1,721,032 research outputs found
The inguinal fold as a flaps bank: the inguinal fold island flap (IFI flap)
No full textThe aim of this article is to describe an island flap, harvested from the inguinal fold, which can be used for vulvar reconstruction: the inguinal fold island flap (IFI flap). IFI flap is indicated for reconstruction of defects of vaginal vestibule and labia minora and it could be raised bilaterally safeguarding regional symmetry and avoiding vaginal introitus or urethral distortion. This flap has been utilized to reconstruct defects after vulvar melanoma and squamous cell carcinoma resections and in one case to restore vaginal vestibule anatomy in a revision surgery in a transgender woman. IFI flap is an example of an "aesthetic/functional " reconstruction which could be proposed to younger patients too
First dorsal metacarpal arterialized venous (FDMAV) flap: intraoperative salvage of an ischemic FDMA flap by arteriovenous supercharging—a case report in thumb reconstruction
No full textSkin reconstruction because of deep wound on the dorsal thumb surface could be challenging. First dorsal metacarpal artery (FDMA) flap could provide excellent functional and cosmetic results. Although it is rare, intraoperative flap ischemia due to poor arterial inflow is possible. We describe an arteriovenous supercharging technique used to successfully revascularize a FDMA flap.Level of evidence: Level V, therapeutic study
Wound Healing: Physiology and Pathology
No full textThe chapter aims to present the mechanisms of the wound healing process. The phases of wound healing and the type and treatment of pathological scars are described in detail.
Factors influencing wound healing processes, both systemic and locoregional, are examined in order to better understand what can be helpful or harmful in this complex process and which results we can achieve by means of those factors. Alterations of the normal wound healing process can lead to the formation of pathological scars. If the scarring process is altered, connective tissues will respond in a wrong manner; if the connective tissues’ response is qualitative/quantitative in deficit, the result will be an atrophic scar; and if the response is excessive, there will be hypertrophic scars or keloids.
As well as the causes, the main techniques for treating hypertrophic, keloid, and atrophic scars are also described. Potential treatments of hypertrophic scars and keloids are represented by a first line comprehending topical medications or, when indicated, surgical treatment, a second line represented by the corticosteroid injections, and finally third-line treatments reserved for more complicated cases including radiotherapy and use of chemotherapeutic drugs.
Laser treatment has also been described for treating both atrophic and hypertrophic scars and keloids. Innovative liquid nitrogen use for scar flattening is additionally included in the chapter for its role in producing anoxia and necrosis of scar tissue. Pros and cons are also discussed in the association of any of the listed treatment options
Axial propeller flaps : a proposal for update of the 'Tokyo consensus on propeller flaps'
Full text linkLETTER TO EDITO
Soft tissue reconstruction of the trunk with pedicled perforator and musculocutaneous flaps: A single‐center comparative retrospective study
No full textBackground Soft tissue trunk reconstruction is often challenging. Although free microvascular flaps are a feasible option in case of extensive defects involving deep structures, pedicled flaps represent a good alternative, especially if harvested and dissected with a "microsurgical" approach. The aim of this study is to evaluate the feasibility of trunk reconstruction with the use of pedicled flaps, according to the application of our reconstructive algorithm, and to compare it to other reconstructive methods.Patients and Methods From January 2017 to December 2021, we retrospectively analyzed patients who underwent soft tissue reconstruction of the trunk with pedicled flaps at the authors' institution. Patient's demographic, clinical and surgical characteristics and postoperative complications were recorded and analyzed by descriptive statistics. A comparative analysis was made between the study group and two other groups who underwent reconstruction of trunk defects with free flaps and skin grafts, respectively, at the authors' institution.Results Forty-seven patients were included in the study. Patients' age ranged between 36 and 82 years (mean: 57.8 years). Twenty-eight patients were male, while 19 patients were female. In 76.6% of patients (36 out of 47), reconstructive procedures were performed to repair defects resulting from cancer resection. Reconstruction of superficial defects was always achieved with perforator flaps (n = 25). In case of full-thickness defects, reconstruction was carried out with musculocutaneous flaps (n = 22); latissimus dorsi and vastus lateralis were the most used flaps for chest and abdominal wall reconstruction, respectively. In our series, we observed only one case of total flap loss requiring re-operation under general anesthesia. Minor complications occurred in 8.5% of cases (4 out of 47 patients). We observed two cases of partial flap necrosis and two cases of wound dehiscence. In the skin grafts group (n = 53), the mean age was 54.5 years (range 39-85) and 56% of patients were male (n = 30). In 66% of cases (n = 30) the defect resulted from oncological resection. The overall complication rate was 18.8% (n = 10). In the free flaps group (n = 10), the mean age was 49.0 years (range 29-77) and 60% of patients (n = 6) were male. In 70% of cases (n = 7) the defect was caused by oncological resection. Complications occurred in two patients (20%). No statistically significant differences were found in terms of overall complication rate between the study group and the two comparative groups (p = .48). A significant correlation was found between the reconstructive method and the type and size of the defect, with reconstruction through free flaps being associated with larger (344.0 vs. 220.4 cm2) (p = .04) and full-thickness defects (80.0% vs. 46.8%) (p < .01) if compared to pedicled flaps.Conclusions In the new era of microsurgery, pedicled flaps represent a valid alternative to free flaps for the majority of soft tissue defects of the trunk. In our series, no statistically significant differences in terms of complications were found between reconstructions of similar defects achieved with pedicled and free flaps, and free flap use was limited to extensive full-thickness defects. In addition, the rate of postoperative complications with pedicled flaps found in our cohort was lower than the rate reported in the literature
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
HUMAN SPHEROIDS FROM ADIPOSE-DERIVED STEM CELLS (SASCS) ON IN-VIVO HIND-LIMB VASCULAR COMPOSITE ALLOTRANSPLANTATION: CAN THEY PREVENT REJECTION?
No full textThe application of 3d printing in plastic and reconstructive surgery: Case-control study in facial reconstruction
Full text linkThe aim of this study was to explore the efficiency and usefulness of tridimensional printing in plastic and reconstructive surgery for lesions of the maxillofacial region. This was comparison study between two groups of patients. Six patients underwent surgical reconstruction, using a threedimensional model built on the basis of CT scans (group 1); and six patients underwent surgical reconstruction, without the use of a three-dimensional model (group 2). The following variables were evaluated: age, gender, histological diagnosis, cancer location, size of bone lesion, type of reconstruction, complications and surgical timing. A statistically significant difference was found in microsurgical flap survival (p = 0.019), with a survival rate higher in group 1 than in the controls. This study provides preliminary evidence and partially confirms the validity of three-dimensional technology in plastic and reconstructive surgery. The results so far obtained, however, lead to hope for future uses of this ever-increasing technique
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
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