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https://www.readbyqxmd.com/read/28106627/outcomes-after-elevation-of-serratus-anterior-fascia-during-prosthetic-breast-reconstruction
#1
Akhil K Seth, Elliot M Hirsch, John Y S Kim, Neil A Fine
BACKGROUND: Achieving optimal inferolateral coverage is critical to successful prosthetic breast reconstruction. Serratus anterior fascia (SF) elevation, a promising alternative to muscle flaps and acellular dermis (ADM), has not been rigorously studied. This study evaluates complication rates after mastectomy and immediate tissue expander (TE) coverage using SF, relative to other existing methods of reconstruction. METHODS: Retrospective review of consecutive patients undergoing mastectomy with immediate TE reconstruction over 10 years at 1 institution was performed...
January 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28099173/surgical-approach-for-ulcerated-locally-advanced-breast-cancer-a-single-center-experience-a-retrospective-study
#2
Rita Laforgia, Clelia Punzo, Annunziata Panebianco, Annalisa Volpi, Marina Minafra, Maria Grazia Sederino
AIM: The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable for a neoadjuvant chemotherapy step and to consider various reconstruction techniques. MATERIAL OF STUDY: Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps...
January 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28097499/automating-perforator-flap-mra-and-cta-reporting
#3
Christopher J Lange, Nanda Deepa Thimmappa, Srikanth R Boddu, Silvina P Dutruel, Mengchao Pei, Zerwa Farooq, Ashkan Heshmatzadeh Behzadi, Yi Wang, Ramin Zabih, Martin R Prince
Surgical breast reconstruction after mastectomy requires precise perforator coordinates/dimensions, perforator course, and fat volume in a radiology report. Automatic perforator reporting software was implemented as an OsiriX Digital Imaging and Communications in Medicine (DICOM) viewer plugin. For perforator analysis, the user identifies a reference point (e.g., umbilicus) and marks each perforating artery/vein bundle with multiple region of interest (ROI) points along its course beginning at the muscle-fat interface...
January 17, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#4
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#5
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28062432/epirubicin-extravasation-consequences-of-delayed-management
#6
Olivia Hale, Peter George Deutsch, Anindya Lahiri
Epirubicin is an anthracycline chemotherapy agent used for treatment of several cancers including oesophageal, breast and gastric. Extravasation is a well-recognised and serious complication of any intravenous therapies but especially chemotherapeutic agents. Signs of the injury can be subtle and without prompt recognition and treatment there can be extensive tissue damage and depending on location of injury this can result in significant functional loss. In this article, a case of delayed management of epirubicin extravasation from a cannula situated at the dorsum of the hand is discussed...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28061518/breast-reconstruction-in-elderly-patients-risk-factors-clinical-outcomes-and-aesthetic-results
#7
Rosaria Laporta, Sorotos Michail, Longo Benedetto, Santanelli di Pompeo Fabio
Background Correlation among age, clinical, and aesthetic outcomes in implant-based and autologous breast reconstructions was investigated. Methods Between 2004 and 2014, a retrospective study was performed on patients who underwent reconstruction following mastectomy. Patients were divided in group A (< 50 years), group B (≥ 50-59 years), group C (≥ 60-69 years), and group D (≥ 70 years). Demographics, comorbidities, American Society of Anesthesiologists (ASA) class, and length of stay were assessed using chi-square and Kruskal-Wallis H analysis considering p ≤ 0...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28052717/oncoplastic-surgery-volume-displacement-techniques-for-breast-conserving-surgery-in-patients-with-breast-cancer
#8
Gunay Gurleyik, Hikmet Karagulle, Esra Eris, Fugen Aker, Basak O Ustaalioglu
BACKGROUND: Surgical management of breast cancer has drastically changed. Breast-conserving surgery (BCS) has now become a commonly used method for its treatment. Oncoplastic techniques are widely applied with satisfactory aesthetic results. We evaluated the aesthetic and oncological outcomes of BCS with glandular tissue displacement techniques. METHODS: Seventy-five patients with invasive breast cancer were surgically treated by oncoplastic techniques. Preoperative evaluations, including breast and tumor size, localizations and features, were performed by physical examination, imaging methods, and histopathological analysis...
January 5, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#9
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
November 3, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28051831/breast-reduction-personal-technique
#10
P Fino, G Di Taranto, M Toscani, N Scuderi
INTRODUCTION: Macromastia is a health problem that requires the coordination of surgical and medical specialists. Goals of reduction mammaplasty are to alleviate physical, emotional and psychosocial discomforts and to restore a conical-shaped breast, maintaining scars as short as possible. We report our approach for reduction mammaplasty with superior pedicle. MATERIALS AND METHODS: Our method combines advantages of round block with vertical scar, using a dermal flap that is fixed to the new mammary crease...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28040452/delay-techniques-for-nipple-sparing-mastectomy-a-systematic-review
#11
REVIEW
Laurel S Karian, Paul J Therattil, Philip D Wey, Kevin T Nini
BACKGROUND: Rare but serious complications of nipple-sparing mastectomy (NSM) include necrosis of the nipple-areolar complex (NAC) and mastectomy skin flaps. NAC and mastectomy flap delay procedures are novel techniques designed to avoid these complications and may be combined with retroareolar biopsy as a first-stage procedure. We performed a systematic review of the literature to evaluate various techniques for NAC and mastectomy flap delay. METHODS: PubMed and Cochrane databases were searched from January 1975 through April 15, 2016...
November 29, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28039502/nipple-reconstruction-with-dorsal-skin-provides-better-projection-than-reconstruction-with-abdominal-or-breast-skin-with-cartilage-grafting
#12
Runa Mihara, Hiroki Mori, Mutsumi Okazaki
Nipple projection of a modified C-V flap with or without costal cartilage was compared on abdominal, breast, and dorsal skin. A total of 81 patients and 85 sites were studied. The nipple was reconstructed secondarily using a modified C-V flap. Patients were classified by breast mound skin into five groups: dorsal skin without cartilage (group A, n = 18); abdominal skin without cartilage (group B, n = 6); abdominal skin with cartilage (group C, n = 26); breast skin without cartilage (group D, n = 20); and breast skin with cartilage (group E, n = 15)...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28035905/a-rare-case-of-umbilical-metastasis-after-delayed-transverse-rectus-abdominis-myocutaneous-flap-reconstruction-for-invasive-breast-cancer
#13
Nicky Claire Seymour, Rathi Rathinaezhil
A 46-year-old female presented with an inflamed and painful umbilicus. Past medical history included breast cancer, followed by metastatic sternal cancer two years after the initial breast cancer diagnosis.The painful umbilicus was confirmed metastasis from a primary breast cancer she had treated eleven years previously.Metastases to the umbilicus are rare, and are usually gastrointestinal in origin. To our knowledge this is the first report of a metastasis from any primary cancer to the umbilicus after transverse rectus abdominis myocutaneous flap (TRAM)...
December 29, 2016: Breast Disease
https://www.readbyqxmd.com/read/28033508/pathological-complete-response-in-invasive-breast-cancer-treated-by-skin-sparing-mastectomy-and-immediate-reconstruction-following-neoadjuvant-chemotherapy-and-radiation-therapy-comparison-between-immunohistochemical-subtypes
#14
J Barrou, M Bannier, M Cohen, E Lambaudie, A Gonçalves, P Bertrand, M Buttarelli, P Opinel, N Sterkers, A Tallet, C Zinzindohoué, G Houvenaeghel
CONTEXT: Even if neoadjuvant chemotherapy (NACT) and oncoplastic techniques have increased the breast conserving surgery rate, mastectomy is still a standard for multifocal or extensive breast cancers (BC). In the prospect of increasing breast reconstruction, an alternative therapeutic protocol was developed combining NACT with neoadjuvant radiation therapy (NART), followed by mastectomy with immediate breast reconstruction (IBR). The oncological safety of this therapeutic plan still needs further exploration...
December 26, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28032178/comparison-of-aesthetic-outcomes-between-vertical-and-horizontal-flap-insets-in-breast-reconstruction-with-the-tram-or-diep-flaps
#15
Woo Shik Jeong, Wooyeon Han, Jin Sup Eom
BACKGROUND: Tissue transfer, such as use of the transverse rectus abdominis myocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) free flaps, is considered a standard method. However, outcomes may vary among inset methods. Here we compared the aesthetic outcomes of breast reconstructions using vertical and horizontal flap inset methods. METHODS: We, respectively, reviewed 274 patients who underwent unilateral post-mastectomy breast reconstruction using TRAM or DIEP free flaps between April 2006 and December 2013...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032155/serratus-anterior-fascia-flap-versus-muscular-flap-for-expander-coverage-in-two-stage-breast-reconstruction-following-mastectomy-early-post-operative-outcomes
#16
Daniele Bordoni, Pierfrancesco Cadenelli, Nicola Rocco, Ariel Tessone, Giuseppe Falco, Cesare Magalotti
INTRODUCTION: The demand for reconstructive breast surgery after mastectomy is increasing among women and the two-stage option remains the most commonly performed technique. We conducted a self-controlled prospective clinical trial comparing the use of the serratus anterior fascia with the serratus anterior detached fibers to cover the inferolateral aspect of the expander in immediate two-stage breast reconstruction following conservative mastectomies as oncological or risk-reducing procedures...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28031664/using-a-single-internal-mammary-artery-as-retrograde-and-antegrade-flow-for-bilateral-deep-inferior-epigastric-artery-perforator-reconstruction-a-case-report
#17
Richard Tyrell, Rachelle Y Leong, Sandeep A Sathyanarayana, Peter Korn, Alan S Kadison
Deep inferior epigastric artery perforator (DIEP) flaps have become an attractive option for autologous breast reconstruction. The internal mammary artery (IMA) is the usual artery of choice for reconstruction. Unfortunately, there are certain situations when the IMA may not be suitable for usage as in previous radiation or diminutive size. Several options have been documented, such as using the thoracodorsal vessels. In this case report, we report usage of the distal and proximal ends of a contralateral single mammary artery to supply antegrade and retrograde flow to bilateral DIEP flaps...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029602/use-of-both-antegrade-and-retrograde-internal-mammary-vessels-in-the-bipedicled-deep-inferior-epigastric-perforator-flap-for-unilateral-breast-reconstruction
#18
Jonatan Hernandez Rosa, Rami D Sherif, Philip J Torina, Marco A Harmaty
BACKGROUND: Autologous abdominal tissue transfer is a well-established method of breast reconstruction. The deep inferior epigastric perforator (DIEP) flap has the additional benefit of minimal donor site morbidity as it spares the muscle and fascia. Conventional DIEP flaps may not provide adequate volume in cases where the patient is thin, has midline abdominal scars, and/or has a large volume of tissue to replace. One solution is to use a bipedicled DIEP flap, incorporating all the available abdominal tissue...
September 20, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28027223/staged-suprapectoral-expander-implant-reconstruction-without-acellular-dermal-matrix-following-nipple-sparing-mastectomy
#19
Arthur H Salibian, Jay K Harness, Donald S Mowlds
BACKGROUND: Since the introduction of nipple-sparing mastectomy as an oncologically safe procedure for the treatment of breast cancer, reconstructive efforts for immediate staged expander/implant reconstruction have focused on submuscular implantation with or without acellular dermal matrix. Suprapectoral reconstruction without acellular dermal matrix has received little attention in the reconstructive literature of nipple-sparing mastectomy. METHODS: Between 2005 and 2015, 155 patients (250 breasts) underwent nipple-sparing mastectomy with prepectoral staged expander/implant reconstruction using thick mastectomy skin flaps without acellular dermal matrix...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28011513/tumescent-anesthesia-in-skin-and-nipple-sparing-mastectomy-results-of-a-prospective-clinical-study
#20
Marco Gipponi, Ilaria Baldelli, Giulia Atzori, Piero Fregatti, Federica Murelli, Marianna Pesce, Cecilia Margarino, Francesca Depaoli, Daniele Friedman
BACKGROUND: The tumescent mastectomy technique has been used to facilitate dissection of subcutaneous tissue and mammary gland in order to reduce intraoperative bleeding and speed the operation. PATIENTS AND METHODS: A prospective clinical study was performed on 30 female patients undergoing immediate breast reconstructions after skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) in order to assess early postoperative complications, pain, and final esthetic outcome of skin flaps related to tumescent anesthesia (TA)...
January 2017: Anticancer Research
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