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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: 6, 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: 159, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 13, 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: 173, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 11, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 3, 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  
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: 4, 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: 9, 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: 3, 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: 178, 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: 4)
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: 8, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 7, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 10, 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)
European J. of Law and Economics     Hybrid Journal   (Followers: 175, SJR: 0.242, h-index: 13)

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Journal Cover European Journal of Plastic Surgery
   Journal TOC RSS feeds Export to Zotero [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  [2209 journals]   [SJR: 0.227]   [H-I: 13]
  • Injection solution dyeing for verification of needle position in tissue
    • Abstract: Background When inflating multiple tissue expanders in an outpatient basis, correct location of the expander port can be sometimes perplexing, even for experienced personnel. Herein, we review a series of patients whose expanders were dyed with soluble dye added to the injected solution as a further means of verification of needle position during serial expansions. Methods Thirty patients with a total of 81 expanders were followed. The expanders were filled with methylene blue dyed solution in the initial operative procedure. Data regarding patient demographics, surgery etiology, number and location of implanted expanders, and postoperative complications were collected for analysis. Results At total of 80 (98.7 %) expansions were completed successfully with subsequent reconstructions. Three patients required treatment for surgical site infections, one patient had a wound dehiscence, and one patient required drainage of a postoperative hematoma. One expander was removed due to extrusion. None of the patients had complications related to expander rupture or puncture. None were noted to have side effects related to methylene blue exposure. During subsequent outpatient expander inflations, medical staffs reported a higher confidence in port location thus simplifying the inflation procedure. Conclusions Although many surgeons currently use methylene blue dyeing technique to facilitate tissue expansion, there are no reports to attest to the safety of this method. The short series presented herein serves to further outline the safe application of this technique to tissue expansion. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-11-01
  • TiLoop® Bra mesh used for immediate breast reconstruction: comparison
           of retropectoral and subcutaneous implant placement in a prospective
           single-institution series
    • Abstract: Background Immediate implant reconstruction after a conservative mastectomy is an attractive option made easier by prosthetic devices. Titanized polypropylene meshes are used as a hammock to cover the lower lateral implant pole. We conducted a prospective nonrandomized single-institution study of reconstructions using titanium-coated meshes either in a standard muscular mesh pocket or in a complete subcutaneous approach. The complete subcutaneous approach means to wrap an implant with titanized mesh in order to position the implant subcutaneously and spare muscles. Methods Between November 2011 and January 2014, we performed immediate implant breast reconstructions after conservative mastectomies using TiLoop® Bra, either with the standard retropectoral or with a prepectoral approach. Selection criteria included only women with normal Body Mass Index (BMI), no large and very ptotic breasts, no history of smoking, no diabetes, and no previous radiotherapy. We analyzed short-term outcomes of such procedures and compared the outcomes to evaluate implant losses and surgical complications. Results A total of 73 mastectomies were performed. Group 1 comprised 29 women, 5 bilateral procedures, 34 reconstructions, using the standard muscular mesh pocket. Group 2 comprised 34 women, 5 bilateral procedures, 39 reconstructions with the prepectoral subcutaneous technique. Baseline and oncologic characteristics were homogeneous between the two groups. After a median follow-up period of 13 and 12 months, respectively, no implant losses were recorded in group 1, and one implant loss was recorded in group 2. We registered three surgical complications in group 1 and two surgical complications in group 2. Conclusions Titanium-coated polypropylene meshes, as a tool for immediate definitive implant breast reconstruction, resulted as safe and effective in a short-term analysis, both for a retropectoral and a totally subcutaneous implant placement. Long-term results are forthcoming. A strict selection is mandatory to achieve optimal results. Level of Evidence: Level II, therapeutic study.
      PubDate: 2014-11-01
  • Railway graft for internal nasal valve reconstruction
    • Abstract: Background Although many methods have been proposed to restore the internal nasal valve (INV) such as suture techniques, various grafts, upper lateral cartilage folding techniques, and combined techniques, the most popular and effective one remains spreader grafts. The aim of the present study is to propose a new graft design for INV reconstruction and to test the reliability and feasibility of the technique. Methods Thirty-two primary septorhinoplasty patients divided in three groups underwent surgery with railway, spreader, and no graft techniques. The functional results were evaluated with the Nasal Obstruction Evaluation Scale (NOSE) scores subjectively. Results Significant improvements were observed comparing preoperative and postoperative NOSE scores in railway and spreader grafts groups. However, there was no significant difference in NOSE scores between those groups of patients. Conclusions Railway graft is an effective method that can be recommended if septal cartilage is limited for reconstruction of INV. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-11-01
  • Management of facial and periocular dog bites: a review of 104 cases
    • Abstract: Background Dog bites are a frequent cause of facial and periocular injuries in both children and adults. This aim of this study is to review current practice in the management of facial and periorbital dog bite injuries and to examine the current evidence-base for such treatment strategies. Methods Five hundred eighty-seven patients with dog bite injuries requiring surgical intervention were identified from operating theatre records in one tertiary centre over a 9-year period. A retrospective case note review of 104 patients with facial and periorbital dog bite injuries was performed. Data on patient demographics, type of injury, treatment, and outcome was collected and analysed. Results The majority of patients were children, with a mean age of 11 years (range 1–91 years). Injuries involved the cheek in 57 cases (55 %), eyelids in 17 cases (16 %), lips in 24 cases (23 %) and nose in 8 cases (8 %). No facial fractures, canalicular, or globe injuries were recorded. All patients underwent irrigation, debridement, and primary wound closure. Surgical repair occurred within 24 h in 19 cases (18.2 %), within 48 h in 71 cases (68.3 %) and within 5 days in 14 cases (13.4 %). Three patients (2.9 %) developed a wound infection. Two patients (1.9 %) required scar revision surgery. Conclusions Periorbital and facial dog bite injuries may result in considerable morbidity. However, the majority of injuries are superficial and canalicular injury and bony injury is uncommon. Early wound irrigation, debridement and primary closure results in a good cosmetic outcome with a low risk of infection. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-11-01
  • Maximizing aesthetic outcome in autologous breast reconstruction with
           implants and lipofilling
    • Abstract: Background Free flap breast reconstruction is an option widely sought in postmastectomy breast reconstruction. However, the volume of autologous tissue from the patient is often not sufficient for symmetrical reconstruction. In these cases, flaps can be used in combination with implants or autologous fat injections to augment volume and achieve shape, symmetry, and contour. Methods A retrospective chart review was performed on patients who underwent postmastectomy free flap reconstruction with secondary augmentation using autologous fat grafting or implant from 2008 to 2011. Results Twenty-four patients (39 breasts) received further augmentation of autologous tissue reconstruction during this period. Sixteen patients (26 breasts) had fat graft augmentation only, four patients (eight breasts) had implant augmentation only, and three patients (five breasts) had both procedures. Among patients who had fat grafting, operative intervention was required twice for fat necrosis. Contrastingly, of patients who received implants, one patient required operative intervention for implant malpositioning. These differences were not significant (P = 0.57). The group with both fat grafting and implant augmentation had significantly higher aesthetic scores regarding overall appearance, contour, and volume, but not projection, than the group with fat grafting only and the group with implant only. Conclusions Autologous fat grafting offers several contouring aesthetic advantages, including selectively augmenting areas of hollowness to improve contour and maximize symmetry. However, implant augmentation generally allows for a larger increase in projection in a single procedure, with similar rates of postaugmentation complications. Use of both autologous fat grafting and implant augmentation may allow for superior aesthetic results. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-11-01
  • Twenty-year follow-up of reconstruction with allogeneic hemimandible and
           autogenous particulate bone and cancellous marrow
    • Abstract: Abstract This report shows a long-term follow-up of a mandibular reconstruction with a composite graft, consisting of an allogeneic bone crib packed with autogenous particulate bone and cancellous marrow (PBCM). In this patient, segmental mandibulectomy including exarticulation of the temporomandibular joint (TMJ) had been necessary, due to recurrent odontogenic myxoma including the TMJ. Reconstruction was performed with an allogeneic freeze-dried hemimandible with TMJ, packed with compressed autogenous PBCM. Oral rehabilitation was completed with a fixed bridge on two dental implants in the distal part of the graft. During the early follow-up, osteolysis at the mandibular angle and gradual resorption of the temporomandibular joint was observed. Long-term follow-up revealed stable incorporation of the graft with consolidation of defects. A class I occlusion and uninhibited maximum mouth opening remained present. Twenty years after reconstruction with the composite graft, the patient is very satisfied, with high functional success. This implies the composite graft can be a successful treatment option in specific cases of mandibular reconstruction. Level of evidence: Level V, therapeutic study.
      PubDate: 2014-11-01
  • Management of advanced rhinophyma with shave excision and noncultured
           autologous skin cell transplantation
    • Abstract: Abstract Rhinophyma is a benign skin disorder characterized by hypertrophy of the nasal skin, inflammation and telangiectatic changes. This process disfigures the nose and represents the final stage of acne rosacea. The mainstay of treatment is surgery and various techniques have been proposed. We hereby, present a case of a patient with advanced rhinophyma who was treated by tangential skin excision and non-cultured autologous skin cells application. This method hastened wound healing, reduced dressing changes and patient discomfort. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-11-01
  • Towards a global plastic surgery research network
    • PubDate: 2014-11-01
  • Complexity of bra measurement system: implications in plastic surgery
    • PubDate: 2014-11-01
  • Askin tumor: a rare chest wall sarcoma in an Asian adult patient—a
           literature review and a suggested treatment protocol
    • Abstract: Abstract Askin tumor is a sarcoma of the chest wall of neuroectodermal origin, and is part of Ewing’s sarcoma family of tumors. It is a rare disease with high recurrence rates and poor prognosis. Management involves wide resection of the tumour with adjuvant/neo-adjuvant chemotherapy and radiotherapy. Advances in reconstructive options allow for wider resection margins that hopefully help to reduce local recurrence. Much of what we know about Askin tumors was extrapolated from Ewing’s sarcoma, and there is a lack of clear evidence and guidelines to the management of these tumors. We report a rare case of Askin tumor of the anterior chest wall in a 50-year-old Malay man and suggest a treatment protocol based on a review of current literature. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-11-01
  • Improvement of efficacy in surgical management of facial basal cell
           carcinoma: an interdisciplinary pilot study in The Netherlands
    • Abstract: Background The increasing incidence of basal cell carcinoma demands for an improvement of current health care management to gain more efficacies in the interdisciplinary treatment of facial basal cell carcinoma. We prospectively evaluated the level of agreement between referring dermatologists and plastic surgeons to assess in which cases routine pre-operative consultation of patients with facial basal cell carcinoma was not required for surgical treatment by plastic surgeons. Methods The outcome of a self-designed standardized referral form was prospectively evaluated in 100 patients with clinically suspected facial basal cell carcinoma that were referred from the dermatology outpatient clinic to the surgical outpatient clinic of Plastic Surgery for tumor removal under local anesthetics between 2009 and 2011. Results The level of agreement between the dermatologists and plastic surgeons on whether patients could be booked on the surgical outpatient clinic without routine pre-operative consultation was categorized as “moderate agreement” (Kappa = 0.589). We found that in 12.7 % of the patients with high-risk facial basal cell carcinoma (BCCs), both specialists agreed that pre-operative consultation was not required. In another 12.7 % of the patients, consensus was not achieved. In 74.6 % of the patients, both specialists agreed that pre-operative consultation was recommended. Conclusions We found that in selected patients with high-risk facial BCCs, both specialists agreed that pre-operative consultation was not required. Once a standardized referral system has been implemented, its use may improve efficacy in the surgical treatment of high-risk facial BCC. Future research should be directed towards clinical controlled trials. Level of Evidence: Level III, risk/prognostic study.
      PubDate: 2014-11-01
  • Orofacial cleft outreach in rural Ghana: any positive impact on the
    • Abstract: Background Orofacial clefts (OFC) are common congenital malformations in humans. They impact negatively on the life of the affected and often regarded as stigma in the society especially among the rural folks. The aim of this study was to analyze retrospectively the cases managed by a Ghanaian indigenous plastic surgery outreach team and prospectively outline the social impacts on the lives of those treated and their communities. Methods The study reviewed the medical records of patients treated during OFC outreaches in rural Ghana from January 2003 to December 2012 (10 years). This involved visiting and interviewing patients and their parents/relatives, as well as the community leaders comprising chiefs, assemblymen, church leaders, etc., using structured pretested questionnaires within 5 days (September 1–5, 2013) in communities in southeast of Ghana. Results A total of 32 outreach services were handled over the 10-year period, treating 303 OFC patients (among other pathologies), comprising 175 (57.8 %) males and 128 (42.2 %) females. Out of the 303, 159 (52.5 %) were located and interviewed; also, 65 community/opinion leaders/relatives were interviewed. Sixty-one percent (61 % = 35 patients) of the females and 48 % (n = 49) of the males got married after the surgery; 83 % (n = 45) of the school-going-age patients continued and completed basic schools. Conclusions OFC outreaches help to restore the lives and dignity of cleft patients and their families improving their quality of life. Stigmatization and psychological effects on them were removed; they were well accepted in their societies and family gatherings. Level of Evidence: Level III, risk-prognostic study.
      PubDate: 2014-10-29
  • Giant malignant triton tumor of the scalp
    • Abstract: Abstract Malignant triton tumor is a malignant schwannoma with rhabdomyoblastic differentiation. This tumor is very rare. Case reports and small series have been reported in medical literature. Malignant triton tumor occurs predominantly in the trunk, head, neck, and lower extremities. There is an important relationship with Von Recklinghausen disease. Patients with this tumor have a very poor prognosis, with a rapid and fatal course. We present a clinical case with a giant malignant triton tumor of the scalp. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-10-17
  • 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
  • Repetitive burn victims are burned more seriously and have more
    • Abstract: Background Though sustaining burn injury requiring hospital admission is not too common, there are patients who happen to return to the burn unit with a new injury. Our aim was to characterise the repeatedly burned patients and their cases. The question was whether we can detect an objective reason for this higher susceptibility for burn injuries. Methods Data of twice- or more times-burned patients (group A) were compared to a randomly chosen group of normal-burned patients (group B) treated at the burn unit of the Department of Dermatology, Debrecen University. Results Alcohol consumption was found in 12 of 35 cases (34 %) in group A, and in 6 of 168 cases in group B (3.6 %; p < 0.001). In 25 of 35 cases, surgery was neeeded because of deep burns (71 %), and this ratio was 44 % in the control (B) group, in 74 from 168 cases (p = 0.005). Average length of hospital stay was 13.43 days (95 % CI 11.03–15.83) in group A and 8.18 days (95 % CI 7.27–9.1) in group B (p < 0.001). Neurological disease—mostly epilepsy—was found in 7 cases of 35 in group A (20 %), whereas in 14 cases of 168 in group B (8.3 %; p = 0.061). Conclusions Our data show that among repetitively burned patients, there are more alcohol abusers, more patients with deep burns who need surgery and that their average stay in the hospital is longer. These patients also have a neurologic illness (epilepsy) more frequently, although this difference was not statistically significant. Level of Evidence: Level IV, risk/prognostic study
      PubDate: 2014-10-01
  • DermACELL: a novel and biocompatible acellular dermal matrix in tissue
           expander and implant-based breast reconstruction
    • Abstract: Background Acellular dermal matrices present a new alternative to supporting expanders and implants for breast reconstruction in breast cancer patients following mastectomy. However, some studies have suggested that acellular dermal matrix may increase the complication rates in certain clinical settings. DermACELL acellular dermal matrix offers advanced processing in order to attempt to decrease bio-intolerance and complications. Methods Ten consecutive patients that presented for breast reconstruction and were candidates for tissue expanders underwent the procedure with the use of an acellular dermal matrix. The patients underwent postoperative expansion/adjuvant cancer therapy, then tissue expander exchange for permanent silicone breast prostheses. Patients were followed through the postoperative course to assess complication outcomes. Histologic evaluation of host integration into the dermal matrix was also assessed. Results Of the ten patients, eight completed reconstruction while two patients failed reconstruction. The failures were related to chronic seromas and infection. Histology analysis confirms rapid integration of mesenchymal cells into the matrix compared to other acellular dermal matrices. Conclusions Based on our observations, DermACELL is an appropriate adjunct to reconstruction with expanders. Histological analysis of vascularization and recellularization support the ready incorporation of DermACELL into host tissue. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-10-01
  • Single-stage reconstruction of alar defect of the nose by subcutaneous
           island nasolabial and remnant alar flap
    • Abstract: Abstract A single-stage technique for reconstruction of the medial nasal ala with a nasolabial flap and an inferiorly based remnant alar flap is presented in this article. The technique has been used in four cases. All the flaps healed uneventfully with aesthetically pleasing results using the one-stage technique. The subcutaneous nasolabial island flap and alar remnant flap have become the method of choice in the author’s clinic for partial medial nasal ala reconstruction. It allows one-stage reconstruction with very similar tissue and a concealed scar in the natural groove. The remnant ala as an inferiorly based flap has been used by the author to cover the subcutaneous pedicle of the nasolabial flap to provide better shape to the alar base without its lateral drift during healing. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-10-01
  • An unusual variant of infected median sternotomy wound: an addition to the
           Pairolero classification
    • PubDate: 2014-10-01
  • The clinical landmark of infraorbital foramen in Chinese population: a
           prospective measurement study
    • Abstract: Background Infraorbital nerve block can only be administered effectively with good knowledge of the location of the infraorbital foramen (IOF). In this article, we will describe the clinical landmark of the IOF with references to the infraorbital rim (IOR), mid-pupillary line (MPL), and facial midline (FML). Methods In our division, maxillary swing approach was adopted for the access of the nasopharynx and skull base. Through a Weber-Ferguson-Longmire incision, the maxilla was freed from its bony connections and swung out to expose the skull base. With this approach, the infraorbital foramen and nerve were identified under direct vision. Prospective measurements were taken intraoperatively on a series of patients who underwent maxillary swing operation. The distances between the IOF and various reference points (IOR, MPL, and FML) were measured with caliper. Means, standard deviations, and ranges were determined. Results From April 2009 to October 2012, 30 patients were included in this study. The locations of 30 infraorbital foramina were analyzed. The distances between IOF and IOR, MPL, and FML ranged from 8 to 12 (mean 9.6 ± 1.3) mm, 4 to 14 (mean 9.3 ± 2.4) mm, and 24 to 38 (mean 32.7 ± 3.4) mm, respectively. Conclusions To our knowledge, this is the first study in the literature demonstrating the clinical landmark of IOF on living persons and adopting MPL as a reference point. We believe that the IOR and MPL are convenient reference points for the accurate localization of IOF. Level of Evidence: Level IV, diagnostic study.
      PubDate: 2014-10-01
  • Revisiting the work of Maurice Goldenhar—an overview of Goldenhar
    • Abstract: Abstract Goldenhar syndrome is a heterogeneous disorder resulting in craniofacial and vertebral malformations. Due to its low prevalence and extreme phenotypic variation, there is limited published literature on the disorder. The aim of this paper is to provide an updated review of the literature in order to improve awareness of Goldenhar syndrome and to guide physicians in their diagnosis and treatment plans. Goldenhar syndrome is a multifactorial disorder with most cases being sporadic, though autosomal dominant and autosomal recessive cases have been reported. Due to the high degree of phenotypic variation, Goldenhar syndrome is considered to be part of the oculo-auriculo-vertebral spectrum. Although there are no minimal diagnostic criteria, patients typically present with varying degrees of microtia, ear tags, craniofacial microsomia, eye anomalies, and diverse vertebral anomalies. For optimal outcomes, a multidisciplinary approach is required to best address ocular, auricular, vertebral, craniofacial, dental, and psychological manifestations. This paper reviews the etiology, risk factors, screening procedures, clinical features, and treatment for Goldenhar syndrome in order to aid in the early diagnosis of affected individuals and improve treatment outcomes. Level of Evidence: Not ratable
      PubDate: 2014-09-07
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