11 research outputs found
Thoracic outlet syndrome following breast implant rupture
No full textCase ReportWe present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.Raakhi Mistry, Yugesh Caplash, Pratyush Giri, Daniel Kearney, Marcus Wagstaf
A novel way to repair the earlobe after ear-gauging
No full textLetterBroughton J. Snell, Yugesh Caplas
Approaches to routine handling of basal cell carcinoma re-excision specimens: a survey of Australian histopathologists
No full textAimsTo investigate and assess variation in routine approaches to the handling of basal cell carcinoma (BCC) re-excision specimens by Australian histopathologists.MethodsA questionnaire was sent to 440 Australian histopathologists requesting details of their routine approach to the handling of BCC re-excision specimens. Responses were collated and compared to demonstrate any variation in approach.ResultsResponses received from 208 pathologists indicated that variation was present in most aspects of specimen handling, including cut-up, examination of the specimen and reporting.ConclusionsVariation demonstrated in the routine handling of BCC re-excision specimens may have important academic and clinical implications. It is important for pathologists to communicate their specimen handling approach to the surgeon. Further study should be conducted to specifically compare the various specimen handling approaches that were identified in this study. The development of evidence-based guidelines for the routine handling of BCC re-excision specimens may be appropriate.Leigh R. Warren, Richard Karoo, Yugesh Caplash and Sophia Ott
The medial sural artery as recipient vessel and the impact on the medial gastrocnemius
No full textMicrosurgical free tissue transfer is a valuable technique for the reconstruction of soft-tissue defects around the knee, and the medial sural artery (MSA) is an ideal recipient vessel for anastomosis. Previously, the vessel has been described as the dominant supply to the medial gastrocnemius, but no research has addressed the subsequent effect to the muscle after interruption of MSA. The volume of the postoperative medial gastrocnemius of 4 patients treated with free flap reconstruction using MSA as recipient, was assessed clinically and using magnetic resonance imaging, with muscle function assessed using a patient questionnaire, and measurement of ankle torque with concurrent electromyography. Magnetic resonance imaging volume assessment revealed the postoperative medial head of gastrocnemius proportional to its synergist of separate blood supply, the lateral gastrocnemius and functional assessment suggest little difference between limbs such that the MSA should be used with confidence as recipient vessel for free flap reconstruction of soft-tissue defects around the knee.Jesse D. Beumer, Richard Karoo, Yugesh Caplash, John G. Semmler and Jamie Taylo
A biodegradable polyurethane dermal matrix in reconstruction of free flap donor sites: a pilot study
No full textWe have developed a biodegradable temporizing matrix (BTM) capable of supporting secondary split-skin graft-take in animal studies. We report its first long-term implantation and use as a dermal scaffold in humans. This preliminary study assesses its ability to integrate, its ease of delamination, its ability to sustain split-skin graft in complex wounds, the degree of wound contraction, and ultimately the quality of the scar at 1 year postimplantation. Ten patients were recruited, each requiring elective free flap reconstruction. Free flap donor sites created were anterolateral thigh flaps, fibular osseocutaneous flaps, or radial/ulnar forearm (RF/UF) flaps. The BTM was implanted when the flap was detached from its donor site. Dressing changes were performed twice weekly. The time elapsed between implantation and delamination depended on the type of flap and thus the wound bed left. Once integrated, the BTMs were delaminated in theatre, and the surface of the "neodermis" was refreshed by dermabrasion, prior to application of a split-skin graft. The BTM integration occurred in all patients (100% in 6 patients, with 90%, 84%, 76%, and 60% integration in the remainder). Integrated BTM sustained successful graft-take in all patients. Complete take was marred in 2 patients, over areas of BTM that had not integrated and graft application was performed too early. The BTM can be applied into wounds in humans and can integrate, persist in the presence of infection, and sustain split-skin overgrafting, despite the trial group presenting with significant comorbidities.Marcus J.D. Wagstaff, Bradley J. Schmitt, Patrick Coghlan, James P. Finkemeyer, Yugesh Caplash and John E. Greenwoo
Metastatic squamous cell carcinoma of distal phalanx presenting incidentally from a presumed subungal haematoma: a unique case
No full textReconstructive Options for Composite Maxillary Defects With Orbital Exenteration—The Royal Adelaide Experience
No full text
The Lymphatic Response to Injury with Soft-Tissue Reconstruction in High-Energy Open Tibial Fractures of the Lower Extremity
No full textThoracic Outlet Syndrome Following Breast Implant Rupture
No full textSummary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient
