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Dysphagia     Hybrid Journal   (Followers: 170, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 7, 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: 6, SJR: 0.289, h-index: 23)
EcoHealth     Hybrid Journal   (Followers: 1, SJR: 0.651, h-index: 22)
Ecological Research     Hybrid Journal   (Followers: 7, 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: 5, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal  
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: 146, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 11, 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: 8, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 157, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 9, 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: 2, 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: 7, 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: 29, 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: 30, 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: 162, 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)

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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  [2210 journals]   [SJR: 0.227]   [H-I: 13]
  • Distally based posterior tibial artery perforator flap for coverage of
           defects around the ankle, heel and lower third of leg
    • Abstract: Introduction Reconstruction of distal leg region remained a difficult task. Free flaps had long been considered as a gold standard for these regions. However, due to various limitations of the free flap, a local fasciocutaneous flap could be considered as a good alternative. In this study, the use of a distally based posterior tibial artery perforator flap had been evaluated in the coverage of defects around the ankle, heel, and lower third of a leg. The study also outlined the donor-site morbidity and the technical details of the surgical procedure. Methods In this prospective study, a total of 42 patients with distal lower leg defects were included. The defects were located on the lower third of the leg (n = 23), ankle (n = 11), and heel (n = 8). Reconstruction was performed using distally pedicled posterior tibial artery perforator flaps. Patients were evaluated in terms of viability of the flap, functional gain, and donor-site morbidity. The technical details of the operative procedure have also been outlined. Results All the flaps survived well, with the exception of one patient, who experienced complete flap loss. Minor complications were, however, noted in four other patients: One patient developed superficial epidermolysis; one developed postoperative venous congestion, which subsided within 3 days by conservative means, and in two patients, partial loss of the skin graft occurred at the donor site but healed completely with dressing and antibiotics. The patients were followed up for an average period of 6 months, ranging from 1 to 13 months. Donor-site morbidity was minimal. Conclusions It was concluded that the distally based pedicled posterior tibial artery perforator flap was a reliable, easy, less time-consuming, and versatile procedure for covering the defects around the ankle, heel, and lower third a leg. Level of Evidence: Level IV, therapeutic study
      PubDate: 2014-10-01
  • Peripheral primitive neuroectodermal tumor/primary cutaneous Ewing’s
           sarcoma (PPNET/ES) of the upper eyelid in an adult patient
    • Abstract: Abstract Peripheral primitive neuroectodermal tumor (PPNET) and Ewing’s sarcoma (ES) are two variants of a highly malignant bone tumor usually affecting children and young adults with a tendency for early metastasis. Cutaneous localization of PPNET/ES is very uncommon in adult age and is normally confused with other tumors. We report the first recorded case of PPNET of the eyelid in an adult patient. The patient underwent one biopsy, two surgical wide excisions, and two series of 4 cycles of chemotherapy without radiotherapy. At 8 years of follow-up from the first wide excision, the patient is tumor free. Cutaneous PPNET/ES is rare and not considered in the usual differential diagnosis of skin lesions, especially those involving the eyelid. Once diagnosed, a multidisciplinary approach to treatment offers the highest survival rates. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-10-01
  • 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
  • Total mandibular reconstruction using four free flap transfers in a
           patient with large mandibular osteosarcoma
    • Abstract: Abstract Mandibular reconstructions with composite defects are complex procedures that aim to achieve soft tissue closure, bony support and to restore facial contours. When large defects are present, multiple flaps may be required for optimal aesthetic and functional outcomes. Facial reconstruction using multiple flaps has been described. In 1993, Sanger et al. reported the use of three free flaps in a patient with osteoradionecrosis of the mandible. However, the feasibility of using more than three free flaps in a mandibular reconstruction remained to be determined. In this report, we describe the use of bilateral deep circumflex iliac artery (DCIA) iliac crest flaps and two radial forearm free flaps for the mandibular reconstruction in a 19-year-old male with radical excision of mandibular osteosarcoma and total mandibulectomy. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-10-01
  • Body contouring surgery in a patient with Ehlers–Danlos syndrome
    • Abstract: Abstract Ehlers–Danlos syndrome is a rare genetic disease that is mainly characterized by skin hyperextensibility. In its most advanced forms, Ehlers–Danlos syndrome may cause disabling anomalies of the silhouette. Very few articles have discussed the role of the plastic surgeon in the treatment of this disease. We herein report a case involving a 28-year-old patient with Ehlers–Danlos syndrome in its hypermobile form, which caused an abdominal wall laxity associated with major breast ptosis. Our treatment plan comprised three phases over the course of 18 months: modified abdominoplasty according to the De La Plaza technique, mastopexy with autologous augmentation, and high transversal abdominoplasty. The surgical outcome was marked by the occurrence of multiple wound dehiscences and the development of a hematoma following the second abdominoplasty. Now 7 months postoperatively, the healing is complete, and the patient’s silhouette is improved. Although the aesthetic improvement was modest, the patient’s quality of life was substantially enhanced. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-10-01
  • Predisposing factors, clinical presentation and outcome of treatment of
           avulsive human bites on the face: a case series analysis from Abuja,
    • Abstract: Background Human bite can be classified as occlusive or non-occlusive. Occlusive bites are seldom reported to occur outside the facial region. This study aims to analyze cases of avulsive human bite and find which part of the face is the most frequently involved in such cases. The findings may indicate which part of the face is generally perceived as the most critical in judging attractiveness. Methods This retrospective study was carried out using a data review of all consecutive avulsive facial human bite cases seen in the maxillofacial surgery unit, National Hospital Abuja, between February 2001 and January 2014. Uniform protocol of prophylactic oral antibiotic and anti-tetanus cover was ensured throughout the study period. Results Seventeen cases were included in this study. Amorous jealousy was the cause of altercation in 15 (88.2 %) cases. Twelve (70.6 %) cases involved the lip. There were eight female and nine male victims. There were nine female and eight male assailants. Conclusions The lip is the most frequently affected region of the face in avulsive human bite attacks in our environment. This may be because it is considered the most important anatomical region of the face on which judgment of attractiveness is based. Level of evidence: Level IV, prognostic/risk study.
      PubDate: 2014-10-01
  • Nipple projection evolution using the modified arrow flap: prospective
           study on 25 consecutive nipple reconstructions
    • Abstract: Background Nipple–areola complex reconstruction represents the final stage of breast reconstruction. It is considered one of the most important landmarks of the entire process. It is known that nipples reconstructed with local flaps slowly and inexorably flatten with time. The authors undertook this prospective study to evaluate the effectiveness of a modified arrow flap technique for nipple reconstruction. Methods A series of 25 consecutive nipple reconstructions were performed on post-mastectomy defects reconstructed with tissue expander and implant or autologous tissues. All patients have been followed for at least 12 months, and the involution of the nipple projection was assessed through digital caliper measuring. Results No immediate complications were observed. The average immediate postoperative projection was 12.9 mm. The average residual projection at 3, 6, and 12 months was 69, 47, and 35 %, respectively. Conclusions The modified arrow flap has proved to have an acceptable residual projection with pleasing clinical outcome. It is a reliable procedure, easy to learn, and reproduce. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-10-01
  • Genta-Foil resorb, a novel advance in the treatment of paediatric nail bed
    • PubDate: 2014-10-01
  • 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: 2014-09-13
  • The oval sponge: a simplified method for scrotal skin graft fixation using
           VAC device
    • PubDate: 2014-09-12
  • 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
  • Isolated APTT prolongation—not always a bleeding risk in acute
           paediatric burns surgery
    • PubDate: 2014-09-05
  • Complexity of bra measurement system: implications in plastic surgery
    • PubDate: 2014-09-04
  • Commentary on &quot;A new device for nerve approximation in traumatic
           injuries of extremities&quot; by K.S. Forootan et al.
    • PubDate: 2014-09-01
  • The surgical management of angiosarcoma of the breast—a single
           institution experience
    • Abstract: Background Angiosarcoma of the breast is a rare and aggressive tumour of the vascular endothelium. It may arise spontaneously or secondary to radiation. We present our experience of managing breast angiosarcoma, the largest single institution case series from the UK to date along with a summary of the relevant literature. Methods Data on all patients with breast angiosarcoma treated in our unit were prospectively recorded (2002–2014). Demographics, surgical details and outcomes were analysed. Results Eighteen female patients presented with breast angiosarcoma. Sixteen patients previously underwent adjuvant radiotherapy following surgery for breast carcinoma; the mean duration between radiotherapy and angiosarcoma development was 8.4 years (range 3–21). Resections were as follows: radical mastectomy (n = 14), simple mastectomy (n = 1) and wide local excision (n = 3). Reconstruction was undertaken as follows: pedicled lattisimus dorsi (LD) musculocutaneous flap (n = 5), pedicled LD muscle flap and split skin graft (n = 7), free deep inferior epigastric perforator (DIEP) flap (n = 1), pedicled vertical rectus abdominus muscle (VRAM) flap and split skin graft (n = 1), pedicled LD muscle and pedicled VRAM muscle flaps and split skin graft (n = 1), pedicled LD muscle and pedicled (contralateral) pectoralis major muscle flaps and split skin graft (n = 1) and direct closure (n = 2). Three patients developed local recurrence; mean duration from resection to recurrence was 12 months (range 9–19). Three patients developed metastasis. Seven patients (38.8 %) died; median survival from presentation was 19 months (range 2–55 months). The remaining eleven patients remain well with no disease recurrence; mean follow-up was 38 months (range 4–125). The estimated 5-year survival (Kaplan-Meier equation) in our cohort was 49 %. Conclusions Breast angiosarcomas are rare and challenging to manage. Successful outcomes can be achieved by early, aggressive resection and appropriate reconstruction. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-09-01
  • Surgical site fire caused by alcohol and diathermy
    • PubDate: 2014-09-01
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