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GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW

Ahmed Hassan El-Sabbagh
Background: The forehead is a donor site for facial reconstruction but has no generous donor site for its coverage. All options of the reconstructive ladder can be used. A large rotation flap was used to reconstruct a big central forehead defect following failed previous repair in an elderly diabetic patient after a motor car accident. Case presentation: A 64-year-old diabetic man presented with an extensive central forehead defect after failed previous repair following a motor car accident. Coverage of the defect was performed using a flap based around the ear on one side in a rotation movement...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Reinhard E Friedrich, Kirsten Schmidt, András Treszl, Jan F Kersten
Introduction: Surgical procedures require informed patient consent, which is mandatory prior to any procedure. These requirements apply in particular to elective surgical procedures. The communication with the patient about the procedure has to be comprehensive and based on mutual understanding. Furthermore, the informed consent has to take into account whether a patient is of legal age. As a result of large-scale migration, there are eventually patients planned for medical procedures, whose chronological age can't be assessed reliably by physical inspection alone...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Jonas Kolbenschlag, Yannick Diehm, Adrien Daigeler, David Kampa, Sebastian Fischer, Nicolai Kapalschinski, Ole Goertz, Marcus Lehnhardt
Background: Microvascular tissue transfer has become a safe and reliable tool in the reconstructive armamentarium, yielding high success rates. However, little is known about the changes in coagulation after free tissue transfer and their potential impact on morbidity. Methods: Fibrinogen concentration and platelet count among other values were available and assessed in 139 undergoing free tissue transfer before, immediately after, and 1-3 as well as 8-11 days after surgery. In patients undergoing urgent revision for either bleeding or microvascular thrombosis, blood samples were drawn directly before re-exploration...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Andreas Sakkas, Konstantinidis Ioannis, Karsten Winter, Alexander Schramm, Frank Wilde
Background: The aim of this study was the evaluation of the clinical success and complication rates associated with autologous bone grafts harvested from the mandibular ramus for alveolar ridge augmentation and the identification of possible risk factors for graft failure. Methods: In a consecutive retrospective study 86 patients could be included. In these patients a total of 104 bone grafts from the mandibular ramus were harvested for alveolar ridge augmentation. Medical history, age of patient, smoking status, periodontal status and complications were recorded...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Serafim Tsitsilonis, David Machó, Sebastian Manegold, Björn Dirk Krapohl, Florian Wichlas
INTRODUCTION/BACKGROUND: The operative treatment of distal radius fractures has significantly increased after the introduction of locking plates. The aim of the present study was the evaluation of health-related quality of life, functional and radiological outcome of patients with distal radius fractures treated with the locking compression plate (LCP). MATERIALS AND METHODS: In the present study 128 patients (130 fractures) that were operatively treated with the LCP (2...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Christian Beltzer, Alexander Eisenächer, Steffen Badendieck, Dietrich Doll, Markus Küper, Stefan Lenz, Björn Dirk Krapohl
INTRODUCTION: The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. MATERIAL AND METHODS: Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Kristina Lenz, Michael Brandt, Sandra Fraund-Cremer, Jochen Cremer
The incidence of sternal wound infections (SWI) after coronary artery bypass surgery (CABG) as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Peter Melcher, Dirk Zajonz, Andreas Roth, Christoph-E Heyde, Mohamed Ghanem
BACKGROUND: The OSCE (objective structured clinical examination) is composed of oral and practical examination in order to examine students' abilities to imply clinical examination techniques and to interact with patients. The examiners for this procedure can be either lecturers or peers. The aim of this work is to evaluate the peer-assisted teaching student tutors as examiners in an orthopedic surgery OSCE station. METHODS: We analyzed the OSCE data from 2013 to 2015...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Reinhard E Friedrich, Liska Viezens, Ulrich Grzyska
PURPOSE: Zygomatic air cells (ZAC) are a variant of temporal bone pneumatization that needs no treatment. However, ZAC can have an impact on surgical procedures in the temporo-mandibular joint region. Recent reports suggest that computed tomography will disclose more ZAC than can be diagnosed on panoramic radiography. The aim of this study was to analyze ZAC prevalence on CT in a population that was not pre-selected by admission to a dental clinic. Furthermore, an extensive literature review was performed to assess the prevalence of ZAC and to address the impact of imaging technique on the definition of the item...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Eleni Naziri, Alexander Schramm, Frank Wilde
OBJECTIVES: The purpose of this study was to assess the accuracy of computer-assisted implant insertion based on computed tomography and template-guided implant placement. MATERIAL AND METHODS: A total of 246 implants were placed with the aid of 3D-based transfer templates in 181 consecutive partially edentulous patients. Five groups were formed on the basis of different implant systems, surgical protocols and guide sleeves. After virtual implant planning with the CoDiagnostiX Software, surgical guides were fabricated in a dental laboratory...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Ahmed Hassan El-Sabbagh
BACKGROUND: Upper third defects of the ear are too large to be closed primarily without distorting the auricle. Full thickness defects can be reconstructed with local flaps. In this article, Davis flap was used to fill the upper third defects of the ear with some modifications. PATIENTS AND METHODS: Eight patients underwent reconstruction of full thickness auricular defects with Davis flaps from July 2012 to December 2014. The posterior surface of the flap and the raw area of conchal area were covered by full thickness graft taken from posterior surface of ear...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Mohamed Ghanem, Almuth Glase, Dirk Zajonz, Andreas Roth, Christoph-E Heyde, Christoph Josten, Georg von Salis-Soglio
INTRODUCTION: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR) in multi-morbid patients...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Mohamed Ghanem, Dirk Zajonz, Juliane Bollmann, Vanessa Geissler, Torsten Prietzel, Michael Moche, Andreas Roth, Christoph-E Heyde, Christoph Josten
BACKGROUND: Infection after total knee replacement (TKR) is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Andreas Sakkas, Ioannis Konstantinidis, Karsten Winter, Alexander Schramm, Frank Wilde
BACKGROUND: Sinuslift is meanwhile an established method of bone augmentation in the posterior maxilla. Aim of the study was to evaluate the significance of intraoperative Schneiderian membrane perforations during maxillary sinus floor elevation surgery using autogenous bone harvested from two different donor sites using a Safescraper device on the success rate, graft survival and implant integration. METHODS: The investigators conducted a retrospective cohort study at the Department of Oral and Maxillofacial Surgery of Military Hospital Ulm composed of patients with severe maxillary atrophy who underwent sinus augmentation from January 2011 until December 2011...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Ahmed Hassan El-Sabbagh
BACKGROUND: Gynecomastia is a deformity of male chest. Treatment of gynecomastia varied from direct surgical excision to other techniques (mainly liposuction) to a combination of both. Skin excision is done according to the grade. In this study, experience of using liposuction adjuvant to surgical excision was described. PATIENTS AND METHODS: Between September 2012 and April 2015, a total of 14 patients were treated with liposuction and surgical excision through a periareolar incision...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Stefan Langer, Christian Beescho, Andrej Ring, Olivia Dorfmann, Hans Ulrich Steinau, Nick Spindler
INTRODUCTION: Diabetes mellitus describes a dysregulation of glucose metabolism due to improper insulin secretion, reduced insulin efficacy or both. It is a well-known fact that diabetic patients are likely to suffer from impaired wound healing, as diabetes strongly affects tissue angiogenesis. Until now, no satisfying in vivo murine model has been established to analyze the dynamics of angiogenesis during diabetic wound healing. To help understand the pathophysiology of diabetes and its effect on angiogenesis, a novel in vivo murine model was established using the skinfold chamber in mice...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Luz Angela Torres-de la Roche, Rajesh Devassy, Sreelatha Gopalakrishnan, Maya Sophie de Wilde, Anja Herrmann, Angelika Larbig, Rudy Leon De Wilde
Vaginal agenesis is a congenital anomaly that affects the life of one of each four thousand women around the world. There is a trend that patients request immediate surgical correction, instead of passive vaginal dilatation. Therefore a differentiated counselling should be provided. We present a comparative chart, based on published evidence, with aspect to the available techniques, which will facilitate the decision-making process in the clinical practice. From our point of view, the best results are achieved with techniques that combine the advantages of the minimal-invasive surgery with those derived of the use of peritoneum as covering tissue of the neovagina...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Isabelle Citron, Rory Dower, Mark Ho-Asjoe
Acellular dermal matrix (ADM) implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI). But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Peter L Stollwerck, Dominik Schlarb, Nicole Münstermann, Sebastian Stenske, Christoph Kruess, Gerhard Brodner, Björn Dirk Krapohl, Albrecht F Krause-Bergmann
BACKGROUND: Inguinal lymph node dissection (ILND) is associated with a high rate of morbidity. To evaluate the clinical benefit of surgical adhesives to reduce complications in patients undergoing ILND, we compared the use of TissuGlu(®) Surgical Adhesive and ARTISS(®) fibrin sealant with a control population. MATERIAL AND METHODS: We conducted a retrospective analysis of patients undergoing ILND for metastatic malignant skin tumors at one hospital, Fachklinik Hornheide (Münster, Germany), from January 2011 through September 2013, assessing 137 patients with a total of 142 procedures...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
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