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Showing 1201 - 1400 of 2353 Journals sorted alphabetically
J. of Clinical Geropsychology     Hybrid Journal   (Followers: 1)
J. of Clinical Immunology     Hybrid Journal   (Followers: 14, SJR: 1.332, h-index: 75)
J. of Clinical Monitoring and Computing     Hybrid Journal   (Followers: 1, SJR: 0.661, h-index: 37)
J. of Clinical Psychology in Medical Settings     Hybrid Journal   (Followers: 13, SJR: 0.46, h-index: 34)
J. of Cluster Science     Hybrid Journal   (SJR: 0.416, h-index: 31)
J. of Coal Science and Engineering (China)     Hybrid Journal   (SJR: 0.188, h-index: 8)
J. of Coastal Conservation     Hybrid Journal   (Followers: 7, SJR: 0.474, h-index: 25)
J. of Coatings Technology and Research     Hybrid Journal   (Followers: 5, SJR: 0.425, h-index: 25)
J. of Combinatorial Optimization     Hybrid Journal   (Followers: 5, SJR: 1.093, h-index: 34)
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 2, SJR: 0.29, h-index: 16)
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.727, h-index: 14)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.921, h-index: 44)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 8, SJR: 1.087, h-index: 74)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 4, SJR: 1.126, h-index: 59)
J. of Compassionate Health Care     Open Access   (Followers: 2)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.291, h-index: 19)
J. of Computational Electronics     Hybrid Journal   (Followers: 4, SJR: 0.511, h-index: 20)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 25, SJR: 1.068, h-index: 60)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.27, h-index: 13)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.437, h-index: 31)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 6, SJR: 0.151, h-index: 2)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 2, SJR: 0.995, h-index: 78)
J. of Computers in Education     Hybrid Journal   (Followers: 11)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 13, SJR: 0.363, h-index: 21)
J. of Consumer Policy     Hybrid Journal   (Followers: 7, SJR: 0.704, h-index: 30)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.237, h-index: 5)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 11, SJR: 0.197, h-index: 6)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 6, SJR: 0.397, h-index: 23)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.359, h-index: 19)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 10, SJR: 0.231, h-index: 9)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 6, SJR: 0.631, h-index: 29)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.989, h-index: 11)
J. of Cryptology     Hybrid Journal   (Followers: 3, SJR: 1.443, h-index: 55)
J. of Cultural Economics     Hybrid Journal   (Followers: 4, SJR: 0.539, h-index: 29)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 9, SJR: 0.149, h-index: 8)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 8, SJR: 0.114, h-index: 5)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.574, h-index: 29)
J. of Digital Imaging     Hybrid Journal   (Followers: 10, SJR: 0.578, h-index: 35)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 8, SJR: 0.154, h-index: 6)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.4, h-index: 26)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.418, h-index: 31)
J. of Earth Science     Hybrid Journal   (Followers: 10, SJR: 0.483, h-index: 16)
J. of Earth System Science     Open Access   (Followers: 47, SJR: 0.448, h-index: 32)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 6, SJR: 0.537, h-index: 20)
J. of Echocardiography     Hybrid Journal   (Followers: 4, SJR: 0.22, h-index: 3)
J. of Ecology and Environment     Open Access  
J. of Economic Growth     Hybrid Journal   (Followers: 29, SJR: 3.273, h-index: 63)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.263, h-index: 12)
J. of Economics     Hybrid Journal   (Followers: 17, SJR: 0.418, h-index: 23)
J. of Economics and Finance     Hybrid Journal   (Followers: 6, SJR: 0.272, h-index: 19)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.961, h-index: 21)
J. of Elasticity     Hybrid Journal   (Followers: 6, SJR: 0.851, h-index: 45)
J. of Electroceramics     Hybrid Journal   (SJR: 0.577, h-index: 57)
J. of Electronic Materials     Hybrid Journal   (Followers: 5, SJR: 0.609, h-index: 75)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.372, h-index: 27)
J. of Electronics (China)     Hybrid Journal   (Followers: 4, SJR: 0.112, h-index: 9)
J. of Elementary Science Education     Hybrid Journal   (Followers: 9)
J. of Elliptic and Parabolic Equations     Hybrid Journal  
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.347, h-index: 37)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.288, h-index: 11)
J. of Engineering Research     Open Access   (Followers: 1, SJR: 0.145, h-index: 5)
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 4, SJR: 0.763, h-index: 9)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.609, h-index: 25)
J. of Evolution Equations     Hybrid Journal   (SJR: 0.826, h-index: 26)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.145, h-index: 11)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 9, SJR: 0.492, h-index: 52)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 3, SJR: 0.458, h-index: 39)
J. of Experimental Criminology     Hybrid Journal   (Followers: 48, SJR: 1.445, h-index: 28)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.261, h-index: 15)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.396, h-index: 32)
J. of Family Violence     Hybrid Journal   (Followers: 38, SJR: 0.639, h-index: 56)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.273, h-index: 10)
J. of Financial Services Research     Hybrid Journal   (Followers: 24, SJR: 0.572, h-index: 36)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.644, h-index: 13)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.465, h-index: 56)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.307, h-index: 4)
J. of Food Science and Technology     Hybrid Journal   (Followers: 7, SJR: 0.441, h-index: 29)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.495, h-index: 27)
J. of Forestry Research     Hybrid Journal   (Followers: 4, SJR: 0.304, h-index: 14)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.18, h-index: 42)
J. of Friction and Wear     Hybrid Journal   (Followers: 7, SJR: 0.373, h-index: 7)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.387, h-index: 19)
J. of Gambling Studies     Hybrid Journal   (Followers: 7, SJR: 1.171, h-index: 57)
J. of Gastroenterology     Hybrid Journal   (Followers: 12, SJR: 1.651, h-index: 88)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 4, SJR: 0.304, h-index: 39)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 7, SJR: 1.64, h-index: 99)
J. of General Internal Medicine     Hybrid Journal   (Followers: 17, SJR: 1.804, h-index: 134)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.554, h-index: 22)
J. of Genetic Counseling     Hybrid Journal   (Followers: 6, SJR: 0.902, h-index: 39)
J. of Genetics     Open Access   (Followers: 5, SJR: 0.458, h-index: 28)
J. of Geodesy     Hybrid Journal   (Followers: 9, SJR: 2.173, h-index: 56)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.8, h-index: 23)
J. of Geographical Systems     Hybrid Journal   (Followers: 4, SJR: 0.822, h-index: 39)
J. of Geometric Analysis     Hybrid Journal   (Followers: 2, SJR: 1.491, h-index: 27)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.272, h-index: 15)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 0.992, h-index: 60)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 11)
J. of Grid Computing     Hybrid Journal   (Followers: 1, SJR: 1.414, h-index: 37)
J. of Happiness Studies     Hybrid Journal   (Followers: 25, SJR: 0.881, h-index: 39)
J. of Hematopathology     Hybrid Journal   (Followers: 4, SJR: 0.2, h-index: 13)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.308, h-index: 50)
J. of High Energy Physics     Hybrid Journal   (Followers: 18, SJR: 1.052, h-index: 153)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.232, h-index: 2)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 8, SJR: 0.648, h-index: 28)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.344, h-index: 19)
J. of Ichthyology     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 10)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 12, SJR: 0.759, h-index: 37)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 46)
J. of Indian Council of Philosophical Research     Hybrid Journal  
J. of Indian Philosophy     Hybrid Journal   (Followers: 12, SJR: 0.127, h-index: 12)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 16, SJR: 0.966, h-index: 80)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 8, SJR: 0.327, h-index: 15)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.673, h-index: 46)
J. of Information Technology     Hybrid Journal   (Followers: 54, SJR: 1.474, h-index: 55)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 9)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 2, SJR: 1.25, h-index: 36)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.389, h-index: 77)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 9, SJR: 0.338, h-index: 33)
J. of Insect Behavior     Hybrid Journal   (Followers: 8, SJR: 0.569, h-index: 39)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, SJR: 0.872, h-index: 43)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 3, SJR: 0.629, h-index: 43)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.691, h-index: 43)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 3, SJR: 1.397, h-index: 54)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 0.93, h-index: 43)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 32, SJR: 4.208, h-index: 130)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 9, SJR: 0.549, h-index: 23)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 13, SJR: 0.308, h-index: 13)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 20, SJR: 0.793, h-index: 22)
J. of Labor Research     Hybrid Journal   (Followers: 19, SJR: 0.394, h-index: 27)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 7, SJR: 0.288, h-index: 25)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 3, SJR: 0.531, h-index: 52)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.203, h-index: 7)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.134, h-index: 37)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 2, SJR: 2.252, h-index: 83)
J. of Management and Governance     Hybrid Journal   (Followers: 14, SJR: 0.805, h-index: 33)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.605, h-index: 6)
J. of Marine Science and Application     Hybrid Journal   (Followers: 2, SJR: 0.439, h-index: 11)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.235, h-index: 19)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.228, h-index: 8)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 4)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.449, h-index: 22)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 22, SJR: 0.544, h-index: 40)
J. of Materials Science     Hybrid Journal   (Followers: 21, SJR: 0.836, h-index: 123)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 5)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 5)
J. of Mathematical Biology     Hybrid Journal   (Followers: 11, SJR: 1.011, h-index: 71)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 4, SJR: 0.497, h-index: 45)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 7, SJR: 1.22, h-index: 22)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 5, SJR: 0.901, h-index: 53)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.414, h-index: 23)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.272, h-index: 23)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 17, SJR: 1.062, h-index: 20)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 3)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 6, SJR: 0.589, h-index: 26)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 1, SJR: 0.387, h-index: 18)
J. of Medical Humanities     Hybrid Journal   (Followers: 22, SJR: 0.299, h-index: 18)
J. of Medical Systems     Hybrid Journal   (Followers: 1, SJR: 0.717, h-index: 44)
J. of Medical Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.874, h-index: 28)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.18, h-index: 13)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 2, SJR: 0.738, h-index: 82)
J. of Micro-Bio Robotics     Hybrid Journal   (SJR: 0.28, h-index: 3)
J. of Microbiology     Hybrid Journal   (Followers: 8, SJR: 0.741, h-index: 43)
J. of Mining Science     Hybrid Journal   (Followers: 4, SJR: 0.317, h-index: 16)
J. of Molecular Evolution     Hybrid Journal   (Followers: 9, SJR: 0.952, h-index: 108)
J. of Molecular Histology     Hybrid Journal   (Followers: 4, SJR: 0.755, h-index: 48)
J. of Molecular Medicine     Hybrid Journal   (Followers: 14, SJR: 2.165, h-index: 113)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.466, h-index: 50)
J. of Molecular Neuroscience     Partially Free   (Followers: 11, SJR: 0.988, h-index: 69)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.418, h-index: 15)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 1.264, h-index: 55)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, SJR: 0.583, h-index: 84)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.602, h-index: 28)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 4, SJR: 0.689, h-index: 55)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.466, h-index: 26)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.034, h-index: 86)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.274, h-index: 90)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.662, h-index: 45)
J. of Neurology     Hybrid Journal   (Followers: 16, SJR: 1.429, h-index: 105)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 0.979, h-index: 69)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 11, SJR: 0.863, h-index: 27)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.887, h-index: 42)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 5, SJR: 0.723, h-index: 47)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.024, h-index: 68)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 25, SJR: 0.919, h-index: 60)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 6, SJR: 0.214, h-index: 6)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 16, SJR: 0.811, h-index: 51)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 2)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.237, h-index: 11)
J. of Oceanography     Hybrid Journal   (Followers: 9, SJR: 0.796, h-index: 52)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.183, h-index: 11)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 4)
J. of Optics     Hybrid Journal   (Followers: 7, SJR: 0.214, h-index: 8)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 5, SJR: 0.898, h-index: 65)
J. of Ornithology     Hybrid Journal   (Followers: 24)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal   (SJR: 0.574, h-index: 33)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.203]   [H-I: 16]   [7 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1435-0130 - ISSN (Online) 0930-343X
   Published by Springer-Verlag Homepage  [2353 journals]
  • Acellular bovine pericardium in implant-based breast reconstruction: A
           systematic review of the literature
    • Authors: Uppara Mallikarjuna; Minahil Mujahid; Richard Pilkington; M Shaheer; Pervaz Mujahid
      Pages: 265 - 270
      Abstract: Background The use of bovine acellular pericardium as a pectoral extender is a relatively newer biologic in prosthetic breast reconstruction. Fewer studies with smaller sample sizes have been conducted on the outcome and complications of its use lacking comprehensive data. We therefore reviewed the published literature and conducted a systematic review to summarise both aesthetic benefits and reported complications. Methods A literature search of electronic databases (Medline/PubMed and Embase) between January 2010 and July 2016 was conducted. The search terms breast reconstruction, Veritas®, bovine pericardial patch, bovine pericardium and acellular collagen matrix were used. Inclusion criteria were restricted to articles containing data on bovine pericardial collagen matrix used in breast reconstruction either immediate or delayed. Graph Pad Prism statistical software was used for summarising and depicting results. Results Data from 87 patients included in five articles which met the inclusion criteria were collated. In total, 135 procedures were performed using Veritas®. Sixty-six patients’ procedures were immediate reconstruction, 57 procedures were delayed reconstruction, and seven patients lack the details of the type of reconstruction. Complications were reported for 80 patients seroma was noticed in 12 patients (15%); skin necrosis was noticed in 5 patients (6.25%); infection was noticed in 6 patients (7.5%); and haematoma was noticed in 3 patients (3.75%). No patient presented with a capsular contracture. In total, 9 patients have received radiotherapy. Conclusion Use of acellular bovine pericardium is safe according to the results published in the literature so far. Randomised controlled study comparing acellular dermal matrix with acellular bovine pericardium using a similar group of patients with minimal or no inter surgeon variance are warranted to compare and contrast outcomes. Level of Evidence: Not ratable
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1284-0
      Issue No: Vol. 40, No. 4 (2017)
  • Ultrastructural effects of topical dimethyl sulfoxide on collage fibers
           during acute skin expansion in a human ex-vivo model
    • Authors: Edoardo Raposio; Nicolò Bertozzi
      Pages: 271 - 276
      Abstract: Background Despite some studies confirming the effectiveness of dimethyl sulfoxide (DMSO) on acute skin expansion, the precise mechanism through which it quickens tissue expansion is yet unknown. No studies have been carried out to date to thoroughly investigate the ultrastructural effects of DMSO on intraoperative tissue expansion. The aim of the present study was to test the ex vivo ultrastructural effects of topical 60% DMSO on dermal collagen fibers of acutely expanded human cutaneous flaps. Methods Specimens were obtained and ultrastructurally examined from two groups of ex vivo cutaneous flaps from the anterior thigh: group A (experimental) DMSO-treated and acutely expanded flaps, and group B (control), acutely expanded flaps. Results A statistically significant difference was observed between groups A and B, with respect to the width of dermal collagen fibers, distance between dermal collagen fibers, and percentage of area not occupied by collagen fibers. Conclusions These findings demonstrate how DMSO affects collagen cross-linkage in the surrounding dermis, decreasing the mechanical resistance of the acutely expanded skin in this ex-vivo model, supporting its use in intra-operative tissue expansion. Level of Evidence: Not ratable.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1301-3
      Issue No: Vol. 40, No. 4 (2017)
  • Microsurgical reconstruction in mandible osteoradionecrosis: a clinical
           experience from Portugal
    • Authors: Cristina Pinto; João Coelho; Tiago Guedes; Carolina Andresen; Diana Santos; João Matos Martins; Nuno Gomes; Horácio Zenha; Horácio Costa
      Pages: 277 - 288
      Abstract: Background Osteoradionecrosis (ORN) is one of the most feared complications of head and neck cancer radiotherapy. The most common location for facial ORN is the mandible. Optimal clinical management is still under debate, insofar as a clear definition of its pathological process is yet to be obtained. Osseous surgical debridement is mandatory in advanced stages, but the reconstructive technique has to be specifically tailored to ORN characteristics. Methods Data from patients with ORN treated in our institution from 2000 to 2014 was reviewed. Twenty-one patients were included. We retrospectively analyzed risk factors, severity of bone lesions, extension of bone resection, reconstructive option, and complications. A control group without ORN was used for comparison. Results In this study, radical excision and reconstruction with free flaps was the treatment of choice for moderate and severe ORN. We found a statistically significant higher rate of salvage procedures in ORN patients when compared with the control non-ORN cohort (p < 0.05). Sixty percent of the patients with ORN achieved stable coverage; 83.3% of the patients had evidence of bone union in imaging exams, and 75% recovered oral feeding capability. There was a tendency towards healing problems in ORN patients, but it did not reach statistical significance. Conclusion Although there was a higher rate of surgical complications in ORN patients when compared to the control group, microsurgical approach leads to good morphofunctional results in moderate to severe ORN. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1286-y
      Issue No: Vol. 40, No. 4 (2017)
  • Functional evaluation of the restored mucosa after nasal reconstruction
           with a forehead-galea flap
    • Authors: Maria A. Bocchiotti; Luca Spaziante; Erind Ruka; Giancarlo Pecorari; Massimiliano Garzaro; Giuseppe Riva; Mia Rossi; Stefano Bruschi
      Pages: 289 - 294
      Abstract: Background Recovery of the internal mucosal lining is the most problematic step in nasal reconstruction. Restoration of both aesthetic and functional components should be the goal to be pursued. For this purpose, we performed a study for functional evaluation of the restored mucosa after nasal reconstruction. Methods From April 2009 to May 2016, 10 patients in whom the galea was used to reconstruct the nasal lining were selected from our casuistic of nasal reconstruction. In order to visualize the nasal and nasopharyngeal cavity, an antero-posterior rhinoendoscopy was performed in all patients. Additionally, patients were asked to complete a visual analogue scale (VAS) evaluation regarding nasal obstruction. Active anterior rhinomanometry analysis, olfactometry analysis and a cytologic examination were also conducted. Results Near-normal results in nasal obstruction evaluation were reported subjectively by patients. Near-normal inspiratory values were obtained using rhinomanometry. Average values of TDI (threshold, discrimination and identification), a comprehensive olfactometric parameter, were essentially normal. Cytological sampling examination did not reveal any substantial abnormal variation. Conclusions Based on our morphological and functional results, we can assert that the forehead flap in association with galea for lining is a safe and practical surgical technique in total nasal reconstruction. Level of Evidence: Level V, prognostic study
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1275-1
      Issue No: Vol. 40, No. 4 (2017)
  • Fascio-cutaneous flaps for chest wall reconstruction after massive
           inflammatory breast cancer: a case series
    • Authors: Renzo Panizza; Marco Ghiglione; Michela Massa; Emanuela Grosso; Enrico Zingarelli; Silvia Scarrone
      Pages: 295 - 298
      Abstract: Background Inflammatory breast cancer represents a rare condition that presents poor prognosis with high risk of recurrences and greatly affects patients’ quality of life. The resective surgical treatment frequently requires challenging reconstructive solutions to restore a proper tissue layer for the chest wall. Reconstructive methods are nowadays still matter of debate. Methods A retrospective review of all cases of massive inflammatory breast cancer that underwent mastectomy and reconstruction with fasciocutaneous flaps from October 2009 to September 2014 was performed at our department. Patient demographics, indications, flap specifics, complications, and number of operations were collected. Results Our review identified five cases. A lateral thoracic flap was planned in two cases, a modified lateral thoraco-dorsal flap in one case, a combination of scapular and pubic flaps in other case, and a thoraco-epigastric and lateral thoracic flap association in the remaining case. The mean patient age was 60 years (range, 35 to 76 years). Flap dimensions ranged from 9cm to 14 cm in width and 20 to 24 cm in length. Partial necrosis of the flap distal part occurred in two cases requiring minor flap revision. Conclusions Resective surgical treatment of inflammatory breast cancer might require a challenging reconstructive planning. In this scenario, fasciocutaneous flaps are an interesting option due to their versatility, easiness of harvesting, low morbidity, and complications rate. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1257-8
      Issue No: Vol. 40, No. 4 (2017)
  • Effect of neoadjuvant chemotherapy on women undergoing breast cancer
           surgery and immediate breast reconstruction with latissimus dorsi flap and
           silicone implants
    • Authors: Gabriel Salum D’Alessandro; Alejandro Povedano; Lauren Klas Iurk Leme dos Santos; Alexandre Mendonça Munhoz; Rolf Gemperli; João Carlos de Sampaio Góes
      Pages: 299 - 308
      Abstract: Abstract The use of the latissimus dorsi flap in immediate breast reconstruction is a relatively simple procedure using a flap with a very reliable and consistent vascularity. Neoadjuvant chemotherapy improves local surgical conditions; however, most chemotherapeutic agents are cytotoxic and may increase the risk of postoperative complications. This study evaluated the effects of neoadjuvant chemotherapy on women with cancer who underwent immediate breast reconstruction with latissimus dorsi flap and silicone implants. Data were collected from medical records of 102 patients with cancer who had undergone immediate breast reconstruction with latissimus dorsi flap and silicone implants from August 2010 to December 2014. Thirty-three patients received neoadjuvant chemotherapy (study group) and 69 patients underwent primary surgical treatment (control group). Three (2.9%) patients in the study group had a major postoperative complication (two cases of hematoma requiring surgical drainage and a case of flap necrosis), which was the only variable showing a significant difference between groups (P = 0.032). Neoadjuvant chemotherapy followed by cancer surgery with immediate breast reconstruction with latissimus dorsi flap and silicone implants was not associated with an increased risk of postoperative surgical and clinical minor complications. It was associated with a significant increase in postoperative major complications, despite the small number of cases. However, patients who received neoadjuvant chemotherapy had a significantly more aggressive disease and advanced-stage cancer, and required a more extensive cancer surgery. Level of Evidence: Level III, risk / prognostic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1263-x
      Issue No: Vol. 40, No. 4 (2017)
  • Fatty degeneration of mammary glands in female-to-male transsexuals
    • Authors: Taro Makino; Tadayoshi Fujita; Tomoka Nakano
      Pages: 309 - 314
      Abstract: Background Subcutaneous mastectomy is an accepted procedure for surgical reassignment in female-to-male (FtM) transsexuals. However, fatty degeneration of the mammary gland (FDMG) is sometimes observed in FtM transsexuals, with implications for mastectomy outcomes. In this study, we describe the characteristics and risk factors of FDMG. Methods A total of 48 FtM transsexual patients underwent bilateral subcutaneous mastectomies (96 subcutaneous mastectomies) at our clinics from January 2015 to February 2016. The patients were divided into FDMG and non-FDMG groups after evaluation of the cut surface of the resected mammary gland. The groups were compared in terms of age, smoking, hormonal therapy (testosterone), body mass index (BMI), breast size (top–under perimeter), distance between sternal notch and nipple–areolar complex (NAC), breast ptosis grade, weight of resected breast tissue, and complication rate. FDMG tissue specimens were examined histologically. Results Comparing the FDMG and non-FDMG groups, hormonal therapy was more common (91.3 vs. 72.0%, p = 0.049), BMI was higher (24.3 vs. 21.1%, p < 0.001), and distance between the sternal notch and NAC was longer (20.5 vs. 18.8%, p = 0.03). Conclusions Hormonal therapy, high BMI, and long distance from the sternal notch to the NAC are risk factors for FDMG and should be considered prior to mastectomy in FtM transsexuals. Level of Evidence: Level III, risk/prognostic study
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1269-4
      Issue No: Vol. 40, No. 4 (2017)
  • The outcome of primary brachial plexus reconstruction in extended Erb’s
           obstetric palsy when only one root is available for intraplexus
    • Authors: Mohammad M. Al-Qattan; Amel Ahmed F. El-Sayed
      Pages: 323 - 328
      Abstract: Background A recent review by the International Federation of Societies for Surgery of the Hand showed no studies comparing the results of nerve grafting to distal nerve transfer for primary reconstruction of the brachial plexus in infants with obstetric brachial plexus palsy (OBBP). The aim of this retrospective study is to compare two surgical reconstructive strategies in primary reconstruction of the brachial plexus in extended Erb’s obstetric palsy with double root avulsion: one with and one without distal nerve transfer for elbow flexion. Methods Two groups of infants with extended Erb’s palsy and double root avulsion were included in the study. Group I (n = 29) underwent reconstruction of the brachial plexus without distal nerve transfer. In group II (n = 26), the reconstruction included a distal nerve transfer for elbow flexion. Results Both groups had an excellent (over 96%) satisfactory outcome for elbow flexion. Group II has a significantly better outcome (P < 0.05) of shoulder abduction and wrist extension than group I. Conclusions The use of a distant nerve transfer for bicep reconstruction in extended Erb’s obstetric palsy with double root avulsion gives a better outcome for shoulder abduction and wrist extension; and this seems to be related to the availability of more cable grafts to reconstruct the posterior division of the upper trunk and the middle trunk. Level of Evidence: Level III, therapeutic study
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1302-2
      Issue No: Vol. 40, No. 4 (2017)
  • The outcome of primary brachial plexus reconstruction in extended Erb’s
           obstetric palsy when two roots are available for intraplexus neurotization
    • Authors: Mohammad M. Al-Qattan; Amel A.F El-Sayed
      Pages: 329 - 332
      Abstract: Background The outcome of primary brachial plexus reconstruction in extended Erb’s obstetric palsy with single root avulsion has not been specifically documented in the literature. Methods A series of 46 consecutive cases of extended Erb’s obstetric palsy with single root avulsion was retrospectively reviewed. The upper and middle trunks were reconstructed with nerve grafts from the available two roots. No nerve transfers were used. The percentage of a satisfactory motor recovery was documented. Results The postoperative motor recovery was excellent (over 97%) satisfactory outcome for elbow flexion, elbow extension, and digital extension. A satisfactory wrist extension was noted in 84.8% of children. The lowest rates of satisfactory outcomes were for shoulder external rotation (65.2%) and shoulder abduction (56.5%). Conclusions In extended Erb’s obstetric palsy with single root avulsion, two ruptured roots are available for intraplexus neurotization of the upper and middle trunks. The surgeon gives a priority to elbow flexion and this is translated in an excellent outcome for elbow flexion. The triceps and digital extensors get a major contribution form the unaffected C8 root, and this is also translated in an excellent outcome for these two functions. Fewer cable grafts are available for reconstruction of the posterior division of upper trunk and the middle trunk, resulting in a lower rate of satisfactory outcomes at the shoulder for wrist extension. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1267-6
      Issue No: Vol. 40, No. 4 (2017)
  • Analysis of the two-point discrimination test in daily routine practice
    • Authors: Cedric E Boesch; Fabian Medved; Manuel Held; Dominik Bender; Hans-Eberhard Schaller; Thomas Fuchsberger
      Pages: 333 - 336
      Abstract: Background Finger nerve lesions lead to a sensory deficit with para-anesthesia or anesthesia and impair hand functions. In daily clinical practice, the diagnosis of an injured finger nerve can be challenging. This study aims at evaluating if the two-point discrimination (2PD) test is a good predictor of nerve lesions to indicate operative treatments in hand trauma patients. Methods Based on the record of patients with an acute hand and finger injury, it was evaluated whether a pathological 2PD test in the clinical examination corresponds to the intraoperative findings of a severed nerve. From 2008 and 2014, patients with isolated finger nerve lesions were included, while patients with concomitant bone or tendon injuries were excluded. Results As many as 113 patients with a total of 131 nerve injuries of the hand and fingers were suitable for this study. The statistical analysis revealed a sensitivity of 98% among them for the 2PD test. Further, a positive predictive value of 96% was demonstrated. Conclusions The results of our study showed that the 2PD test is a valuable examination to diagnose nerve injuries of fingers in hand trauma patients. It is a simple, reliable, and available examination tool and therefore can be suggested in daily clinical practice. Level of Evidence: Level III, diagnostic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1265-8
      Issue No: Vol. 40, No. 4 (2017)
  • Reverse dorsal metacarpal flaps for reconstruction of proximal phalanx
           defects following skin tumor excision: A case series
    • Authors: Adem Özkan
      Pages: 337 - 342
      Abstract: Background Reverse dorsal metacarpal flaps (RDMFs) are widely used to cover significant skin and soft tissues defects of the finger.However, there is a current lack of information regarding the use of RDMFs in the reconstruction of phalanx defects following skin tumor excision. Methods From October 2012 to April 2016, medical records of all patients who underwent reconstruction of proximal phalanx defects with RDMF were retrospectively reviewed. Patient age and gender, tumor type, tumor location, donor site coverage, flap dimensions, range of motion of the metacarpophalangeal joint, and postoperative complications were evaluated. Results Seven patients underwent closure of skin defects of the proximal phalanx with RDMF. All flaps survived completely without complication. Flap size ranged from 1.5 × 2 to 3 × 3.5 cm. Good coverage was obtained in all cases. Skin paddle was taken from the dorsal aspect of the second, third, and fourth intermetacarpal area. All patients had full range of movement of the reconstructed and donor digits when followed at 6 months after surgery. Conclusions The RDMF is a flap which is safe, easy to apply in the context of soft tissue coverage procedures, and does not result in the loss of finger functions. It also confers excellent aesthetic skin suitability and does not require debulking procedures. Level of Evidence: Level V, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1282-2
      Issue No: Vol. 40, No. 4 (2017)
  • Massive localized lymphedema of the mons: the pi-cut technique
    • Authors: Hubert B. Shih; Rahim Nazerali; Anandev Gurjala; Leila Jazayeri; Gordon K. Lee
      Pages: 343 - 346
      Abstract: Abstract Massive localized lymphedema (MLL) is a form of secondary lymphedema caused by obstruction of lymphatic flow seen in morbidly obese patients. Common areas for the large mass include the abdomen, suprapubic region, scrotum, and thigh. Skin changes and the sheer size cause significant morbidity. Described as a benign lymphoproliferative overgrowth, MLL if left untreated can progress to angiosarcoma. The key to resection is minimizing blood loss and the key to reconstruction is to reconstruct utilizing the principles of vulvar esthetic subunits. For hemostasis, a tourniquet is used around the base of the mass and infiltration with wetting solution is injected. Reconstruction with the “pi-cut” technique, so named because of its resemblance to the mathematical symbol of pi, allows closure along the vulvar esthetic subunits. To illustrate our surgical technique, we present a case of MLL of the mons veneris in a 53-year-old woman with a BMI (body mass index) of 78 kg/m2. The specimen weighed approximately 17.5 kg, the heaviest MLL of the mons veneris described in the literature. Our resection technique and pi-cut closure technique allowed for minimal blood loss and postoperative morbidity and an esthetic closure respecting the vulvar esthetic subunits. MLL of the mons veneris can be successfully and safely resected with an esthetic result using our technique. Level of Evidence: Level V, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-016-1270-y
      Issue No: Vol. 40, No. 4 (2017)
  • Contralateral sensitive cross flap for reconstruction of a burned breast
    • Authors: Alessio Caggiati; Stefania Tenna; Fabio Santanelli di Pompeo; Rosaria Laporta
      Pages: 347 - 350
      Abstract: Abstract Several different approaches for reconstruction have been already described taking into account size and shape of the native breast, location and type of cancer, whether adjuvant radiation and/or chemotherapy is needed, patient’s demographic information, and surgeon’s preferences and experience. We report a case of reconstruction in burn patient using a breast sensitive perforator flap from the contralateral side. Thanks to the volume excess, the left side was large enough to reconstruct the affected side. A supero-medial pedicled reduction mammaplasty was performed on the left breast, and the excess inferior-part was elevated laterally and caudally off the pectoralis major. The flap was supplied by two perforators from the internal mammary vessels, and it was transposed to the right side after resection of the burned breast tissue. The right nipple-areola complex was left buried under the flap. After 2 months, the flap pedicle was deepithelialized, debulked, and passed through inframammary fold. The nipple-areola complex was released as a pedicled flap and sutured to the flap tissue approximately at the same level of the contralateral from the sternal notch. Preoperative sensitivity assessment demonstrated worst sensation of the right breast compared to the uninjured side. At 6 months, postoperatively, the patient could localize pressure and sensibility tested by the use of cotton wool and a pinprick test was quite normal. A clear improvement was observed in cutaneous pressure sensation thresholds over the time. At 12 months, she could recognize cotton wool and a pinprick. No changes were observed in the nipple-areola complex sensibility. Level of Evidence: Level V, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1287-x
      Issue No: Vol. 40, No. 4 (2017)
  • Hemi-facial reconstruction following extensive crush avulsion injury of
           the face
    • Authors: Gopal Malhotra; Rahul K. Patil; Komma Venkata Nageshwara Reddy; Ahmed Osama Abdul Hameed; Mahil Cherian
      Pages: 351 - 358
      Abstract: Abstract Post-traumatic facial defects need to be treated sensitively, as the emotional repercussions and possible deformity can have lasting effects on the patient’s psychological well-being. Thus, the management of posttraumatic facial injuries requires meticulous planning and adherence to both aesthetic and reconstructive principles. We describe the case of a 29-year-old male who underwent multistage reconstruction following extensive facial injuries. The clinical challenges presented by this rare case and steps of the reconstruction procedure are presented. Sequential flaps that were placed during the restoration survived, and the patient had no lasting donor site morbidity. Post-surgery, the patient’s self-confidence was dramatically improved, as were his interactions with his family and friends. Careful planning and staged microvascular procedures were important in the management of this patient with severe injuries. The patient was rehabilitated and able to live a near-normal life, without the need for synthetic implants or lifelong immune suppression. Level of Evidence: Level V, therapeutic study.
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1291-1
      Issue No: Vol. 40, No. 4 (2017)
  • Erratum to: The outcome of primary brachial plexus reconstruction in
           extended Erb’s obstetric palsy when only one root is available for
           intraplexus neurotization
    • Authors: Mohammad M. Al-Qattan; Amel Ahmed F. El-Sayed
      Pages: 359 - 359
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1332-9
      Issue No: Vol. 40, No. 4 (2017)
  • Erratum to: The outcome of primary brachial plexus reconstruction in
           extended Erb’s obstetric palsy when two roots are available for
           intraplexus neurotization
    • Authors: Mohammad M. Al-Qattan; Amel A. F El-Sayed
      Pages: 361 - 361
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1330-y
      Issue No: Vol. 40, No. 4 (2017)
  • Erratum to: question mark ear deformity-revisited
    • Authors: Mohammad M. Al-Qattan; Noha M. Al-Qattan
      Pages: 363 - 363
      PubDate: 2017-08-01
      DOI: 10.1007/s00238-017-1329-4
      Issue No: Vol. 40, No. 4 (2017)
  • Erratum to: Lipofilling effects after breast cancer surgery in
           post-radiation patients: an analysis of results and algorithm proposal
    • Authors: Manuel Debald; Thomas Pech; Christina Kaiser; Mignon-Denise Keyver-Paik; Gisela Walgenbach-Bruenagel; Joerg C. Kalff; Walther Kuhn; Klaus J. Walgenbach
      PubDate: 2017-08-05
      DOI: 10.1007/s00238-017-1351-6
  • A comparison of the tongue-in-groove and columellar strut in creating and
           maintaining tip projection and rotation: a randomized single blind trial
    • Authors: Razie Yaberi; Amin Amali; Hamed Emami; Babak Saedi
      Abstract: Background Rhinoplasty is one of the most challenging esthetic operations. The ability to achieve precise and predictable changes in the shape and position of the nasal tip is still among the demanding areas of rhinoplasty. Tongue in groove (TIG) and columellar strut are two of the many techniques to ensure an adequate nasal tip projection and rotation; however, there is little evidence to support long-term efficacy of these techniques. Methods In a clinical trial, 80 cases who were rhinoplasty candidates were studied prospectively. They were randomly divided into two groups according to the use of columellar strut and TIG. The outcome measures were gaining and maintaining tip projection and rotation in the long term. Standardized photographs before and 6 and 12 months after the surgery were the measurements to compare the results between the two groups, which were evaluated for nasolabial angle and projection. Also, the patients’ satisfaction with beauty and nasal obstruction were assessed using the VAS (Visual Analogue Scale). Results Forty patients were operated using the columellar strut technique while the TIG method was used in 40 cases. Preoperatively, tip rotation, tip projection, and other characteristics were not significantly different between the two groups. Postoperatively, the patients’ esthetic satisfaction was significantly greater in the TIG group 6 and 12 months after the surgery (P value = 0.001). The rest of the evaluated variables did not have any significant differences between the two groups. Conclusions It seems that both columellar strut and tongue in groove methods are effective techniques in maintaining tip projection and/or rotation in rhinoplasty. Using the tongue in groove technique in qualified hands may give significantly better esthetic satisfaction to patients than the columellar strut technique. Level of evidence: Level I, therapeutic study.
      PubDate: 2017-08-02
      DOI: 10.1007/s00238-017-1346-3
  • Erratum to: an unusual pre-ligamentous thenar motor branch of the median
    • Authors: Mohammad M. Al-Qattan; Khalid Al-Zahrani
      PubDate: 2017-06-14
      DOI: 10.1007/s00238-017-1334-7
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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