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https://www.readbyqxmd.com/read/28728333/the-lazy-s-design-a-novel-skin-closure-design-in-skin-sparing-mastectomy-for-implant-based-breast-reconstruction
#1
June-Kyu Kim, Yong Seong Kim
Preservation of the breast skin envelope during immediate implant-based breast reconstruction is important for producing symmetrical and natural-looking breasts. We propose the lazy S design for the closure of round-shaped wounds with the hope of improving the aesthetic outcomes and reducing the tension on the wound by preserving the skin. Additionally, the direction of tension is dispersed due to the shape of this design. Patients undergoing implant reconstruction after skin-sparing mastectomy may benefit from the lazy S design...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28720989/trapezius-perforator-flap-for-reconstruction-of-a-posterior-cervical-defect
#2
Ricardo Nascimento, Joana Costa, Ricardo Horta, Álvaro Silva
The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720851/microneedle-patch-delivery-of-influenza-vaccine-during-pregnancy-enhances-maternal-immune-responses-promoting-survival-and-long-lasting-passive-immunity-to-offspring
#3
E Stein Esser, Joanna A Pulit-Penaloza, Haripriya Kalluri, Devin McAllister, Elena V Vassilieva, Elizabeth Q Littauer, Nadia Lelutiu, Mark R Prausnitz, Richard W Compans, Ioanna Skountzou
Influenza virus causes life-threatening infections in pregnant women and their newborns. Immunization during pregnancy is the most effective means of preventing maternal and infant mortality/morbidity; however, influenza vaccination rates of pregnant women remain under 50%. Furthermore, the availability of vaccines in low-resource populations is limited. Skin immunization with microneedle patches (MN) is a novel and safe vaccination platform featuring thermostable vaccine formulations. Cold-chain independence and the potential for self-administration can expand influenza vaccination coverage in developing countries...
July 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28716116/catching-and-monitoring-clinical-innovation-through-performance-indicators-the-case-of-the-breast-conserving-surgery-indicator
#4
Anna Maria Murante, Silvio Candelori, Paola Rucci, Sabina Nuti, Manuela Roncella, Matteo Ghilli, Andrea Mercatelli, Maria Pia Fantini
BACKGROUND: The evolution in the surgical and diagnostic procedures, the attention to women's preferences, the case mix, and differences in professional practices may lead to a variability in the quality of breast cancer clinical pathway. To catch and manage this variability it is important to use valid measures. The aim of this paper is to examine the concurrent validity of the breast-conserving surgery (BCS) indicator and to provide evidence to guide the quality improvement process...
July 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28709454/comparison-of-skin-sparing-mastectomy-using-ligasure%C3%A2-small-jaw-and-electrocautery
#5
Young Woo Chang, Hwan Soo Kim, Seung Pil Jung, Sang Uk Woo, Jae Bok Lee, Jeoung Won Bae, Gil Soo Son
BACKGROUND: Skin-sparing mastectomy (SSM) is increasingly used in patients with breast cancer. We compared the differences between use of electrocautery and LigaSure™ Small Jaw in patients with breast cancer who underwent SSM. METHODS: Between January 2012 and December 2015, 81 patients with breast cancer who underwent SSM were selected and were divided into the electrocautery group and the LigaSure™ Small Jaw group based on the devices that were used. Clinicopathological characteristics, body mass index, operative time, and weight of removed breast were obtained from medical records...
July 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28705456/feeling-touch-on-the-own-hand-restores-the-capacity-to-visually-discriminate-it-from-someone-else-hand-pathological-embodiment-receding-in-brain-damage-patients
#6
Carlotta Fossataro, Valentina Bruno, Patrizia Gindri, Lorenzo Pia, Anna Berti, Francesca Garbarini
The sense of body ownership, i.e., the belief that a specific body part belongs to us, can be selectively impaired in brain-damaged patients. Recently, a pathological form of embodiment has been described in patients who, when the examiner's hand is located in a body-congruent position, systematically claim that it is their own hand (E+ patients). This paradoxical behavior suggests that, in these patients, the altered sense of body ownership also affects their capacity of visually discriminating the body-identity details of the own and the alien hand, even when both hands are clearly visible on the table...
June 23, 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/28699269/determinants-of-short-and-long-term-outcomes-in-patients-undergoing-immediate-breast-reconstruction-following-neoadjuvant-chemotherapy
#7
Craig A Wengler, Stephanie A Valente, Zahraa AlHilli, Neil M Woody, Julia H Muntean, Jame Abraham, Rahul D Tendulkar, Risal Djohan, Colin O'Rourke, Joseph P Crowe, Stephen R Grobmyer
BACKGROUND: We evaluated oncologic outcomes and complications of skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate reconstruction (IR) after neoadjuvant chemotherapy (NAC) in patients with early-stage and locally advanced breast cancer (BC). METHODS: BC patients from 2000 to 2014 treated with NAC followed by SSM/NSM and IR were reviewed. Patient demographics, tumor characteristics, NAC response, complications, and recurrence were analyzed...
July 11, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28697225/low-dose-methotrexate-for-vitiligo
#8
Anna Cristina Garza-Mayers, Daniela Kroshinsky
<p>BACKGROUND: Treatment of vitiligo is aimed at repigmentation and often consists of multiple modalities, none of which are universally or rapidly successful. Extensive cases are most often treated with ultraviolet light therapy, which can be both costly and time-consuming. Though vitiligo is an autoimmune disease, there is no current data to support systemic immunosuppressive monotherapy.</p> <p>CASE SUMMARY: Here we present a case series of 3 patients with vitiligo treated for 11-16 months with low-dose methotrexate (12...
July 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28697085/humeral-shaft-fracture-intramedullary-nailing
#9
Sanjit R Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture. METHODS: The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure. RESULTS: This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28690051/nipple-sparing-mastectomy-for-breast-cancer-and-implant-reconstruction-is-associated-with-high-patients-satisfaction-and-safe-oncological-outcomes
#10
Violette Mesdag, Claudia Régis, Emmanuelle Tresch, Marie-Pierre Chauvet, Loïc Boulanger, Pierre Collinet, Sylvia Giard
BACKGROUND: The preservation of the nipple areolar complex (NAC) for cancer treatment is still a matter of debate because of suspected increase of local recurrence and surgery-specific complications. The aim of the study was to investigate both the relapse risk associated with Nipple Sparing Mastectomy (NSM) for breast cancer and women's satisfaction with preservation of the NAC. METHODS: We included retrospectively all patients who had skin-sparing mastectomy (SSM) or NSM from 2007 to 2012 for breast cancer or ductal carcinoma in situ (DCIS)...
July 6, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28684896/a-technique-of-endoscopic-nipple-sparing-mastectomy-for-breast-cancer
#11
Yu Wang, Ji-Xiang Wu, Shan Guan
BACKGROUND AND OBJECTIVES: Nipple-sparing mastectomy (NSM) is a widely accepted surgical technique for patients with early breast cancer. The technique improves cosmetic outcomes, but a decrease in nipple sensitivity has been observed with NSM because of the incision into the nipple-areola complex (NAC). Endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) removes all breast tissue through the axillary incision used for the sentinel lymph node biopsy, to avoid incision around the NAC area...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28681156/margin-proximity-correlates-with-local-recurrence-after-mastectomy-for-patients-not-receiving-adjuvant-radiotherapy
#12
Jaime M Glorioso, Alexandra B Gonzalez Juarrero, Brian R Rodysill, William S Harmsen, Elizabeth B Habermann, Jodi M Carter, Robert W Mutter, Amy C Degnim, James W Jakub
BACKGROUND: Although considerable evidence exists regarding margin status and reexcision for patients undergoing breast conservation therapy, few data address the impact of a close margin for patients undergoing mastectomy without postmastectomy radiotherapy. METHODS: This retrospective review identified 1147 patients who underwent 1206 mastectomies with negative final margins for breast cancer from 2006 to 2010. Margin distance was analyzed as a continuous variable and dichotomized variable ((≤2 vs >2 mm)...
July 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28676157/mohs-micrographic-surgery-for-the-management-of-cutaneous-malignancies
#13
REVIEW
Bobbak Mansouri, Lindsay M Bicknell, Dane Hill, Gregory D Walker, Katherine Fiala, Chad Housewright
Mohs micrographic surgery is a specialized form of skin cancer surgery in which the Mohs surgeon acts as both surgeon and pathologist. The procedure is characterized by its histopathologic margin control and ability to spare tissue, particularly in cosmetically sensitive locations. Mohs surgery is known for both limiting the size of the final defect and its high cure rate. In this review, the authors highlight indications for the procedure, detail the technique itself, discuss cutaneous tumors for which Mohs micrographic surgery is indicated, and present the economic benefit of Mohs surgery...
August 2017: Facial Plastic Surgery Clinics of North America
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/28673535/nipple-sparing-and-skin-sparing-mastectomy-review-of-aims-oncological-safety-and-contraindications
#15
Viviana Galimberti, Elisa Vicini, Giovanni Corso, Consuelo Morigi, Sabrina Fontana, Virgilio Sacchini, Paolo Veronesi
Skin-sparing (SSM) and nipple-sparing (NSM) mastectomies are relatively new conservative surgical approaches to breast cancer. In SSM most of the breast skin is conserved to create a pocket that facilitates immediate breast reconstruction with implant or autologous graft to achieve a quality cosmetic outcome. NSM is closely similar except that the nipple-areola complex (NAC) is also conserved. Meta-analyses indicate that outcomes for SSM and NSM do not differ from those for non-conservative mastectomies. Recurrence rates in the NAC after NSM are acceptably low (0-3...
June 30, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28671888/complications-after-total-skin-sparing-mastectomy-and-expander-implant-reconstruction-effects-of-radiation-therapy-on-the-stages-of-reconstruction
#16
Anne Warren Peled, Marie Sears, Frederick Wang, Robert D Foster, Michael Alvarado, Jasmine Wong, Cheryl A Ewing, Hani Sbitany, Laura J Esserman, Barbara Fowble
BACKGROUND: Many patients undergoing total-skin sparing mastectomy (TSSM) and 2-staged expander-implant (TE-I) reconstruction require postmastectomy radiation therapy (PMRT). Additionally, many patients undergoing TSSM for recurrent cancer have a history of lumpectomy and radiation therapy (XRT). Few studies have looked at the impact of XRT on the stages of TE-I reconstruction. METHODS: Patients undergoing TSSM and immediate TE-I reconstruction between 2006 and 2013 were identified from a prospectively maintained database...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28666767/towards-breast-cancer-rotational-radiotherapy-with-synchrotron-radiation
#17
Francesca Di Lillo, Giovanni Mettivier, Antonio Sarno, Roberta Castriconi, Paolo Russo
PURPOSE: We performed the first investigations, via measurements and Monte Carlo simulations on phantoms, of the feasibility of a new technique for synchrotron radiation rotational radiotherapy for breast cancer (SR(3)T). METHODS: A Monte Carlo (MC) code based on Geant4 toolkit was developed in order to simulate the irradiation with the SR(3)T technique and to evaluate the skin sparing effect in terms of centre-to-periphery dose ratio at different energies in the range 60-175keV...
June 27, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28664306/axillary-advancement-suture-to-minimize-post-implantation-deformity-in-implant-based-breast-reconstruction
#18
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/28663629/the-effect-of-multimodal-analgesia-on-intraoperative-morphine-requirement-in-lumbar-spine-surgeries
#19
Keelara Shivalingaiah Savitha, Radhika Dhanpal, Apoorwa N Kothari
BACKGROUND: Lumbar spine surgery demands intense analgesia. Preemptive multimodal analgesia (MMA) is a novel approach to attenuate the stress response to surgical stimulus. AIMS: The aim of the study was to assess the intraoperative morphine consumption in patients undergoing lumbar spine surgery. PATIENTS AND METHODS: A randomized, prospective, double-blind study involving 42 patients belonging to the American Society of Anesthesiologists Class I and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28662949/patched-skin-bilirubin-assay-to-monitor-neonates-born-extremely-preterm-undergoing-phototherapy
#20
Daniele De Luca, Valentina Dell'Orto
OBJECTIVE: To verify the reliability and safety of transcutaneous bilirubin (TcB) measurements in patched skin areas in neonates born extremely preterm under phototherapy. STUDY DESIGN: Sixty neonates (<30 weeks' gestation) receiving phototherapy were enrolled and TcB was measured via a second-generation transcutaneous bilirubinometer in patched skin areas (of at least 2.5 cm diameter). Total serum bilirubin (TSB), lactate, pH, hemoglobin, and skin temperature were measured within 10 minutes of the TcB assay...
June 26, 2017: Journal of Pediatrics
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