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https://www.readbyqxmd.com/read/28211139/scabies-in-a-bilateral-hand-allograft-recipient-an-additional-mimicker-of-acute-skin-rejection-in-vascularized-composite-allotransplantation
#1
Jean Kanitakis, Emmanuel Morelon
Vascularized composite tissue allografts include skin, which frequently undergoes, in the early post-graft period, acute rejections. The diagnosis of acute rejection may be difficult as it can be mimicked by several dermatoses. We present a bilateral hand allograft recipient who developed, 16.5 years post-graft, cutaneous lesions raising suspicion about rejection. Physical examination and skin biopsy were diagnostic of scabies. This ectoparasitosis should be added in the list of dermatoses that can mimic allograft rejection in vascular composite allografts...
February 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28209630/inhibition-of-phosphodiesterase-4-pde4-reduces-dermal-fibrosis-by-interfering-with-the-release-of-interleukin-6-from-m2-macrophages
#2
Christiane Maier, Andreas Ramming, Christina Bergmann, Rita Weinkam, Nicolai Kittan, Georg Schett, Jörg H W Distler, Christian Beyer
OBJECTIVES: To investigate the disease-modifying effects of phosphodiesterase 4 (PDE4) inhibition in preclinical models of systemic sclerosis (SSc). METHODS: We studied the effects of PDE4 inhibition in a prevention and a treatment model of bleomycin-induced skin fibrosis, in the topoisomerase mouse model as well as in a model of sclerodermatous chronic graft-versus-host disease. To better understand the mode of action of PDE4 blockade in preclinical models of SSc, we investigated fibrosis-relevant mediators in fibroblasts and macrophages from healthy individuals and patients suffering from diffuse-cutaneous SSc on blockade of PDE4...
February 16, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28209412/injectable-chondroplasty-enzymatic-reshaping-of-cartilage-grafts
#3
J R Gandy, A Foulad, K K Chao, B J F Wong
OBJECTIVE/HYPOTHESIS: To develop an injection-based enzymatic technique that selectively softens cartilage tissue for reshaping cartilaginous structures in the head and neck. MATERIALS AND METHODS: Two groups were formed using fresh rabbit ears: (1) whole rabbit ear group; (2) composite graft group (2.5mm×3.0cm specimens sectioned from the central region of the pinna). Subperichondrial injections using three enzymes (hyaluronidase, pronase, and collagenase II) in sequence were performed for the experimental specimens from both groups...
February 10, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28207637/the-efficacy-of-a-prevascularized-retrievable-poly-d-l-lactide-co-%C3%AE%C2%B5-caprolactone-subcutaneous-scaffold-as-transplantation-site-for-pancreatic-islets
#4
Alexandra M Smink, Shiri Li, Don T Hertsig, Bart J de Haan, Leendert Schwab, Aart A van Apeldoorn, Eelco de Koning, Marijke M Faas, Jonathan R T Lakey, Paul de Vos
BACKGROUND: The liver as transplantation site for human pancreatic islets is a harsh microenvironment for islets and it lacks the ability to retrieve the graft. A retrievable, extrahepatic transplantation site that mimics the pancreatic environment is desired. Ideally this transplantation site should be located subdermal for easy surgical-access but this never resulted in normoglycemia. Here we describe the design and efficacy of a novel prevascularized, subcutaneously implanted, retrievable poly (D,L-lactide-co-ε-caprolactone) (PDLLCL) scaffold...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207636/association-between-pretransplant-cancer-and-survival-in-kidney-transplant-recipients
#5
Dag Olav Dahle, Tom Grotmol, Torbjørn Leivestad, Anders Hartmann, Karsten Midtvedt, Anna V Reisæter, Geir Mjøen, Hege K Pihlstrøm, Hege Næss, Hallvard Holdaas
BACKGROUND: Kidney transplantation in recipients with a previous malignancy is often deferred 2-5 years after cancer treatment due to fear of cancer recurrence. In Norway, the required waiting period has been 1 year. METHODS: We compared patient and graft survival of recipients with pretransplant cancer to the outcomes of matched recipients without such cancer (comparators) using Cox regression. RESULTS: From 1963 to 2010, 377 of 5867 recipients (6...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207466/the-subunit-principle-in-scar-face-revision
#6
Ahmed Elshahat, Riham Lashin
Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28207463/implantation-of-thickened-artificial-bone-for-reduction-of-dead-space-and-prevention-of-infection-between-implant-and-dura-in-secondary-reconstruction-of-the-skull
#7
Mine Ozaki, Keigo Narita, Masakazu Kurita, Yuki Iwashina, Akihiko Takushima, Kiyonori Harii
For the treatment of skull defect compensation after neurosurgery, a customized artificial bone is often employed owing to its toughness and the relative ease of producing cosmetically good result. However, implants are vulnerable to infection and removal of implant is sometimes necessary. Several other treatment options such as autologous bone graft or free flap are likely to be considered for the secondary reconstruction to avoid reinfection; however, reimplantation of artificial bone is beneficial for the patients, being not concerned with donor site morbidity...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28207197/changing-the-surgical-dogma-in-frontal-sinus-trauma-transnasal-endoscopic-repair
#8
Jessica W Grayson, Hari Jeyarajan, Elisa A Illing, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. METHODS: Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed...
February 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28204937/a-new-approach-to-upper-eyelid-reconstruction
#9
A Bulla, C Vielà, L Fiorot, A Bolletta, E Pancrazi, G V Campus
BACKGROUND: Reconstruction of large defects of the upper eyelid is challenging because of its complex anatomy and specialized function. The aim of this work is to develop a single-stage reconstruction procedure based on a new approach. The technique consists of the advancement of an orbicularis oculi myocutaneous flap designed within the blepharoplasty skin excision pattern. METHODS: After the tumor's excision is completed with clear margins, the borders of the flap are incised down to the submuscular plane inside the classical pattern of upper eyelid blepharoplasty...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28203511/a-retrospective-look-at-integrating-a-novel-regenerative-medicine-approach-in-plastic-limb-reconstruction
#10
Edgardo R Rodriguez Collazo, Christopher R Rathbone, Brian R Barnes
Full-thickness wounds that have rendered patients candidates for amputation may require techniques that may include a combinatorial approach above traditional standard of care. The purpose of this retrospective study was to evaluate the effectiveness of an innovative approach whereby several therapies were combined to avoid amputation. Patients with full-thickness wounds who were previously recommended for amputation and were treated with the combinatorial approach of muscle flap reconstruction and concentrated bone marrow aspirate, platelet-rich plasma, INTEGRA Wound matrix, vacuum-assisted closure, and split-thickness skin grafts were assessed retrospectively...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203501/partial-breast-reconstruction-with-goldilocks-technique-after-excision-of-giant-fibroadenoma-a-case-report
#11
Ryan P Ter Louw, Sara B Bruce, Maurice Y Nahabedian
Giant juvenile fibroadenomas are relatively rare, accounting for less than 1% fibroadenomas. Large breast tumors create significant asymmetry and provide unique reconstructive challenges after removal. In this case, we describe a 21-year-old female with delayed presentation of a giant fibroadenoma of the right breast. This represents an unusual presentation of benign breast disease requiring reduction of the skin envelope, extensive glandular resection, lower pole reconstruction, and free nipple grafting to achieve symmetry with the opposite breast...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203499/sandwich-fascial-anterolateral-thigh-flap-in-head-and-neck-reconstruction-evolution-or-revolution
#12
Mario Cherubino, Jens Berli, Mario Turri-Zanoni, Paolo Battaglia, Francesca Maggiulli, Martina Corno, Federico Tamborini, Edoardo Montrasio, Paolo Castelnuovo, Luigi Valdatta
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28202371/negative-pressure-wound-therapy-an-update
#13
Ahmed Hassan El-Sabbagh
PURPOSE: To get the maximum benefit of vacuum-assisted closure (VAC) in the management of acute and chronic wounds without abuse or misuse. METHODS: Fourty one patients were included in the study. Among them, 9 patients had chronic wounds and the rest 32 patients had acute wounds. In acute wounds, 19 patients had co-morbid conditions. Seven patients had gaped wounds, 4 patients had necrotizing fasciitis and 2 patients had enterocutaneous fistula. RESULTS: The hospitalization period varied from 1 to 6 weeks...
January 25, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28198772/micro-free-orbital-fat-grafts-to-the-tear-trough-deformity-during-lower-blepharoplasty
#14
Suzette G Miranda, Mark A Codner
BACKGROUND: The tear trough deformity is challenging in lower eyelid rejuvenation. Surgical treatment has evolved with more modern techniques preserving orbital fat and using autologous fat transposition. The author reviewed his own experience in targeting the tear trough in lower lid blepharoplasty and presented a new technique that incorporates the addition of micro free fat grafts which adds direct volume to the underlying anatomical depression using a transcutaneous skin-muscle approach...
February 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28198101/systematic-review-and-meta-analysis-of-the-efficacy-of-epidermal-grafting-for-wound-healing
#15
Muholan Kanapathy, Oliver J Smith, Nadine Hachach-Haram, Nicola Bystrzonowski, Afshin Mosahebi, Toby Richards
Autologous skin grafting is an important method for wound coverage; however, it is an invasive procedure and can cause donor site morbidity. Epidermal grafting (EG) enables epidermal transfer to wounds with minimal donor site morbidity. However, data to date have been heterogeneous. This study aims to synthesise the current evidence on EG for wound healing to establish the efficacy of this surgical technique. A comprehensive search in the MEDLINE, EMBASE and CENTRAL databases was conducted. The endpoints assessed were proportion of wounds healed and mean wound-healing time...
February 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28197297/reconstruction-of-an-anterior-cervical-necrotizing-fasciitis-defect-using-a-biodegradable-polyurethane-dermal-substitute
#16
Marcus Jd Wagstaff, Yugesh Caplash, John E Greenwood
Introduction: Although we have previously described the use of a novel polyurethane biodegradable dermal substitute in the reconstruction of 20 free flap donor sites, and extensive cutaneous defects, including a large area of exposed calvarium secondary to burn injury, our experience with this material now extends to 35 free flap donor site reconstructions and 13 major or complex burns. Methods: The polyurethane material (NovoSorb BTM; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) was recently employed in another complex wound scenario, implanted into a large anterior cervical cutaneous and soft-tissue defect remaining after serial radical debridement for necrotizing fasciitis...
2017: Eplasty
https://www.readbyqxmd.com/read/28196742/comparison-of-different-skin-preservation-methods-with-gamma-irradiation
#17
Linda Guerrero, Bernardo Camacho
Allografts are in constant demand, not only for burn victims, but also for all open wounds as "biological dressings". Tissue quality and security are two of the major concerns of Tissue Banks. There are limited studies published. There has been extensive discussion on the subject of preservation methods for cadaver skin. Most literature available comes from clinical reports. In this research, the authors compared 85% glycerolized non irradiated skin allografts with three glycerolized irradiated skin allografts (using different glycerol concentrations 50%, 70% and 85%)...
February 11, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28195891/simple-skin-stretching-device-in-assisted-tension-free-wound-closure
#18
Li-Fu Cheng, Jiunn-Tat Lee, Honda Hsu, Meng-Si Wu
BACKGROUND: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195002/coverage-of-tendon-exposure-after-radial-forearm-free-flap-by-the-dorsoulnar-artery-perforator-flap
#19
Rémi Foissac, Marc Benatar, Olivier Dassonville, Alexandre Bozec, Gilles Poissonnet, Olivier Camuzard
Objective This study was designed to assess the effectiveness of an alternative technique using a perforator flap to manage secondary tendon exposure after a radial forearm free flap in head and neck oncologic surgery. Study Design Prospective cohort study. Setting Plastic Reconstructive Surgery Unit, Nice University Hospital, Pasteur 2 Hospital, France. Subjects and Methods Despite its numerous advantages, the radial forearm free flap is associated with significant donor site morbidity and the risk of secondary tendon exposure...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28194320/congenital-upper-eyelids-ectropion-in-down-s-syndrome
#20
Rafael Corredor-Osorio, José Luis Tovilla-Pomar, José Luis Tovilla-Canales
Congenital bilateral ectropion of the upper eyelids is a rare, benign condition reported in ophthalmic literature. It is more frequently associated with Down's syndrome, ichthyosis, and sporadic cases in newborns from black population. We report three cases of congenital bilateral upper eyelid ectropion associated with Down's syndrome. Management of these patients usually requires medial and lateral canthoplasties, full-thickness pentagonal resection of the upper eyelids and placement of skin grafts. We present herein the evolution of one of these patients and we will discuss the mechanism of the eyelid ectropion and its treatment...
2017: GMS Ophthalmology Cases
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