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Dynamic Games and Applications     Hybrid Journal   (Followers: 2)
Dysphagia     Hybrid Journal   (Followers: 200, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 8, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 12, SJR: 0.367, h-index: 12)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.245, h-index: 5)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 5, SJR: 0.436, h-index: 28)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.433, h-index: 17)
Earthquake Science     Hybrid Journal   (Followers: 9, SJR: 0.486, h-index: 7)
East Asia     Hybrid Journal   (Followers: 7, SJR: 0.165, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 8, SJR: 0.289, h-index: 23)
EcoHealth     Hybrid Journal   (Followers: 1, SJR: 0.651, h-index: 22)
Ecological Research     Hybrid Journal   (Followers: 8, SJR: 0.698, h-index: 38)
Economic Botany     Hybrid Journal   (Followers: 8, SJR: 0.666, h-index: 40)
Economic Bulletin     Hybrid Journal   (Followers: 4)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.263, h-index: 6)
Economic Theory     Hybrid Journal   (Followers: 8, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal   (Followers: 1)
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.367, h-index: 12)
Ecosystems     Hybrid Journal   (Followers: 19, SJR: 1.793, h-index: 83)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.041, h-index: 53)
Education and Information Technologies     Hybrid Journal   (Followers: 189, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 14, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 14, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 7, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 10, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 188, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 12, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 4, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 5, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 12)
Empirical Economics     Hybrid Journal   (Followers: 8, SJR: 0.5, h-index: 29)
Empirical Software Engineering     Hybrid Journal   (Followers: 4, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 5, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 11, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 10, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 28, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 17, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 3, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 10, SJR: 0.601, h-index: 55)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 6, SJR: 0.35, h-index: 3)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.732, h-index: 23)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 0.909, h-index: 32)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 14)
Environmental Management     Hybrid Journal   (Followers: 33, SJR: 0.773, h-index: 60)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 11, SJR: 0.413, h-index: 27)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 9, SJR: 0.671, h-index: 46)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 11, SJR: 0.878, h-index: 42)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 2, SJR: 1.002, h-index: 14)
Epileptic Disorders     Hybrid Journal   (Followers: 1, SJR: 0.669, h-index: 34)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.435, h-index: 58)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.749, h-index: 85)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.661, h-index: 57)
EPMA J.     Open Access   (SJR: 0.161, h-index: 4)
ERA-Forum     Hybrid Journal   (Followers: 2, SJR: 0.13, h-index: 2)
Erkenntnis     Hybrid Journal   (Followers: 11, SJR: 0.62, h-index: 14)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.173, h-index: 8)
Esophagus     Hybrid Journal   (SJR: 0.268, h-index: 9)
Estuaries and Coasts     Hybrid Journal   (Followers: 3, SJR: 1.111, h-index: 61)
Ethical Theory and Moral Practice     Hybrid Journal   (Followers: 7, SJR: 0.278, h-index: 8)
Ethics and Information Technology     Hybrid Journal   (Followers: 190, SJR: 0.363, h-index: 20)
Ethik in der Medizin     Hybrid Journal   (SJR: 0.204, h-index: 6)
Euphytica     Hybrid Journal   (Followers: 7, SJR: 0.709, h-index: 57)
Eurasian Soil Science     Hybrid Journal   (Followers: 2, SJR: 0.271, h-index: 10)
EURO J. of Transportation and Logistics     Hybrid Journal   (Followers: 4)
EURO J. on Computational Optimization     Hybrid Journal  
EURO J. on Decision Processes     Hybrid Journal  
Europaisches J. fur Minderheitenfragen     Hybrid Journal  
European Actuarial J.     Hybrid Journal   (Followers: 3)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (Followers: 4, SJR: 0.737, h-index: 37)
European Archives of Paediatric Dentistry     Hybrid Journal   (Followers: 1, SJR: 0.446, h-index: 12)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (Followers: 2, SJR: 1.334, h-index: 62)
European Biophysics J.     Hybrid Journal   (Followers: 4, SJR: 0.979, h-index: 53)
European Child & Adolescent Psychiatry     Hybrid Journal   (Followers: 5, SJR: 1.269, h-index: 51)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (Followers: 5)
European Food Research and Technology     Hybrid Journal   (Followers: 8, SJR: 0.773, h-index: 49)
European J. for Education Law and Policy     Hybrid Journal   (Followers: 5)
European J. for Philosophy of Science     Partially Free   (Followers: 4, SJR: 0.165, h-index: 2)
European J. of Ageing     Hybrid Journal   (Followers: 9, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 8, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 11, SJR: 0.958, h-index: 74)
European J. of Clinical Pharmacology     Hybrid Journal   (Followers: 9, SJR: 0.916, h-index: 69)
European J. of Dermatology     Hybrid Journal   (Followers: 7)
European J. of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (Followers: 7, SJR: 0.24, h-index: 25)
European J. of Epidemiology     Hybrid Journal   (Followers: 17, SJR: 1.946, h-index: 60)
European J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.864, h-index: 25)

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Journal Cover European Journal of Plastic Surgery
   [4 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  [2210 journals]   [SJR: 0.227]   [H-I: 13]
  • Hypertrophic scar as an areola graft in nipple-areola reconstruction
    • PubDate: 2014-12-14
  • Post-traumatic radioulnar synostosis treated effectively with tissue
           expander capsule interposition: a novel technique
    • Abstract: Abstract Post-traumatic radioulnar synostosis is a rare condition characterised by abnormal fibro-osseous union between radius and ulna along the length of the interosseous membrane, resulting in loss of forearm pronation and supination. Various surgical techniques have been described and numerous interpositional materials have been used. We present a novel technique of utilising a tissue expander capsule as the interpositional gliding surface. This technique provides an autologous capsule and an expanded adipofascia, which are well vascularised for increased length and reliability. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-14
  • Cause of death among head and neck skin cancer patients in a Nigerian
           hospital: significance of the cranium
    • Abstract: Background Most cancers in the head and neck region spread locally. This study was designed to evaluate the involvement of the cranium in cause of death among head and neck skin cancer patients. Methods All cases of skin malignancy appearing in the head and neck region were documented. Cause of death was noted for all deceased head and neck skin cancer patients. Cranial involvement, or not, was recorded in each case. Recurrent lesions, types of previous treatment, if any, and cranial perforation, when present, were documented. Results One hundred thirty-one patients were seen. One hundred eighteen (90.1 %) had lesions involving the cranium. Thirty-four head and neck cancer patients died during study period. Thirty-two (94.1 %) died as a result of local spread of disease to the brain through the cranium. Recurrent and persistent lesions were accounted for 35 (26.7 %) cases; out of which, 18 (13.7 %) had been excised and wound was immediately closed directly; 10 (7.6 %) had been excised and wound immediately primarily closed using vascularized free flaps. Five (3.8 %) had previously been managed solely with radiotherapy. Two (1.5 %) applied 5FU ointment on prescription for basal cell carcinoma, which transmuted to squamous cell carcinoma. Eleven (8.4 %) referral cases with cranial perforation presented after recurrence. Conclusions Deaths that were caused by spread of cancer to the brain through the cranium were 94.1 %. Radiotherapists should be educated on the grave danger of causing osteoradionecrosis of the cranium. The value of medical remedies for malignancies around the cranium should be properly reevaluated. Surgery appears to be the favoured therapy for cranium-involved skin cancer. Level of Evidence: Level IV, risk / prognostic study
      PubDate: 2014-12-09
  • A case of non-ischaemic blue finger and toe
    • PubDate: 2014-12-09
  • Fibro-osseous pseudotumour of the digit: the importance of correct
    • Abstract: Abstract Fibro-osseous pseudotumour of the digit (FOPT) is a rare, benign lesion of proliferating spindled myofibroblasts found in the soft tissue of the distal aspect of the digits. Misdiagnosis as malignant neoplasms such as osteosarcomas results in needlessly aggressive surgery and hinders reconstruction. We report the case of a 6-year-old girl presenting with an enlarging lesion of the left hallux for over a year, causing elevation of the medial nail fold of the left big toe over the distal phalanx. An incisional biopsy was undertaken revealing a lesion histopathologically consistent with a diagnosis of fibro-osseous pseudotumour. Accurate diagnosis through clinical reasoning and histopathology prevented digit amputation. Level of evidence: Level V, diagnostic study
      PubDate: 2014-12-04
  • Clinical and histopathological analysis of 790 naevi excised from 509
           patients due to cosmetic reasons
    • Abstract: Background The risk of malignant transformation is the most important reason for melanocytic naevi excision whereas the most common reason for excision is cosmetic disturbance. Methods Our study was conducted in a retrospective design from June 2009 to October 2013 involving 790 naevi excisions from 509 patients (332 male, 177 female) due to cosmetic disturbance. Each patient was evaluated for age and gender in addition to the clinical characteristics of the lesions such as location, size, depth and morphology. Results The average age of our patient group was 36.4 (18–68). Of the 509 patients, 332 were female (65.2 %) and 177 were male (34.7 %). Intradermal naevus was the most common type. Of all patients, 93.3 % had intradermal, dysplastic or compound naevi. Of all lesions, 93.9 % were intradermal, dysplastic or compound naevi. Buccal region was the most common excision site in the face with 112 excisions. Female gender was dominant in all naevi types except for dysplastic naevi and junctional naevi. Male gender was dominant in these groups. Conclusions Gender and age in addition to the clinical characteristics of the lesion such as location, size, depth and morphology were analysed for each patient. To our knowledge, our study has the largest naevi excision number performed for only cosmetic reasons. Even though there was no malignant melanoma identified, high rate of dysplastic naevi was an important data due to its malignancy risk. Level of Evidence: Level III, risk/prognostic study.
      PubDate: 2014-12-04
  • Fold-back perineoscrotal flap plus penile inversion vaginoplasty for
           male-to-female gender reassignment surgery in circumcised subjects
    • Abstract: Background The use of the penile skin for vaginoplasty is a common method in male-to-female (MTF) transsexual surgery. We aim to describe the results of a one-stage vaginoplasty in previously circumcised sex reassignment surgery using fold-back perineoscrotal flap plus penile inversion flap. Methods In a prospective study, 112 previously circumcised MTF subjects underwent a modification of penile inversion vaginoplasty by adding a fold-back perineoscrotal flap to form the whole posterior vaginal wall and about half of the anterior vaginal wall (the proximal part). Patients follow-up, outcomes, and complications were recorded. Results The mean age of the subjects was 25.8 ± 3.3 years underwent feminizing genitoplasty. The success rate was 92.86 %, and the complication-free success rate was achieved in 74.11 % of subjects in general. The need for repeated surgery (failure rate) was 7.14 % (due to vaginal shrinkage in four patients, bulging in anterior vaginal wall in one case and excessive labial skin in three cases). By adding the perineoscrotal flap to the penile skin flap, we were able to reach a mean vaginal depth of 13.1 ± 1.7 and a satisfaction level of 85.71 %. Conclusions Fold-back perineoscrotal flap plus penile inversion vaginoplasty is a suitable surgical approach for achieving adequate vaginal depth in cases of male-to-female (MTF) transsexual vaginoplasty when subjects have short penile skin flap because of circumcision. Level of Evidence: Level III, therapeutic study.
      PubDate: 2014-12-03
  • Long-term outcome after use of an acellular collagen matrix in a finger
           degloving injury
    • Abstract: Abstract In ring avulsion injuries, replantation may not always be possible because of the extent of the injury or the loss of the severed part. Under these circumstances, other treatment options should be considered. We describe our 5-year follow-up experience after the coverage of a complete digital ring degloving injury with an acellular collagen matrix. The distal phalanx needed to be amputated. Acceptable long-term functional and cosmetic outcomes were attained. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-01
  • Treatment of ischial pressure sores. Our experience of 99 patients with
           108 sores
    • Abstract: Background Ischial pressure sores concern patients in the sitting position and particularly the rehabilitated patients. Spontaneous healing may be very difficult without surgery, and ischial pressure sores have the highest recurrence rate among other decubitus. Furthermore, there is no consensus concerning the ideal surgical technique in order to definitely treat the patients. This is a retrospective analysis of the surgical treatment of ischial pressure sores aiming to identify the ulcer recurrence rate per surgical technique and describe the early complications. Methods This was a retrospective study that was conducted in Marseille, France, between 1988 and 2007. The medical records concerning patients with ischial pressure sores were collected and analyzed. The main objective was to identify the ulcer recurrence rate after ischial pressure sore surgical treatment. The secondary objective was the identification and description of early complications. Results Ninety-nine patients were finally selected and analyzed for 108 ischial pressure sore treatments. Primary endpoint analysis identified 25 recurrences for 108 sores (23.14 %). Hamstring V-Y advancement flap had 71 % recurrence rate. Wound dehiscence was the primary complication. Six out of seven hamstring V-Y advancement flaps had early complications. Conclusions Pressure sore treatment can be difficult and challenging. In this retrospective study, we have found that the hamstring V-Y advancement flaps have a much higher recurrence rate and a higher rate of complications. Our results may be limited by the retrospective nature of this study but they imply that the V-Y advancement flaps should not be used as a first choice for ischial pressure sore treatment. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-12-01
  • Consecutive formation of extensive late seromas with sudden onset: a
           breast augmentation patient with a puzzling clinical presentation
    • Abstract: Abstract Silicone gel-filled breast implants are the backbone of augmentation mammoplasty. Although a safe and straightforward procedure, augmentation mammoplasty is not exempted from complications. Seroma formation—as a well-known complication—generally occurs at early postoperative period. Although it generally undergoes spontaneous resorption within four to six postoperative weeks, its persistence can cause increased pain, wound dehiscence and infection, which might necessitate subsequent removal of the implant. The term “late seroma” describes seroma after 4 months postoperatively. Late seromas are rare and tend to occur unilaterally. Although late seromas generally have an insidious onset, clinical presentation may vary regarding each individual patient. We present a case report of extensive late seroma formations, with sudden onset, on both sides in a consecutive manner. Our review of the literature suggests that this is the only report of consecutive late seroma formation on both sides of a silicone gel breast augmentation patient. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-12-01
  • Outcome assessment in plastic surgery—tools, techniques and the
    • PubDate: 2014-12-01
  • Isolated APTT prolongation—not always a bleeding risk in acute
           paediatric burns surgery
    • PubDate: 2014-12-01
  • Basal cell carcinoma on rhinophyma: a case series analysis
    • Abstract: Background Several authors described the presence of malignant tumors that rarely can grow hidden over rhinophymatous skin. Basal cell carcinoma (BCC) is the most commonly reported tumor and it should always be sought and diagnosed in presence of a rhinophyma. Methods Between 1998 and 2012, 56 cases of rhinophyma were treated at our department. There were 54 males and 2 females with an age range between 34 to 87 years. In all cases of major or moderate degree, scalpel decortications was executed, while in cases of suspicious lesions, a biopsy and histological examination was also indicated. Results In this series, six cases of BCC were diagnosed and treated showing an incidence rate higher than 10 %. Conclusions Our results support the need of histological examination of the surgically removed tissue in patients with rhinophyma. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-12-01
  • Post-radiation tracheoesophageal fistula following salvage laryngectomy:
           microsurgical repair using a “bi-laminar” lateral arm flap
    • Abstract: Abstract Post-radiotherapy tracheoesophageal fistula (TOF) is a serious complication following salvage laryngectomy, associated with severe morbidity and high mortality. In the absence of recurrent disease, they commonly follow creation of a tracheoesophageal puncture for speech rehabilitation after total laryngectomy. Frequently, direct closure, local and regional flaps repairs are unsuccessful, further making the bed hostile or challenging for definitive treatment. We report using a free fasciocutaneous lateral arm flap, folded to create a bi-laminar (epithelial) reconstruction for salvage repair of large, high output persistent TOF initiated by tracheoesophageal puncture following total laryngectomy, two previous courses of radiotherapy and two unsuccessful repairs using small local flap and a pedicled pectoralis major. The folded lateral arm free flap provided resolution of the fistula, interposition of well-vascularised soft tissue, in addition to oesophageal lining and external tension-free cutaneous coverage, while maintaining a patent endotracheostomy. Chronic high output fistulas present extremely high risk and post-operative complications and necessitate complex reconstruction. Careful surgical planning, multidisciplinary approach and conservative measures to optimise the patient are paramount to achieve success. Microsurgical reconstruction provides an alternate and important adjunct in salvage repair of persistent and large TOFs. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-01
  • Intralesional cryosurgery for the treatment of upper lip keloid following
           deep chemical peeling
    • Abstract: Abstract Scarring following chemical peeling of the face is the worst fear for the treating physician. This case report describes the successful treatment of a large mature keloid of the upper lip following deep chemical peeling by using intralesional cryosurgery. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-01
  • Fat grafting used for the prevention of cardiac implantable electronic
           devices (CIED) exposure. Preliminary report of a clinical study
    • Abstract: Background Subcutaneous cardiac devices can sometimes undergo exposure, and often, the removal and contralateral repositioning of a new device is necessary. Pressure sores of the device cause a gradual thinning of the cutaneous and subcutaneous layers resulting in implant exposure. Our department has developed a closed collaboration with the Department of Cardiology in order to prevent the exposure of subcutaneous devices and to avoid the more risky and invasive surgery necessary for implant removal and reposition. Methods Thirty selected cardiopathic patients presenting pressure sores of the device, without exposure, were selected for lipofilling. The selection of patients is a key moment to ensure the success of the procedure. The surgery was performed under local anaesthetic without epinephrine. Results There was an improvement of local conditions, and none of the patients, after a year, were subjected to a removal operation of the implant. No cases of infection were observed. Conclusions Adipose tissue graft improved cutaneous trophism and increased the thickness of the subcutaneous tissue, reducing the risk of implant exposure. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-12-01
  • The oval sponge: a simplified method for scrotal skin graft fixation using
           VAC device
    • PubDate: 2014-12-01
  • Lymphatic drainage study after latissimus dorsi flap breast reconstruction
    • Abstract: Background Recurrence of breast cancer to latissimus dorsi (LD) flap donor site is a very rare condition, and as a result, few data are currently available on its possible causes. The aim of the study was to investigate the role of LD flap transfer in lymphangiogenesis and connection to the preexisting lymphatic network after mastectomy and axillary lymph node dissection and the lymphatic drainage involvement in local relapse to flap donor site. Methods Lymphoscintigraphy was performed on subgroup of ten patients who had previously undergone modified radical mastectomy, axillary lymph node dissection, and pedicled LD flap reconstruction. Lymphatic drainage was imaged by static gamma camera acquisitions after two intradermal injections of 37 MBq 99mTc-Nanocoll® on residual breast skin and LD skin paddle, respectively. Results In eight cases (80 %), the residual breast skin showed fast lymphatic drainage directed only toward the ipsilateral axilla, while in two cases (20 %), it was also seen to the internal mammary nodes. LD skin paddle showed slower drainage in all cases but 1, where no visible drainage was observed within 2 h after injection. Conclusions Although a small case series is the study limitation, our findings suggested that the LD flap harvest can promote a preferential route of lymphatic drainage in the axillary region and could be involved in a metastatic spread to the dorsum because of the new tissue plane opening. The direct communication created between recipient and donor sites could have lead to cell cancer transfer to the donor site either by lymphatic or a contiguity pathway. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-12-01
  • Reduction mammaplasty in adolescents: a review of the indications, timing,
           and outcomes in a regional plastic surgery unit
    • Abstract: Background With an increase in the incidence of childhood obesity and body awareness among adolescents, there has been a rise in the number of reduction mammaplasties being performed in this group of patients. Our study aims to review the indications, complications, and long-term outcomes of reduction mammaplasty in this subgroup of patients. Methods A retrospective review included female patients under 19 years old undergoing reduction mammaplasty. Data was obtained on patient demographics, mechanical and psychological symptoms and postoperative complications. A qualitative prospective questionnaire study was performed between 5 to 13 years following surgery. Responses were rated using the standardized Likert Scaling system to assess subjective benefits of the procedure. Results Thirty-six females had unilateral or bilateral reduction mammaplasty at a mean age of 17.40 years. Primary mechanical symptoms included back/neck pain, difficulty sleeping, and intertrigo. The principal psychological complaints were increased self-consciousness, low self-esteem, depression, and bullying. Sixty-seven percent agreed there was an immediate resolution of mechanical symptoms, and 47 % reported an improvement in psychological symptoms following surgery. Conclusions Reduction mammaplasty is especially beneficial in this group of patients as they suffer increased psychological comorbidities versus their adult counterparts. Patients need to be adequately assessed and counseled for optimal outcome.Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-12-01
  • V-Y rotation advancement flap: A metanalysis and systematic review
    • Abstract: Abstract Local skin flaps are used to close defects adjacent to the donor site. They are classified according to their method of movement: flaps that advance from its base to the defect (V-Y, Y-V, single-pedicle, and bipedicle advancement flaps) and flaps that move on a pivot point (rotation, transposition, and interpolation flaps). Despite its frequent use, there is not a unique name for V-Y rotation advancement flap; moreover, there is not a flap class called “rotation advancement” in the textbooks. A systematic review of the literature was conducted using “PubMed” and “Google Scholar” in December 2013. We made different searches using keywords “V-Y-S flap,” “V-Y rotation advancement flap,” and “hatchet flap”. The search was limited to the studies published in English and French. In total, 31 articles were found. Five articles presenting musculocutaneous hatchet flap, were excluded from the review. We included 26 articles in which cutaneous and fasciocutaneous flaps were described. We found 12 case series and five case reports presenting “hatchet flap.” Two case series and two case reports about “V-Y-S flap” were reported. Four case series and one case report about “V-Y rotation and advancement flap” were written. V-Y rotation and advancement flap were performed under different names on any regions of the body by several authors, and none of the authors reported flap loss or any dehiscence that resulted with a second surgery. With the help of this review, we would like to standardize its design and its dissection. Level of Evidence: Not ratable.
      PubDate: 2014-10-10
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