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Showing 1201 - 1400 of 2352 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: 14, 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: 5, 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: 6, 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   (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: 9, SJR: 1.087, h-index: 74)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 5, SJR: 1.126, h-index: 59)
J. of Compassionate Health Care     Open Access   (Followers: 3)
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: 3, SJR: 0.995, h-index: 78)
J. of Computers in Education     Hybrid Journal   (Followers: 12)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, 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: 10, SJR: 0.197, h-index: 6)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 5, 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: 9, SJR: 0.231, h-index: 9)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 3)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 6, SJR: 0.631, h-index: 29)
J. of Cryptographic Engineering     Partially Free   (Followers: 4, 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: 2, SJR: 0.539, h-index: 29)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 10, SJR: 0.149, h-index: 8)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 7, SJR: 0.114, h-index: 5)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 7, SJR: 0.574, h-index: 29)
J. of Digital Imaging     Hybrid Journal   (Followers: 6, 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: 1, 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: 9, SJR: 0.483, h-index: 16)
J. of Earth System Science     Open Access   (Followers: 49, 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: 5, SJR: 0.22, h-index: 3)
J. of Ecology and Environment     Open Access   (Followers: 1)
J. of Economic Growth     Hybrid Journal   (Followers: 21, 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: 12, SJR: 0.418, h-index: 23)
J. of Economics and Finance     Hybrid Journal   (Followers: 5, SJR: 0.272, h-index: 19)
J. of Educational Change     Hybrid Journal   (Followers: 6, 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: 4, 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: 8)
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   (Followers: 1, SJR: 0.145, h-index: 11)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 7, 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: 50, 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: 3, SJR: 0.396, h-index: 32)
J. of Family Violence     Hybrid Journal   (Followers: 41, 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: 6, SJR: 0.441, h-index: 29)
J. of Forest Research     Hybrid Journal   (Followers: 2, SJR: 0.495, h-index: 27)
J. of Forestry Research     Hybrid Journal   (Followers: 3, 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: 11, SJR: 1.651, h-index: 88)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 39)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 10, 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: 8, 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: 10)
J. of Grid Computing     Hybrid Journal   (Followers: 1, SJR: 1.414, h-index: 37)
J. of Happiness Studies     Hybrid Journal   (Followers: 26, SJR: 0.881, h-index: 39)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.2, h-index: 13)
J. of Heuristics     Hybrid Journal   (Followers: 4, SJR: 1.308, h-index: 50)
J. of High Energy Physics     Hybrid Journal   (Followers: 17, 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: 7, 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: 2, 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: 9, 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: 2, 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: 10)
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: 10, SJR: 0.338, h-index: 33)
J. of Insect Behavior     Hybrid Journal   (Followers: 7, 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: 37, SJR: 4.208, h-index: 130)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 12, SJR: 0.549, h-index: 23)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 14, 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: 6, 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: 6, 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: 9, SJR: 0.805, h-index: 33)
J. of Management Control     Hybrid Journal   (Followers: 5, 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: 17, SJR: 0.228, h-index: 8)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 5)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 2, SJR: 0.449, h-index: 22)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 23, SJR: 0.544, h-index: 40)
J. of Materials Science     Hybrid Journal   (Followers: 22, SJR: 0.836, h-index: 123)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 4)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
J. of Mathematical Biology     Hybrid Journal   (Followers: 9, SJR: 1.011, h-index: 71)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 3, SJR: 0.497, h-index: 45)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 8, 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: 1, 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: 16, 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: 5, SJR: 0.589, h-index: 26)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 3, 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   (SJR: 0.717, h-index: 44)
J. of Medical Toxicology     Hybrid Journal   (Followers: 5, 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: 1, 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: 6, 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: 11, 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: 2, 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: 1)
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: 2, 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: 9, SJR: 0.863, h-index: 27)
J. of Nonlinear Science     Hybrid Journal   (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: 24, SJR: 0.919, h-index: 60)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 4, 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: 3)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.237, h-index: 11)
J. of Oceanography     Hybrid Journal   (Followers: 10, 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: 8, 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: 23)
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]   [10 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  [2352 journals]
  • Comparison of pain, nausea, and complications in outpatient and inpatient
           breast augmentation
    • Authors: Carlos Weck Roxo; Ana Claudia Weck Roxo; Fernando Serra; Denise da Mota; João Henrique Spagolla Pontello; Daniel Leal; José Horácio Aboudib; Fábio X. Nahas
      Pages: 27 - 30
      Abstract: Background Outpatient surgery is growing exponentially in different surgical areas, driven by cost savings and convenience for both the patient and the surgeon. Breast augmentation is one of the most commonly performed cosmetic surgical procedures and despite being a simple procedure, some surgeons prefer to keep the patient overnight, due to fear of complications and unsatisfactory pain and nausea management. The aim of this study was to compare postoperative complications, pain, nausea, and satisfaction between an outpatient and on 24-h hospitalization basis. Methods Eighty female patients undergoing breast augmentation were selected. Patients were allocated randomly, 40 patients each group. One group remained hospitalized for 24 h and the other group was discharged after surgery. In both groups were evaluated the following: complications, postoperative pain, nausea, and patient satisfaction with the recovery regime. Patients were followed up weekly within the first 4 weeks and then monthly. Pain evaluation was carried out using the pain scale proposed by Huskisson. A statistical analysis was also made. Results Eighty patients were operated, 40 patients in each group. There were no intraoperative complications in any group. In the hospital group, there was one case of hematoma (2.5%) and in the outpatient group, there was one case of infection (2.5%) (p = 1). Regarding postoperative pain, the average score was 3.9 in the hospital group and 4.1 in the outpatient group (p = 0.39). All patients in the outpatient group (100%) reported being satisfied with their recovery site and only 80% in the hospital group were satisfied (p = 0.002). Eight patients (20%) would rather have been discharged after the procedure. Conclusions Breast augmentation performed in an outpatient setting presented complication rates similar to conventional hospitalization, as well as levels of postoperative pain and nausea. However, there was a higher rate of patient’s satisfaction in the outpatient group. Level of Evidence: Level I, risk / prognostic study.
      PubDate: 2018-02-01
      DOI: 10.1007/s00238-017-1316-9
      Issue No: Vol. 41, No. 1 (2018)
  • Reconstruction of the composite defect after extended abdominoperineal
           resection (eAPR): a clinical experience from Italy
    • Authors: Marco Fraccalvieri; Umberto Morozzo; S. Sandrucci; Marco Salomone; Ezio Falletto; Massimiliano Mistrangelo; Erind Ruka; Stefano Bruschi
      Pages: 49 - 56
      Abstract: Background Abdominalperineal resection (APR) represents the gold standard for lower third of rectum and anal cancer; after this wide excision, it results a large non-collapsible dead space that tends to collect fluid, increasing the risk of infection and wound dehiscence. Moreover, APR is associated to neoadjuvant/adjuvant radiation therapy with further risk of local complications. In this background, flap reconstruction after APR o eAPR represents the best strategy for minimizing tension in skin closure, providing healthy well vascularized and restoring a good functional local anatomy. Methods A retrospective study was performed at the Department of Plastic Reconstructive and Aesthetic Surgery at the University Hospital Città della Salute e della Scienza of Turin from March 2013 to November 2016: 11 patients were included in the study: 5 men and 6 women aged 53 to 76 years (mean ± SD age: 66 ± 7 years). All of them received eAPR (extended-APR). Seven patients required a total dose of 20Gy as neoadjuvant radiotherapy treatment and 6 patients needed adjunctive chemotherapy treatment. Skin defects size ranged from 56 to 180 cm2 (mean 114 ± 38 cm2). Skin defect less than 5 cm of maximum width was not included in the study because no major reconstructions were needed. Surgical reconstruction was planned depending on sacrectomy eventually associated to eAPR and defect size too. Planned follow-up was carried out at 1, 3, and 6 months recording clinical data, local and systemic complications, and pain evaluation at sitting position and during normal walking activity. Results Wound healing was achieved in all patients within a period of 21 days. Only one patient showed partial flap necrosis and required wound surgical revision with simple skin closure. Another one patient suffered from mild venous congestion and partial flap necrosis was observed: a period of 2 weeks of negative pressure wound therapy and dressing led to complete healing of the defect (both these patients received 20Gy neoadjuvant radiotherapy). Esthetic pleasant results, high patient satisfaction, and no significant motor impairment were recorded among all patients, excepting for just one patient who reports mild walking impairment and pain at sitting position, after the 6th month follow-up. None of the patient referred significant life quality impairment and all of them expressed general high satisfaction concerning reconstructive expectations. Conclusions Many flaps can be harvested to fill and close the large defect after eAPR, with respectively advantages and disadvantages, but we found the use composite gluteal flap technique suitable for most of the patients undergoing eAPR, with good functional results and low rates of morbidity and complications. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2018-02-01
      DOI: 10.1007/s00238-017-1325-8
      Issue No: Vol. 41, No. 1 (2018)
  • Continuous veno-venous haemodiafiltration in burns patients: a role in
    • Authors: Jonathan James Cubitt; Janakan Anandarajah; Meryl Webb; Andrew J. Williams; William A. Dickson; Peter J. Drew
      Pages: 57 - 62
      Abstract: Background A burn injury results in the release of proinflammatory cytokines and catecholamines, causing a hypermetabolic state which may lead to hyperpyrexia (>40 °C). This risk is increased with concomitant sepsis. Hyperpyrexia is associated with a high mortality. Continous veno-venous haemodiafiltration (CVVHDF) can be used to reduce the circulating cytokines thereby reducing the cause of the hyperpyrexia. CVVHDF use has been well documented in sepsis and SIRS in the ITU population. In our Burns Centre, CVVHDF is routinely used to treat patients with persistent hyperpyrexia. The aim of this study was to evaluate the role of CVVHDF in burns patients with hyperpyrexia. Methods A retrospective analysis was carried out of all patients admitted to the Burns ITU between 2005 and 2012 who received CVVHDF for hyperpyrexia. The medical notes and electronic database was used to collect data on indication, renal function, duration and outcome. Results Five hundred seventy patients were admitted over the time period. Sixty-one patients received CVVHDF overall and of these 32 were for hyperpyrexia alone. In these patients, there was a significant reduction in temperature within 3 h of initiating CVVHDF (p < 0.0001). The cumulative predicted mortality using Modified Baux score was seven patients. In our group 2 patients died, possibly implying a survival benefit. Conclusions CVVHDF can be successfully used to regulate the temperature in burns patients with hyperpyrexia. Level of evidence: Level IV, therapeutic study.
      PubDate: 2018-02-01
      DOI: 10.1007/s00238-017-1318-7
      Issue No: Vol. 41, No. 1 (2018)
  • A new treatment of hypertrophic and keloid scars with combined
           triamcinolone and verapamil: a retrospective study
    • Authors: S. B. Kant; E. van den Kerckhove; C. Colla; S. Tuinder; R.R.W.J. van der Hulst; A.A. Piatkowski de Grzymala
      Pages: 69 - 80
      Abstract: Background Since the management of keloid and hypertrophic scars still remains a difficult clinical problem, there is need for adequate, effective therapy. In this study, we explored for the first time the efficacy and the potential synergetic effect of combined triamcinolone and verapamil for the treatment of hypertrophic and keloid scars. The objective was to assess the efficacy of combined intralesional triamcinolone and verapamil therapy for hypertrophic and keloid scars. Methods Fifty-eight patients with hypertrophic scars (n = 31) and keloid scars (n = 27) were included. A specific injection therapy scheme was applied. Five follow-up moments were chosen, with a maximum follow-up of nearly 2 years. The effects of combination therapy on scar pliability, thickness, relief, vascularization, surface area, pain, and pruritus were examined by means of the Patient and Observer Scar Assessment Scale (POSAS). Results Our results reveal a fast and abiding improvement of both keloid and hypertrophic scars after treatment with the combination therapy. All POSAS components showed a reduction in scar score, while scar relief, pain, itchiness, and surface area improved significantly (P < 0.05) in keloids. Significant improvement in hypertrophic scars was found in scar pigmentation, vascularization, pliability, thickness, pain, and surface area. Overall POSAS scores revealed statistically significant decreases between baseline and 3–4 months, 4–6 months, and >12 months after start of therapy in both keloids and hypertrophic scars. Conclusions This study reveals that combined therapy of triamcinolone and verapamil results in overall significant scar improvement with a long-term stable result. Level of evidence: Level IV, therapeutic study.
      PubDate: 2018-02-01
      DOI: 10.1007/s00238-017-1322-y
      Issue No: Vol. 41, No. 1 (2018)
  • Ablation of facial adenoma sebaceum using the Versajet™
           Hydrosurgery System
    • Authors: Martin Grohmann; Stefan Benedikt; Abigail Forbes; Ivo Justich
      Pages: 93 - 96
      Abstract: Sebaceous adenomas, histologically facial angiofibromas, are closely associated with the tuberous sclerosis complex. The dermatologic disorder constitutes one of the main characteristics for that disease. The lesions commonly involve the central part of the face, including the cheeks, perioral region and nose with predominance in the nasolabial folds, causing a major cosmetic disfigurement. Aesthetic surgery of the face comprises different forms of ablative treatments using mechanical dermabrasion, shave excision, radiofrequency ablation, cryosurgery, laser therapy, and electrocoagulation. The use of Versajet™ Hydrosurgery System has not been previously described in the treatment of adenoma sebaceum so far. In this case report, we present the successful application of this hydrosurgical system in a patient with tuberous sclerosis and multiple facial angiofibromas indicating it as a feasible, effective, reliable, and economical treatment option. Level of Evidence: Level V, therapeutic study.
      PubDate: 2018-02-01
      DOI: 10.1007/s00238-017-1347-2
      Issue No: Vol. 41, No. 1 (2018)
  • Correction to: Subcutaneous lipomas: A minimally invasive method for
           resection of subcutaneous lipomas preserving retaining ligaments
    • Authors: Akio Sakamoto; Takeshi Okamoto; Shuichi Matsuda
      Abstract: The article Subcutaneous lipomas: A minimally invasivemethod for resection of subcutaneous lipomas preserving retaining ligaments, written by Akio Sakamoto, Takeshi Okamoto, Shuichi Matsuda, was originally published electronically on the publisher’s internet portal (currently SpringerLink).
      PubDate: 2018-03-21
      DOI: 10.1007/s00238-018-1409-0
  • Managing complex trauma injuries in the elderly: a case report of a free
           flap and circular frame in a 95-year old patient with an open IIIB tibial
    • Authors: Charlotte Hammonds; Philippa C. Jackson; Patrick Foster; Jonathan D. Wiper
      Abstract: In an ageing population, increasing numbers of patients over the age of 70 are sustaining severe trauma. These patients require careful multidisciplinary team (MDT) management with careful consideration of existing co-morbidities, as such their treatment should be individually tailored. We present the case of a patient believed to be the oldest documented patient treated in a trauma setting with free flap and circular frame fixation to an open tibial fracture. A 95-year-old male presented to the Level 1 Major Trauma Centre (MTC) with multiple injuries after a pedestrian vs car incident. His injury severity score (ISS) was 22. For treatment of his open tibial fracture, he required soft tissue coverage with a free anterolateral thigh (ALT) flap, and circular frame application. Microsurgery was performed after consultation with the MDT and was uneventful. The circular frame was removed after 10 months and the patient went on to regain pre-injury mobility. Use of free tissue transfer in elderly patients is well documented in the elective setting, but less so in trauma. This case demonstrates that careful patient selection, attention to detail and MDT working can result in an excellent outcome for the patient. The challenges faced in treating this patient will be described in detail. Level of Evidence: Level V, therapeutic study.
      PubDate: 2018-03-20
      DOI: 10.1007/s00238-018-1405-4
  • A new otoplasty procedure: combination of perichondrio-adipo-dermal flap,
           posterior auricular muscle transpositioning and cartilage suturing to
           decrease the post-operative complication rates
    • Authors: Burak Ersen; Yucel Sarialtin; Bulent Cihantimur; Mustafa Ozyurtlu
      Abstract: Background Prominent ear deformity is a common congenital deformity of the external ear affecting 5% of the general population. Although this is a harmless deformity, several publications demonstrate the psychological distress, emotional trauma and behavioural problems that this deformity can inflict on children. As a result of these concerns, corrective prominent ear surgery is now widely performed as a prophylactic surgery. Methods Three different prominent ear repair techniques were combined. First, a laterally based perichondrio-adipo-dermal flap was elevated. The posterior auricular muscle was dissected and transected from its insertion. After concha-mastoid suture replacement, the posterior auricular muscle transposition and flap positioning were performed. The helix–mastoid distances and concha-mastoid angles of the patients were measured pre-operatively and at the sixth month of the surgery as the late post-operative assessment. Patients were also evaluated for suture extrusion, granuloma formation, deformity recurrence and postauricular area sensitivity. Results Fourteen patients with bilateral prominent ear deformities were treated between January 2016 and January 2017. None of the patients suffered from skin necrosis, suture extrusion, hematoma or wound infection at the early or late post-operative period. No recurrence was noted. Conclusions The combination of these three techniques not only decreases post-operative complication rates but also provides a primary otoplasty technique. All three techniques are well-documented and reliable protruding ear correction methods. It was aimed to benefit from specific advantages of each technique while decreasing the complication rates. The primary drawback of our study is the amount of patients in our sample. Complication rates of this technique remain debatable in the 14 cases. The need for further prospective comparative studies about this subject remains. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2018-03-07
      DOI: 10.1007/s00238-018-1407-2
  • A skin stretch system for the immediately closing of the large skin
           defects of the anterior chest wall following large keloid excision
    • Authors: Zhanyong Zhu; Yueqiang Zhao; Mosheng Yu; Moris Topaz
      Abstract: Large anterior chest wall skin defects following keloid resection, which are not suitable for primary closure, represent a substantial reconstructive challenge, partly due to the expected high tension closure and the considerable rate of recurrence. The TopClosure® Tension Relief System (TRS) is a novel skin stretching and wound closure-secure system which has been shown as a substitute for skin grafts, tissue expanders, and flaps. A 36-year-old man presented with a large keloid with ulcerations on the anterior chest wall. The patient underwent surgical resection of the keloid with immediate primary closure of the chest wall skin defect using the TRS. The surgical procedure and the postoperative period were uncomplicated. The wound was completely closed with a slightly raised scar after the 15th month follow-up. This is a rare case of immediate primary closure of a skin defect following resection of a large keloid of the anterior chest wall by the application of a skin stretching technique named as TRS. The TopClosure® TRS can help simplify the surgical procedures and shorten the operative time. Furthermore, the appliance can also be used for cosmetic improvements of the scar and minimize the need for future reconstructive procedures as well. Level of Evidence: Level V, therapeutic study
      PubDate: 2018-03-02
      DOI: 10.1007/s00238-018-1406-3
  • Reply to: Comments on “Breast augmentation together with intraoperative
           glandular transposition flap for prevention and correction of lower pole
    • Authors: Dmitry Batiukov; Vladimir Podgaiski
      PubDate: 2018-03-01
      DOI: 10.1007/s00238-018-1403-6
  • Osteotomies and autografted artificial dermal substitute over bone marrow
           in a bone-deep burn in an elder patient: An alternative to amputation
    • Authors: Enrique Salmerón-González; Elena García-Vilariño; M Dolores Pérez-del-Caz; Alberto Ruiz-Cases; Pilar Corella-Estevez; Álvaro Forés-Zaragoza
      Abstract: In this report, we describe the case of an elder patient who suffered a third-degree fire burn with extensive bone affection and exposure of both tibias. The usual treatment strategy for this type of case would have been amputation, or the performance of a multiple free flap surgery. Notwithstanding taking into account the age and the functional objectives for this patient, the multiple free flap option was disregarded. Therefore, we performed an original limb salvage procedure which consisted in bilateral anterior tibial cortex osteotomies and direct grafting over bone marrow, applying skin grafts over a monolayer artificial dermal substitute (Integra®), covered by a negative pressure therapy device. The wound was successfully and early covered, preventing the patient from the long hospital stay and derived complications that other coverage strategies would have carried. Level of Evidence: Level V, therapeutic study.
      PubDate: 2018-02-27
      DOI: 10.1007/s00238-018-1401-8
  • Management of nipple-areola complex ischemia after breast reduction: A
           systematic literature review and algorithm proposal
    • Authors: Alexandre Vairinho; Kevin Serror; Antoine De Runz; Warren Noel; Marc Chaouat; Maurice Mimoun; David Boccara
      Abstract: Background Rare and dreaded, necrosis of the nipple-areola complex (NAC) is one of the major complications of breast reduction surgery. Our objective was to establish a management algorithm summarizing the different possible treatments reported in the literature. Methods The data extracted from the articles selected for this literature review covered surgical techniques, frequency of NAC necrosis, type of necrosis, and management proposed for women who have had this surgery for macromastia. Results In the 54 articles finally selected, the mean frequency of NAC necrosis was 5.1%. The risk factors for necrosis were the weight of the tissue resected, smoking, obesity, the surgical technique used, and stretch marks. The treatments proposed were listed according to four categories of issues: patient-specific susceptibility, type of breast, surgical technique, and its technical performance. Conclusions No consensus exists about the management of NAC necrosis, which remains a complication feared by surgeons. We propose a management algorithm that simplifies the therapeutic indications. Level of Evidence: Not ratable
      PubDate: 2018-02-27
      DOI: 10.1007/s00238-018-1399-y
  • Near-infrared fluorescence image-guidance in plastic surgery: A systematic
    • Authors: Anouk J. M. Cornelissen; Tom J. M. van Mulken; Caitlin Graupner; Shan S. Qiu; Xavier H. A. Keuter; René R. W. J. van der Hulst; Rutger M. Schols
      Abstract: Background Near-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700–900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research. Methods A systematic literature search was performed in databases of Cochrane Library CENTRAL, MEDLINE, and EMBASE (last search Oct 2017) regarding NIRF imaging in plastic surgery. Identified articles were screened and checked for eligibility by two authors independently. Results Forty-eight selected studies included 1166 animal/human subjects in total. NIRF imaging was described for a variety of (pre)clinical applications in plastic surgery. Thirty-two articles used NIRF angiography, i.e., vascular imaging after intravenous dye administration. Ten articles reported on NIRF lymphography after subcutaneous dye administration. Although currently most applied, general protocols for dosage and timing of dye administration for NIRF angiography and lymphography are still lacking. Three articles applied NIRF to detect nerve injury, and another three studies described other novel applications in plastic surgery. Conclusions Future standard implementation of novel intraoperative optical techniques, such as NIRF imaging, could significantly contribute to perioperative anatomy guidance and facilitate critical decision-making in plastic surgical procedures. Further investigation (i.e., large multicenter randomized controlled trials) is mandatory to establish the true value of this innovative surgical imaging technique in standard clinical practice and to aid in forming consensus on protocols for general use. Level of Evidence: Not ratable
      PubDate: 2018-02-27
      DOI: 10.1007/s00238-018-1404-5
  • Extensive intraneural fascicular dissection of a lipofibromatous hamartoma
           of the ulnar digital nerve of the thumb
    • Authors: Mohamed Elsaid Abdelshaheed
      Abstract: Lipofibromatous hamartoma (LFH) is a rare, benign fibrofatty tumor of the peripheral nerves. Only a handful of cases have been reported in the literature, together with cases of LFH of the digital branches of the median nerve. The median nerve is the most commonly affected site. Different treatment approaches to LFH have been described according to the clinical presentation. A case of LFH of the ulnar digital nerve of the left thumb that underwent extensive intraneural fascicular dissection and mass excision is described in this paper. Good results were obtained, i.e., pain relief and good cosmesis. Extensive intraneural fascicular dissection and mass excision are considered to be a good management option for LFH of the digital branches of the median nerve, without the requirement of nerve excision or nerve grafting. Level of evidence: Level V, therapeutic study.
      PubDate: 2018-02-17
      DOI: 10.1007/s00238-018-1402-7
  • Transcutaneous oximetry and laser Doppler flowmetry values in patients
           with chronic skin ulcers treated with platelet rich plasma and stromal
           vascular fraction cells: a pilot study
    • Authors: Edoardo Raposio; Nicolò Bertozzi; Marco Trevisan; Michele Pio Grieco
      Abstract: Background Stromal vascular fraction cells (SVFs) hold great promise for use in regenerative medicine applications, as a result of their ability to promote the healing process through in situ differentiation and the secretion of paracrine factors. The aim of this paper was to evaluate whether and how the topical application of SVF with platelet-rich plasma (PRP) for the treatment of chronic skin ulcers modified the cutaneous perfusion of the treated areas. Methods Perilesional laser Doppler flowmetry (LDF) and transcutaneous oximetry (tcpO2) values were recorded for a 3-month period in 15 patients with chronic skin ulcers of various etiologies, who had been previously treated with single co-administered perilesional and intralesional injections of SVF+PRP. Results No significant differences were found between pretreatment, 1 month, and 3 month posttreatment values regarding both LDF values (basal: p = 0.10 and declivous: p = 0.0976) and declivous tcpO2 levels (p = 0.0804). The only significant difference reported was between pretreatment and 3-month posttreatment basal tcpO2 levels (p = 0.0466). Conclusions These results may reflect improved subcapillary circulation of the treated areas at 3 months postinjection, without a significant improvement in capillary perfusion. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2018-02-13
      DOI: 10.1007/s00238-018-1394-3
  • The optimal timing of adipose derived stem cells injection to improve skin
           flap survival in a rat model
    • Authors: Ahmed Atef; Ayman Abu El Makarem Shaker; Eman Yahya Sadek; Nahed Samir Boughdadi; Suzi Sobhy Atalla; Fatma Abu Zahra
      Abstract: Background Skin flap surgery is a cornerstone in plastic surgery. However, flaps may encounter postoperative partial or complete necrosis. Different modalities have been used to enhance skin flap survival. Adipose-derived stem cells (ASCs) can promote angiogenesis and improve skin flap survival. We aimed to investigate the appropriate timing of ASC administration to get the maximal angiogenic effect and better skin flap survival in rat model. Methods Thirty-two male albino Wistar rats were used to study the role of ASCs on caudally based (2 × 8 cm) random pattern skin flap survival; the 32 male albino rats were equally divided into four groups according to timing of ASC injection. We applied the ASCs at three different timing, group A (local injection of ASCs along the flap axis simultaneously with flap elevation), group B (2 days preoperatively), and group C (7 days preoperatively). In the control group (group D), the flap was injected with phosphate buffered saline at the time of flap elevation. Skin flap survival was evaluated on the seventh postoperative day through percentage of flap survival, capillary density, and vascular endothelial growth factor (VEGF) expression. Results ASCs led to a statistically significant increase in skin flap viability when administered simultaneously with flap elevation or 2 days prior to flap elevation. This went along with significant increase in capillary density and VEGF expression. However, the ASCs had no effect on flap survival when injected 1 week prior to flap elevation. Conclusions We demonstrate that the skin flap viability can be enhanced by local ASC administration simultaneously with flap elevation or 2 days prior to flap elevation. Their beneficial effect is attributed to paracrine secretion VEGF which enhanced the skin flap vascularity. The angiogenic effect of ASCs can be maximized when the ASCs are injected at the time of flap elevation. Level of Evidence: Not ratable
      PubDate: 2018-02-13
      DOI: 10.1007/s00238-018-1400-9
  • Outcomes of the use of Ligamentotaxor® for proximal interphalangeal
           fractures of the hand: North Bristol hand centre experience
    • Authors: Guirgis A. Awad; F. Everton; M. Downs; S. Chummun; S. M. Wilson
      PubDate: 2018-02-08
      DOI: 10.1007/s00238-018-1398-z
  • The treatment of perianal skin horseshoe melanoma by advancement flap (Y-V
           shaped) and the assessment of outcome over a long-term follow-up
    • Authors: Corrado Rosario Asteria; Angelo Cassisa; Anna Asteria; Andrea Zanca
      Abstract: A horseshoe perianal skin melanoma was treated by cutaneous advancement flap (Y-V shaped) and the outcome was investigated over a long-term follow-up. Objects of investigation were the history taking, the preoperative work-up, the adopted surgical procedure, and the histological and immune-histochemical findings concerning additional lesions found during the follow-up. The follow-up lasted 140 months. In this patient, a previous breast cancer was diagnosed and treated. Local diffusion of soft tissue, nodes, and anal sphincter infiltration or distant metastasis were not shown preoperatively. A wide excision with an advancement flap Y-V was carried out. Histological findings showed a level II of Clark with Breslow 0.65 mm. No local or distant recurrences were found by follow-up. Sixty months later, two pigmented lesions (0.3 0.2 mm) were detected and removed. Histologically, a hyperpigmentation of the basal layer of epidermis and immunostaining with Melan-A and CD 117 confirmed the absence of any significant melanocytic proliferation. Ninety months after the first procedure, a new small cell carcinoma of the right lung was detected leading the patient to death after 140 months. The findings of this report raise issues related to plastic and reconstructive modality but also to oncological outcome. We were also able to recognize a possible compromised immune deficiency over a considerable life span. However, the occurrence of melanoma did not affect the unfavorable outcome, which was caused by other cancers. Level of Evidence: Level V, prognostic study
      PubDate: 2018-02-05
      DOI: 10.1007/s00238-018-1397-0
  • A rotation flap does not rotate
    • Authors: Klaas W. Marck; Jan J. van Wingerden
      PubDate: 2018-02-02
      DOI: 10.1007/s00238-017-1385-9
  • Acknowledgment to reviewers—2017
    • PubDate: 2018-01-13
      DOI: 10.1007/s00238-018-1390-7
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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