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Publisher: Springer-Verlag   (Total: 2300 journals)

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Diabetologia Notes de lecture     Hybrid Journal  
Diabetology Intl.     Hybrid Journal   (Followers: 1)
Dialectical Anthropology     Hybrid Journal   (Followers: 7, SJR: 0.109, h-index: 7)
Die Weltwirtschaft     Hybrid Journal   (Followers: 2)
Differential Equations     Hybrid Journal   (Followers: 2, SJR: 0.28, h-index: 14)
Differential Equations and Dynamical Systems     Hybrid Journal   (Followers: 1, SJR: 0.337, h-index: 5)
Digestive Diseases and Sciences     Hybrid Journal   (Followers: 4, SJR: 0.803, h-index: 84)
Directieve therapie     Hybrid Journal  
Discrete & Computational Geometry     Hybrid Journal   (Followers: 2, SJR: 1.088, h-index: 37)
Discrete Event Dynamic Systems     Hybrid Journal   (Followers: 2, SJR: 1.028, h-index: 30)
Distributed and Parallel Databases     Hybrid Journal   (Followers: 4, SJR: 0.82, h-index: 29)
Distributed Computing     Hybrid Journal   (Followers: 2, SJR: 1.361, h-index: 29)
DNP - Der Neurologe und Psychiater     Full-text available via subscription  
Documenta Ophthalmologica     Hybrid Journal   (Followers: 2, SJR: 1.418, h-index: 37)
Doklady Biochemistry and Biophysics     Hybrid Journal   (Followers: 2, SJR: 0.18, h-index: 8)
Doklady Biological Sciences     Hybrid Journal   (SJR: 0.193, h-index: 9)
Doklady Botanical Sciences     Hybrid Journal  
Doklady Chemistry     Hybrid Journal   (SJR: 0.261, h-index: 11)
Doklady Earth Sciences     Hybrid Journal   (SJR: 0.386, h-index: 15)
Doklady Mathematics     Hybrid Journal   (SJR: 0.299, h-index: 12)
Doklady Physical Chemistry     Hybrid Journal   (SJR: 0.316, h-index: 10)
Doklady Physics     Hybrid Journal   (Followers: 1, SJR: 0.274, h-index: 14)
Douleur et Analg├ęsie     Hybrid Journal   (SJR: 0.135, h-index: 5)
Drug Delivery and Translational Research     Hybrid Journal   (Followers: 2, SJR: 0.624, h-index: 6)
Drug Safety - Case Reports     Open Access  
Drugs : Real World Outcomes     Hybrid Journal  
Dynamic Games and Applications     Hybrid Journal   (Followers: 2)
Dysphagia     Hybrid Journal   (Followers: 229, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 9, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 13, 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: 6, 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: 8, 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: 8, 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)
Economia e Politica Industriale     Hybrid Journal  
Economia Politica     Hybrid Journal  
Economic Botany     Hybrid Journal   (Followers: 9, 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: 9, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal   (Followers: 2)
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: 228, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 17, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 15, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 7, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 11, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 214, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 13, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 4, 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   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Emission Control Science and Technology     Hybrid Journal  
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: 5, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 5, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 11, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 10, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 28, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 18, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 2, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 11, 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: 8, SJR: 0.671, h-index: 46)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 14, SJR: 0.878, h-index: 42)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 2, 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: 12, SJR: 0.62, h-index: 14)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.173, h-index: 8)

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Journal Cover   European Journal of Plastic Surgery
  [SJR: 0.227]   [H-I: 13]   [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  [2300 journals]
  • Free and pedicle flaps in lower extremity trauma
    • Abstract: 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: 2015-02-18
       
  • Spinal accessory nerve iatrogenic trauma following cervical lymph node
           biopsy. Treatment by anterior medial antebrachial cutaneous nerve graft: A
           case report
    • Abstract: Abstract Spinal accessory nerve (SAN) injury often occurs as an iatrogenic nerve injury following posterior cervical lymph node biopsy. Failure to recognize the injury or delayed intervention by hoping that it will resolve with conservative treatment is a usual pitfall. Pain, shoulder drop, scapula instability, asymmetric neckline, and inability to abduct the arm may variably be the symptoms. Direct repair, nerve grafts, nerve conduits, and muscle transfers have been described as treatment options. We report on a case of using a 4.5-cm nerve autograft from the medial antebrachial cutaneous (MABC) nerve branch in order to repair an iatrogenic accessory nerve complete transection following a cervical node biopsy. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2015-02-11
       
  • Concurrent Poland’s syndrome and gynaecomastia: achieving the
           balance using lipomodelling
    • Abstract: 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: 2015-02-04
       
  • Painless pyoderma gangrenosum: an insidious presentation complicating a
           sternal wound dehiscence
    • PubDate: 2015-02-01
       
  • Melanocytic tumours of uncertain malignant potential (MELTUMPs)—a
           diagnostic and management dilemma
    • Abstract: Background Melanocytic tumours of uncertain malignant potential (MELTUMPs) represent melanocytic proliferations within the dermis and are thereby associated with a potential risk of disease dissemination and metastases. However, there is a paucity of data regarding these lesions, their malignant potential and thus their management. Methods This is a retrospective evaluation of all MELTUMPs treated in a single tertiary plastic surgery unit to establish patient demographics, clinical management and outcomes including recurrence and regional and distant metastases. Results Forty-two patients were treated for MELTUMPs between 2005 and 2011 in our unit. The mean Breslow thickness was 0.85 mm (range in situ disease to 5 mm). A complete data set was available for 37 of these patients, of whom, 32 (86 %) underwent wider excision with a 1-cm margin and 5 (14 %) with 2-cm margin. The mean follow-up time was 23 months (range 2 to 48 months). One patient developed locally recurrent disease, one patient developed regional metastases and one patient died of metastatic disease. Conclusions MELTUMPs present a diagnostic and management dilemma with a paucity of agreed strategies for ongoing patient care. We propose that all MELTUMPs should be treated using a melanoma strategy under the care of a skin cancer multidisciplinary team. Level of Evidence: Level IV, risk / prognostic study.
      PubDate: 2015-02-01
       
  • 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: 2015-02-01
       
  • Skiing as a possible cause of late seroma after breast augmentation
    • PubDate: 2015-02-01
       
  • Swim ring method—a cost-effective alternative for prevention and
           healing of back ulcers
    • PubDate: 2015-02-01
       
  • Fold-back perineoscrotal flap plus penile inversion vaginoplasty for
           male-to-female gender reassignment surgery in circumcised subjects
    • Abstract: Background The use of the penile skin for vaginoplasty is a common method in male-to-female (MTF) transsexual surgery. We aim to describe the results of a one-stage vaginoplasty in previously circumcised sex reassignment surgery using fold-back perineoscrotal flap plus penile inversion flap. Methods In a prospective study, 112 previously circumcised MTF subjects underwent a modification of penile inversion vaginoplasty by adding a fold-back perineoscrotal flap to form the whole posterior vaginal wall and about half of the anterior vaginal wall (the proximal part). Patients follow-up, outcomes, and complications were recorded. Results The mean age of the subjects was 25.8 ± 3.3 years underwent feminizing genitoplasty. The success rate was 92.86 %, and the complication-free success rate was achieved in 74.11 % of subjects in general. The need for repeated surgery (failure rate) was 7.14 % (due to vaginal shrinkage in four patients, bulging in anterior vaginal wall in one case and excessive labial skin in three cases). By adding the perineoscrotal flap to the penile skin flap, we were able to reach a mean vaginal depth of 13.1 ± 1.7 and a satisfaction level of 85.71 %. Conclusions Fold-back perineoscrotal flap plus penile inversion vaginoplasty is a suitable surgical approach for achieving adequate vaginal depth in cases of male-to-female (MTF) transsexual vaginoplasty when subjects have short penile skin flap because of circumcision. Level of Evidence: Level III, therapeutic study.
      PubDate: 2015-02-01
       
  • Penile epidermal inclusion cyst: the importance of surgical care
    • PubDate: 2015-02-01
       
  • Inhibition of bone morphogenetic protein signalling promotes wound healing
           in a human ex vivo model
    • Abstract: Background Bone morphogenetic proteins (BMPs) and their receptors (BMPRs) play roles in embryonic development and postnatal remodelling of the skin. Many indications suggest that BMP signalling regulates keratinocyte proliferation and differentiation. Chronic wounds have been shown to exhibit high levels of BMP ligands; however, the effect of BMP pathway modulation on human skin healing remains undefined. Methods A human ex vivo skin wound healing model was used to analyse the expression of BMP signalling pathway components during healing and to investigate the effects of BMPs and the BMP antagonist Noggin on skin repair. Additionally, the effects of BMP signalling on keratinocyte proliferation, apoptosis and migration were tested using in vitro flow cytometry and ‘scratch’ migration assays, respectively. Results BMP receptor-1B (BMPR-1B) and downstream signalling protein phosphorylated-Smad-1/5/8 were highly expressed in healing epidermis. Treatment of human skin with exogenous BMPs impaired wound closure by reducing keratinocyte proliferation and increasing apoptosis. The BMP antagonist Noggin negated the inhibitory effects of BMP ligands, and when used alone, Noggin reduced keratinocyte apoptosis in the wound bed. In vitro, BMP ligands suppressed keratinocyte proliferation whilst Noggin stimulated proliferation. Keratinocyte migration was slowed following BMP treatment; in contrast, migration was significantly accelerated due to inhibition of BMP activity by either Noggin or BMPR-1B silencing. Conclusions BMP signalling is inherently involved in wound healing. BMPs slow skin repair by suppressing keratinocyte proliferation and migration. Thus, modulation of BMP signalling using BMP inhibitors such as Noggin may serve as a new approach to promote cutaneous wound repair. Level of evidence: Not ratable.
      PubDate: 2015-02-01
       
  • Cryoinjury with compartment syndrome of bilateral hands secondary to Freon
           gas: a case report and review of current literature
    • Abstract: Abstract Freon is an industrial refrigerant that can result in serious cryoinjury of the skin. Although there had been a few reported cases, the optimal management is not clear. We present the first case report of a patient with freon-induced cryoinjury of bilateral hands, complicated with compartment syndrome and treated with a combination of surgical decompression, negative-pressure wound therapy (NPWT), and hyperbaric oxygen therapy (HBOT). On follow-up, there was a complete healing without tissue loss or significant atrophy of the intrinsic muscles of the hand. Therefore, we opined that HBOT and NPWT may work synergistically to prevent progressive tissue damage and improve the long-term outcome, especially when vascularity is compromised in severe cryoinjuries of the hand. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-02-01
       
  • Versatility of muscle splitting biplane technique associated with internal
           mastopexy in breast hypoplasia, ptosis, and asymmetry
    • Abstract: Background Breast augmentation is one of the most highly sought after aesthetic surgeries. For the best outcome, a wide variety of factors such as approach, pocket plane, tissue, and breast characteristics (including asymmetry and ptosis) must be assessed along with the patient’s needs. For patients requiring correction of minor ptosis and breast asymmetry, the current technique involves incisions on the breast, but often the patients are dissatisfied with the visible scars so there is a need for procedures involving less scarring. Methods Since 2010, 200 patients with breast hypoplasia have undergone muscle splitting biplane breast augmentation; 32 patients with breast hypoplasia combined either with asymmetry or/and minor ptosis have undergone a technique combining muscle splitting biplane breast augmentation with internal suture mastopexy; 12 patients with dynamic breast following partial submuscular breast augmentation have undergone replacement of the implants using the muscle splitting biplane technique. Results Satisfactory long-term outcomes were obtained by using muscle splitting breast augmentation, with or without internal suture mastopexy, with more accurate control of the breast’s natural shape, symmetry, and inframammary fold positions as well as proper cleavage and nipple projection. In this way, a smooth transition between the soft tissue and implant in the breast’s upper pole was possible, and more tissue was available to cover the implant’s upper pole. Nipple sensitivity was preserved with no visible scars on the breast. Conclusions The muscle splitting biplane breast augmentation offers improved long-term aesthetic outcomes; is extremely versatile, fast, and easy; and may also be used in patients requiring removal and replacement of breast implants. In combination with the internal mastopexy, this technique is an effective alternative in selected patients requiring correction of breast asymmetry and minor ptosis. Level of Evidence: Level IV, therapeutic study
      PubDate: 2015-02-01
       
  • Applicability of self-inflating tissue expanders in pediatric patients
           with head and neck defects
    • Abstract: Background Self-inflating tissue expanders have been used successfully in breast reconstruction, alopecia, scars, and anophthalmos. The expanders contain an osmotic active hydrogel and a silicon shell. The purpose of this study was to analyze our clinical experience using self-inflating tissue expanders in the treatment of alopecia and cleft palate defects in pediatric patients. Methods Twenty-eight self-inflating tissue expanders were used in 13 patients with alopecia or large cleft palate defects. Expander dimensions were determined by the size of the defect in the scalp and by using a sizer for the palate. In some patients, it was necessary to use more than one expander. A visual analog scale (VAS) and Children’s Hospital of Eastern of Ontario Pain Scale (CHEOPS) were used to determine pain levels. Results Sufficient tissue was gained in nine patients (69.2%) and 11 of the 16 defects were repaired successfully (68.75 %). We observed four implant extrusions as a major complication (14.2 %). Three of these four extrusions were seen in cleft palate expansions. Pain levels were as low as 5 points with CHEOPS in patients younger than 5 years old and 40 mm with VAS in patients older than 5 years of age. Conclusions Self-inflating tissue expanders comfortably ensure sufficient tissue in patients with alopecia; however, there is high risk of extrusion in cleft palate applications. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-02-01
       
  • Meningeal melanocytic tumor of the malar bone
    • Abstract: Abstract Meningeal melanocytoma is a central nervous system tumor. It is a rare and benign lesion originating from leptomeningeal melanocytes. Although usually a unifocal type, there are in the literature reports of multifocal cases and malignant transformations, with leptomeningeal dissemination. We present the clinical case of a male child, 7 years old, diagnosed with meningeal melanocytoma, which surrounded the right malar bone and clearly exceeded the bone limits to the temporal fossa. There was complete bone destruction and exophthalmus with eyeball compression. We opted to perform an extended excision of the tumor, after craniotomy, sacrificing the malar bone, orbital floor, and lateral orbital wall, using coronal, subciliar, and orbital roof approaches. The reconstruction used bone graft from calvaria duplication. During the immediate post-operatory period, the patient had a small ectropion, which disappeared within 8 days. The medium-term result was satisfactory. Meningeal melanocytoma is a rare and benign lesion; however, it can feature severe destruction, and has the potential of becoming malignant, in which case there is no therapeutic protocol. In the present case, we achieved satisfactory functional and aesthetic results, but the repercussions in growth and development of the child are uncertain. Level of Evidence: Level V, diagnostic study
      PubDate: 2015-02-01
       
  • Orofacial cleft outreach in rural Ghana: any positive impact on the
           community'
    • 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: 2015-02-01
       
  • Antibiotic triple therapy versus single-agent combination monotherapy in
           the empirical treatment of culture-positive hand infections
    • PubDate: 2014-12-31
       
  • Influence of patient and injury-related factors in the outcomes of primary
           flexor tendon repair
    • Abstract: Background Flexor tendon injuries are a group of lesions with a high socioeconomic impact and whose results are often uncertain. Knowing the factors associated with a poor outcome after tendon repair could help us find prognostic indicators. The aim of this study was to determine factors associated with the results of primary flexor tendon repair to identify the group of patients who will require exhaustive monitoring and rehabilitation. Methods We studied 95 injuries in which the flexor tendons were completely severed from January 2010 to March 2012. We used Student’s t test and one-way analysis of variance (ANOVA) statistics to study the effects of age, sex, zone, finger, injured tendons, presence of nerve injury, and lesional mechanism on the total active movement achieved. The interactions between variables were evaluated using multivariate analysis. Results A statistically significant relationship was observed between total active movement and age, lesion mechanism, and the affected tendon zone. No statistically significant interaction was observed among these three factors. Sharp injuries in zones III and V in younger patients were associated with better results. Conclusions Our data show that age, finger topography, and injury mechanism are factors that are independently associated with the final prognosis of these lesions. This information enables us to anticipate the range of finger mobility to be expected and to inform patients in advance of their possible post-operation prognosis. Level of Evidence: Level III, risk / prognostic study
      PubDate: 2014-12-31
       
  • Peri-alar hatchet flap for the reconstruction of the columella and nasal
           tip
    • Abstract: Abstract Reconstruction of the nasolabial columella complex is a technical challenge for which many solutions have been suggested. The peri-alar hatchet pedicle flap, herein described, allows the transposition of a well-matched tissue to reconstruct columellar and nasal tip defects while preserving the alar and nasolabial crease. This procedure did not require a columellar strut or a finishing touch-up procedure for sufficient columellar projection and achieved excellent cosmetic results. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-25
       
  • The freestyle pedicle perforator flap: a new favorite for the
           reconstruction of moderate-sized defects of the torso and extremities
    • Abstract: Background Perforating vessels are a consistent anatomical finding and well described in the current literature. Any skin flap can be raised on a subcutaneous pedicle as long as it contains at least one supplying perforator. Perforator flaps have been interlinked with microsurgery and generally not widely performed by the general plastic surgeons. The aim of this paper is to present the simplicity of pedicled perforator flap reconstruction of moderate-sized defects of the extremities and torso. Methods We retrospectively reviewed the charts of 34 patients reconstructed using 34 freestyle pedicled perforator flaps for moderate-sized defects of the truncus and extremities. We registered indications, flap size and localization, success rate, and complications. Most importantly, we describe a simple approach to the design of freestyle pedicled perforator flaps and elaborate on technical aspects in the context of current literature. Results The reconstructive goals were achieved in all cases without any total flap loss or major complications. Minor complications occurred in 7/34 (21 %) cases consisting of venous congestion leading to distal tip necrosis or epidermolysis; partial flap loss was significant in 4 cases, however never more than 10 % of the total flap size. Reconstruction was performed on the lower limb in 13 cases, upper limb in 12, and 9 cases were on the truncus. The angle of rotation was 90° in 21 cases and 180° in 13 cases. The most common indication was reconstruction of oncological skin defects; melanoma 19, BCC 6, SCC 2, other 7. The flap size varied from 1.5×3 cm to 12×22 cm. The perforator identification was done by intraoperative exploration in 17 cases and by color Doppler ultrasonography in 17 cases. Conclusions Moderate-sized defects of the torso and extremities can be successfully reconstructed by pedicled perforator flaps. The flap dissection is simple, and the complication rates comparable to other reconstructive options. Level of evidence IV, therapeutic study
      PubDate: 2014-12-21
       
 
 
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