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Publisher: Springer-Verlag   (Total: 2210 journals)

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Dynamic Games and Applications     Hybrid Journal   (Followers: 2)
Dysphagia     Hybrid Journal   (Followers: 215, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 8, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 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: 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: 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)
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: 8, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal   (Followers: 1)
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.367, h-index: 12)
Ecosystems     Hybrid Journal   (Followers: 19, SJR: 1.793, h-index: 83)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.041, h-index: 53)
Education and Information Technologies     Hybrid Journal   (Followers: 209, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 14, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 14, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 7, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 10, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 204, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 12, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 4, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 6, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 12)
Empirical Economics     Hybrid Journal   (Followers: 8, SJR: 0.5, h-index: 29)
Empirical Software Engineering     Hybrid Journal   (Followers: 4, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 5, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 11, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 10, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 28, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 17, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 2, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 10, SJR: 0.601, h-index: 55)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 6, SJR: 0.35, h-index: 3)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.732, h-index: 23)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 0.909, h-index: 32)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 14)
Environmental Management     Hybrid Journal   (Followers: 32, SJR: 0.773, h-index: 60)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 10, 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: 11, 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: 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: 4, 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: 208, 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: 5, SJR: 1.269, h-index: 51)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (Followers: 5)
European Food Research and Technology     Hybrid Journal   (Followers: 8, SJR: 0.773, h-index: 49)
European J. for Education Law and Policy     Hybrid Journal   (Followers: 6)
European J. for Philosophy of Science     Partially Free   (Followers: 4, SJR: 0.165, h-index: 2)
European J. of Ageing     Hybrid Journal   (Followers: 10, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 8, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 11, SJR: 0.958, h-index: 74)
European J. of Clinical Pharmacology     Hybrid Journal   (Followers: 9, SJR: 0.916, h-index: 69)
European J. of Dermatology     Hybrid Journal   (Followers: 7)
European J. of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (Followers: 7, 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)

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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  [2210 journals]
  • 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: 2015-01-20
       
  • Restoration of a total vaginal closure following McIndoe vaginoplasty
    • Abstract: Abstract Vaginal aplasia is a rare congenital anomaly, and McIndoe technique is the most preferred for this anomaly. Here, the authors present an unusual case with a total vaginal closure following McIndoe vaginoplasty, its management, and surgical tips and reviewed the related literature. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-01-18
       
  • 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: 2015-01-18
       
  • 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: 2015-01-14
       
  • Cutaneous metastasis in the face as the first manifestation of esophageal
           Adenocarcinoma: case report and literature review
    • Abstract: Abstract Metastasis to the skin from carcinoma arising in other organs is uncommon, yet it may be the first presentation of neoplastic disease. The incidence of esophageal adenocarcinoma has been rapidly rising and now accounts for at least half of esophageal carcinomas. Cutaneous metastases of esophageal adenocarcinoma are extremely rare; less than 1 % of patients with metastatic disease have cutaneous involvement. We reported a rare cutaneous cheek metastasis from an adenocarcinoma in an 81-year-old white man, who was excised, and the defect repaired with a reverse cervicofacial flap. Subsequent investigations, based on the result of the pathological anatomy, detected the primary tumor in the esophagus, despite no symptoms. Although cancer of internal organs rarely presents with skin metastases, any suspicious lesions with rapid growth should be ruled out as their metastatic origin. We reported a case and reviewed the clinical characteristics of the few patients reported on the literature. Level of Evidence: Level V, diagnostic study
      PubDate: 2015-01-14
       
  • Single stage immediate prosthetic breast and nipple-areolar complex
           reconstruction with simultaneous contralateral symmetrisation
    • Abstract: 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: 2015-01-14
       
  • Results of upper limb digital and hand replant and revascularisation at a
           UK Hand Centre
    • Abstract: Background There is an increasing awareness of replantation amongst the general public, with an expectation for reattachment of digits. Currently, there is a paucity of evidence on the outcomes of replantation or revascularisations in the UK with most surgical experience literature from the USA or East Asian countries. Methods We report a case series of 28 patients over a 7-year period with replantation or revascularisation performed at a tertiary National Health Service hand centre in the UK. Data was collected retrospectively from hospital clinical notes and electronic imaging. Results Out of the 28 patients identified, 16 had single digit replantation or revascularisation, of which 11 digits ultimately survived. Nine patients underwent multiple digit replantation or revascularisation with a combined total of 25 digits, only five of these digits survived. Conclusions Factors found to adversely affect survival were increased number of attempted replants, power-saw mechanism of injury and prolonged ischaemic time. Reduced ischaemic times and single digit amputations were associated with improved survival. Level of Evidence: level IV, risk/prognostic study.
      PubDate: 2015-01-13
       
  • Non-infective bilateral upper limb subcutaneous emphysema following elbow
           trauma
    • PubDate: 2015-01-13
       
  • How to treat a vaginal burn due to acetic acid?
    • Abstract: Abstract Up to the present, no recommendations have been made on vaginal and cervical burns. The aim of this article was to compare our treatment with other strategies found in the literature on the outcome of vaginal strictures and to propose a protocol for the treatment of vaginal burns. A patient underwent colposcopy with 100 % acetic acid, which caused deep vaginal burns. We treated her with daily vaginal packing with Vaseline gauze for 5 days and daily irrigation with saline solution for 2 weeks. Antibiotic capsules were used for 7 days. Subsequent physiotherapy was performed for 6 months. Topical hyaluronic acid was applied, and hyaluronic vaginal capsules were introduced from 1 month onwards and for 5 months. Healing took 1 month. No vaginal synechia or stricture was found at 6 months. In a review of literature, vaginal stents, topical estrogen, systemic antibiotics, and oral non-steroidal anti-inflammatory agents have been proposed. No cases of vaginal strictures or synechiae have been reported. The treatment has to be the simplest and the less traumatizing. Vaginal packing does not prevent vaginal strictures. Simple saline irrigation with a regular pelvic examination appears to be sufficient for the treatment of vaginal burns. Topical estrogens can be interesting if there is an atrophic mucosa. At distance, topical hyaluronic acid can be used to enhance healing. Level of Evidence: Level V, therapeutic study.
      PubDate: 2015-01-08
       
  • The clinical application of free-style cutaneous perforator flaps
    • Abstract: Abstract Perforator flaps have become increasingly popular in reconstructive surgery. In theory, a flap can be based on any identified perforator, whether free or pedicled, based on the perforasome concept. In this study, we report our initial experience with free-style perforator flaps for reconstruction of complex soft tissue wounds. We present two cases of free-style cutaneous perforator flaps; one pedicled free-style perforator flap was designed and elevated adjacent to a complex hip wound and another free-style free perforator flap was elevated in the thigh based on a perforator identified within the flap territory, but no dominant perforator was present for a free anterolateral thigh (ALT) perforator flap. In this case, a free ALT flap was converted to a free-style free perforator flap for the anterior neck reconstruction. Two free-style perforator flaps, one pedicled and one free, were successfully performed to reconstruct complex wounds of the hip and anterior neck. During more than 12 months of follow-up, both reconstructions have healed adequately with optimal contour in the reconstructed areas. This series demonstrates some of the clinical applications available using both free and pedicled freestyle perforator flaps. These free-style flaps can be used successfully with good esthetic and functional results at various regions of the body if there is a detectable perforator that can be based on as a perforator flap. Level of Evidence: Level V, therapeutic study
      PubDate: 2015-01-07
       
  • Contralateral axillary silicone lymphadenopathy, following skin sparing
           mastectomy and immediate reconstruction with latissimus dorsi myocutaneous
           flap and implant
    • PubDate: 2015-01-07
       
  • 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: 2015-01-07
       
  • 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
       
  • “Slip sliding” technique. A new method to perform
           mastopexy-augmentation
    • Abstract: Background When performing breast augmentation in patients affected by mild-moderate ptosis or pseudoptosis, the plastic surgeon often has to choose whether to perform a glandular mastopexy or not. This decision is controversial not only due to the residual scarring, but also breast reshaping with potential asymmetries, often poorly tolerated or directly rejected by the patient herself. Methods We performed the “slip sliding technique” on nine Caucasian female patients from July 2011 to April 2014. By this technique, a glandular reshaping is performed with a single superior half-moon-shaped periareolar access and an undermining above and underneath the muscle. The breast implant is positioned in the submuscular plane and the breast parenchyma is lifted cranially, resulting in a mastopexy-augmented breast without its traditional scars. Results Ptosis and pseudoptosis correction were satisfactory in all cases to both patients and surgeons. No ptosis recurrence or asymmetries were observed. Conclusions Despite the recent introduction and a limited number of treated patients, the slip sliding technique has proven to reach good results in patients where breast augmentation alone is doubtful. In our opinion, the slip sliding is a valid technique when mastopexy has to be associated to breast augmentation surgery in selected patients. Level of Evidence: Level V, therapeutic 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
       
  • Hypertrophic scar as an areola graft in nipple-areola reconstruction
    • PubDate: 2014-12-14
       
  • Post-traumatic radioulnar synostosis treated effectively with tissue
           expander capsule interposition: a novel technique
    • Abstract: Abstract Post-traumatic radioulnar synostosis is a rare condition characterised by abnormal fibro-osseous union between radius and ulna along the length of the interosseous membrane, resulting in loss of forearm pronation and supination. Various surgical techniques have been described and numerous interpositional materials have been used. We present a novel technique of utilising a tissue expander capsule as the interpositional gliding surface. This technique provides an autologous capsule and an expanded adipofascia, which are well vascularised for increased length and reliability. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-12-14
       
  • Cause of death among head and neck skin cancer patients in a Nigerian
           hospital: significance of the cranium
    • Abstract: Background Most cancers in the head and neck region spread locally. This study was designed to evaluate the involvement of the cranium in cause of death among head and neck skin cancer patients. Methods All cases of skin malignancy appearing in the head and neck region were documented. Cause of death was noted for all deceased head and neck skin cancer patients. Cranial involvement, or not, was recorded in each case. Recurrent lesions, types of previous treatment, if any, and cranial perforation, when present, were documented. Results One hundred thirty-one patients were seen. One hundred eighteen (90.1 %) had lesions involving the cranium. Thirty-four head and neck cancer patients died during study period. Thirty-two (94.1 %) died as a result of local spread of disease to the brain through the cranium. Recurrent and persistent lesions were accounted for 35 (26.7 %) cases; out of which, 18 (13.7 %) had been excised and wound was immediately closed directly; 10 (7.6 %) had been excised and wound immediately primarily closed using vascularized free flaps. Five (3.8 %) had previously been managed solely with radiotherapy. Two (1.5 %) applied 5FU ointment on prescription for basal cell carcinoma, which transmuted to squamous cell carcinoma. Eleven (8.4 %) referral cases with cranial perforation presented after recurrence. Conclusions Deaths that were caused by spread of cancer to the brain through the cranium were 94.1 %. Radiotherapists should be educated on the grave danger of causing osteoradionecrosis of the cranium. The value of medical remedies for malignancies around the cranium should be properly reevaluated. Surgery appears to be the favoured therapy for cranium-involved skin cancer. Level of Evidence: Level IV, risk / prognostic study
      PubDate: 2014-12-09
       
 
 
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