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Publisher: Springer-Verlag   (Total: 2302 journals)

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Diabetologia     Hybrid Journal   (Followers: 156, SJR: 3.157, h-index: 161)
Diabetologia Notes de lecture     Hybrid Journal  
Diabetology Intl.     Hybrid Journal   (Followers: 1, SJR: 0.273, h-index: 5)
Dialectical Anthropology     Hybrid Journal   (Followers: 8, SJR: 0.314, h-index: 9)
Die Weltwirtschaft     Hybrid Journal   (Followers: 2)
Differential Equations     Hybrid Journal   (Followers: 2, SJR: 0.364, h-index: 15)
Differential Equations and Dynamical Systems     Hybrid Journal   (Followers: 1, SJR: 0.63, h-index: 7)
Digestive Diseases and Sciences     Hybrid Journal   (Followers: 4, SJR: 1.19, h-index: 89)
Directieve therapie     Hybrid Journal  
Discrete & Computational Geometry     Hybrid Journal   (Followers: 2, SJR: 1.269, h-index: 40)
Discrete Event Dynamic Systems     Hybrid Journal   (Followers: 2, SJR: 0.42, h-index: 32)
Distributed and Parallel Databases     Hybrid Journal   (Followers: 4, SJR: 0.766, h-index: 30)
Distributed Computing     Hybrid Journal   (Followers: 2, SJR: 1.41, h-index: 31)
DNP - Der Neurologe und Psychiater     Full-text available via subscription  
Documenta Ophthalmologica     Hybrid Journal   (Followers: 2, SJR: 0.946, h-index: 40)
Doklady Biochemistry and Biophysics     Hybrid Journal   (Followers: 2, SJR: 0.2, h-index: 10)
Doklady Biological Sciences     Hybrid Journal   (SJR: 0.248, h-index: 10)
Doklady Botanical Sciences     Hybrid Journal  
Doklady Chemistry     Hybrid Journal   (SJR: 0.272, h-index: 12)
Doklady Earth Sciences     Hybrid Journal   (SJR: 0.48, h-index: 17)
Doklady Mathematics     Hybrid Journal   (SJR: 0.345, h-index: 13)
Doklady Physical Chemistry     Hybrid Journal   (SJR: 0.299, h-index: 12)
Doklady Physics     Hybrid Journal   (Followers: 1, SJR: 0.293, h-index: 17)
Douleur et Analg├ęsie     Hybrid Journal   (SJR: 0.113, h-index: 6)
Drug Delivery and Translational Research     Hybrid Journal   (Followers: 2, SJR: 0.607, h-index: 8)
Drug Safety - Case Reports     Open Access  
Drugs : Real World Outcomes     Hybrid Journal   (Followers: 1)
Dynamic Games and Applications     Hybrid Journal   (Followers: 2, SJR: 0.481, h-index: 5)
Dysphagia     Hybrid Journal   (Followers: 82, SJR: 0.822, h-index: 52)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 9, SJR: 0.279, h-index: 9)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 14, SJR: 0.466, h-index: 16)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.282, h-index: 7)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 7, SJR: 0.303, h-index: 29)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.482, h-index: 21)
Earthquake Science     Hybrid Journal   (Followers: 8, SJR: 0.418, h-index: 9)
East Asia     Hybrid Journal   (Followers: 7, SJR: 0.18, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 9, SJR: 0.362, h-index: 27)
EcoHealth     Hybrid Journal   (Followers: 2, SJR: 0.88, h-index: 26)
Ecological Research     Hybrid Journal   (Followers: 8, SJR: 0.847, h-index: 43)
Economia e Politica Industriale     Hybrid Journal  
Economia Politica     Hybrid Journal   (SJR: 0.375, h-index: 6)
Economic Botany     Hybrid Journal   (Followers: 9, SJR: 0.527, h-index: 44)
Economic Bulletin     Hybrid Journal   (Followers: 4)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.264, h-index: 9)
Economic Theory     Hybrid Journal   (Followers: 9, SJR: 2.557, h-index: 34)
Economic Theory Bulletin     Hybrid Journal   (Followers: 2)
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.408, h-index: 14)
Ecosystems     Hybrid Journal   (Followers: 19, SJR: 1.909, h-index: 93)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.333, h-index: 56)
Education and Information Technologies     Hybrid Journal   (Followers: 92, SJR: 0.366, h-index: 16)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 18, SJR: 0.374, h-index: 15)
Educational Psychology Review     Hybrid Journal   (Followers: 17, SJR: 2.776, h-index: 61)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 7, SJR: 0.273, h-index: 9)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 11, SJR: 0.825, h-index: 32)
Educational Technology Research and Development     Partially Free   (Followers: 75, SJR: 1.785, h-index: 52)
Electrical Engineering     Hybrid Journal   (Followers: 14, SJR: 0.336, h-index: 18)
Electrocatalysis     Hybrid Journal   (SJR: 0.883, h-index: 10)
Electronic Commerce Research     Hybrid Journal   (Followers: 4, SJR: 0.582, h-index: 16)
Electronic Markets     Hybrid Journal   (Followers: 5, SJR: 0.411, h-index: 8)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 1.407, h-index: 15)
Elemente der Mathematik     Hybrid Journal   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.678, h-index: 25)
Emission Control Science and Technology     Hybrid Journal  
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.319, h-index: 16)
Empirical Economics     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 31)
Empirical Software Engineering     Hybrid Journal   (Followers: 7, SJR: 1.285, h-index: 39)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.361, h-index: 15)
Endocrine     Hybrid Journal   (Followers: 6, SJR: 0.878, h-index: 57)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.638, h-index: 31)
Energy Efficiency     Hybrid Journal   (Followers: 12, SJR: 0.732, h-index: 14)
Energy Systems     Hybrid Journal   (Followers: 11, SJR: 1.176, h-index: 7)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.433, h-index: 30)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.144, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 29, SJR: 0.419, h-index: 29)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.458, h-index: 32)
Environmental and Resource Economics     Hybrid Journal   (Followers: 18, SJR: 1.632, h-index: 54)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.725, h-index: 58)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 2, SJR: 0.741, h-index: 28)
Environmental Earth Sciences     Hybrid Journal   (Followers: 12, SJR: 0.724, h-index: 63)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 6, SJR: 0.524, h-index: 4)
Environmental Evidence     Open Access   (Followers: 1)
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.437, h-index: 24)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 1.013, h-index: 36)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 3, SJR: 0.522, h-index: 19)
Environmental Management     Hybrid Journal   (Followers: 32, SJR: 0.942, h-index: 66)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 10, SJR: 0.533, h-index: 31)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 9, SJR: 0.685, h-index: 52)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 14, SJR: 0.885, h-index: 46)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 4, SJR: 1.4, h-index: 17)
Epileptic Disorders     Hybrid Journal   (SJR: 0.608, h-index: 38)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.287, h-index: 63)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.731, h-index: 89)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.641, h-index: 62)
EPMA J.     Open Access   (SJR: 0.284, h-index: 6)
ERA-Forum     Hybrid Journal   (Followers: 2, SJR: 0.128, h-index: 3)
Erkenntnis     Hybrid Journal   (Followers: 13, SJR: 0.621, h-index: 16)

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Journal Cover   European Journal of Plastic Surgery
  [SJR: 0.171]   [H-I: 14]   [2 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  [2302 journals]
  • Hypertrophic scar as an areola graft in nipple-areola reconstruction
    • PubDate: 2015-06-01
       
  • Contralateral axillary silicone lymphadenopathy, following skin sparing
           mastectomy and immediate reconstruction with latissimus dorsi myocutaneous
           flap and implant
    • PubDate: 2015-06-01
       
  • Fibro-osseous pseudotumour of the digit: the importance of correct
           diagnosis
    • Abstract: Fibro-osseous pseudotumour of the digit (FOPT) is a rare, benign lesion of proliferating spindled myofibroblasts found in the soft tissue of the distal aspect of the digits. Misdiagnosis as malignant neoplasms such as osteosarcomas results in needlessly aggressive surgery and hinders reconstruction. We report the case of a 6-year-old girl presenting with an enlarging lesion of the left hallux for over a year, causing elevation of the medial nail fold of the left big toe over the distal phalanx. An incisional biopsy was undertaken revealing a lesion histopathologically consistent with a diagnosis of fibro-osseous pseudotumour. Accurate diagnosis through clinical reasoning and histopathology prevented digit amputation. Level of evidence: Level V, diagnostic study
      PubDate: 2015-06-01
       
  • Utility of chest X-ray and abdominal ultrasound for stage III cutaneous
           malignant melanoma
    • Abstract: Background Current Danish Melanoma Guidelines suggest that stage III cutaneous malignant melanoma receive chest X-ray and abdominal ultrasound to exclude lung and liver metastases. The aim of this study was to examine the sensitivity, specificity, and negative predictive value of chest X-ray and abdominal ultrasound in excluding lung and liver metastases in stage III cutaneous malignant melanoma disease. Methods A retrospective study was conducted on stage III malignant melanoma patients who underwent wide local excision and complete lymph node dissection from 1 January 2009 to 31 December 2012. Patients were identified by procedure codes and cross-checked with the Danish National Pathology Database. Results Ninety patients were included. All patients had chest X-ray and abdominal ultrasound performed. Five chest X-rays raised suspicion of lung metastases and four ultrasounds of liver metastases. One patient had pleural metastases. Additional imaging and biopsies ruled out metastases in eight of nine cases. Eighty patients had normal imaging, and among these, two had metastases in the lungs and two in the liver at 1-year follow-up. For chest X-ray and abdominal ultrasound, sensitivity, specificity, and negative predictive value were estimated to be 33/0, 95/95, and 98/98 %, respectively. Conclusions The present study showed little correlation between imaging findings and metastases, suggesting that chest X-ray and abdominal ultrasound might be doubtable in excluding lung and liver metastases in stage III cutaneous malignant melanoma patients. Level of Evidence: Level IV, prognostic study
      PubDate: 2015-06-01
       
  • Painless pyoderma gangrenosum: an insidious presentation complicating a
           sternal wound dehiscence
    • PubDate: 2015-06-01
       
  • Chemical burns from topical use of traditional Chinese medicine
    • PubDate: 2015-06-01
       
  • The reconstructive challenges of electrical burns to the scalp: A case
           series
    • Abstract: Soft tissue or bony loss to the scalp and forehead present a reconstructive challenge, especially in the young patient. Much literature is available on scalp and forehead reconstruction for primary malignant pathologies, however reconstruction for contact electrical burns is reported infrequently in the literature. This case series looks at two patients with full thickness burns to the scalp and forehead requiring free flap reconstruction over 11 years at the Burns Unit at Royal Perth Hospital in Perth, Western Australia. We describe the flap reconstruction and outcomes of these patients and review the relevant literature. Three free flap reconstructions were performed on the two patients. The first patient had a free gracilis flap which failed five days post-operatively. 25 days post initial injury a free rectus flap was used to cover the predominantly forehead defect. The second patient had a free latissimus dorsi flap completed one week after initial injury. Free flap reconstruction of scalp and forehead following contact electrical burns is complicated and challenging. The outcomes of both of the patients in this case series was positive and both have had satisfactory flap survival at the time of writing. Due to rare nature of this type of burn there is little published evidence outlining the definitive management of this type of injury. Level of Evidence: Level V, therapeutic study
      PubDate: 2015-06-01
       
  • Clinical audit of tetanus prophylaxis in open hand surgery
    • Abstract: Background Requirements of wound management include wound excision, cleansing, administration of antibacterials and prophylaxis against Tetanus. We performed a prospective study to highlight areas of concern and discrepancy between the national recommendations of Tetanus prophylaxis in patients with open hand injuries and the actual practice of a tertiary plastic surgery centre. Methods Data were collected on Tetanus immunisation status, wound type and prophylaxis administered to patients admitted to day surgery unit for wound exploration. Following the first group (A) analysis, teaching on Tetanus prophylaxis was provided. Second group (B) of patients was recruited to the study 8 weeks later. Results Both the quality of documentation and correct type of Tetanus prophylaxis administered improved by 46 and 66 %, respectively, in the post-teaching group. Conclusions Simple measures like teaching and distribution of guidelines improved clinical practice and reduced number of clinical errors. Level of evidence: Level III, risk/prognostic study
      PubDate: 2015-06-01
       
  • Concurrent Poland’s syndrome and gynaecomastia: achieving the
           balance using lipomodelling
    • Abstract: The occurrence of both Poland’s syndrome and gynaecomastia in the same patient is extremely rare. This is only the second report in the medical literature. These distinct deformities of the chest wall have very different aetiologies. Poland’s syndrome is a heterogeneous congenital condition thought to be a consequence of a developmental hypoxic insult between 6 and 8 weeks of gestation as the upper limb and chest musculature develops. It encompasses a spectrum of congenital anomalies, characterised by hypoplasia or agenesis of the pectoralis muscles, breast, nipple areolar complex, soft tissue and upper limb skeletal anomalies. It is usually unilateral. Gynaecomastia by contrast is the benign enlargement of breast tissue in males. Aetiology in adult patients includes systemic disease, hormone imbalances and drugs, and may be unilateral or bilateral. We report the case of a 46-year-old man who presented with chest wall asymmetry. The Poland’s syndrome affecting his right chest had only become apparent with the development of a contralateral gynaecomastia. Surgery was performed with liposuction and nipple-preserving skin reduction of the gynaecomastia. The harvested fat from the breast was used with additional abdominal wall fat and transferred to the right chest defect caused by Poland’s syndrome. This is the first time that lipomodelling has been reported in the reconstruction of Poland’s syndrome using fat transferred from the contralateral breast. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-06-01
       
  • Modified radical neck dissection vs. selective neck dissection: an
           analysis of lymph node yield and post-surgical outcomes
    • Abstract: Background Modified radical neck dissection (MRND) and selective neck dissection (SND) are widely used techniques for the management of metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the neck. This study compared the yield of lymph nodes for both techniques and evaluated clinically relevant outcomes. Methods A retrospective study design was utilised. Patients undergoing either the MRND or SND between January 2010 and March 2012 for metastatic SCC were eligible for inclusion. The primary outcome was mean number of lymph nodes extracted per neck level. Secondary outcomes were all cause mortality, regional recurrence and complications. Results Fifty-two patients who underwent 58 neck dissections (12 MRND and 46 SND) were included in the final analysis with a mean follow-up of approximately 1 year for both groups. No significant differences were observed between the groups with regards to follow-up time, age or gender. No significant differences were observed in terms of surgical complications including haematoma, infection and thromboembolic complications. Both the MRND and SND were found to be similar in terms of the number of lymph nodes extracted per anatomical neck level (p > 0.05 for levels I–V). There were no significant differences between the MRND and SND in terms of regional recurrence and overall survival. Conclusions Our results showed no difference between the MRND and SND in terms of lymph node yield after adjusting for the number of anatomical levels dissected. The MRND and SND also demonstrated similar complication profiles and rates of recurrence and survival. Level of evidence: Level III, risk/prognostic study
      PubDate: 2015-06-01
       
  • Single stage immediate prosthetic breast and nipple-areolar complex
           reconstruction with simultaneous contralateral symmetrisation
    • Abstract: The authors present a case report of a patient with two foci carcinoma of the left breast. The selected therapeutic surgical indication was a left skin sparing mastectomy with amputation of the nipple-areolar complex, immediate breast reconstruction and contralateral breast reduction for symmetrisation. The redundant skin of the right areola was used as a spiral graft to reconstruct the left areola. The reconstruction of the left amputated breast was immediately obtained by placing a permanent anatomical breast implant in a subpectoral position in the superior half and in a retro-dermoadipose flap position in the inferior half (dual plane technique). The weight difference between the mastectomy side and the reduction side gave the calculated implant size of the procedure. This one stage technique achieved a good end-result considering symmetry and shape. The 3.5 years follow-up revealed no complications, no recurrence and aesthetic quality. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-06-01
       
  • Free and pedicle flaps in lower extremity trauma
    • Abstract: Improvements in microsurgical techniques and perioperative management have led to more attempts at limb salvage surgery after severe extremity trauma. Although some microsurgery-trained orthopedic surgeons will perform extremity soft tissue reconstruction, many rely on plastic surgeons or hand surgeons. However, the orthopedic trauma surgeon often remains the principle decision maker in the follow-up of these patients. Therefore, orthopedic surgeons should have a clear understanding of the planning and execution of flap reconstruction of the traumatized extremities. Collaboration with the microsurgery team will also improve planning of orthopedic procedures and facilitate a better understanding of the expected outcomes after tissue transfer. This becomes especially important when considering, debridement, early amputation versus extensive soft tissue reconstruction and when discussing these alternatives with patients and family as well as postoperative course. The goals of this article are to provide orthopedic trauma surgeons with an understanding of the selection, planning, and execution of tissue transfers for posttraumatic extremity reconstruction and to review their successes and outcomes in the literature. Communication between teams involved in reconstruction of the traumatized extremity and an understanding of limitations are paramount to successful outcomes after reconstruction. Level of Evidence: Not ratable.
      PubDate: 2015-06-01
       
  • The use of triamcinolone combined with surgery in major ear keloid
           treatment: a personal two stages approach
    • Abstract: Background Keloid is a fibroproliferative disorder characterized by an abnormal deposition of collagen within a wound. Despite an increased understanding of wound healing and collagen metabolism, the exact cause, the clinical behavior, and gold standard of treatment for keloids remain an enigma. There is no one right way of treatment, the results are variable, and the management of ear keloids can be difficult and frustrating both for patients and physicians. Traditional techniques include intralesional steroids, topical applications of silicone, vitamins, and segmental excision by lasers or surgery. The purposes of this article are to review the literature concerning the current therapies as well as to present the authors’ experience in the treatment of major ear keloids. Methods Twenty-seven consecutive black race patients (18 cases and 9 controls) underwent surgery for major keloids of the external ear at the Plastic and Reconstructive Surgery Unit of University of Palermo. The authors performed the radical excision and intralesional triamcinolone acetonide injection intraoperative and 1 month after surgical treatment. Results No complications were noticed in the early postoperative period, and no recurrence was noticed in all the patients. Conclusions The radical excision and the intralesional triamcinolone acetonide injection appear to be a successful option of treatment for major ear keloids. Compared to other methods, it does not necessitate several stages of treatment, moreover, it has the advantages to lower the risk of recurrence, the healing process is rapid, and improvement of quality of life is significant. Level of evidence: Level IV, therapeutic study
      PubDate: 2015-06-01
       
  • Erratum to: The reconstructive challenges of electrical burns to the
           scalp: a case series
    • PubDate: 2015-06-01
       
  • Thickness of calvarium and diploic space in children ages 0 to 17 as
           assessed by computed tomography
    • Abstract: Background The thickness of the calvarium and presence of the diploic space in children can aid surgical planning for split-thickness calvarial bone grafting when needed in calvarial reconstruction. However, the normal anatomical characteristics of calvarial thickness and the diploic space in children are poorly defined. Methods Computed tomography scans of pediatric heads over a 2-year period were culled from a large, urban pediatric referral hospital. Subjects with a craniofacial/developmental abnormality or history of surgery were excluded. 104 scans met inclusion criteria. Each skull was marked at 40 locations over the frontal, parietal, and occipital bones. At each location, thickness measurements of the calvarium and the diplöe were taken. Results The left posterior parietal region was thicker than the right in both skull and diploic thickness. Over 90 % of subjects had diplöe demonstrable on CT in the frontal and posterior parietal regions by age 3–5. In all ages, the diplöe was thickest in the frontal bone and in posterolateral parts of the parietal bones. Conclusions The skull and the diplöe are bilaterally symmetric except in the posterior parietal region, where the left is thicker than the right. The presence of a diplöe in surgically important regions can be reliably demonstrated using CT by age 3–5. Level of Evidence Level IV, diagnostic study.
      PubDate: 2015-06-01
       
  • Medial sural artery perforator flap: a challenging free flap
    • Abstract: Background Oral and extremity defect reconstruction can often require a flap that is thin, and traditionally, the radial forearm free flap has been used, however, this has significant donor site morbidity. Over the last decade, the medial sural artery perforator (MSAP) flap has emerged as a possible alternative with lower donor site morbidity. We present our experiences and review the literature regarding this promising but challenging flap. Methods The study was a retrospective case series in a university hospital setting. All patients who had a MSAP flap performed at our institution were included until March 2015, and their data was retrieved from electronic patient records. Results In total, ten patients were reconstructed with a MSAP flap for floor of mouth (eight) and lower extremity (two) defect reconstruction. The median flap dimensions were as follows: 10 cm (range 7–14 cm), width 5 cm (range 3.5–8 cm), thickness 5 mm (range 4–8 mm), and pedicle length 10 cm (range 8–12 cm). In one case, the procedure was abandoned because of very small perforators and another flap was used. In two cases, late onset of venous congestion occurred which could not be salvaged. There were no donor site complaints. Conclusions The MSAP flap is an ideal flap when a thin free flap is needed with lower donor site morbidity than alternative solutions. There seems to be a higher rate of late onset of venous thrombosis compared with more established flaps. Therefore, this flap should be monitored more closely for venous problems and we recommend performing two venous anastomoses when using this flap. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2015-05-24
       
  • Immediate microsurgical breast reconstruction in pregnant breast cancer
           patients
    • Abstract: Pregnancy-associated breast cancer (PABC) is defined as breast cancer occurring anytime during gestation, lactation or within 1 year after delivery. Breast reconstruction is considered an essential component in managing breast cancer patients, and immediate reconstruction provides superior esthetic outcome and better patient satisfaction. There are no sufficient reports on the feasibility of immediate breast reconstruction in patients during the course of gestation and no studies have been published using microsurgery breast reconstruction in PABC. We report three cases of immediate microsurgery breast reconstruction in pregnant cancer patient. We consider two distinct subsets in breast reconstruction in PABC: “pregnancy” and “after delivery.” Pregnant breast cancer patients can be considered for immediate microsurgical breast reconstruction with optimal treatment through multidisciplinary management. Level of Evidence: Level V, therapeutic study
      PubDate: 2015-05-17
       
  • Prune belly syndrome: modified Monfort abdominoplasty with a horizontal
           scar and a dermal layer
    • Abstract: Prune belly syndrome is a rare congenital disease occurring in 1/40,000 births, mostly in male patients. Abdominal hypoplasia has aesthetic and functional consequences on breathing, intestinal transit, and stature. Thus, the goal of the surgical treatment must be both functional and aesthetic. Through two cases, we present a modified technique of the usual abdominoplasty to obtain better functional and aesthetic results. Two male patients have been operated on, when they, respectively, were 10 months old and 3 years old. Our surgical technique was inspired from Callia’s as we used a horizontal incision, and from the Monfort abdominoplasty for the muscular wall repair, which we reinforced by preserving a dermal layer under the umbilicus. Patients have been followed up 1 to 2 years. We reported a functional and aesthetic improvement in both patients, and no complication occurred. These preliminary results showed satisfactory functional and aesthetic results with a hidden scar. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-04-26
       
  • Adipocyte and preadipocyte viability in autologous fat grafts: comparing
           the water jet-assisted liposuction (WAL) and Coleman techniques
    • Abstract: Background Autologous fat transplantation is a promising technique for soft tissue augmentation. However, the long-term maintenance of fat grafts remains unpredictable. Based on Peer’s cell theory, techniques that cause less cellular damage will optimize graft integration. Water jet-assisted liposuction (WAL) was introduced as a gentle and efficient technique for harvesting a large volume of fat in a short period of time. In this study, we evaluated the viability and function of adipocytes and preadipocytes harvested using WAL and compared this with the Coleman technique. Methods Eleven patients were enrolled in this study. Fat grafts were harvested using WAL from one limb and the Coleman technique from the other limb. The lipoaspirates were compared based on the following analyses: trypan blue vital staining for viable adipocyte and preadipocyte counts, glycerol-3-phophatase dehydrogenase assay for adipocyte function, histological examination, and speed of fat harvest. Results Viable adipocyte and preadipocyte counts were significantly higher in the Coleman group. The level of G3PDH activity was also significantly higher in the Coleman group, indicating that adipocytes within the harvested fat have improved cellular function. Histological findings were comparable between the two techniques, showing mild to moderate architectural disruption and adipocyte degeneration, with no evidence of tissue necrosis. Time taken for fat aspiration was significantly shorter using WAL. Conclusions This study demonstrated that the Coleman technique yields a greater number of viable adipocytes and preadipocytes. Although the histologic structure of fat grafts was comparable between the two techniques, the cellular function of adipocytes was higher for fat grafts harvested using the Coleman technique. Nonetheless, for cases where large volume of fat graft is required, the WAL technique may be preferred for its efficiency in fat harvesting. Level of Evidence: Not ratable
      PubDate: 2015-04-26
       
  • A general algorithm for chest wall reconstruction based on a retrospective
           review
    • Abstract: Background Many chest wall reconstruction algorithms have been proposed, but there is still no general consensus. The purpose of this study is to review our single institutional experience in chest wall reconstruction and identify a working algorithm based on our retrospective analysis. Methods This is a retrospective analysis of 54 patients who underwent chest wall reconstruction in our department from 1996 to 2011. Results The mean follow-up was 38 months. Central chest wall defects were the most common, while infection and tumour resection were the two most common indications. The pedicled latissimus dorsi flap was a versatile flap, used as a single or combination flap for anterolateral, lateral and posterior defects. The pectoralis major flap was suitable for central and anterolateral defects and the rectus abdominis flap for lower central defects. Omentum flaps were useful in radiation-damage skin or in patients with recurrent infection. Conclusions Locoregional flaps are the mainstay of chest wall reconstruction. Most skeletal reconstruction, when required, is safely accomplished with the use of prosthetic materials. Free flaps are usually only indicated for large defects or when regional flaps are unavailable. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2015-04-16
       
 
 
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