
Fibroepithelioma of Pinkus (FeP) is a rare tumor that most often affects women aged between 40 and 60 years. Clinically FeP presents as a soft, usually solitary, polypoid or papillomatous well circumscribed tumor of skin color. It is typically located to the trunk and extremities.
CASE REPORT:
A 75 year old male presented to our Department complaining for the presence of a lesion of the dorsal region. His medical history was free except for several basal cell carcinoma (BCC) surgically excised. Clinical examination revealed a pigmented lesion in the back. The lesion was surgically excised and histopathology showed of a fibroepithelioma of Pinkus.
DISCUSSION:
Currently, FeP is considered a rare variant of basal cell carcinoma, with characteristic histopathological features, although this view is somewhat controversial as some authors considered FeP to be a variant of trichoblastoma. The pathogenesis of FeP is still under investigation. It is thought that a mutation in the tumor suppressor gene TP53 might predispose to the development of FeP.
CONCLUSIONS:
Our case is interesting for two reasons. First, in our case FeP is pigmented. Moreover we present a case of Fep in a patient with a history of BCC, a finding that supports the classification of fibroepithelioma of Pinkus as a variant of basal cell carcinoma
Plastic surgery in the time of Coronavirus in Italy. Maybe we should say: “Thanks Darwin we are Plastic Surgeons!”
No full textWe read with great interest the article: Plastic Surgery in the time of Coronavirus in Italy. Can we really say “Thanks God we are plastic surgeons?”, by Elia et al.
Lately, Intensive Care Units, Infectious Disease, Pneumology and Hygiene services played the main role in facing the pandemic. Nowadays, in the middle of the virus backfire, some specialties look somehow doomed to step back from the race for worldwide population salvation and face a second break of the daily activities
A single-stage triple-inset vascularized gastroepiploic lymph node transfers for the surgical treatment of extremity lymphedema
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