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European Journal of Plastic Surgery

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https://www.readbyqxmd.com/read/30100678/managing-complex-trauma-injuries-in-the-elderly-a-case-report-of-a-free-flap-and-circular-frame-in-a-95-year-old-patient-with-an-open-iiib-tibial-fracture
#1
Charlotte Hammonds, Philippa C Jackson, Patrick Foster, Jonathan D Wiper
In an ageing population, increasing numbers of patients over the age of 70 are sustaining severe trauma. These patients require careful multidisciplinary team (MDT) management with careful consideration of existing co-morbidities, as such their treatment should be individually tailored. We present the case of a patient believed to be the oldest documented patient treated in a trauma setting with free flap and circular frame fixation to an open tibial fracture. A 95-year-old male presented to the Level 1 Major Trauma Centre (MTC) with multiple injuries after a pedestrian vs car incident...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/30100677/an-enhanced-fresh-cadaveric-model-for-reconstructive-microsurgery-training
#2
Tarak Agrebi Moumni Chouari, Karen Lindsay, Ellen Bradshaw, Simon Parson, Lucy Watson, Jamil Ahmed, Alain Curnier
Background: Performing microsurgery requires a breadth and depth of experience that has arguably been reduced as result of diminishing operating exposure. Fresh frozen cadavers provide similar tissue handling to real-time operating; however, the bloodless condition restricts the realism of the simulation. We describe a model to enhance flap surgery simulation, in conjunction with qualitative assessment. Methods: The fresh frozen cadaveric limbs used in this study were acquired by the University...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/30100676/is-single-stage-implant-based-breast-reconstruction-ssbr-with-an-acellular-matrix-safe-strattice%C3%A2-or-meso-biomatrix%C3%A2-in-ssbr
#3
Nadine S Hillberg, Patrick I Ferdinandus, Rieky E G Dikmans, Bjorn Winkens, Juliette Hommes, René R W J van der Hulst
Background: Acellular matrices (AM) might enable a direct single-stage breast reconstruction procedure resulting in an improved efficacy of the reconstruction phase for patients. Safety concerns are an important issue due to a recent study which shows that single-stage breast reconstruction with Strattice™ resulted in more complications versus a two-stage reconstruction. Therefore, the goal of this study is to compare the short- and long-term complications of a single-stage breast reconstruction with the use of two types of AM (Strattice™ and Meso Biomatrix®) versus two-stage breast reconstruction without the use of an AM...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/30100675/towards-standardization-of-training-and-practice-of-reconstructive-microsurgery-an-evidence-based-recommendation-for-anastomosis-thrombosis-prophylaxis
#4
REVIEW
Marie C Kearns, Jill Baker, Simon Myers, Ali Ghanem
Background: Despite significant improvements in survival rates, free flap failures still occur even in experienced hands and are most commonly due to arterial or venous thrombosis. In the absence of an evidence-based guideline on the prevention of thrombosis, we reviewed the literature to assess the evidence base for commonly used interventions aimed at its prevention. Methods: A comprehensive literature search was performed using the following keywords "free flap" and microsurgery with "pre-operative screening," "prevention of thrombosis," "ketorolac," "heparin," "low molecular weight heparin," "aspirin," "dextran," and "statins...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29780209/near-infrared-fluorescence-image-guidance-in-plastic-surgery-a-systematic-review
#5
REVIEW
Anouk J M Cornelissen, Tom J M van Mulken, Caitlin Graupner, Shan S Qiu, Xavier H A Keuter, René R W J van der Hulst, Rutger M Schols
Background: Near-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700-900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29606803/the-double-pedicled-dorsal-metacarpal-artery-dpdmca-flap-of-the-hand-a-novel-dmca-derived-flap
#6
Till Wagner, Oliver Kloeters, Dietmar Ulrich
The dorsal-metacarpal-artery (DMCA) flap in its standard or extended version is considered as the working horse to cover dorsal soft tissue finger defects with exposed extensor tendon or bone. We hereby present a clinical case of an 80-year-old male patient who is right-handed and sustained a soft tissue defect of the proximal dorsal aspect of his left 5th finger and the postoperative outcome employing a modified transposition flap. The double-pedicled DMCA flap (dpDMCA flap) of the hand poses in adequate clinical scenarios a comparably fast and safe solution to cover dorsal finger defects extending just distal to the PIP joint...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29606802/development-and-validation-of-a-new-assessment-tool-for-suturing-skills-in-medical-students
#7
Henriette Pisani Sundhagen, Stian Kreken Almeland, Emma Hansson
Background: In recent years, emphasis has been put on that medical student should demonstrate pre-practice/pre-registration core procedural skills to ensure patient safety. Nonetheless, the formal teaching and training of basic suturing skills to medical students have received relatively little attention and there is no standard for what should be tested and how. The aim of this study was to develop and validate, using scientific methods, a tool for assessment of medical students' suturing skills, measuring both micro- and macrosurgical qualities...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29606801/subcutaneous-lipomas-a-minimally-invasive-method-for-resection-of-subcutaneous-lipomas-preserving-retaining-ligaments
#8
Akio Sakamoto, Takeshi Okamoto, Shuichi Matsuda
Background: Lipomas are common benign tumors usually located in the subcutaneous tissues. Resection of lipomas frequently requires incisions equal to the diameter of the tumor. The "squeeze technique" with a small incision is well-described, but is frequently not successful, particularly for lipomas in the shoulder region. We report a method for resection of subcutaneous lipomas that preserves retaining ligaments. Methods: Lipomas are characterized by high signal intensity on T1- and T2-weighted images on magnetic resonance imaging...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29398785/a-new-treatment-of-hypertrophic-and-keloid-scars-with-combined-triamcinolone-and-verapamil-a-retrospective-study
#9
S B Kant, E van den Kerckhove, C Colla, S Tuinder, R R W J van der Hulst, A A Piatkowski de Grzymala
Background: Since the management of keloid and hypertrophic scars still remains a difficult clinical problem, there is need for adequate, effective therapy. In this study, we explored for the first time the efficacy and the potential synergetic effect of combined triamcinolone and verapamil for the treatment of hypertrophic and keloid scars. The objective was to assess the efficacy of combined intralesional triamcinolone and verapamil therapy for hypertrophic and keloid scars. Methods: Fifty-eight patients with hypertrophic scars ( n  = 31) and keloid scars ( n  = 27) were included...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29398784/reconstruction-of-acquired-ischiatic-and-perineal-defects-an-anatomical-and-clinical-comparison-between-gluteal-thigh-and-inferior-gluteal-perforator-flaps
#10
Eduardo Montag, Thiago Ueda, Alberto Okada, Bruno Onishi, Rolf Gemperli
Background: Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29062167/characterization-of-the-foreign-body-response-to-common-surgical-biomaterials-in-a-murine-model
#11
Mohamed Ibrahim, Jennifer Bond, Manuel A Medina, Lei Chen, Carlos Quiles, George Kokosis, Latif Bashirov, Bruce Klitzman, Howard Levinson
BACKGROUND: Implanted biomaterials are subject to a significant reaction from the host, known as the foreign body response (FBR). We quantified the FBR to five materials following subcutaneous implantation in mice. MATERIALS AND METHODS: Polyvinyl alcohol (PVA) and silicone sheets are considered highly biocompatible biomaterials and were cut into 8mm-diameter disks. Expanded PTFE (ePTFE)and polypropylene are also widely used biocompatible biomaterials and were cut into 2cm-long cylinders...
November 2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28989239/scarring-of-the-c8-t1-roots-with-partial-avulsion-in-situ-in-total-obstetric-brachial-plexus-palsy
#12
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach. METHODS: A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots)...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28989238/hand-rejuvenation-with-fat-grafting-a-12-year-single-surgeon-experience
#13
Fabio Fantozzi
BACKGROUND: Fat grafting has been successfully used for reconstructive and esthetic surgery of the breast, face, and other body parts. In this article, we present our protocol for hand fat grafting and over a decade of clinical experience. METHODS: Fat tissue is obtained from the flanks, peri-umbilical region, or internal side of the thigh or knee. No centrifuge machine is used to prevent fat damage. After decantation, fat is injected into the dorsum of the hand using a cannula from the wrist and not from the fingers...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28989237/lipofilling-effects-after-breast-cancer-surgery-in-post-radiation-patients-an-analysis-of-results-and-algorithm-proposal
#14
Manuel Debald, Thomas Pech, Christina Kaiser, Mignon-Denise Keyver-Paik, Gisela Walgenbach-Bruenagel, Joerg C Kalff, Walther Kuhn, Klaus J Walgenbach
BACKGROUND: Lipofilling or autologous fat transfer is an established technique in plastic surgery. Herein, we describe the lipofilling effects after implant-based breast reconstruction in post-radiation patients and propose an algorithm for indication of lipofilling. METHODS: Forty patients with a history of breast cancer were included in this retrospective analysis. Patients had undergone either breast conserving therapy or mastectomy. Twenty-six patients underwent additional radiation therapy...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28989236/alar-cartilage-an-alternative-for-spreader-graft-in-primary-rhinoplasty
#15
Carlos Oscar Uebel, Renato Matta
BACKGROUND: Alar cartilage can be very useful for tip and dorsum grafts. Depending on its size and thickness, it can be an important alternative for spreader grafts to improve endonasal functional deficiencies, correct deviated noses, and prevent inverted "V" deformities. Caucasian patients with bulbous tips are the most common candidates to achieve such benefits. It is easy to obtain and to frame into a desired graft. METHODS: The authors describe a surgical technique using the alar cartilages as spreader grafts...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28989235/a-new-treatment-for-reliable-functional-and-esthetic-outcome-after-local-facial-flap-reconstruction-a-transparent-polycarbonate-facial-mask-with-silicone-sheeting
#16
Sander B Kant, Patrick I Ferdinandus, Eric Van den Kerckhove, Carlo Colla, René R W J Van der Hulst, Andrzej A Piatkowski de Grzymala, Stefania M H Tuinder
BACKGROUND: Facial flap surgery predominantly leads to good functional results. However, in some cases, it can cause unsatisfactory esthetic results. They include persistent erythema, pincushioning, and development of hypertrophic scars. Conservative, reliable treatment for facial flaps is lacking. Pressure and silicone therapy have proven to result in significant improvement in scar erythema, pliability, and thickness in postburn hypertrophic scars. By combining these therapies in a facial mask, the esthetic outcome of facial flaps could be improved...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28798538/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-two-roots-are-available-for-intraplexus-neurotization
#17
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: The outcome of primary brachial plexus reconstruction in extended Erb's obstetric palsy with single root avulsion has not been specifically documented in the literature. METHODS: A series of 46 consecutive cases of extended Erb's obstetric palsy with single root avulsion was retrospectively reviewed. The upper and middle trunks were reconstructed with nerve grafts from the available two roots. No nerve transfers were used. The percentage of a satisfactory motor recovery was documented...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28798537/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-only-one-root-is-available-for-intraplexus-neurotization
#18
Mohammad M Al-Qattan, Amel Ahmed F El-Sayed
BACKGROUND: A recent review by the International Federation of Societies for Surgery of the Hand showed no studies comparing the results of nerve grafting to distal nerve transfer for primary reconstruction of the brachial plexus in infants with obstetric brachial plexus palsy (OBBP). The aim of this retrospective study is to compare two surgical reconstructive strategies in primary reconstruction of the brachial plexus in extended Erb's obstetric palsy with double root avulsion: one with and one without distal nerve transfer for elbow flexion...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28615800/question-mark-ear-deformity-revisited
#19
Mohammad M Al-Qattan, Noha M Al-Qattan
We report on two unusual cases of Cosman (question mark) ear; both required modifications of the standard techniques for surgical correction. The first patient presented with a unilateral question mark ear and concurrent ear prominence and bulging of the cartilage of the anti-helix. Simultaneous correction was done using a combination of cartilage suturing/scoring (for the prominence and the cartilage bulge) as well as Al-Qattan's "v-y skin flap-cartilage graft-z-plasty" technique (for the correction of the ear cleft deformity)...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28603387/an-unusual-pre-ligamentous-thenar-motor-branch-of-the-median-nerve
#20
Mohammad M Al-Qattan, Khalid Al-Zahrani
The pre-ligamentous variant of the thenar motor branch (TMB) of the median nerve is extremely rare. In all previously reported cases, the branch arose from the radial or antero-radial aspect of the median nerve in the distal forearm and then pierced the antebrachial fascia to reach the thenar muscles. We report on a case in which the pre-ligamentous TMB not only arose from the ulnar side of the median nerve but it also remained deep to both the antebrachial fascia and the transverse carpal ligament until it reached the thenar muscles...
2017: European Journal of Plastic Surgery
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