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https://www.readbyqxmd.com/read/28728326/the-role-of-negative-pressure-wound-therapy-in-latissimus-dorsi-flap-donor-site-seroma-prevention-a-cohort-study
#1
Apichai Angspatt, Thana Laopiyasakul, Pornthep Pungrasmi, Poonpissamai Suwajo
BACKGROUND: Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. METHODS: In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28724133/a-nationwide-analysis-of-cost-variation-for-autologous-free-flap-breast-reconstruction
#2
Jessica I Billig, Yiwen Lu, Adeyiza O Momoh, Kevin C Chung
Importance: Cost variation among hospitals has been demonstrated for surgical procedures. Uncovering these differences has helped guide measures taken to reduce health care spending. To date, the fiscal consequence of hospital variation for autologous free flap breast reconstruction is unknown. Objective: To investigate factors that influence cost variation for autologous free flap breast reconstruction. Design, Setting, and Participants: A secondary cross-sectional analysis was performed using the Healthcare Cost and Utilization Project National Inpatient Sample database from 2008 to 2010...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28713719/stacked-pap-flaps-for-two-stage-immediate-bilateral-breast-reconstruction-a-case-report
#3
Luis Parra
No abstract text is available yet for this article.
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28713695/robotic-modified-radical-neck-dissection-with-bilateral-axillo-breast-approach
#4
REVIEW
June Young Choi, Kyung Ho Kang
Bilateral axillo-breast approach (BABA) robotic thyroidectomy has been performed since 2008, and the indications of the BABA robotic operation has been widened to the robotic modified radical neck dissection (MRND). The indication for BABA robotic MRND is suspicious lateral neck metastasis of well-differentiated thyroid carcinoma, and the contraindication is far advanced carcinoma such as encasement of common carotid artery. Surgical procedures start from flap formation as a routine BABA robotic thyroidectomy and the lateral neck dissection is performed from level IV and Vb to level III and IIA...
June 2017: Gland Surgery
https://www.readbyqxmd.com/read/28695998/co-surgeons-in-breast-reconstructive-microsurgery-what-do-they-bring-to-the-table
#5
Nicholas T Haddock, Samar Kayfan, Ronnie A Pezeshk, Sumeet S Teotia
INTRODUCTION: Current research within other surgical specialties suggests that a co-surgeon approach may reduce operative times and complications associated with complex bilateral procedures, possibly leading to improved patient and surgical outcomes. We sought to evaluate the role of the co-surgery team and its development in free flap breast reconstruction. METHODS: A retrospective review of free-flap breast reconstruction by two surgeons from 2011 to 2016 was conducted...
July 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28693999/-profunda-artery-perforator-flap-reliable-secondary-option-for-breast-reconstruction
#6
P Fosseprez, A Gerdom, M Servaes, C Deconinck, G Pirson, A Berners
BACKGROUND: In recent years, the DIEP-flap has become the standard for autologous breast reconstruction. However, when abdominal donor site is unavailable, secondary options are numerous. This report documents our experience with PAP-flap breast reconstruction. METHOD: We carried out a retrospective study of patients who underwent reconstructive breast surgery by PAP-flaps in our institution since 2014. RESULTS: Seventeen PAP-flaps were carried out in 15 patients, two of which received consecutive reconstruction of each breast at distinct intervals...
July 7, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28688657/umbilical-necrosis-rates-after-abdominal-based-microsurgical-breast-reconstruction
#7
Joseph A Ricci, Parisa Kamali, Babette E Becherer, Daniel Curiel, Winona Wu, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. METHODS: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28687258/sensory-recovery-of-the-breast-after-innervated-and-non-innervated-autologous-breast-reconstructions-a-systematic-review
#8
REVIEW
J Beugels, A J M Cornelissen, A J Spiegel, E M Heuts, A Piatkowski, R R W J van der Hulst, S M H Tuinder
BACKGROUND: The sensory recovery of the reconstructed breast is an undervalued topic in the field of autologous breast reconstruction. This systematic review aimed to evaluate the available literature on the sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions and to assess the possible benefits of sensory nerve coaptation compared to spontaneous reinnervation of the flap. METHODS: A comprehensive literature search was conducted in PubMed, Embase and the Cochrane Library to identify all eligible studies regarding the sensory recovery of all types of innervated and non-innervated autologous breast reconstructions...
May 24, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28685613/highlights-of-the-san-antonio-breast-cancer-symposium-2016
#9
John R Benson, Ismail Jatoi
The 39th annual San Antonio Breast Cancer Symposium (SABCS) was convened in San Antonio, Texas, on 9-13 December 2016. More than 7000 clinicians and scientists from around the world participated in the symposium which featured a range of presentations and keynote talks pertaining to breast cancer screening, prevention, locoregional and systemic therapies. This two-part report highlights a selection of important studies presented at this premier breast cancer event with Part 1 focusing onmetastatic breast cancer, extended endocrine therapy and the prognostic significance of BRCA1/2 gene mutations...
July 7, 2017: Future Oncology
https://www.readbyqxmd.com/read/28684286/donor-site-morbidity-in-diep-free-flap-breast-reconstructions-a-comparison-of-unilateral-bilateral-and-bipedicled-surgical-procedure-types
#10
Taj Tomouk, Anita T Mohan, Alex Azizi, Elena Conci, Elizabeth B Brickley, Charles M Malata
BACKGROUND: The use of abdominal tissue in post-mastectomy autologous breast reconstruction is a popular choice among reconstructive surgeons. This is the first study to evaluate donor complications comparing unilateral, bilateral, and bipedicled DIEP breast reconstructions. METHODS: A retrospective chart review was conducted of all women undergoing rib-preserving DIEP free flap breast reconstruction at a University Hospital between 2008 and 2015 by the senior surgeon (CMM)...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28679373/a-comprehensive-overview-on-the-surgical-management-of-secondary-lymphedema-of-the-upper-and-lower-extremities-related-to-prior-oncologic-therapies
#11
REVIEW
Ramon Garza, Roman Skoracki, Karen Hock, Stephen P Povoski
Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections...
July 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28678328/oncoplastic-breast-surgery-comprehensive-review
#12
N Bertozzi, M Pesce, P L Santi, E Raposio
Breast cancer is the most common female cancer in Western populations, affecting 12.5% of women, with 1.38 million patients per year. Breast-conserving surgery followed by postoperative radiotherapy replaced the radical and modified-radical procedures of Halsted and Patey as the standard of care for early-stage breast cancer once the overall and disease-free survival rates of breast-conserving surgery were demonstrated to be equivalent to those of mastectomy. However, excision of >20% of breast tissue, low or centrally located cancer, and large-sized breasts with various grades of breast ptosis, result a in unacceptable cosmetic outcomes...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28676319/impact-of-adjuvant-anti-estrogen-therapies-tamoxifen-and-aromatase-inhibitors-on-perioperative-outcomes-of-breast-reconstruction
#13
Raphaëlle Billon, Romain Bosc, Yazid Belkacemi, Elias Assaf, Mounia SidAhmed-Mezi, Barbara Hersant, Jean-Paul Meningaud
PURPOSE: Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend the duration of adjuvant treatment from 5 to 10 years. The association between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. However, while estrogens play a crucial role in wound healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative complications, including wound healing complications...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28673764/how-to-assess-sensory-recovery-after-breast-reconstruction-surgery
#14
Helena K Puonti, Taina A Broth, Seppo O Soinila, Helena K Hallikainen, Satu K Jääskeläinen
BACKGROUND: We evaluated clinical against psychophysical (tactile and thermal quantitative sensory test [QST]), neurophysiologic (somatosensory evoked potential [SEP]), and epithelial nerve fiber density (ENFD) examinations in detection and follow-up of sensory alterations after breast reconstruction done with or without nerve anastomoses. PATIENTS AND METHODS: In a prospective 2-year follow-up design, 56 breast cancer patients underwent innervated and 20 patients noninnervated free rectus abdominis muscle-sparing flap (ms-TRAM) breast reconstruction...
April 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28670389/sapylin-promotes-wound-healing-in-mouse-skin-flaps
#15
Huijing Huang, Deguang Kong, Yu Liu, Qiuxia Cui, Kun Wang, Dan Zhang, Jinli Wang, Maocai Zhai, Jinhua Yan, Cuntai Zhang, Gaosong Wu
Seroma formation is one of the most common complications after modified radical mastectomy. Sapylin is an agent used to reduce seroma formation following breast cancer surgery. In this article, we aimed to identify the potential mechanism by which Sapylin reduced seroma formation. Thirty-six female C57 mice were randomly divided into three groups. All mice were anaesthetized and a skin flap was generated on their abdomens. Each group was treated with normal saline, 0.5 KE/ml of Sapylin, or 50% hypertonic glucose, respectively...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28664306/axillary-advancement-suture-to-minimize-post-implantation-deformity-in-implant-based-breast-reconstruction
#16
Jun Ho Lee, Chi-Ho Yeo, Kyu-Jin Chung, Taegon Kim
Patients who have undergone implant-based breast reconstruction after skin-sparing mastectomy often complain about bulging on the upper flank or inferior axillary area. This is most likely because the subcutaneous tissue layer of the upper flank, which is continuous with the breast tissue, tends to show inferolateral drooping once the subcutaneous tissue becomes loose after eliminating the breast parenchyma. In addition, one of the weaknesses of implant surgery is that implants cannot completely replace the tissue removed during skin-sparing mastectomy (SSM)...
June 29, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28663773/optimizing-outcomes-of-postmastectomy-breast-reconstruction-with-acellular-dermal-matrix-a-review-of-recent-clinical-data
#17
Michael Zenn, Mark Venturi, Troy Pittman, Scott Spear, Geoffrey Gurtner, Geoffrey Robb, Alex Mesbahi, Joseph Dayan
Background: This article reports on the current use of acellular dermal matrix in breast reconstruction. Methods: A literature review of articles on acellular dermal matrix in breast reconstruction from January 1, 2010, through December 20, 2016, was performed and analyzed for trends in acellular dermal matrix use and differences between commonly used acellular dermal matrixes. Findings: Clinical findings varied but include improved cosmesis and more 1-stage reconstructions using acellular dermal matrix. Superiority of sterile versus aseptic acellular dermal matrixes was noted, and the increased incidence of red breast syndrome with AlloDerm was significant...
2017: Eplasty
https://www.readbyqxmd.com/read/28658472/association-of-fat-grafting-with-patient-reported-outcomes-in-postmastectomy-breast-reconstruction
#18
Katelyn G Bennett, Ji Qi, Hyungjin M Kim, Jennifer B Hamill, Edwin G Wilkins, Babak J Mehrara, Jeffrey H Kozlow
Importance: Fat grafting has proven to be a useful adjunct to breast reconstruction for the treatment of contour irregularities and volume deficits, but the proposed US Food and Drug Administration regulations may severely limit the ability of plastic surgeons to continue its use in this clinical context. Objective: To determine whether fat grafting is associated with patient-reported outcomes (PROs) in patients undergoing breast reconstruction. Design, Setting, and Participants: A longitudinal, multicenter, prospective cohort study was conducted between February 1, 2012, and July 31, 2016, at the 11 sites associated with the Mastectomy Reconstruction Outcomes Consortium Study...
June 28, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28657247/giant-desmoid-tumour-of-the-thorax-following-latissimus-dorsi-and-implant-breast-reconstruction-case-report-and-review-of-the-literature
#19
A M Collins, A M Granahan, D G Healy, C A Lawlor, S P O'Neill
The case of a giant thoracic desmoid tumour in a 44-year-old woman, who presented two years following a breast reconstruction with a latissimus dorsi (LD) flap and implant, is reported. Clinical findings included a rapidly growing, painless mass. Computed tomography (CT) suggested skin and intercostal soft tissue invasion. The tumour was resected en bloc with the LD muscle, implant capsule and underlying rib segments. The resultant thoracic and abdominal wall defects were reconstructed with Dualmesh® and polypropylene meshes respectively...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28654584/a-novel-noncontact-diffuse-correlation-spectroscopy-device-for-assessing-blood-flow-in-mastectomy-skin-flaps-a-prospective-study-in-patients-undergoing-prosthesis-based-reconstruction
#20
Nneamaka B Agochukwu, Chong Huang, Mingjun Zhao, Ahmed A Bahrani, Li Chen, Patrick McGrath, Guoqiang Yu, Lesley Wong
A new advanced technology, noncontact diffuse correlation spectroscopy, has been recently developed for the measurement of tissue blood flow through analyzing the motions of red blood cells in deep tissues. This technology is portable, inexpensive, and noninvasive, and can measure up to 1.5-cm tissue depth. In this prospective study, the authors aimed to explore the use of this novel device in the prediction of mastectomy skin flap necrosis. The noncontact diffuse correlation spectroscopy device was used to measure mastectomy skin flap flow in patients undergoing mastectomy and immediate implant-based breast reconstruction before and immediately after mastectomy, and after placement of the prosthesis...
July 2017: Plastic and Reconstructive Surgery
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