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Publisher: Elsevier   (Total: 3163 journals)

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Showing 1 - 200 of 3163 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 30, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 88, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 35, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 394, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 244, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 27, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 16, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3, SJR: 0.732, CiteScore: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 134, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 29, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 53, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 37, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 16, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 385, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 10, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 334, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 10, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 436, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 10, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 51, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 43)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 202, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 63, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 15, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 173, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)

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Journal Cover
Annales de Chirurgie Plastique Esthétique
Journal Prestige (SJR): 0.365
Citation Impact (citeScore): 1
Number of Followers: 2  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0294-1260
Published by Elsevier Homepage  [3163 journals]
  • The ongoing emergence of robotics in plastic and reconstructive surgery
    • Authors: S. Struk; Q. Qassemyar; N. Leymarie; J.-F. Honart; H. Alkhashnam; K. De Fremicourt; A. Conversano; J.-B. Schaff; F. Rimareix; F. Kolb; B. Sarfati
      Pages: 105 - 112
      Abstract: Publication date: April 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 2
      Author(s): S. Struk, Q. Qassemyar, N. Leymarie, J.-F. Honart, H. Alkhashnam, K. De Fremicourt, A. Conversano, J.-B. Schaff, F. Rimareix, F. Kolb, B. Sarfati
      Robot-assisted surgery is more and more widely used in urology, general surgery and gynecological surgery. The interest of robotics in plastic and reconstructive surgery, a discipline that operates primarily on surfaces, has yet to be conclusively proved. However, the initial applications of robotic surgery in plastic and reconstructive surgery have been emerging in a number of fields including transoral reconstruction of posterior oropharyngeal defects, nipple-sparing mastectomy with immediate breast reconstruction, microsurgery, muscle harvesting for pelvic reconstruction and coverage of the scalp or the extremities.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.01.002
       
  • Reconstruction of an anterior chest wall radionecrosis defect by a
           contralateral latissimus dorsi flap: A case report
    • Authors: A. Vairinho; A. Al Hindi; M. Revol; A. Legras; K. Rem; Y. Guenane; S. Cristofari; T. Sorin
      Pages: 182 - 186
      Abstract: Publication date: April 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 2
      Author(s): A. Vairinho, A. Al Hindi, M. Revol, A. Legras, K. Rem, Y. Guenane, S. Cristofari, T. Sorin
      Introduction Soft tissue and bone radionecrosis are rare but serious complications may occur late after radiotherapy. Case report We report the case of an 86-year-old woman with a history an infiltrating ductal carcinoma of the left breast, treated by total mastectomy, left axillary dissection and adjuvant radiotherapy. Eighteen years later, the first radionecrosis lesions appeared and grew progressively in a 6-month period. These lesions are deep, involving the anterior aspect of the 4th to the 6th ribs and infiltrating the chest wall to the left cardio-thoracic space communicating largely with the pericardium. During axillary dissection, the neurovascular pedicle of the left latissimus dorsi muscle had been severed. The first part of the operation consisted of performing a left side parietectomy of the thoracic wall with a large resection of pericardial tissue and a small myocardial patch. The second step consisted of repairing the thoracic wall defect with a contralateral musculocutaneous latissimus dorsi flap. Conclusion Due to its significant axis of rotation, the latissimus dorsi muscle flap must be considered in the therapeutic algorithm for covering of contralateral anterior chest wall defects.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.12.002
       
  • Reconstruction mammaire autologue par lambeau perforant lombaire
    • Authors: J.-F. Honart; N. Leymarie; B. Sarfati; H. Alknashnam; K. Rem; F. Rimareix; F. Kolb
      Pages: 25 - 30
      Abstract: Publication date: February 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 1
      Author(s): J.-F. Honart, N. Leymarie, B. Sarfati, H. Alknashnam, K. Rem, F. Rimareix, F. Kolb
      À l’instar des classiques lambeaux de grand dorsal et lambeaux abdominaux (DIEP, SIEA) utilisés en reconstruction mammaire autologue, de nombreuses alternatives ont été décrites. L’objectif est de pouvoir choisir le site donneur le plus adapté au prélèvement du lambeau, selon la morphologie de la patiente, et d’en limiter les séquelles esthétiques et fonctionnelles. Le lambeau perforant lombaire (LAP) est une possibilité, mais reste encore peu répandu. Les auteurs présentent ici leur début d’expérience d’utilisation du lambeau LAP en reconstruction mammaire. Une analyse rétrospective des patientes ayant bénéficié d’une telle reconstruction a été réalisée. Trois patientes ont été opérées d’une reconstruction mammaire immédiate ou différée par LAP. Aucun pontage vasculaire n’a été nécessaire pour allonger la longueur du pédicule. Aucune nécrose partielle ou totale n’a été observée et aucune complication postopératoire répertoriée au niveau mammaire comme au niveau du site donneur. La durée opératoire moyenne était de 7heures. Le lambeau LAP peut donc être considéré comme un outil intéressant dans le champ de la reconstruction mammaire autologue, en particulier en cas d’impossibilité d’utiliser le lambeau de DIEP, classiquement utilisé. Even though DIEP–SIEA flaps or latissimus dorsi musculocutaneous flap are the most frequently used, a wide variety of flaps have been described for autologous breast reconstruction. Concerning the choice of donor-site, the aim is to prevent and to limit the morbidity. That is why the donor-site should be carefully chosen, according to the morphology of the patient. Lumbar artery perforator flap (LAP) is an option for breast reconstruction, but it is not well known and its use is limited. This study summarizes the authors’ early experience with free LAP flap for breast reconstruction. Three patients underwent immediate or delayed autologous breast reconstruction using a LAP flap. No vascular by pass was required to lengthen the pedicle. No partial or complete flap necrosis has been reported. There was no surgical donor-site complication. Mean operative time was 7hours. LAP flap can be considered as a good option for autologous breast reconstruction, especially in patients with unfavorable abdominal donor-site, and impossibility to use a DIEP flap.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.07.011
       
  • Photographie 3D en chirurgie de la face : principes,
           intérêts et perspectives
    • Authors: N. Sigaux; L. Ganry; A. Mojallal; P. Breton; P. Bouletreau
      Pages: 62 - 68
      Abstract: Publication date: February 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 1
      Author(s): N. Sigaux, L. Ganry, A. Mojallal, P. Breton, P. Bouletreau
      L’analyse clinique de la face manque d’un outil objectif, fiable et sans contre-indication. La photographie 3D est une technique disponible pour un usage clinique depuis plus de 15 ans mais sa diffusion est pour l’instant limitée par un prix encore élevé. Nous proposons, à travers cette mise au point, de définir les principes de la photographie 3D, de décrire ses champs d’application en chirurgie de la face et enfin, les perspectives qu’offrira bientôt l’accès élargi à cette technique. The clinical examination of the face needs a reliable, objective and innocuous tool. Stereophotogrammetry for a medical use has been available for more than fifteen years but its popularity is still limited by a high cost. We hereby define the principles of stereophotogrammetry, its fields of application in facial surgery and the prospects, which might soon be offered by a wider access to this technique.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.07.006
       
  • Endoscopic robot-assisted C7 nerve root retrophalangeal transfer from the
           contralateral healthy side: A cadaver feasibility study
    • Authors: C. Bijon; L. Chih-Sheng; D. Chevallier; N. Tran; F. Xavier; P. Liverneaux
      Pages: 86 - 90
      Abstract: Publication date: February 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 1
      Author(s): C. Bijon, L. Chih-Sheng, D. Chevallier, N. Tran, F. Xavier, P. Liverneaux
      Controlateral C7 nerve root transfer in brachial plexus palsy requires a nerve graft and large incisions. This study investigated the feasibility of transferring the right C7 to the left C7 nerve root, without a graft, via a minimally invasive retropharyngeal approach. After installation of 6 trocars of 1cm diameter in the supraclavicular space, a Da Vinci SI® robot was placed. After locating the right brachial plexus, the C7 root was sectioned flush with the clavicle, transferred behind the pharynx and sutured to the left C7 root severed at the foramen level. The duration of the procedure was 2h40min. No technical difficulties were encountered. The hypothesis of this work was verified since it was possible to carry out a transfer of the right C7 root on the left C7 root by direct retropharyngeal suture without graft and by a minimally invasive technique.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.05.004
       
  • Reconstruction orbito-frontale osseuse sur mesure par guides de coupes
    • Authors: M. Atanasiu; A. Paré; A. Joly; D. Goga; B. Laure
      Pages: 91 - 96
      Abstract: Publication date: February 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 1
      Author(s): M. Atanasiu, A. Paré, A. Joly, D. Goga, B. Laure
      Introduction La prise en charge des séquelles des traumatismes orbito-frontaux est difficile compte tenu du retentissement fonctionnel, de l’impact esthétique mais aussi de la complexité géométrique du squelette craniofaciale. L’utilisation de guides de coupes et de repositionnement permet une nouvelle approche de reconstruction craniofaciale grâce à des greffes osseuses sur mesure. Nous présentons pour illustrer cette technique le cas d’un patient. Observation Un patient de 50 ans présentait des séquelles de traumatisme craniofaciale avec une déformation frontale gauche, une orbite gauche élargie avec une énophtalmie et une valgisation du zygoma gauche. Le patient souffrait d’une diplopie permanente, d’un gène esthétique et sociale importante entravant sa vie quotidienne. Une planification chirurgicale a été réalisée pour une prise en charge optimale. Nous avons réalisé une cranioplastie fronto-temporale par dédoublement pariétal, une ostéotomie de zygoma et greffe osseuse intra-orbitaire sur mesure à l’aide de guides de coupe. Les pièces osseuses ont été repositionnées grâce aux guides de repositionnement. Discussion Cette présentation illustre une nouvelle application des guides de coupe. Cette technique a pour avantage l’utilisation d’os autologue sur mesure. S’il s’agit du gold standard celle-ci nécessite une certaine expérience chirurgicale. Introduction Reconstruction of craniofacial defects due to traumatic injuries is a challenge for a reconstructive surgeon, given the functional impact, the aesthetic impact and the geometric complexity of the craniofacial skeleton. The use of cutting and repositioning guides enables a new approach from the craniofacial reconstruction with bone grafts on measure. We are presented to illustrate this technique the case of a patient. Observation The patient was 50 years old, he presented a traumatic facial sequelar: a left frontal craniofacial deformation, an enlarged left orbit with enophthalmos and valgus left zygoma. The patient had a permanent diplopia, an important aesthetic and social gene impeding daily life. Surgical planning was performed for optimal care. We performed a cranioplasty frontotemporal by bone parietal duplication, osteotomy of zygoma and intra-orbital bone graft customized using cutting guides. The bone pieces were positioned with the repositioning books. Discussion This presentation illustrates a novel application of cutting guides. This technique has the advantage of using customized autologous bone. This is the gold standard, it requires surgical experience.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.03.010
       
  • Kyste trichilemmal proliférant malin du scalp : une nouvelle
           observation
    • Authors: J. ElBenaye; Y. Elkhachine; A. Sakkah; M. Sinaa; M. Moumine; A. Jakar; M. Elhaouri
      Pages: 97 - 101
      Abstract: Publication date: February 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 1
      Author(s): J. ElBenaye, Y. Elkhachine, A. Sakkah, M. Sinaa, M. Moumine, A. Jakar, M. Elhaouri
      Introduction Le kyste trichilemmal proliférant (KTP) est une tumeur annexielle rare, d’évolution généralement bénigne, se développant principalement au cuir chevelu des femmes âgées. Seulement une cinquantaine de cas malins sont rapportés dans la littérature. Nous décrivons une nouvelle observation illustrant toute l’agressivité de cette entité rendant sa prise en charge particulièrement complexe. Observation Une patiente de 70 ans, consultait pour une augmentation de la taille d’un kyste occipital évoluant depuis 6 ans. Un scanner céphalique et une excision chirurgicale large ont confirmé le diagnostic d’un KTP malin. Quatre mois plus tard, la patiente a présenté des métastases régionales et une invasion intracérébrale. Discussion À travers notre cas et en analysant la littérature, nous discutons le cadre nosologique du KTP ainsi que ses éléments clinico-histologiques et pronostiques distinctifs. Conclusion Des études larges sont nécessaires pour mieux cerner les particularités du KTP, notamment la forme maligne, mais cela reste difficile de par sa rareté. Background Proliferating trichilemmal cyst (PTC) is a rare adnexal tumor, generally benign, primarily sitting on the scalp of elderly women. About fifty cases are reported in the literature. Herein, we describe another one particularly aggressive. Observation A 70-year-old woman had been showing an increase in the size of an occipital cyst for 6years. A cephalic scan and wide surgical excision had confirmed the diagnosis of a malignant PTC. Four months later, the tumor recurred with regional metastases and intracerebral invasion. Discussion Through our case and based on the literature analyzing, we discuss the nosology of PTC and its clinical and histological distinctive elements. Conclusion Large studies are needed to better understand the specificities of PTC, specially malignant form, but it remains difficult because of its rarity.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2017.06.003
       
  • Extradigital glomic tumor of the forearm. About a case and review of
           literature
    • Authors: Ugo Lancien; Michael Atlan; Marie Guitteny; Pierre Perrot; Franck Duteille
      Pages: 43 - 46
      Abstract: Publication date: April 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 2
      Author(s): U. Lancien, F. Duteille, P. Perrot
      We report the clinical case of a 72-year-old man followed for 10years by a specialized pain center, for neuropathic pain poorly systematized, triggered by the contact of the anteromedial face of the right forearm. After surgical excision, histological analysis indicated a well-circumscribed nodule in the subcutaneous region, confirming that the mass was a glomus tumor. In this clinical case, surgical excision allowed an immediate disappearance of the pains without recurrence to this day.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/s2468-9114(18)30011-2
       
  • Le lambeau fasciocutané fibulaire en ilôt
    • Authors: A.-C. Masquelet; J. Gaillard; A. Cambon-Binder; R. Mauprivez
      Abstract: Publication date: Available online 4 May 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): A.-C. Masquelet, J. Gaillard, A. Cambon-Binder, R. Mauprivez
      L’artère fibulaire émet le long de son parcours de nombreuses perforantes cutanées qui irriguent la face postéro-latérale de jambe. Ces perforantes sont reliées entre elle par des arcs anastomotiques qui constituent un véritable réseau supra-fascial. Nous présentons une courte série clinique de cinq cas de lambeau fascio cutané fibulaire en ilôt dont la palette cutanée et le pédicule adipo-fascial ont été prélevés en regard de l’axe fibulaire. Quatre lambeaux à point de pivot distal ont été réalisés pour des pertes de substance du tiers inférieur de jambe (3 cas) et de la face latérale du talon (1 cas). Un lambeau à point de pivot proximal a permis de réparer une perte de substance de la région du genou. Tous les lambeaux ont cicatrisé en totalité sans congestion veineuse. Le lambeau fascio cutané fibulaire offre de nombreux avantages : position opératoire de prélèvement qui permet un accès aisé à la face antéro-médiale de jambe, préservation du nerf sural et de la veine petite saphène, point de pivot du pédicule qui peut être choisi sur la projection du trajet de l’artère fibulaire. Sous réserve de placer au tiers moyen de jambe le point de pivot distal du pédicule adipo-fascial, il est possible d’associer un lambeau sural distal. En pratique, le lambeau fibulaire en ilôt nous paraît particulièrement indiqué pour les pertes de substance du tiers distal de jambe. The perforators of the fibular artery provide a well vascularised supra fascial network which allows to raise a proximally or a distally based island fascio cutaneous flap with an adipo-fascial pedicle. We present a short series of five cases of this flap for coverage of soft tissue defects involving the region of the knee, the distal third of the leg and the lateral aspect of the heel. All flaps healed entirely without venous congestion. The advantages of the fascio cutaneous fibular island flap are the supine operative position, the preservation of the sural nerve and the lesser saphenous vein and a pivot point which can be located at the middle third of the leg. According to our experience, the fascio cutaneous fibular island flap is especially indicated for repairing defects of the distal leg.

      PubDate: 2018-05-31T18:24:26Z
      DOI: 10.1016/j.anplas.2018.02.004
       
  • Multicenter evaluation of quality of life and patient satisfaction after
           breast reconstruction, a long-term retrospective study
    • Authors: Michot Tamburino; Weigert Pinsolle
      Abstract: Publication date: April 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 2
      Author(s): T. Ménez, A. Michot, S. Tamburino, R. Weigert, V. Pinsolle
      Introduction Breast reconstruction techniques are multiple and they should be chosen in order to improve women's satisfaction and well-being, thus obtaining a personalized treatment. This report's major purpose was to study, through the Breast-Q questionnaire, how the functional and aesthetic outcomes, as well as the complications, of the main autologous breast reconstruction techniques, can affect patients quality of life and well-being at long-term. The secondary purpose was to analyse, thus to identify, the independent factors characterizing the different reconstructive techniques, which may affect patients’ satisfaction. Methods Women who underwent autologous breast reconstruction through deep inferior epigastric artery perforator or Latissimus dorsi muscle flap from May 2006 to May 2013 were included. The assessment was based on the Breast-Q reconstruction questionnaire. All times of post-mastectomy reconstruction were concerned: immediate, delayed, after previous procedure failure or conversion to another reconstructive technique due to the patient's dissatisfaction. Results A total of 98 patients were included. Concerning patients satisfaction, the breast-Q score is highest in patients who underwent immediate breast reconstruction, while scores after delayed breast reconstruction, previous surgery failure or conversion to another technique are generally equivalent. Higher scores have been observed in patients who underwent reconstruction through autologous Latissimus dorsi compared to Latissimus dorsi with prosthetic implant reconstruction. Conclusion The authors identified factors of higher patients’ satisfaction, like absence of major complication and advanced patient's age, in order to personalize the surgical planning according to the patient's priorities.

      PubDate: 2018-05-31T18:24:26Z
       
  • Injections d’acides hyaluroniques au niveau de visages atteints de
           malformations faciales. Étude préliminaire de l’assouplissement des
           zones cicatricielles et de l’amélioration esthétique
    • Authors: G. Franchi; C. Neiva-Vaz; A. Picard; M.-P. Vazquez
      Abstract: Publication date: Available online 3 February 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): G. Franchi, C. Neiva-Vaz, A. Picard, M.-P. Vazquez
      Objectif de l’étude Les « volumateurs » à base d’acide hyaluronique réticulé sont la référence pour traiter les rides superficielles, les plis profonds et les creux liés au vieillissement du visage. Cette étude a pour objectif d’évaluer, en plus des effets d’augmentation de volume, les effets sur la souplesse et l’élasticité des tissus cicatriciels, de 3 acides hyaluroniques réticulés commercialisés (dosés à 15mg/mL, 17,5mg/mL et 20mg/mL), après chirurgie réparatrice chez des patients atteints d’anomalies faciales congénitales ou acquises. Patients et méthode Nous avons débuté l’usage des acides hyaluroniques réticulés en gel injectable dans ces indications en 2013 et avons réalisé à ce jour 46 séances d’injections, chez 32 patients âgés de 13–32 ans. Les résultats ont été évalués par le patient lui-même et par un chirurgien, environ 15jours après les injections et 6–18 mois plus tard. Résultats Les acides hyaluroniques réticulés ont apporté des résultats morphologiques et esthétiques très subtils, en complément des interventions chirurgicales, avec un niveau de satisfaction élevé des patients. Dans les zones cicatricielles fibreuses, la première session d’injections améliorait la souplesse et l’élasticité ; la seconde session améliorait les volumes. Les acides hyaluroniques sont capables de restaurer simultanément les volumes manquants et l’élasticité des tissus cicatriciels. Conclusion Au-delà de leur fonction de volumateur, un second effet des acides hyaluroniques réticulés est démontré cliniquement : l’augmentation de la souplesse et de l’élasticité des tissus cicatriciel fibreux. Plusieurs études expérimentales corroborent nos résultats en démontrant qu’ils modifient la composition des matrices extra cellulaires notamment en stimulant la production d’élastine et de collagène. Background Cross-linked hyaluronic acid-based fillers have gained rapid acceptance for treating facial wrinkles, deep tissue folds and sunken areas due to aging. This study evaluates, in addition to space-filling properties, their effects on softness and elasticity as a secondary effect, following injection of 3 commercially available cross-linked hyaluronic acid-based fillers (15mg/mL, 17,5mg/mL and 20mg/mL) in patients presenting with congenital or acquired facial malformations. Patients et methods We started injecting gels of cross-linked hyaluronic acid-based fillers in those cases in 2013; we performed 46 sessions of injections in 32 patients, aged from 13–32. Clinical assessment was performed by the patient himself and by a plastic surgeon, 15 days after injections and 6–18 months later. Results Cross-linked hyaluronic acid-based fillers offered very subtle cosmetic results and supplemented surgery with a very high level of satisfaction of the patients. When injected in fibrosis, the first session enhanced softness and elasticity; the second session enhanced the volume. Cross-linked hyaluronic acid-based fillers fill sunken areas and better softness and elasticity of scar tissues.
      PubDate: 2018-05-31T18:24:26Z
      DOI: 10.1016/j.anplas.2018.01.001
       
  • Apport du lambeau scrotal pour la couverture des escarres ischiatiques et
           périnéales
    • Authors: M. Vantomme; R. Viard; R. Aimard; P.-L. Vincent; J.-P. Comparin; D. Voulliaume
      Abstract: Publication date: Available online 11 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): M. Vantomme, R. Viard, R. Aimard, P.-L. Vincent, J.-P. Comparin, D. Voulliaume
      Introduction L’escarre ischiatique est une pathologie fréquente chez les blessés médullaires rééduqués, malgré une prévention attentive. Le traitement médical par décharge et cicatrisation dirigée n’est pas toujours suffisant et une chirurgie utilisant des lambeaux musculocutanés locaux est souvent indispensable. Malheureusement, la récidive est fréquente et la disponibilité des lambeaux locaux est limitée. Le lambeau scrotal est un excellent complément aux lambeaux classiques, lambeaux glutéaux ou lambeaux d’ischiojambiers. Il peut être utilisé seul ou en complément d’un autre lambeau musculocutané, en première ou deuxième intention. Matériel et méthodes Le lambeau scrotal est un lambeau musculocutané, utilisant le Dartos, muscle peaucier du scrotum. Il est richement vascularisé, extensible et résistant. Sa grande plasticité permet de l’adapter à toute forme de perte de substance, avec un arc de rotation pouvant atteindre la marge anale. Il peut également être désépidermisé et enfoui pour combler un défect profond. Dix cas de lambeaux scrotaux et leurs différentes indications sont revus : certains sont utilisés en première intention, d’autres en complément de lambeaux musculocutanés. Résultats Le prélèvement d’un lambeau scrotal est rapide et extrêmement facile. La fermeture aisée du site donneur autorise, grâce à la grande laxité locale, des prélèvements de la moitié du scrotum. Les lambeaux scrotaux réalisés ont rapidement cicatrisé, ainsi que les sites donneurs. Une seule récidive a été observée, secondaire à un traitement inadapté de l’ostéite sous-jacente. Aucune complication n’est survenue. Conclusion Le lambeau musculocutané scrotal, fiable, résistant, et de prélèvement aisé et rapide est un excellent moyen de couverture de la région périnéale. Il peut être utilisé pour le traitement de toute perte de substance périnéale chez l’homme, mais reste particulièrement utile pour le traitement des escarres ischiatiques ou périnéales. Introduction The ischiatric pressure sore is a common pathology in rehabilitated spinal cord injured people, despite careful prevention. Medical treatment by discharge and directed healing is not always sufficient and surgery using local musculocutaneous flaps is often essential. Unfortunately, recidivism is frequent and the availability of local flaps is limited. The scrotal flap is an excellent complement to classic flaps, gluteal flaps or hamstrings. It can be used alone or in addition to another musculocutaneous flap, in first or second intention. Material and methods The scrotal flap is a musculocutaneous flap, using the Dartos, the platys muscle of the scrotum. It is richly vascularized, extensible and resistant. Its great plasticity makes it adaptable to any form of loss of substance, with an arc of rotation that can reach the anal margin. It can also be desepidermized and buried to fill a deep defect. Ten cases of scrotal flaps and their different indications are reviewed: some are used in first intention, others in addition to musculocutaneous flaps. Results The removal of a scrotal flap is fast and extremely easy. The simple closure of the donor site allows the sampling of half of the scrotum due to the great local laxity. The scr...
      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.005
       
  • Les brûlures profondes par agents basiques : évaluation d’une
           stratégie chirurgicale en deux temps
    • Authors: F. Devinck; C. Deveaux; Y. Bennis; V. Deken-Delannoy; M. Jeanne; V. Martinot-Duquennoy; P. Guerreschi; L. Pasquesoone
      Abstract: Publication date: Available online 10 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): F. Devinck, C. Deveaux, Y. Bennis, V. Deken-Delannoy, M. Jeanne, V. Martinot-Duquennoy, P. Guerreschi, L. Pasquesoone
      Introduction Les brûlures chimiques sont rares mais entraînent des lésions cutanées souvent profondes. Les agents basiques possèdent un pouvoir pénétrant fort et prolongé, provoquant des brûlures évolutives sur plusieurs jours. Le traitement local de ces patients est chirurgical associant excision et couverture par greffe de peau mince. Réalisées précocement dans un contexte d’agent chimique, ces greffes sont de prise difficile, retardant la cicatrisation. Nous proposons donc pour ces patients de différer la greffe de peau mince, 10jours après l’excision de la brûlure. Nous présentons une étude comparative originale et nouvelle pour évaluer notre stratégie chirurgicale en deux temps. Matériel et méthodes Nous avons réalisé une étude rétrospective des patients victimes de brûlures profondes par agents basiques pris en charge dans le centre des brûlés de Lille. Les caractéristiques épidémiologiques et les modalités de prise en charge chirurgicales ont été étudiées sur dossier. Nous avons comparé la durée de cicatrisation et le taux de lyse de greffes de peau chez les patients ayant bénéficié d’une couverture initiale (témoins) ou secondaire (cas) après excision. Cette comparaison a été possible après appariement sur l’âge et le sexe. Résultats Notre population a inclus 25 témoins et 16 cas. Les hommes étaient majoritairement atteints avec un âge moyen de 41,9 ans. Les brûlures étaient localisées dans 78 % des cas aux membres inférieurs. Le délai entre la brûlure et l’excision était en moyenne de 16,5jours. Chez les cas, la greffe de peau mince était réalisée en moyenne 11,3jours après l’excision initiale. Nous n’avons pas mis en évidence de différence significative entre les deux groupes pour la surface corporelle totale atteinte, la topographie des brûlures et l’agent causal. La durée de cicatrisation était significativement plus courte chez les cas par rapport aux témoins (37,5jours vs 50,3jours ; p <0,025). On observait de plus une diminution du nombre de lyse de greffes chez les cas par rapport aux témoins (13,3 % vs 46,7 % ; p =0,059). Conclusion Notre étude montre l’intérêt d’une stratégie chirurgicale en deux temps chez les patients victimes de brûlures par agents basiques. L’excision dite précoce associée à la réalisation d’une greffe de peau mince dans un second temps permet une cicatrisation plus rapide et diminue les risques de lyse de greffe. Introduction Chemical burns are rare but often lead to deep cutaneous lesions. Alkali agents have a deep and long lasting penetrating power, causing burns that evolve over several days. The local treatment for these patients is excision of the wound and split thickness skin graft. Early excision and immediate skin grafting of alkali burns are more likely to be complicated by graft failure and delayed wound healing. We propose a two-step method that delays skin grafting until two-three days after burn wound excision. Results Our population included 25 controls and 16 cases. Men were predominant with a mean age of 41.9 years. In 78% of cases, burns were located on the lower limbs. The mean delay between the burn and excision was 16.5 days. In cases, the skin graft was performed at a mean of 11.3 days after the initial excision. We did not unveil a...
      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.008
       
  • Faut-il encore drainer les réductions mammaires '
    • Authors: N. Vidali; A. Chevet-Noel; P. Ringenbach; J.B. Andreoletti
      Abstract: Publication date: Available online 9 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): N. Vidali, A. Chevet-Noel, P. Ringenbach, J.B. Andreoletti
      Objectif Le drainage du site opératoire est courante en chirurgie mammaire pour diminuer les complications à court et moyen termes. Il n’existe pas à l’heure actuelle d’« evidence-based medicine » justifiant son utilisation qui relève plus des habitudes de chaque chirurgien. L’objectif de cette étude était de démontrer que le taux de complications n’était pas plus élevé en l’absence de drainage après réduction mammaire. Patientes et méthode Nous avons réalisé une étude rétrospective et comparative de deux cohortes de patientes ayant bénéficié d’une réduction mammaire avec et sans drainage postopératoire. Les complications suivantes ont été colligées : épanchements (sérome, hématome), infections, désunions cicatricielles, nécroses cutanées ou aréolaires, cytostéatonécroses et reprises chirurgicales. Résultats Cent trente-huit seins ont été opérés (37 patientes avec drain et 32 sans drain). Le recul moyen pour le recueil des complications était de 10 mois (1–15 mois). Nous n’avons pas retrouvé de différences significatives entre les deux groupes concernant les taux de complications, ce qui correspond aux données de la littérature. Conclusion Hormis pour certains cas (comme la gigantomastie), le drainage de routine après réduction mammaire ne nous paraît pas indiqué. Il ne diminue pas les complications postopératoires et induit un allongement de la durée d’hospitalisation impliquant des frais médicaux évitables. Il est source d’inconfort, de douleurs et d’anxiété supplémentaire pour les patientes. Objective Despite the absence of “evidence-based medicine”, the use of closed suction drainage in breast surgery is currently the standard practice. Its goal is to minimize the amount of fluid at the operation site, the dead space that can involve postoperative complications. The purpose of this study is to demonstrate that with or without drainage the complication rate is unchanged. Methods We conducted a retrospective and comparative study of two groups of breast reduction with and without drainage. Every complication has been recorded and statistically analyzed: seroma and hematoma, infections, wound breakdown, skin flap or nipple-areola complex necrosis, fat necrosis and reoperation. Results A total of 138 breast reductions were performed (37 drained patients and 32 non-drained). Data collection of complications was done on average 10months after the operation (1–15). There was no statistical difference between the two groups regarding the complication rate. Our results confirm the ones found in the literature. Conclusion Except for specific cases (e.g. gigantomasty), this study demonstrates that after breast reduction, drainage is not appropriate. Drains do not reduce postoperative complications and can increase hospitalization length of stay (inducing higher costs). Furthermore, it is often source of pain, anxiety and discomfort for patients.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.006
       
  • Triple flap technique for vulvar reconstruction
    • Authors: R. Mercut; R. Sinna; R. Vaucher; P.A. Giroux; N. Assaf; A. Lari; S. Dast
      Abstract: Publication date: Available online 9 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): R. Mercut, R. Sinna, R. Vaucher, P.A. Giroux, N. Assaf, A. Lari, S. Dast
      Objective Perineal defects are encountered ever more frequently, in the treatment of vulvar cancers or abdominoperineal resection. The surgical treatment of vulvar cancer leads to significant skin defect. The aim of the reconstruction is not to provide volume but rather to resurface perineum. We propose a new solution to cover the extensive skin defect remaining after excision. Methods We report 3 patients who underwent large excision for vulvar cancer, with lymph node dissection. For reconstruction, we performed 3 advancement flaps. Two V-Y flaps cantered on the infra-gluteal folds and based on pudendal perforator arteries were used to cover the postero-lateral parts of the defect. The third advancement flap from the superior aspect of the defect was a Y-V Mons pubis flap. Results The defects were successfully covered by the 3 flap technique. The first patient suffered a non-union that slowly healed by secondary intention. For the other cases, we used the same technique, but applied negative pressure wound therapy on the sutures, with excellent results. Conclusion The 3 flap technique is a simple and reliable method and the donor site morbidity is minimal. It can be realised without changing the position of the patient after tumour excision, and does not require delicate perforator dissection. This surgical option can be easily applied, allowing better management of these cases.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.007
       
  • Partial medial second toe pulp free flap and dermal substitute with skin
           graft for salvage reconstruction of a complete skin envelope degloving of
           the small finger
    • Authors: V. Calafat; C. Strugarek; D. Montoya-Faivre; F. Dap; G. Dautel
      Abstract: Publication date: Available online 5 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): V. Calafat, C. Strugarek, D. Montoya-Faivre, F. Dap, G. Dautel
      Skin envelope degloving of fingers are rare injuries that require rapid care and surgical treatment. Mostly caused by ring finger injuries, these traumas include bone, tendon and neurovascular pedicle damage. The authors present an unusual case of finger degloving limited exclusively to the skin envelope, without skeletal, tendinous or vascular lesion. This rare case of skin envelope degloving rendered microsurgical revascularization impossible. The authors report the results at 12 months following salvage reconstruction combining a partial second toe pulp free flap for the volar side and a dermal substitute with a thin skin graft for the dorsum.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.001
       
  • Sans complexe et à côté de la plaque !
    • Authors: J. Glicenstein
      Abstract: Publication date: Available online 4 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): J. Glicenstein


      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.002
       
  • Une forme pagétoïde de pseudomélanome d’Ackerman secondaire à un
           naevus congénital dans l’enfance : à propos d’un cas
    • Authors: L. Bompy; J. Levasseur; A. Hallier; S. Fraitag; M.-H. Aubriot-Lorton; B. Bonniaud; N. Zwetyenga
      Abstract: Publication date: Available online 4 April 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): L. Bompy, J. Levasseur, A. Hallier, S. Fraitag, M.-H. Aubriot-Lorton, B. Bonniaud, N. Zwetyenga
      Introduction Le pseudomélanome d’Ackerman est une tumeur bénigne présentant des similitudes avec des lésions malignes. Il survient classiquement chez l‘adulte à la suite de l’exérèse incomplète d’un naevus commun acquis. Son incidence varie de 0,3 à 27 % selon les études. Nous présentons ici un cas clinique pédiatrique de forme pagétoïde de pseudomélanome d’Ackerman apparu dans les suites de l’exérèse d’un naevus congénital. Cas clinique L’exérèse d’un naevus congénital localisé au niveau du thorax a été réalisée sur une patiente de 9 mois. L’analyse histologique a conclu à un naevus commun acquis d’exérèse complète. À sept mois post-opératoires, deux autres lésions cutanées sont apparues. Nous avons réalisé l’exérèse de ces deux lésions avec 2mm de marges. L’analyse a conclu à un pseudomélanome d’Ackerman avec des atypies histologiques. Il n’a pas été constaté de récidive à trois ans post-opératoires. Discussion Il s’agit d’un cas clinique original devant l’apparition d’un pseudomélanome d’Ackerman après exérèse d’un naevus congénital chez un enfant. De plus, cette tumeur présentait plusieurs atypies histologiques. Les médecins, qu’il s’agisse de chirurgiens, dermatologues ou anatomopathologistes, se doivent d’être informés du risque d’erreur diagnostic dont est source cette lésion qui présente des similitudes avec le mélanome SSM en régression. Il serait intéressant de déterminer des marqueurs qui permettrait de statuer sur son caractère bénin. Il n’existe pas de recommandation quant à la conduite à tenir face à cette tumeur mais il semble nécessaire de la retirer afin d’éliminer une tumeur maligne. Introduction Recurrent nevus (RN) is a cutaneous benign tumour with similarities with malignant lesions. Typically, it occurs after a partial resection of commun-acquired nevus. Its incidence varies from 0.3 to 27% according to the studies. We present here a pediatric case of a pagetoid form of a recurrent nevus occurring from a congenital nevus. Case report A congenital nevus was removed from a 9-month-old girl. Pathologists concluded to a commun-acquired nevus of complete exeresis. Two other cutaneous lesions appeared and we decided to realise a total removal. Analysis showed a recurrent nevus with some atypical histological features. No recurrence has occurred during the three post-operative of follow-up. Discussion It is an interesting case because of the occurrence of a RN after the removal of a congenital nevus in a child. Furthermore, it displayed some atypical histological features. Practicians, such as surgeons, dermatologists or pathologists, have to be aware of the risk of misdiagnosis with this lesion, which presents some similarities with SSM melanoma. It would be interesting to determinate some markers to statuate about its benign feature. There is no management recommendation about this lesion but it seems to be necessary to remove it to eliminate a malignant tumour.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.03.003
       
  • Three-dimensional imaging, an important factor of decision in breast
           augmentation
    • Authors: Runz Boccara; Bertheuil Claudot Brix Simon
      Abstract: Publication date: April 2018
      Source:Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 2
      Author(s): A. de Runz, D. Boccara, N. Bertheuil, F. Claudot, M. Brix, E. Simon
      Introduction Since the beginning of the 21st century, three-dimensional imaging systems have been used more often in plastic surgery, especially during preoperative planning for breast surgery and to simulate the postoperative appearance of the implant in the patient's body. The main objective of this study is to assess the patients’ attitudes regarding 3D simulation for breast augmentation. Method A study was conducted, which included women who were operated on for primary breast augmentation. During the consultation, a three-dimensional simulation with Crisalix was done and different sized implants were fitted in the bra. Results Thirty-eight women were included. The median age was 29.4, and the median prosthesis volume was 310mL. The median rank given regarding the final result was 9 (IQR: 8–9). Ninety percent of patients agreed (66% absolutely agreed, and 24% partially agreed) that the final product after breast augmentations was similar to the Crisalix simulation. Ninety-three percent of the patients believed that the three-dimensional simulation helped them choose their prosthesis (61% a lot and 32% a little). After envisaging a breast enlargement, patients estimated that the Crisalix system was absolutely necessary (21%), very useful (32%), useful (45%), or unnecessary (3%). Regarding prosthesis choice, an equal number of women preferred the 3D simulation (19 patients) as preferred using different sizes of implants in the bra (19 patients). Conclusion The present study demonstrated that 3D simulation is actually useful for patients in order to envisage a breast augmentation. But it should be used as a complement to the classic method of trying different sized breast implants in the bra.

      PubDate: 2018-04-25T09:57:11Z
       
  • Three-stage post-oncological reconstruction of the scalp using a
           dermal-assisted skin graft, adipose tissue graft and follicular graft: A
           clinical case
    • Authors: N. Ouar; Q. Qassemyar; D. Boccara; M. Atlan
      Abstract: Publication date: Available online 19 March 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): N. Ouar, Q. Qassemyar, D. Boccara, M. Atlan


      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.02.002
       
  • Fente labiale inférieure para-commissurale : stratégie
           thérapeutique
    • Authors: J. Chauvel-Picard; A. Gleizal
      Abstract: Publication date: Available online 19 March 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): J. Chauvel-Picard, A. Gleizal
      Nous rapportons le premier cas décrit dans la littérature de fente labiale inférieure para-commissurale droite retrouvée chez un enfant de 2 ans. Cette anomalie causait une incompétence labiale nécessitant une correction chirurgicale. Différentes techniques chirurgicales ont été décrites pour le traitement des fentes labiales supérieures. Nous avons étudié chacune d’elles, analysé les avantages et inconvénients de ces techniques en les inversant et en les adaptant pour la lèvre inférieure. Nous avons opté pour la plastie en double « Z » de Malek car la différence de hauteur entre le côté fendu et le côté sain était importante. De plus, cette technique dissimule une partie de la cicatrice dans le sillon labio-mentonnier. Le résultat fonctionnel et esthétique à 6 mois postopératoire est satisfaisant. We report the first case described in the literature of lateral, paracommissural cleft of the lower lip in a 2-year-old child. This anomaly caused labial incompetence requiring surgical correction. Different surgical techniques have been described for the treatment of the cleft of the upper lip. We studied each of them, analyzed the advantages and disadvantages of these techniques by inverting them and adapting them for the lower lip. We opted for the double “Z” plasty of Malek because the difference in height between the cleft side and the healthy side was important. In addition, this plasty hides part of the scar in the labiomental groove. The functional and aesthetic result at 6 months after surgery is satisfactory.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.02.005
       
  • Le lambeau de grand épiploon : traitement des plaies et lymphorrhees
           chroniques : à propos d’un cas
    • Authors: D. Boccara; K. Serror; M. Mimoun; M. Chaouat
      Abstract: Publication date: Available online 24 February 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): D. Boccara, K. Serror, M. Mimoun, M. Chaouat
      Introduction Les complications cicatricielles post-chirurgie abdominale ou pelvienne sont plus fréquentes chez les patientes obèses. L’infection, les séromes et les retards de cicatrisation occasionnés peuvent dans ce cas être extrêmement difficiles à traiter. L’objectif de cette note technique est de vous présenter un cas original d’une patiente de 48 ans obèse, opérée neuf ans auparavant d’une hystérectomie par laparotomie et présentant de manière chronique une fistule chronique associée à une lymphorrée septique non résolutive malgré de multiples interventions chirurgicales, dont la guérison a pu être obtenue par un lambeau de grand épiploon. Technique chirurgicale L’idéal est de réaliser cette intervention en double équipe avec un chirurgien digestif en cas de survenue de plaie viscérale ou vasculaire intra-abdominale durant la dissection. Le lambeau de grand épiploon était levé de manière classique sur l’artère gastro-épiploïque droite. Un orifice suffisamment large doit être laissé au niveau de l’aponévrose abdominale afin d’éviter toute compression du pédicule. Enfin, le lambeau doit être étalé sur toute la surface du décollement et fixé à l’aponévrose antérieure. Conclusion La fiabilité et la richesse à la fois vasculaire et lymphatique font du lambeau de grand épiploon une méthode très efficace dans les cas de plaies chroniques associées à une lymphorrhée majeure. La cicatrisation obtenue dans le cas clinique présenté met ainsi en valeur les qualités spécifiques de ce lambeau. Introduction Cicatricial complications after abdominal or pelvic surgery are more frequent in obese patients. In this case, infection, seroma and delays in scarring can be extremely difficult to treat. The objective of this technical note is to present an original case of an obese patient operated nine years ago of a hysterectomy by laparotomy and chronically presenting a non-resolving septic seroma despite multiple surgical procedures whose healing could be obtained by a flap of greater omentum. Surgical technique The ideal is to carry out this intervention in a double team with a digestive surgeon in case of intra-abdominal visceral or vascular wound during dissection. The greater omentum flap was raised in a conventional manner over the gastroepiploic artery. A sufficiently wide orifice should be left at the level of the abdominal aponeurosis in order to avoid any compression of the pedicle. Finally, the flap must be spread over the whole surface of the detachment and fixed to the anterior aponeurosis. Conclusion Reliability and vascular and lymphatic richness make the greater omentum flap a very effective method in chronic wound cases associated with important seroma. The scarring obtained in the clinical case presented thus highlights the specific qualities of this flap.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.02.001
       
  • Sinus pericranii occipital : à propos d’une situation inhabituelle et
           revue de la littérature
    • Authors: M.A. Ennouhi; F. Choumi; A. Boudhas; M. Moumine; A. Moussaoui
      Abstract: Publication date: Available online 15 February 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): M.A. Ennouhi, F. Choumi, A. Boudhas, M. Moumine, A. Moussaoui
      Le sinus pericranii désigne un ensemble de présentations cliniques qui ont en commun une connexion pathologique entre les veines du scalp et le sinus veineux intracrânien sous-jacent. La nature de cette communication va de la simple dilatation des veines émissaires du crâne, à des connexions larges à travers un os calvarial défectueux laissant quasiment le sinus veineux intracrânien en contact direct avec les structures sous-cutanées. Les auteurs présentent le cas d’un sinus pericranii occipital de découverte peropératoire. Congénitale, post-traumatique ou spontanée, l’anomalie concerne le plus souvent le scalp frontal, et siège sur ou près de la ligne médiane. La présentation clinique habituelle est celle d’une masse souple qui se vide à la pression en position debout, tandis qu’elle se remplit dans toutes les situations qui augmentent la pression intracrânienne (manœuvre de Valsalva …). Le diagnostic de certitude n’est pas toujours facile à établir, et repose sur un faisceau d’arguments cliniques et radiologiques. À travers une revue de la littérature nous proposons de mettre le point sur les particularités cliniques, moyens diagnostiques et options thérapeutiques de cette entité rare. The sinus pericranii refers to a set of clinical presentations that share a pathological communication between the scalp veins and the underlying cranial venous sinus. The nature of this connection ranges from the simple dilatation of the emissary veins, to wide connections through a calvarial bone loss leaving almost the cranial venous sinus in direct contact with the subcutaneous tissue. The authors present the case of an occipital pericranii sinus of intraoperative discovery. Congenital, post-traumatic or spontaneous, this anomaly is most often frontal and located on or close to the midline. The usual clinical presentation is that of a soft mass that empties to the pressure while standing, while it fills in all situations that increase the intracranial pressure (Valsalva maneuver …). The diagnosis is not always easy to establish, and relies on a bundle of clinical and radiological arguments. Through a review of the literature we propose to focus on the clinical features, diagnostic means and therapeutic options of this rare entity.

      PubDate: 2018-04-25T09:57:11Z
      DOI: 10.1016/j.anplas.2018.01.005
       
  • Erratum à « Le lifting cervical : évolutions récentes » [Annales
           de chirurgie plastique esthétique 2017;62:461–73. DOI:
           10.1016/j.anplas.2017.08.002]
    • Authors: D. Labbé; P. Guerreschi
      Abstract: Publication date: Available online 9 January 2018
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): D. Labbé, P. Guerreschi


      PubDate: 2018-01-10T08:54:54Z
      DOI: 10.1016/j.anplas.2017.12.001
       
  • Complex upper arm reconstruction using an antero-lateral thigh free flap
           after an extravasation of Yttrium-90-ibritumomab Tiuxetan: A case report
           and literature review
    • Authors: A. Baus; C. Keilani; C.-S. Bich; F. Entine; M. Brachet; P. Duhamel; J.-C. Amabile; J.V. Malfuson; E. Bey
      Abstract: Publication date: Available online 28 December 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): A. Baus, C. Keilani, C.-S. Bich, F. Entine, M. Brachet, P. Duhamel, J.-C. Amabile, J.V. Malfuson, E. Bey
      Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) is used in the treatment of non- Hodgkin's lymphoma. Extravasation is an iatrogenic complication that is fortunately rare. However, the treatment of this complication is often complex due to the risk of extensive skin necrosis and unpredictable evolution of localized irradiation. This vesicant drug requires emergency management when extravasation occured. Radiations burns have specificities. Therefore, wound coverage involves specific plastic surgical techniques. Here, we report the case of a man presenting a chronic and extensive skin necrosis of upper arm treated with an antero-lateral thigh free flap. Moreover, we compare our experience of Zevalin® extravasation management to other past publications and propose recommendations to prevent this unacceptable complication.

      PubDate: 2018-01-05T07:28:04Z
      DOI: 10.1016/j.anplas.2017.11.007
       
  • A porcine model for robotic training harvest of the rectus abdominis
           muscle
    • Authors: V. Louis; L. Chih-Sheng; D. Chevallier; J.C. Selber; F. Xavier; P.A. Liverneaux
      Abstract: Publication date: Available online 26 December 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): V. Louis, L. Chih-Sheng, D. Chevallier, J.C. Selber, F. Xavier, P.A. Liverneaux
      Conventional open surgical approaches for the harvesting of the rectus abdominis muscle carry a high risk of morbidity. It is possible to reduce these risks by using laparoscopy or robot-assisted techniques. This work hypothesizes that a porcine model could be used for learning the robot-assisted collection of the rectus abdominis. The rectus abdominis was taken in 3 stages in 3 pigs: installation of the robot, surgical approaches with 4 trocars, dissection and collection of the muscle. The average operating time was 1h20min and the average muscular length was 16cm. Our results showed a learning curve for the robot-assisted harvesting of the rectus abdominis on a porcine model.

      PubDate: 2017-12-27T06:24:25Z
      DOI: 10.1016/j.anplas.2017.11.010
       
  • Le lambeau médial sural perforant : bases anatomiques, technique
           chirurgicale et indications en reconstruction cervicofaciale
    • Authors: S. Struk; J.-B. Schaff; Q. Qassemyar
      Abstract: Publication date: Available online 6 December 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): S. Struk, J.-B. Schaff, Q. Qassemyar
      Introduction Le lambeau médial sural perforant (medial sural artery perforator [MSAP] flap) est un lambeau cutanéo-graisseux, fin et malléable, prélevé aux dépens de la face médiale de la jambe. Ce lambeau est encore peu utilisé en France. L’objectif de ce travail, effectué à partir de dissections sur sujets anatomiques, est de rappeler les bases anatomiques et la technique chirurgicale de ce lambeau, et de proposer des indications en reconstruction cervicofaciale. Matériel et méthodes Nous avons disséqué 10 lambeaux MSAP sur 5 sujets anatomiques différents. Dans chaque cas, le nombre et la localisation des perforantes issues de l’artère surale médiale étaient enregistrés. Pour chaque lambeau, nous avons rapporté la longueur du pédicule, le calibre des vaisseaux à l’origine du pédicule ainsi que l’épaisseur du lambeau. Enfin, nous avons réalisé un cas clinique pour un trismus post-thérapeutique. Résultats Un total de 23 perforantes de calibre supérieur à 1mm a été identifié sur les 10 jambes disséquées. L’artère surale médiale donnait 1 à 4 perforantes musculocutanées. Les perforantes étaient localisées en moyenne à 10,3cm±2cm du creux poplité et à 3,6cm±1cm de la ligne médiane du mollet. La longueur moyenne du pédicule était de 12,1cm±2,5cm. À l’origine du pédicule, l’artère mesurait en moyenne 1,8mm±0,25mm et les veines mesuraient en moyenne 2,45mm±0,9mm. Le cas clinique s’est déroulé sans complication avec le prélèvement d’un lambeau perforant sural médial droit. Discussion Cette étude confirme la constance de l’anatomie du lambeau médial sural perforant. Le lambeau MSAP est fin, malléable et particulièrement adaptée à la reconstruction des pertes de substance muqueuses de la cavité orale ou pour le « resurfaçage » de la face ou des extrémités. Les séquelles au niveau du site donneur sont moindres qu’avec le lambeau antébrachial radial pour des résultats fonctionnels équivalents en reconstruction cervicofaciale. Introduction The medial sural artery perforator (MSAP) flap is defined as a thin cutaneo-adipose perforator flap harvested on the medial aspect of the leg. The aims of this study were to describe the anatomical basis as well as the surgical technique and discuss the indications in head and neck reconstructive surgery. Material and methods We harvested 10 MSAP flap on 5 fresh cadavers. For each case, the number and the location of the perforators were recorded. For each flap, the length of pedicle, the diameter of source vessels and the thickness of the flap were studied. Finally, we performed a clinical application of a MSAP flap. Results A total of 23 perforators with a diameter superior than 1mm were dissected on 10 legs. The medial sural artery provided between 1 and 4 musculocutaneous perforators. Perforators were located in average at 10.3cm±2cm from the po...
      PubDate: 2017-12-13T06:14:29Z
      DOI: 10.1016/j.anplas.2017.11.002
       
  • Attelle nasale externe sur-mesure après rhinoplastie, introduction au
           concept de « tissu-modelage »
    • Authors: E. Auclair; W. Noel
      Abstract: Publication date: Available online 27 November 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): E. Auclair, W. Noel
      Les auteurs rapportent leur expérience de 2 ans (43 patients) d’utilisation d’une attelle « sur-mesure » constituée de thermoplastique qui est moulée sur le nouveau nez au terme de la rhinoplastie, selon un procès comparable à celui utilisé par les dentistes pour fabriquer les gouttières. Cette attelle sera portée plusieurs semaines afin de guider la cicatrisation dans une direction désirée. Le moulage du nez peut-être re-sculpté pour guider la cicatrisation vers un meilleur résultat. Légère, lavable, discrète, notre attelle a l’avantage de pouvoir être portée plusieurs semaines sans inconfort dans le but d’améliorer l’efficacité de la contention. The authors report their experience of 2 years (43 patients) using a customized splint consists of thermoplastic which is molded on the new nose after rhinoplasty, according to a process comparable to that used by dentists to make the gutters. This splint will be applied several weeks to guide healing in a desired direction. The molding of the nose can be re-sculpted to guide the scarring to a better result. Lightweight, washable, discreet, our splint works to the advantage to be worn without discomfort for several weeks in order to improve the efficiency of contention.

      PubDate: 2017-12-02T04:59:02Z
      DOI: 10.1016/j.anplas.2017.06.002
       
  • La septoplastie lors de la chéilorhinoplastie primaire dans les fentes
           labio-palatines unilatérales
    • Authors: Saboye
      Abstract: Publication date: Available online 20 November 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): J. Saboye
      Lors de la réparation primaire des fentes labio-palatines la chéilorhinoplastie est devenue le « gold standard ». Pour améliorer les résultats sur la symétrie nasale nous proposons une septoplastie extensive qui repositionne le nez sur un axe médian et facilitera le deuxième temps de fermeture palatine. Cette septoplastie extensive de reposition septale, sans résection de cartilage, n’entraîne pas de troubles de croissance du nez et elle favorise la croissance du maxillaire en améliorant tôt la ventilation nasale. Elle peut éviter une rhinoplastie secondaire, source de nouvelles cicatrices. Cependant la rhinoplastie peut être à l’origine de cicatrices rétractiles, un conformateur narinaire est donc indispensable. Primary repair of cleft lip and palate has become a nasal and lip repair. In the aim to improve our nasal results on symmetry we perform an extensive septoplasty to put the nose in a good shape and a median axis. This septoplasty without resection of cartilage does not cause growth disorders to the nose and it promotes maxillary growth by improving early nasal breathing. It can prevent secondary rhinoplasty, source of new scars (externally, fork). But rhinoplasty will increase the incidence of scar contraction, thus shaping with a nasal conformer is essential.

      PubDate: 2017-11-21T03:18:39Z
       
  • Traitement des ridules de la lèvre supérieure par graisse émulsifiée
           ou « Nanofat » : étude biologique et clinique à propos de 4 cas
    • Authors: F. Mesguich Batel; B. Bertrand; J. Magalon; P. François; M. Velier; J. Veran; S. Mallet; E. Jouve; F. Sabatier; D. Casanova
      Abstract: Publication date: Available online 20 November 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): F. Mesguich Batel, B. Bertrand, J. Magalon, P. François, M. Velier, J. Veran, S. Mallet, E. Jouve, F. Sabatier, D. Casanova
      Objectif Plusieurs travaux sur l’injection de graisse émulsifiée ont montré leurs intérêts en chirurgie esthétique de la face. Le prélèvement de tissu adipeux est émulsionné mécaniquement puis filtré. La suspension obtenue est injectée dans le derme au travers d’aiguilles de 27 à 30 gauges. L’objectif de notre étude est d’évaluer la composition biologique de la graisse émulsifiée, son efficacité et sa tolérance clinique dans le traitement des ridules périorales chez 4 patientes de 50 à 59 ans. Matériel et méthode Chaque patiente a bénéficié sous anesthésie locale d’une injection intradermique de graisse émulsifiée au niveau des ridules péribuccales, préparée à partir d’un lipo aspirat abdominal. La viabilité cellulaire, la composition de la fraction vasculaire stromale (FVS) de la graisse émulsifiée et la capacité de différenciation adipocytaire des cellules souches mésenchymateuses (CSM) de cette émulsion ont été étudiées. Les résultats cliniques ont été évalués sur une durée de 4 mois par photographies standardisées, microphotographies 3D, microscopie confocale, et auto-évaluation de la satisfaction. Résultats L’étude biologique de la graisse émulsifiée a retrouvé une lyse de l’ensemble des adipocytes. Le nombre moyen de cellules de la FVS était de 126 330±2758 cellules par cm3 de graisse émulsifiée avec une viabilité cellulaire de 85,1±6,84 % et une proportion de CSM de 18,77±6,2 %. L’étude photographique standardisée et micro 3D a retrouvé une tendance à la diminution du volume des ridules non significative. Les patientes étaient satisfaites du traitement avec un score moyen de 7±1,15/10 à 4 mois. Conclusion L’injection intradermique de graisse émulsifiée apparaît comme un traitement intéressant des ridules du visage. Notre étude a montré son innocuité, mais des études supplémentaires semblent nécessaires pour confirmer son efficacité clinique. Objective Emulsified fat injection showed its interest in aesthetic facial surgery. The adipose tissue harvested is mechanically emulsified and filtered. The suspension obtained is injected into the dermis through small diameter needles (27 to 30 gauges). The objective of our study was to evaluate the biological composition of emulsified fat and its clinical effectiveness in the treatment of peri-oral wrinkles in 4 patients aged 50 to 59 years. Material and method Each patient received an intradermal injection of emulsified fat in the peri-oral wrinkles prepared from abdominal fat under local anesthesia. The cell viability, stromal vascular fraction (FVS) composition in emulsified fat and the adipocyte differentiation capacity of mesenchymal stem cells (MSC) were studied. The clinical results were evaluated by standardized photographs, 3D microphotography, confocal microscopy, and self-evaluation of patient satisfaction over a period of 4 months. Results The biological study of the emulsified fat found a lysis of all the adipocytes. The mean number of FVS cells was 126,3...
      PubDate: 2017-11-21T03:18:39Z
      DOI: 10.1016/j.anplas.2017.10.004
       
  • Déroutage de la veine céphalique dans la reconstruction mammaire par
           lambeaux libres : note technique
    • Authors: T. Silhol; T. Suffee; M. Hivelin; L. Lantieri
      Abstract: Publication date: Available online 16 November 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): T. Silhol, T. Suffee, M. Hivelin, L. Lantieri
      L’utilisation des lambeaux libres est devenue une pratique fiable dans la reconstruction mammaire. Cependant, la congestion veineuse reste la cause la plus fréquente d’échec. Elle est due à des veines mammaires internes de mauvaise qualité, à un drainage veineux superficiel préférentiel ou à une thrombose veineuse. La veine céphalique peut être une alternative de branchement dans certaines situations. Nous décrivons la technique chirurgicale et proposons un algorithme décisionnel en peropératoire. Sur les 17 patientes incluses (15 DIEP et 2 PAP), 29,4 % avaient une veine mammaire interne inutilisable d’emblée, 23,5 % un drainage veineux superficiel préférentiel et 47,1 % une thrombose veineuse. La veine céphalique était disséquée sur une longueur de 15 à 25cm. La durée moyenne de dissection était de 39min. Il n’y a eu aucun échec de reconstruction après déroutage. Les séquelles du site donneur se limitaient à une ou deux incisions de 2–3cm, sans aucune conséquence fonctionnelle. Le déroutage de la veine céphalique est une alternative fiable et peu morbide en cas de veine mammaire interne de mauvaise qualité avec une artère mammaire de bon calibre, en cas de nécessité d’un drainage superficiel supplémentaire ou en cas de thrombose veineuse. Free flaps have become a reliable practice for breast reconstruction. However, the venous congestion is still the most frequent reason of flap failure. It is due to bad quality of the internal mammary veins, a preferential superficial venous outflow of the flap or due to venous thrombosis. The transposition of the cephalic vein could useful in some cases. We describe the surgical technique and suggest an intraoperative algorithm. Seventeen patients (15 DIEP and 2 PAP) were included. Twenty nine point four percent had an unusable internal mammary vein, 23.5% a preferential superficial venous outflow and 47.1% a venous thrombosis. The length of the cephalic vein dissected varied from 15 to 25cm. The mean time of dissection was 39min. There was no flap failure after cephalic vein transposition. The sequelae were one or two scars on the arm without any functional morbidity. The transposition of the cephalic vein is a reliable, less morbid alternative in case of bad quality internal mammary vein with a good quality internal mammary artery, in case of an additional venous outflow necessity or in case of venous thrombosis.

      PubDate: 2017-11-21T03:18:39Z
      DOI: 10.1016/j.anplas.2017.10.007
       
  • Utilisation du vert d’indocyanine en chirurgie sénologique et
           reconstruction mammaire
    • Authors: S. Struk; J.-F. Honart; Q. Qassemyar; N. Leymarie; B. Sarfati; H. Alkhashnam; C. Mazouni; F. Rimareix; F. Kolb
      Abstract: Publication date: Available online 26 October 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): S. Struk, J.-F. Honart, Q. Qassemyar, N. Leymarie, B. Sarfati, H. Alkhashnam, C. Mazouni, F. Rimareix, F. Kolb
      Le vert d’indocyanine est un colorant soluble dans l’eau, à élimination hépatique et excrétion biliaire. Illuminé par une source laser infrarouge, le vert d’indocyanine émet une lumière fluorescente dans le spectre du proche-infrarouge qui est invisible à l’œil nu mais qui peut être visualisée à l’aide d’une caméra proche-infrarouge. Lorsqu’il est injecté en intraveineux, il peut être utilisé comme marqueur de la perfusion cutanée. Injecté en sous-cutané, il permet de cartographier le réseau lymphatique. En chirurgie sénologique et en reconstruction mammaire, il est utilisé pour repérer le ganglion sentinelle chez les patientes atteintes d’un cancer du sein, pour évaluer la perfusion des lambeaux cutanés de mastectomie, pour évaluer la perfusion des lambeaux libres utilisés en reconstruction mammaire autologue et dans la prise en charge du lymphœdème secondaires des membres. Le vert d’indocyanine pourrait être enfin utilisé pour guider l’excision des tumeurs non palpables du sein. The Indocyanine green (ICG) is a soluble dye that is eliminated by the liver and excreted in bile. When illuminated by an near-infrared light, the ICG emits fluorescence in the near-infrared spectrum, which can be captured by a near-infrared camera-handled device. In case of intravenous injection, ICG may be used as a marker of skin perfusion. In case of interstitial injection, it may be useful for lymphatic network mapping. In oncological and reconstructive breast surgery, ICG is used for sentinel lymph node identification, to predict mastectomy skin flap necrosis, to assess the perfusion of free flaps in autologous reconstruction and for diagnosis and treatment of upper limb secondary lymphedema. Intraoperative indocyanine green fluorescence might also be used to guide the excision of nonpalpable breast cancer.

      PubDate: 2017-10-28T13:17:20Z
      DOI: 10.1016/j.anplas.2017.09.008
       
  • The inframammary skin-sparing mastectomy technique
    • Authors: G.-T. Lam; J.-G. Feron; P. Mallon; A. Roulot; B. Couturaud
      Abstract: Publication date: Available online 16 October 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): G.-T. Lam, J.-G. Feron, P. Mallon, A. Roulot, B. Couturaud
      Skin-sparing mastectomy and immediate implant-based breast reconstruction is technically a challenging procedures for women with large, ptotic breasts. This is usually performed using the Wise pattern incision resulting in an inverted T scar, which is associated with postoperative complications. The other challenge is obtaining adequate coverage of the prosthesis. We describe a technique that avoids the inverted T scar and provides a single horizontal scar with a double dermo-muscular layer coverage of the prosthesis.

      PubDate: 2017-10-28T13:17:20Z
      DOI: 10.1016/j.anplas.2017.09.006
       
  • Intraoperative instillation of ropivacaine during the placement of
           sub-muscular cosmetic breast implants: Is there a clinical benefit'
    • Authors: F. Picard; J. Niddam; A. De Runz; M. Chaouat; M. Mimoun; D. Boccara
      Abstract: Publication date: Available online 9 October 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): F. Picard, J. Niddam, A. De Runz, M. Chaouat, M. Mimoun, D. Boccara
      Introduction The sub-muscular placement of cosmetic breast implants leads to substantial pain due to the muscular distention. The aim of this study was to assess the efficiency of intraoperative ropivacaine instillation to reduce postoperative pain the day after surgery. Material and methods We conducted a prospective, controlled, single-blinded study comparing the intraoperative instillation of 7.5mg of ropivacaine through Redon drains with the standard procedure in 72 patients undergoing sub-muscular cosmetic breast augmentation for the first time. Results Pain at the awakening on postoperative day 1 was 4.8 on a simple numeric pain scale in the treatment group and 5.1 in the control group (P >0.05). On postoperative day 3, pain at awakening was 3.7 in both groups (P >0.05), and on postoperative day 5, pain was 2.8 in the treatment group and 2.7 in the control group (P >0.05). Conclusion Local instillation of ropivacaine in the implant pocket during surgery did not decrease postoperative pain on day 1, day 3 and day 5. From now on, we are able to tell to patients that the postoperative pain after sub-muscular cosmetic breast implants surgery is about 5/10 on postoperative day 1, 4/10 at day 3 and 3/10 at day 5. Level of evidence Level II.

      PubDate: 2017-10-14T06:57:12Z
      DOI: 10.1016/j.anplas.2017.07.012
       
  • The anterolateral thigh perforator flap in pharyngo-esophageal
           reconstruction
    • Authors: M.K. De Frémicourt; S. Temam; F. Janot; F. Kolb; Q. Qassemyar
      Abstract: Publication date: Available online 9 October 2017
      Source:Annales de Chirurgie Plastique Esthétique
      Author(s): M.K. De Frémicourt, S. Temam, F. Janot, F. Kolb, Q. Qassemyar
      Today's customary techniques for pharyngo-esophageal reconstruction are jejunum and radial forearm free flaps. In this type of reconstruction, the jejunum flap is considered as the reference, but when its harvesting is not possible, the radial forearm flap is used. Since perforator flaps have begun to be developed, the anterolateral thigh flap (ATF) has become increasingly prominent in pharyngo-esophageal reconstruction. The aim of our study was to describe the use of the anterolateral perforator flap in pharyngo-esophageal reconstruction (indications, harvesting method, flap design) and to discuss its advantages and drawbacks as regards oral feeding and esophageal speech.

      PubDate: 2017-10-14T06:57:12Z
      DOI: 10.1016/j.anplas.2017.09.004
       
 
 
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