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https://www.readbyqxmd.com/read/28932726/comparison-of-morbidity-related-seroma-formation-following-conventional-latissimus-dorsi-flap-versus-muscle-sparing-latissimus-dorsi-flap-breast-reconstruction
#1
Yoshihiro Sowa, Toshiaki Numajiri, Katsuhiko Nakatsukasa, Koichi Sakaguchi, Tetsuya Taguchi
PURPOSE: The pedicled, descending-branch muscle-sparing latissimus dorsi (MSLD) flap has been widely used for breast reconstruction following total mastectomy. However, the superiority of the MSLD flap compared to the conventional latissimus dorsi (CLD) flap in preventing seroma formation has not been demonstrated. This study compares the morbidities related to seroma formation following pedicled MSLD flap and CLD flap breast reconstruction. METHODS: A total of 15 women who underwent partial mastectomy and immediate partial breast reconstruction with MSLD flaps were compared with 15 women under identical conditions with CLD flap breast reconstruction...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28929035/porcine-urinary-bladder-matrix-for-management-of-infected-radiation-mastectomy-wound
#2
Yana Puckett, Theophilus Pham, Shirley McReynolds, Catherine A Ronaghan
We present a case report on the successful healing of a Pseudomonas infection wound in a 52-year-old female with morbid obesity, noninsulin dependent diabetes mellitus and a history of tobacco use, who presented with Stage IIIA (T3, N2, Mo) infiltrating ductal carcinoma. The patient received neoadjuvant chemotherapy prior to her bilateral skin-sparing total mastectomies with right axillary sentinel lymphadenectomy. She also had staged reconstruction with temporary breast implants and plans for deep inferior epigastric perforator flaps...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28918997/tolerance-of-latissimus-dorsi-in-immediate-breast-reconstruction-without-implant-to-radiotherapy
#3
G Berthet, C Faure, M A Dammacco, C Vermesch, E Delay, C Ho Quoc, N Carrabin
INTRODUCTION: Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported by patients who underwent IBR by LDF with or without subsequent radiotherapy. MATERIALS AND METHODS: We performed a retrospective case-control study in a population of women who were diagnosed with breast cancer between January 1999 and January 2014 and who had mastectomies with IBR by LDF without prostheses...
August 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28917935/trends-in-post-mastectomy-breast-reconstruction-types-at-a-breast-cancer-tertiary-referral-centre-before-and-after-introduction-of-acellular-dermal-matrices
#4
Hadyn K N Kankam, George J M Hourston, Laura J Fopp, John R Benson, Sarah L Benyon, Michael S Irwin, Amit Agrawal, Parto Forouhi, Charles M Malata
BACKGROUND: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution. METHODS: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs...
August 31, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28915211/minimally-invasive-laparoscopic-dissected-deep-inferior-epigastric-artery-perforator-flap-mild-diep-an-anatomic-feasibility-study-and-a-first-clinical-case
#5
Mikael Hivelin, Antoine Soprani, Nathaniel Schaffer, Stéphane Hans, Laurent Lantieri
The deep inferior epigastric perforator (DIEP) flap is a workhorse of breast reconstruction. Risks of herniation derive from violation of the rectus abdominis muscle anterior rectus sheath (ARS) and might be reduced by Minimally Invasive Laparoscopic Dissection (MILD) of the deep inferior epigastric vessels. We performed a feasibility study on five anatomical subjects and performed a secondary right breast reconstruction on a 67 year-old woman. A 30° laparoscope was used with laparoscopy ports inset to preserve the flap...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28912877/fen1-knockdown-improves-trastuzumab-sensitivity-in-human-epidermal-growth-factor-2-positive-breast-cancer-cells
#6
Xue Zeng, Xiaofang Che, Yun-Peng Liu, Xiu-Juan Qu, Lu Xu, Chen-Yang Zhao, Chun-Lei Zheng, Ke-Zuo Hou, Yuee Teng
Trastuzumab has been widely applied as a treatment for human epidermal growth factor 2 (HER2)-overexpressing breast cancer. However, the therapeutic efficacy of trastuzumab is limited. Flap endonuclease 1 (FEN1) is a multifunctional endonuclease that has a crucial role in DNA recombination and repair. Inhibition of FEN1 is associated with the reversal of anticancer drug resistance. However, it is unclear whether FEN1 is involved in trastuzumab resistance. In the present study, it was demonstrated that trastuzumab increases the expression of FEN1, and FEN1 knockdown significantly enhanced the sensitivity of BT474 cells to trastuzumab (P<0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28906298/a-simple-flap-design-for-the-salvage-of-immediate-implant-based-breast-reconstruction
#7
Sukru Yazar, Altug Altinkaya, Emine Cigdem Karadag, Halil Kara, Cihan Uras
BACKGROUND: Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant. In this article, the use of local pedicled flap for the management of these situations was discussed. METHODS: Between April 2010 and July 2015, 54 patients underwent breast reconstruction by inverted-T skin-reducing mastectomy and immediate implant-based breast reconstruction at our clinic...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28895195/estimation-of-diep-flap-weight-for-breast-reconstruction-by-the-pinch-test
#8
Kyong-Je Woo, Goo-Hyun Mun
BACKGROUND: Various methods have been introduced for estimating deep inferior epigastric artery perforator (DIEP) flap volume based on computed tomography or magnetic resonance angiographic images. However, when radiologic images cannot be obtained, estimations are subjective. The purpose of this study was to develop a prediction model for estimating DIEP flap weight using the pinch test. METHODS: The pinch test was performed at three paraumbilical sites using a skin-fold caliper in 107 consecutive patients who underwent DIEP flap breast reconstruction...
September 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28894666/optimizing-aesthetic-outcomes-in-delayed-breast-reconstruction
#9
Wojciech Dec
BACKGROUND: The need to restore both the missing breast volume and breast surface area makes achieving excellent aesthetic outcomes in delayed breast reconstruction especially challenging. Autologous breast reconstruction can be used to achieve both goals. The aim of this study was to identify surgical maneuvers that can optimize aesthetic outcomes in delayed breast reconstruction. METHODS: This is a retrospective review of operative and clinical records of all patients who underwent unilateral or bilateral delayed breast reconstruction with autologous tissue between April 2014 and January 2017...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894664/aesthetic-female-to-male-chest-transformation-power-of-combining-modified-mastectomy-with-a-pectoral-implant
#10
Turkia Abbed, David A Shifrin
Gender reassignment surgery has gained in popularity with increased media exposure and society's recognition of gender dysphoria. Female-to-male gender reassignment often begins with the "top" or chest surgery. Mastectomy with free nipple grafting is the most frequently described technique in the literature. This technique is reliable yet lacks the ability to provide a true male chest shape. We discuss our technique for female-to-male "top" surgery combining traditional mastectomy techniques with a lower pole pedicle vascularized areola and a pectoral implant...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894660/mastectomy-flap-thickness-and-complications-in-nipple-sparing-mastectomy-objective-evaluation-using-magnetic-resonance-imaging
#11
Jordan D Frey, Ara A Salibian, Mihye Choi, Nolan S Karp
BACKGROUND: Ischemic complications after nipple-sparing mastectomy (NSM) have been associated with numerous variables. However, the impact of NSM flap thickness has been incompletely evaluated. METHODS: NSM flap thickness was determined for all NSMs from 2006 to 2016 with available pre- or postoperative breast magnetic resonance imaging (MRIs). Demographics and outcomes were stratified by those with and without ischemic complications. RESULTS: Of 1,037 NSM reconstructions, 420 NSMs had MRI data available, which included 379 preoperative MRIs and 60 postoperative MRIs...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28892228/immediate-nipple-reconstruction-in-combination-with-implant-reconstruction-using-dermal-sling
#12
George Filobbos, Nathan Hamnett, Joseph Hardwicke, Joanna Skillman
The inferior de-epithelialized dermal flap with implant is increasingly used for immediate breast reconstruction. We have adapted the technique to provide concurrent immediate nipple reconstruction by recruiting the triangle of skin above the excised nipple as a modified C-V flap. The safety and efficacy of this technique has been assessed in 15 patients, of which eight were bilateral and seven were unilateral cases. We suggest that this is a safe, reliable, and original technique for immediate nipple reconstruction in patients undergoing immediate breast reconstruction with an inferior dermal sling and implant...
September 11, 2017: Breast Journal
https://www.readbyqxmd.com/read/28885315/tuberous-breast-past-present-and-future-personal-classification-treatment-and-surgical-outcomes
#13
Alessandro Innocenti, Marco Innocenti, Francesco Mori, Dario Melita, Francesco Ciancio, Adriana Cordova
BACKGROUND: Tuberous breast (TB) is a rare congenital deformity, which may appear in different clinical forms representing various degrees of a single pathological entity. The worst cases are characterized by severe hypoplasia. Following a detailed analysis of the available relevant literature and a significant number of treated cases, in this article, the authors propose a new classification, with the aim of summarizing and simplifying a more intuitive categorization of the malformation, considering all the clinical aspects and including all types of TBs, even the minor ones, thus allowing a more immediate diagnosis and surgical planning...
September 6, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#14
Norbert Heine, Christoph Koch, Vanessa Brebant, Andreas Kehrer, Alexandra Anker, Lukas Prantl
BACKGROUND: Breast Carcinoma is the most common malign tumor disease in women. 20-30% of these tumors have to be treated by removing all of the breast tissue. After that kind of therapeutic procedure, most of the women are severely traumatized and ask for reconstruction. The goldstandard of breast reconstruction is the free perforator flap from the lower abdomen (DIEAP-flap), which can provide body-own tissue and natural shape for the reconstructed breast.Many studies evaluate the shape of the reconstructed breast but neglect the skin sensitivity...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28882494/the-merits-of-decision-modelling-in-the-earliest-stages-of-the-ideal-framework-an-innovative-case-in-diep-flap-breast-reconstructions
#15
S Hummelink, J G W Gerrits, L J Schultze Kool, D J O Ulrich, M M Rovers, J P C Grutters
BACKGROUND: The IDEAL framework aims at improving the evidence base of available surgical innovations. However, the development of such innovations and collection of evidence is costly. Surgical innovation can provide more value for money if innovations are evaluated at an early stage, where evaluations can inform the decision whether to stop or to further develop an innovation. We illustrate how decision modelling can be readily adopted at the earliest stages (0-1) of the IDEAL framework, using an innovation in bilateral DIEP flap breast reconstruction as an example...
August 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28882492/assessing-the-effort-associated-with-teaching-residents
#16
Kelli R Aibel, Tracy Truong, Ronnie L Shammas, Eugenia H Cho, Kate J Buretta, Gina-Maria Pomann, Scott T Hollenbeck
BACKGROUND: Intraoperative resident education is an integral mission of academic medical centers and serves as the basis for training the next generation of surgeons. The actual effort associated with teaching residents is unknown as it pertains to additional operative time. Using a large validated multi-institutional dataset, this study aims to quantify the effect of having a resident present in common plastic surgery procedures on operative time. Future directions for developing standardized methods to record and report teaching time are proposed, which can help inform prospective studies...
August 5, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28878901/breast-reconstruction-in-pregnancy-a-case-report-of-multidisciplinary-team-approach-in-immediate-autologous-flap-reconstruction-for-pregnancy-associated-breast-cancer
#17
Prakasit Chirappapha, Panya Thaweepworadej, Nuttapong Ngamphaiboon, Matchuporn Sukprasert, Thongchai Sukarayothin, Monchai Leesombatpaiboon
This report presents the results of immediate breast reconstruction with autologous flap in Pregnancy-associated breast cancer (PABC). There was no obstetrics and surgical complications in our report. Immediate breast reconstruction can be performed in PABC after a careful selection. Multidisciplinary team approach is the key in managing these groups of patients.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28876635/the-surgical-management-of-central-breast-tumours-at-a-specialist-breast-unit-in-johannesburg-south-africa
#18
L Van Schalkwyk, C A Benn, K Bergstrom
BACKGROUND: Central breast tumours are defined as tumours in the retroareolar area, or within 1.5-2.0 cm from the areolar edge. In the past, breast conservation therapy (BCT) for central breast tumours was considered controversial due to concerns regarding oncologic safety and cosmesis. Recent evidence does however suggest that oncoplastic techniques offer a cosmetically acceptable and safe alternative to mastectomy in these tumours. METHOD: Patients with central breast tumours (invasive and in situ) were identified from a breast cancer database of 431 patients who presented to the Netcare Breast Care Centre in Johannesburg over a one-year period (June 2015-June 2016)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871582/pyoderma-gangrenosum-after-breast-mastectomy-and-primary-rectus-abdominis-flap-reconstruction
#19
Yasuhiro Suzuki, Kozue Yokoyama, Mayako Terao, Toru Morioka, Banri Tsuda, Naoki Niikura, Takuho Okamura, Eri Yamada, Kotaro Imagawa, Tadashi Akamatsu, Yutaka Tokuda, Nobue Kumaki
Pyoderma gangrenosum is an intractable disease of unknown cause involving recurrent ulcerative lesions on the skin, and may accompany ulcerative colitis, rheumatoid arthritis, leukemia, systemic lupus erythematosus, and other conditions. Here, we report a rare case of pyoderma gangrenosum in the thoracic abdomen following post-mastectomy reconstructive surgery. A 39-year-old presented at the hospital with a complaint of left papilla erosion. Skin biopsy at the site revealed invasive skin cancer, with Paget-like progression in the cancerous nipple and suspected malignancy of skin appendages...
September 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28870056/-application-of-autologous-fat-grafting-in-breast-reconstruction
#20
L Cai, X F Han, B Q Wang, F C Li
Objective: To observe the outcome of breast reconstruction with autologous fat grafting in the patients following treatment for breast cancer. Methods: The clinical data of 22 patients after breast cancer modified radical mastectomy with fat grafting for breast reconstruction from January 2012 to March 2015 at Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College were analyzed retrospectively. The age of 22 patients (all female) was 28 to 54 years...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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