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Dysphagia     Hybrid Journal   (Followers: 193, 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: 7, 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: 7, 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: 171, 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: 6, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 9, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 181, 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: 2, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 6, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal  
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: 32, 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: 1, 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: 182, 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: 4, 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: 6, 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)
European J. of Health Economics     Hybrid Journal   (Followers: 11, SJR: 0.67, 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]
  • 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
  • The national variation in peri-operative anaesthetic technique for breast
           free flap reconstruction in the UK: is it time to define best
    • Abstract: Background Peri-operative anaesthetic techniques are important in maximising microsurgical success and analgesic delivery. The National Mastectomy and Breast Reconstruction Audit highlighted variation in breast free flap reconstruction success. As current UK peri-operative anaesthetic practice is unknown, a national survey was conducted. Methods A link to an online questionnaire was sent to lead consultant anaesthetists in each UK unit undertaking breast free flap reconstruction. Data was collected on important aspects of peri-operative anaesthetic technique including fluid therapy, haemodynamic monitoring, analgesic strategy and transfusion practice. Results A response was received from 34 of the 41 units identified (83 %). Twice as many units undertook deep inferior epigastric artery perforator (DIEP) flap reconstruction compared with transversus abdominis musculocutaneous (TRAM) flap reconstruction. Peri-operative fluid therapy was mainly ‘liberal’ in nature with little evidence of a ‘goal-directed’ approach. The intraoperative haemodynamic monitor of choice was continuous arterial blood pressure monitoring. Use of oesophageal Doppler or lithium diluted cardiac output (LiDCO) monitoring is not widespread. Many units undertake some form of regional analgesic strategy, with transversus abdominis plane and rectus sheath blocks the commonest techniques. Peri-operative blood transfusion practice showed considerable variation between units. Conclusions There is a wide national variation in reported peri-operative anaesthetic technique for breast free flap reconstruction. Further research is recommended to confirm whether this translates into varied clinical outcomes. Although modern breast free flap reconstruction failure rates are currently low, targeting peri-operative anaesthetic technique could lead to improved clinical outcomes. In addition, improved peri-operative anaesthetic technique has a key role to play if enhanced recovery programmes after surgery (ERAS) for breast free flap reconstruction are to be created. Level of Evidence: Not ratable.
      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
  • Applicability of self-inflating tissue expanders in pediatric patients
           with head and neck defects
    • Abstract: Background Self-inflating tissue expanders have been used successfully in breast reconstruction, alopecia, scars, and anophthalmos. The expanders contain an osmotic active hydrogel and a silicon shell. The purpose of this study was to analyze our clinical experience using self-inflating tissue expanders in the treatment of alopecia and cleft palate defects in pediatric patients. Methods Twenty-eight self-inflating tissue expanders were used in 13 patients with alopecia or large cleft palate defects. Expander dimensions were determined by the size of the defect in the scalp and by using a sizer for the palate. In some patients, it was necessary to use more than one expander. A visual analog scale (VAS) and Children’s Hospital of Eastern of Ontario Pain Scale (CHEOPS) were used to determine pain levels. Results Sufficient tissue was gained in nine patients (69.2%) and 11 of the 16 defects were repaired successfully (68.75 %). We observed four implant extrusions as a major complication (14.2 %). Three of these four extrusions were seen in cleft palate expansions. Pain levels were as low as 5 points with CHEOPS in patients younger than 5 years old and 40 mm with VAS in patients older than 5 years of age. Conclusions Self-inflating tissue expanders comfortably ensure sufficient tissue in patients with alopecia; however, there is high risk of extrusion in cleft palate applications. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-11-18
  • Cryoinjury with compartment syndrome of bilateral hands secondary to Freon
           gas: a case report and review of current literature
    • Abstract: Abstract Freon is an industrial refrigerant that can result in serious cryoinjury of the skin. Although there had been a few reported cases, the optimal management is not clear. We present the first case report of a patient with freon-induced cryoinjury of bilateral hands, complicated with compartment syndrome and treated with a combination of surgical decompression, negative-pressure wound therapy (NPWT), and hyperbaric oxygen therapy (HBOT). On follow-up, there was a complete healing without tissue loss or significant atrophy of the intrinsic muscles of the hand. Therefore, we opined that HBOT and NPWT may work synergistically to prevent progressive tissue damage and improve the long-term outcome, especially when vascularity is compromised in severe cryoinjuries of the hand. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-11-14
  • Swim ring method—a cost-effective alternative for prevention and
           healing of back ulcers
    • PubDate: 2014-11-14
  • Versatility of muscle splitting biplane technique associated with internal
           mastopexy in breast hypoplasia, ptosis, and asymmetry
    • Abstract: Background Breast augmentation is one of the most highly sought after aesthetic surgeries. For the best outcome, a wide variety of factors such as approach, pocket plane, tissue, and breast characteristics (including asymmetry and ptosis) must be assessed along with the patient’s needs. For patients requiring correction of minor ptosis and breast asymmetry, the current technique involves incisions on the breast, but often the patients are dissatisfied with the visible scars so there is a need for procedures involving less scarring. Methods Since 2010, 200 patients with breast hypoplasia have undergone muscle splitting biplane breast augmentation; 32 patients with breast hypoplasia combined either with asymmetry or/and minor ptosis have undergone a technique combining muscle splitting biplane breast augmentation with internal suture mastopexy; 12 patients with dynamic breast following partial submuscular breast augmentation have undergone replacement of the implants using the muscle splitting biplane technique. Results Satisfactory long-term outcomes were obtained by using muscle splitting breast augmentation, with or without internal suture mastopexy, with more accurate control of the breast’s natural shape, symmetry, and inframammary fold positions as well as proper cleavage and nipple projection. In this way, a smooth transition between the soft tissue and implant in the breast’s upper pole was possible, and more tissue was available to cover the implant’s upper pole. Nipple sensitivity was preserved with no visible scars on the breast. Conclusions The muscle splitting biplane breast augmentation offers improved long-term aesthetic outcomes; is extremely versatile, fast, and easy; and may also be used in patients requiring removal and replacement of breast implants. In combination with the internal mastopexy, this technique is an effective alternative in selected patients requiring correction of breast asymmetry and minor ptosis. Level of Evidence: Level IV, therapeutic study
      PubDate: 2014-11-13
  • Idiopathic scaphoid avascular necrosis in a patient with hypohidrotic
           congenital ectodermal dysplasia
    • Abstract: Abstract Hypohidrotic ectodermal dysplasia (HED), also called Christ–Siemens–Touraine (CST) syndrome, is a rare genetic syndrome that affects structures of ectodermal origin, such as the nails, teeth, hair, sweat glands, and skin. Deficiency or absence of these anatomical structures can result in hypotrichosis, hypodontia, hypohidrosis, or anhidrosis. Most cases show X-linked inheritance associated with mutations in the ectodysplasin (EDA) gene, although autosomal dominant or recessive inheritance patterns have also been observed. Avascular necrosis of the scaphoid bone is common after a fracture and can also be associated with systemic disease or chronic steroid administration, while idiopathic avascular necrosis of the scaphoid is very rare. This report presents a patient with HED who developed idiopathic avascular necrosis of the scaphoid and discusses the potential association between the two. Level of Evidence: V, diagnostic study.
      PubDate: 2014-11-13
  • Extensive cervicofacial necrotizing fasciitis of odontogenic origin: case
           report and literature review
    • Abstract: Abstract Necrotizing fasciitis is a potentially fatal soft tissue infection characterized by generalized necrosis and gas formation in the subcutaneous tissues and fascia. It is rarely seen in the head and neck area. This report presents the case of a 62-year-old diabetic female patient with generalized cervicofacial necrotizing fasciitis extending to the front chest wall. The cause of the disease was the extraction of the infected second molar tooth. Debridement was performed on the generalized necrotic fascia, subcutaneous tissue, and the skin extending from the preauricular area to the front chest wall and nipples. A series of debridement procedures were necessary because of generalized necrosis. The patient received intensive medical supportive treatment. Following the debridement procedures, the defective area from the neck to the front chest wall was closed up with split-thickness skin graft. Abscessed tooth extraction can lead to cervicofacial necrotizing fasciitis. Necrotizing fasciitis still remains as a potentially fatal disease. Early diagnosis, early radical surgical debridement, and a multidisciplinary approach constitute the significant factors in preventing mortality in such patients. Level of Evidence: Level V, therapeutic study
      PubDate: 2014-11-12
  • 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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