Current Issue : October - December Volume : 2014 Issue Number : 4 Articles : 4 Articles
The increasing use of commercially available acellular dermis matrices for postmastectomy breast reconstruction seems to have\nsimplified the surgical procedure and enhanced the outcome.These materials, generally considered to be highly safe or with only\nminor contraindications due to the necessary manipulation in preparatory phases, allow an easier one-phase surgical procedure,\nin comparison with autologous flaps, offering a high patient satisfaction. Unfortunately, the claimfor a higher rate of complications\nassociated with irradiation at the implant site, especially when the radiation therapy was given before the reconstructive surgery,\nsuggested a careful behaviour when this technique is preferred. However, this hypothesis was never submitted to a crucial test,\nand data supporting it are often discordant or incomplete. To provide a comprehensive analysis of the field, we searched and\nsystematically reviewed papers published after year 2005 and registered clinical trials. On the basis of a meta-analysis of data, we\nconclude that the negative effect of the radiotherapy on the breast reconstruction seems to be evident even in the case of acellular\ndermis matrices aided surgery. However, more trials are needed to make solid conclusions and clarify the poor comprehension of\nall the factors negatively influencing outcome....
Asurgical technique using local tissue skate flaps combined with cylindersmade froma naturally derived biomaterial has been used\neffectively for nipple reconstruction. A retrospective review of patients who underwent nipple reconstruction using this technique\nwas performed. Comorbidities and type of breast reconstruction were collected. Outcome evaluation included complications,\nsurgical revisions, and nipple projection.There were 115 skate flap reconstructions performed in 83 patients between July 2009 and\nJanuary 2013. Patients ranged from 32 to 73 years old. Average body mass index was 28.0. The most common comorbidities were\nhypertension (39.8%) and smoking (16.9%). After breast reconstruction, 68.7% of the patients underwent chemotherapy and 20.5%\nunderwent radiation. Seventy-one patients had immediate breast reconstructionwith expanders and 12 had delayed reconstruction.\nThe only reported complications were extrusions (3.5%). Six nipples (5.2%) in 5 patients required surgical revision due to loss of\nprojection; two patients had minor loss of projection but did not require surgical revision. Nipple projection at time of surgery\nranged from 6 to 7mm and average projection at 6 months was 3ââ?¬â??5 mm. A surgical technique for nipple reconstruction using a\nskate flapwith a graftmaterial is described.Complications are infrequent and short-termprojection measurements are encouraging....
Introduction. Foot disorders such as ulceration, infection, and gangrene which are often due to diabetes mellitus are some major\ncauses ofmorbidity and high amputation. Aim. This study aims to use a group of methods for the management of diabetic foot ulcers\n(DFU) in order to salvage the lower limb so as to reduce the rate of high amputations of the lower extremity. Materials and Methods.\nA group of different advanced methods for the management of DFU such as sharp debridement of ulcers, application of vacuum\ntherapy, and other forms of reconstructive plastic surgical procedures were used. Data collection was done at 3 different hospitals\nwhere the treatments were given. Results. Fifty-four patients with type 2 diabetes mellitus were enrolled in the current study:\nfemales n = 37 (68.51%) and males n= 17 (31.49%) with different stages of PEDIS classification.They underwent differentmethods\nof surgical management: debridement, vacuum therapy (some constructed from locally used materials), and skin grafting giving\ngood and fast results. Only 4 had below knee amputations. Conclusion. Using advanced surgical wound management including\nreconstructive plastic surgical procedures, it was possible to reduce the rate of high amputations of the lower limb....
Assessing pressure ulcers (PUs) in early stages allows patients to receive safer treatment.Up to now, in addition to clinical evaluation,\nultrasonography seems to be the most suitable technique to achieve this goal. Several treatments are applied to prevent ulcer\nprogression but none of them is totally effective. Furthermore, the in-depth knowledge of fat regenerative properties has led to a\nwide use of it.With this study the authors aim at introducing a new approach to cure and prevent the worsening of early-stage PUs\nby using fat grafts. The authors selected 42 patients who showed clinical and ultrasonographic evidence of early-stage PUs. Values\nof skin thickness, fascial integrity, and subcutaneous vascularity were recorded both on the PU area and the healthy trochanteric\none, used as control region. Fat grafting was performed on all patients. At three months, abnormal ultrasonographic findings, such\nas reduction of cutaneous and subcutaneous thickness, discontinuous fascia, and decrease in subcutaneous vascularity, all were\nmodified with respect to almost all the corresponding parameters of the control region. Results highlight that the use of fat grafts\nproved to be an effective treatment for early-stage PUs, especially in the care of neurological and chronic bedridden patients....
Loading....