Plastic surgeons accustomed to use autologous fat grafs for augmentation of soft tissues in the last two decades. The main drawback of fat grafting is unpredictable graft resorption. Several studies have searched for ...Plastic surgeons accustomed to use autologous fat grafs for augmentation of soft tissues in the last two decades. The main drawback of fat grafting is unpredictable graft resorption. Several studies have searched for new ways of increasing the viability of the transplanted tissue to overcome this disadvantage. The most recent and promising approach is to mix the fat graft with Platelet-Rich Plasma (PRP) before transplantation. The purpose of this article is to present the initial experience using the autologous fat injection with platlet rich plasma as a method for fascial augmentation.展开更多
Introduction: Penile skin loss poses a particular challenge for reconstruction to the plastic surgeon. These defects, depending on their size, have been reconstructed using skin grafts or regional flap. Patients &...Introduction: Penile skin loss poses a particular challenge for reconstruction to the plastic surgeon. These defects, depending on their size, have been reconstructed using skin grafts or regional flap. Patients & Methods: Ten patients with variable sized penile skin defects were included in this work. Scrotal fascio-myo-cutaneous (Dartos) flap was harvested and used for penile shaft resurfacing. Results: All harvested flaps were successful. None of them showed any ischemic manifestations. Discussion: Despite being a simple and robust flap, its use for resurfacing of moderate to extensive penile skin defects isn’t popular. We propose the use of Dartos flap as a good alternative for challenging moderate to extensive penile skin losses.展开更多
Introduction: Gynaecomastia is a benign enlargement of male breast;many techniques have been described for management but none have gained universal acceptance. We discuss the outcomes of the surgical management of gy...Introduction: Gynaecomastia is a benign enlargement of male breast;many techniques have been described for management but none have gained universal acceptance. We discuss the outcomes of the surgical management of gynaecomastia and assess the morbidity and complication rates associated with the procedure to determine whether certain surgical techniques produce better outcomes. Materials and Methods: 75 patients with gynaecomastia were operated in our hospital during the period from Jan. 2009 to Jan. 2015. Results: A total of 140 breasts were operated on during the study period. Patients underwent either liposuction alone (20 breasts), excision alone (70 breasts), both excision and liposuction (36 breast) or skin reduction procedure (14 breasts). 19 operated breasts (13.4%) experienced some form of complications. Minor complications included seroma (4 patients), superficial wound dehiscence (3 patients) and two patients developed haematomas requiring evacuation in theatre. Unsatisfactory cosmotic result was present in 10 breasts and surgical revision was done in 5 breasts. Simon grade 111 breasts experienced the highest complication rate. Conclusion: The study has found that moderate sized gynaecomastia whether true or pseudo gynaecomastia with mild to moderate breast redundancy can be managed easily and effectively by liposuction alone or combined with glandular resection while the conventional infraareolar subcutaneous mastectomy still gives satisfactory results and with no need to remove extra skin. On the other hand, large gynaecomastia with severe breast redundancy can be treated effectively by the inferior pedicle technique without vertical scar.展开更多
A phenomenon known as trapped penis has numerous origins, including injudicious circumcision. Materials and Methods: Surgery for trapped penis with glanular amputation was performed for 5 children. The surgical policy...A phenomenon known as trapped penis has numerous origins, including injudicious circumcision. Materials and Methods: Surgery for trapped penis with glanular amputation was performed for 5 children. The surgical policy in these cases included complete penile degloving, excising the scarring due to circumcission, fixing the penile skin at the penopubic and penoscrotal angles and reconstructing the penile skin with full thickness skin graft. Results: Improvement was noted in all cases. Conclusion: Surgery for hidden penis using full thickness skin graft achieves very satisfactory aesthetic and functional improvement.展开更多
BACKGROUND: Papillary carcinoma of the breast is a rare malignant tumour accounting for 1% - 2% of all breast cancers in women. Papillary carcinomas of the chest wall are always secondary to thyroid, thymus and ovarie...BACKGROUND: Papillary carcinoma of the breast is a rare malignant tumour accounting for 1% - 2% of all breast cancers in women. Papillary carcinomas of the chest wall are always secondary to thyroid, thymus and ovaries. Other variants of breast cancer metastasizing to the chest wall have been reported. CASE: We report a 67-year-old woman presented to us with an ulcerated anterior chest wall mass of 1-year duration, bilateral axillary, supraclavicular and cervical swellings of 8-month duration. There was a history of breast lump which was noticed 5 years prior to presentation, no history of breast malignancy in the past and no family history of breast cancer. Examination revealed an ulcerated, nodular mass over the sternal angle which measured 14 cm × 12 cm × 4 cm;she had bilateral axillary, supraclavicular and cervical lymphadenopathy which were non-tender and matted. She had a firm, non-tender right breast lump measuring 6 cm × 4 cm. Chest examination and abdominal examinations were essentially normal. Chest X-ray revealed erosion of sternal bone without any evidence of intrathoracic extension. Abdominal ultrasound and thyroid scans were normal. Histology of the mass revealed papillary carcinoma. Biopsy of the right breast also revealed papillary carcinoma. She had excision of the fungating tumour and primary closure of defect. She subsequently had combination chemotherapy using ondasetron, cyclophosphamide, adriamycin and cisplantin. CONCLUSION: Papillary carcinoma of the breast is rare and rarely metastasizes to the chest wall. The diagnosis of metastatic chest wall tumour requires meticulous history taking, clinical examination and relevant investigations to ascertain the primary origin of the carcinoma.展开更多
Introduction: Abdominal wall defects and muscle redundancy in the form of protruded abdomen still represent a challenging problem. The aim of this article is to reconstruct the abdominal wall and regain the abdominal ...Introduction: Abdominal wall defects and muscle redundancy in the form of protruded abdomen still represent a challenging problem. The aim of this article is to reconstruct the abdominal wall and regain the abdominal contour through the application of biosynthetic meshes in certain fashion. Patients and Methods: this is a prospective study done 25 patients with long standing ventral hernia and lax abdominal muscle wall. All patients were performed at Zagazig university hospitals in the period between September 2011 and November 2013. Polypropylene mesh is used for every patient after anatomical hernia repair for hernioplasty and then shaping like outstretched hand (fingers processes). The aim is to reinforce the abdominal wall and reshape the abdomen. Results: regarding to the aesthetic aspect and success rate of the abdominal wall reconstruction, we have a good satisfactory results without recurrence in a period of 2 years follow up. Three patients are suffered from wound infection and partial edge ischemia in two patients. Bleeding and delayed wound healing in ten patients and persistent seroma are occurred in fife patients. Conclusion: It is safe with a good patient satisfaction to combine ventral hernia repair and abdominoplasty in cases with excess skin and musculofascial laxity of the abdominal wall (pendulous abdomen) with application of this finger processes mesh, after following the proper technique and precautions.展开更多
Sometimes in free flap there is a venous congestion without an obstruction of the venous anastomosis or other organic causes of reduction venous drainage (haematoma, seroma compressing the pedicle). In these cases the...Sometimes in free flap there is a venous congestion without an obstruction of the venous anastomosis or other organic causes of reduction venous drainage (haematoma, seroma compressing the pedicle). In these cases the authors suggest the application of nitroglycerine patch in the congested area of the flap few hours before the surgical exploration of the anastomosis. If there is a fast improvement of the clinical feature of the flap, the surgical exploration could be avoided. The authors underline that applying the nitroglycerin patch should not be regarded in any way as a therapy of a free flap venous thrombosis but only as an useful device, an option to be taken only when the surgeon is undecided whether to revisit the anastomosis or not.展开更多
Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast aug...Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods： the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 （＋ 5） years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results： considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series S1DAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test （patch test） were negative, ultrasound and MR have shown that no hearing was damaged or broken. Blood test showed no abnormalities. Discussion： comparing the authors＇ study with other similar works in the literature, they noted that the reported cases of hypersensitivity type 4 silicone prosthesis was not only initially accompanied by specific symptoms such as urticaria and blistering, but mostly it was found to be a net positive patch test. The absence of urticaria, the low values of lgE and total negativity of patch test confirmed the purely inflammatory nature of the lesions in our patients.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Hidradenitis suppurativa</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(HS) or Acne inversa sometimes referred to as Verneuil’s disease</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> is a rare and debilitating condition arising in the intertriginous folds that bear apocrine glands (axillae, groin, perineum, pubis, ano-genital area). It has a deleterious impact on the life of affected persons who tend to be more depressive and poorly socially and sexually connected because of pain, malodor and stigmatization. </span><b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">We conducted a retrospective study in Henri Mondor Hospital in Créteil, France, in order to assess the effectiveness of surgery as a radical treatment and also assess the factors related to recurrence and the surgical and sexual satisfaction in women operated for severe HS of perineum and genitalia.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Fifty-five women were included. We got a recurrence rate of 23.6%. 66.7% of recurrence occurred after localized excision. 83% of patients were satisfied with surgery results and would undergo a revision surgery or recommend it. The factors significantly associated with recurrence were overweight (p =</span><span style="font-family:Verdana;"> 0.0046), location in groin (p = 0.0040), localized excision (p = 0.02), total excision (p = 0.009), healing via secondary intention (p = 0.001) and disability due to HS (p = 0.006). Assessment of sexual response thanks to the FSFI showed an </span><span style="font-family:Verdana;">alteration of all the domains of sexual response but the composite index of 18.51 was below the threshold to diagnose pathologic sexual condition.</span></span></span></span>展开更多
In the recent decades,microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic outcome.This review retraces the main contributions to the a...In the recent decades,microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic outcome.This review retraces the main contributions to the advances of microsurgery for reconstruction of upper and lower extremities and limb preservation.In the upper extremity,it is important to restore fine motility,together with allowing prompt mobilization.In the lower limb,care must be taken in the reconstruction of weight-bearing areas and the aim must be proper ambulation and shoe wearing.Local perforator flaps can be considered for medium size defects.They provide thin coverage and can be performed in short operating time.Their use,though,is often limited by tissue availability.Free flaps allow to overcome this problem and,thanks to the recent development in the study of perforator vessels,the microsurgeon can choose the flap with the most appropriate characteristics.Chimeric flaps can accomplish simultaneous reconstruction of different tissue components and large bone defects often require vascularized bone reconstruction.When dealing with limb preservation it is very important to consider residual functionality.Functioning muscle transfer and targeted muscle re-innervation can be performed in these cases.A useful reconstructive tool in severely damaged limbs with limited blood supply is the use of cross-leg free flaps.In conclusion,extremity reconstruction and limb preservation are reaching new heights thanks,not only to the work of plastic surgeons,but also to the new developments in other fields of study such as oncology,traumatology,radiology and medical engineering.展开更多
Several studies demonstrated the favorable effects of platelet rich plasma(PRP)on the skin and promoted its wide use in clinical practice.The growth factors stored in platelet alfa-granules allow for the tissue regene...Several studies demonstrated the favorable effects of platelet rich plasma(PRP)on the skin and promoted its wide use in clinical practice.The growth factors stored in platelet alfa-granules allow for the tissue regeneration and the main fields of application of PRP in current clinical practice are the cartilage and musculoskeletal defects,osteoarthritis and other bone disorders,chronic and difficult to heal wounds,and aesthetic procedures.The relevant number of different PRP preparation protocols may explain the inconsistency of the different clinical outcomes reported in the literature.Despite the technological advances in PRP preparation,the objective assessment of the clinical efficacy of PRP from the literature reports still is difficult due to the low homogeneity of the samples in terms of both inclusion criteria and size.Therefore,it might be useful to establish standardized and reproducible experimental models to confirm and objectively measure the effectiveness of the available clinical results.Many experimental investigations have been carried out to objectively assess the effectiveness of PRP and platelet gel on several tissues.As far as the skin is concerned,the studies carried out to date are limited to fibroblasts in in-vitro culture models or to collagen,vascular supply,epithelium,and hair follicle in in-vivo models.The skin,however,is a very complex organ,where different cell lines coexist and feature complex mutual interaction.A model that combines the advantages of both in-vitro and in-vivo cultures is the ex-vivo model.The demonstration of the platelet derived growth factors effects through the ex-vivo human full-thickness skin culture model is a keystone to support the evidence of the PRP effectiveness,as it represents an objective,fast,reproducible,and ethical investigational method.展开更多
We read with interest the article entitled“Painful scar neuropathy:principles of diagnosis and treatment”(Plast Aesthet Res Vol 2,Issue 4,Jul 15,2015)where Tos et al.[1]presented a literature review of treatment app...We read with interest the article entitled“Painful scar neuropathy:principles of diagnosis and treatment”(Plast Aesthet Res Vol 2,Issue 4,Jul 15,2015)where Tos et al.[1]presented a literature review of treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis-associated procedures.展开更多
Mycobacterium ulcerans(M Ulcerans)infection leads to the debilitating Buruli ulcer(BU),characterized by necrotizing skin and soft tissue lesions.Conventional treatment primarily focuses on an antibiotic regimen,but wo...Mycobacterium ulcerans(M Ulcerans)infection leads to the debilitating Buruli ulcer(BU),characterized by necrotizing skin and soft tissue lesions.Conventional treatment primarily focuses on an antibiotic regimen,but wound management remains paramount to patient recovery.This literature review aims to evaluate the efficacy and benefits of Vacuum Assisted Dressing(VAC)in the treatment and management of BU wounds.A systematic literature search was undertaken using databases such as PubMed,Cinahl,Cochrane database,Joanna Briggs Institute,Medline,Internurse,Nursing&Allied Health database,and Scopus search from January 1995 to December 2023.The key search terms included“Mycobacterium ulcerans”,OR“Buruli ulcer”,AND“vacuum assisted dressing”,“vacuum assisted therapy”,“Vacuum Assisted Dressing”,“negative pressure wound therapy”,and“Negative Pressure Wound Therapy(NPWT)”.The exclusion criteria were animal studies and studies not in the English language.The current literature emphasizes the importance of antibiotic treatment for BU and highlights the skin and soft tissue damage that results in open,infected wounds.However,there is a notable lack of quantitative data on the efficacy of NPWT for treating BU wounds.Early evidence indicates that NPWT might accelerate wound healing,decrease secondary infections,and enhance wound bed readiness for grafting or secondary healing.While more comprehensive quantitative studies are warranted,NPWT emerges as a promising adjunctive therapy in the holistic management of BU wounds,offering benefits that may improve patient outcomes and reduce morbidity.展开更多
Background:Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-rel...Background:Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-related discrimination. Our aim was to investigate if there are differences in burn treatments between the sexes. Methods:All patients admitted with burns to Link?ping University Hospital during the 16-year period 2000–2015 were included. Interventions were prospectively recorded using the validated Burn SCoring system (BSC). Data were analysed using a multivariable panel regression model adjusted for age, percentage total body surface area (%TBSA), and in-hospital mortality. Results:A total of 1363 patients were included, who generated a total of 22,301 daily recordings while they were inpatients. Males were 70%(930/1363). Sex was not an independent factor for daily scores after adjustment for age,%TBSA, and mortality in hospital (model R2=0.60, p<0.001). Conclusion:We found no evidence of inequity between the sexes in treatments given in our burn centre when we had adjusted for size of burn, age, and mortality. BSC seems to be an appropriate model in which to evaluate sex-related differences in the delivery of treatments.展开更多
文摘Plastic surgeons accustomed to use autologous fat grafs for augmentation of soft tissues in the last two decades. The main drawback of fat grafting is unpredictable graft resorption. Several studies have searched for new ways of increasing the viability of the transplanted tissue to overcome this disadvantage. The most recent and promising approach is to mix the fat graft with Platelet-Rich Plasma (PRP) before transplantation. The purpose of this article is to present the initial experience using the autologous fat injection with platlet rich plasma as a method for fascial augmentation.
文摘Introduction: Penile skin loss poses a particular challenge for reconstruction to the plastic surgeon. These defects, depending on their size, have been reconstructed using skin grafts or regional flap. Patients & Methods: Ten patients with variable sized penile skin defects were included in this work. Scrotal fascio-myo-cutaneous (Dartos) flap was harvested and used for penile shaft resurfacing. Results: All harvested flaps were successful. None of them showed any ischemic manifestations. Discussion: Despite being a simple and robust flap, its use for resurfacing of moderate to extensive penile skin defects isn’t popular. We propose the use of Dartos flap as a good alternative for challenging moderate to extensive penile skin losses.
文摘Introduction: Gynaecomastia is a benign enlargement of male breast;many techniques have been described for management but none have gained universal acceptance. We discuss the outcomes of the surgical management of gynaecomastia and assess the morbidity and complication rates associated with the procedure to determine whether certain surgical techniques produce better outcomes. Materials and Methods: 75 patients with gynaecomastia were operated in our hospital during the period from Jan. 2009 to Jan. 2015. Results: A total of 140 breasts were operated on during the study period. Patients underwent either liposuction alone (20 breasts), excision alone (70 breasts), both excision and liposuction (36 breast) or skin reduction procedure (14 breasts). 19 operated breasts (13.4%) experienced some form of complications. Minor complications included seroma (4 patients), superficial wound dehiscence (3 patients) and two patients developed haematomas requiring evacuation in theatre. Unsatisfactory cosmotic result was present in 10 breasts and surgical revision was done in 5 breasts. Simon grade 111 breasts experienced the highest complication rate. Conclusion: The study has found that moderate sized gynaecomastia whether true or pseudo gynaecomastia with mild to moderate breast redundancy can be managed easily and effectively by liposuction alone or combined with glandular resection while the conventional infraareolar subcutaneous mastectomy still gives satisfactory results and with no need to remove extra skin. On the other hand, large gynaecomastia with severe breast redundancy can be treated effectively by the inferior pedicle technique without vertical scar.
文摘A phenomenon known as trapped penis has numerous origins, including injudicious circumcision. Materials and Methods: Surgery for trapped penis with glanular amputation was performed for 5 children. The surgical policy in these cases included complete penile degloving, excising the scarring due to circumcission, fixing the penile skin at the penopubic and penoscrotal angles and reconstructing the penile skin with full thickness skin graft. Results: Improvement was noted in all cases. Conclusion: Surgery for hidden penis using full thickness skin graft achieves very satisfactory aesthetic and functional improvement.
文摘BACKGROUND: Papillary carcinoma of the breast is a rare malignant tumour accounting for 1% - 2% of all breast cancers in women. Papillary carcinomas of the chest wall are always secondary to thyroid, thymus and ovaries. Other variants of breast cancer metastasizing to the chest wall have been reported. CASE: We report a 67-year-old woman presented to us with an ulcerated anterior chest wall mass of 1-year duration, bilateral axillary, supraclavicular and cervical swellings of 8-month duration. There was a history of breast lump which was noticed 5 years prior to presentation, no history of breast malignancy in the past and no family history of breast cancer. Examination revealed an ulcerated, nodular mass over the sternal angle which measured 14 cm × 12 cm × 4 cm;she had bilateral axillary, supraclavicular and cervical lymphadenopathy which were non-tender and matted. She had a firm, non-tender right breast lump measuring 6 cm × 4 cm. Chest examination and abdominal examinations were essentially normal. Chest X-ray revealed erosion of sternal bone without any evidence of intrathoracic extension. Abdominal ultrasound and thyroid scans were normal. Histology of the mass revealed papillary carcinoma. Biopsy of the right breast also revealed papillary carcinoma. She had excision of the fungating tumour and primary closure of defect. She subsequently had combination chemotherapy using ondasetron, cyclophosphamide, adriamycin and cisplantin. CONCLUSION: Papillary carcinoma of the breast is rare and rarely metastasizes to the chest wall. The diagnosis of metastatic chest wall tumour requires meticulous history taking, clinical examination and relevant investigations to ascertain the primary origin of the carcinoma.
文摘Introduction: Abdominal wall defects and muscle redundancy in the form of protruded abdomen still represent a challenging problem. The aim of this article is to reconstruct the abdominal wall and regain the abdominal contour through the application of biosynthetic meshes in certain fashion. Patients and Methods: this is a prospective study done 25 patients with long standing ventral hernia and lax abdominal muscle wall. All patients were performed at Zagazig university hospitals in the period between September 2011 and November 2013. Polypropylene mesh is used for every patient after anatomical hernia repair for hernioplasty and then shaping like outstretched hand (fingers processes). The aim is to reinforce the abdominal wall and reshape the abdomen. Results: regarding to the aesthetic aspect and success rate of the abdominal wall reconstruction, we have a good satisfactory results without recurrence in a period of 2 years follow up. Three patients are suffered from wound infection and partial edge ischemia in two patients. Bleeding and delayed wound healing in ten patients and persistent seroma are occurred in fife patients. Conclusion: It is safe with a good patient satisfaction to combine ventral hernia repair and abdominoplasty in cases with excess skin and musculofascial laxity of the abdominal wall (pendulous abdomen) with application of this finger processes mesh, after following the proper technique and precautions.
文摘Sometimes in free flap there is a venous congestion without an obstruction of the venous anastomosis or other organic causes of reduction venous drainage (haematoma, seroma compressing the pedicle). In these cases the authors suggest the application of nitroglycerine patch in the congested area of the flap few hours before the surgical exploration of the anastomosis. If there is a fast improvement of the clinical feature of the flap, the surgical exploration could be avoided. The authors underline that applying the nitroglycerin patch should not be regarded in any way as a therapy of a free flap venous thrombosis but only as an useful device, an option to be taken only when the surgeon is undecided whether to revisit the anastomosis or not.
文摘Introduction： breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods： the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 （＋ 5） years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results： considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series S1DAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test （patch test） were negative, ultrasound and MR have shown that no hearing was damaged or broken. Blood test showed no abnormalities. Discussion： comparing the authors＇ study with other similar works in the literature, they noted that the reported cases of hypersensitivity type 4 silicone prosthesis was not only initially accompanied by specific symptoms such as urticaria and blistering, but mostly it was found to be a net positive patch test. The absence of urticaria, the low values of lgE and total negativity of patch test confirmed the purely inflammatory nature of the lesions in our patients.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Hidradenitis suppurativa</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(HS) or Acne inversa sometimes referred to as Verneuil’s disease</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> is a rare and debilitating condition arising in the intertriginous folds that bear apocrine glands (axillae, groin, perineum, pubis, ano-genital area). It has a deleterious impact on the life of affected persons who tend to be more depressive and poorly socially and sexually connected because of pain, malodor and stigmatization. </span><b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">We conducted a retrospective study in Henri Mondor Hospital in Créteil, France, in order to assess the effectiveness of surgery as a radical treatment and also assess the factors related to recurrence and the surgical and sexual satisfaction in women operated for severe HS of perineum and genitalia.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Fifty-five women were included. We got a recurrence rate of 23.6%. 66.7% of recurrence occurred after localized excision. 83% of patients were satisfied with surgery results and would undergo a revision surgery or recommend it. The factors significantly associated with recurrence were overweight (p =</span><span style="font-family:Verdana;"> 0.0046), location in groin (p = 0.0040), localized excision (p = 0.02), total excision (p = 0.009), healing via secondary intention (p = 0.001) and disability due to HS (p = 0.006). Assessment of sexual response thanks to the FSFI showed an </span><span style="font-family:Verdana;">alteration of all the domains of sexual response but the composite index of 18.51 was below the threshold to diagnose pathologic sexual condition.</span></span></span></span>
文摘In the recent decades,microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic outcome.This review retraces the main contributions to the advances of microsurgery for reconstruction of upper and lower extremities and limb preservation.In the upper extremity,it is important to restore fine motility,together with allowing prompt mobilization.In the lower limb,care must be taken in the reconstruction of weight-bearing areas and the aim must be proper ambulation and shoe wearing.Local perforator flaps can be considered for medium size defects.They provide thin coverage and can be performed in short operating time.Their use,though,is often limited by tissue availability.Free flaps allow to overcome this problem and,thanks to the recent development in the study of perforator vessels,the microsurgeon can choose the flap with the most appropriate characteristics.Chimeric flaps can accomplish simultaneous reconstruction of different tissue components and large bone defects often require vascularized bone reconstruction.When dealing with limb preservation it is very important to consider residual functionality.Functioning muscle transfer and targeted muscle re-innervation can be performed in these cases.A useful reconstructive tool in severely damaged limbs with limited blood supply is the use of cross-leg free flaps.In conclusion,extremity reconstruction and limb preservation are reaching new heights thanks,not only to the work of plastic surgeons,but also to the new developments in other fields of study such as oncology,traumatology,radiology and medical engineering.
文摘Several studies demonstrated the favorable effects of platelet rich plasma(PRP)on the skin and promoted its wide use in clinical practice.The growth factors stored in platelet alfa-granules allow for the tissue regeneration and the main fields of application of PRP in current clinical practice are the cartilage and musculoskeletal defects,osteoarthritis and other bone disorders,chronic and difficult to heal wounds,and aesthetic procedures.The relevant number of different PRP preparation protocols may explain the inconsistency of the different clinical outcomes reported in the literature.Despite the technological advances in PRP preparation,the objective assessment of the clinical efficacy of PRP from the literature reports still is difficult due to the low homogeneity of the samples in terms of both inclusion criteria and size.Therefore,it might be useful to establish standardized and reproducible experimental models to confirm and objectively measure the effectiveness of the available clinical results.Many experimental investigations have been carried out to objectively assess the effectiveness of PRP and platelet gel on several tissues.As far as the skin is concerned,the studies carried out to date are limited to fibroblasts in in-vitro culture models or to collagen,vascular supply,epithelium,and hair follicle in in-vivo models.The skin,however,is a very complex organ,where different cell lines coexist and feature complex mutual interaction.A model that combines the advantages of both in-vitro and in-vivo cultures is the ex-vivo model.The demonstration of the platelet derived growth factors effects through the ex-vivo human full-thickness skin culture model is a keystone to support the evidence of the PRP effectiveness,as it represents an objective,fast,reproducible,and ethical investigational method.
文摘We read with interest the article entitled“Painful scar neuropathy:principles of diagnosis and treatment”(Plast Aesthet Res Vol 2,Issue 4,Jul 15,2015)where Tos et al.[1]presented a literature review of treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis-associated procedures.
文摘Mycobacterium ulcerans(M Ulcerans)infection leads to the debilitating Buruli ulcer(BU),characterized by necrotizing skin and soft tissue lesions.Conventional treatment primarily focuses on an antibiotic regimen,but wound management remains paramount to patient recovery.This literature review aims to evaluate the efficacy and benefits of Vacuum Assisted Dressing(VAC)in the treatment and management of BU wounds.A systematic literature search was undertaken using databases such as PubMed,Cinahl,Cochrane database,Joanna Briggs Institute,Medline,Internurse,Nursing&Allied Health database,and Scopus search from January 1995 to December 2023.The key search terms included“Mycobacterium ulcerans”,OR“Buruli ulcer”,AND“vacuum assisted dressing”,“vacuum assisted therapy”,“Vacuum Assisted Dressing”,“negative pressure wound therapy”,and“Negative Pressure Wound Therapy(NPWT)”.The exclusion criteria were animal studies and studies not in the English language.The current literature emphasizes the importance of antibiotic treatment for BU and highlights the skin and soft tissue damage that results in open,infected wounds.However,there is a notable lack of quantitative data on the efficacy of NPWT for treating BU wounds.Early evidence indicates that NPWT might accelerate wound healing,decrease secondary infections,and enhance wound bed readiness for grafting or secondary healing.While more comprehensive quantitative studies are warranted,NPWT emerges as a promising adjunctive therapy in the holistic management of BU wounds,offering benefits that may improve patient outcomes and reduce morbidity.
文摘Background:Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-related discrimination. Our aim was to investigate if there are differences in burn treatments between the sexes. Methods:All patients admitted with burns to Link?ping University Hospital during the 16-year period 2000–2015 were included. Interventions were prospectively recorded using the validated Burn SCoring system (BSC). Data were analysed using a multivariable panel regression model adjusted for age, percentage total body surface area (%TBSA), and in-hospital mortality. Results:A total of 1363 patients were included, who generated a total of 22,301 daily recordings while they were inpatients. Males were 70%(930/1363). Sex was not an independent factor for daily scores after adjustment for age,%TBSA, and mortality in hospital (model R2=0.60, p<0.001). Conclusion:We found no evidence of inequity between the sexes in treatments given in our burn centre when we had adjusted for size of burn, age, and mortality. BSC seems to be an appropriate model in which to evaluate sex-related differences in the delivery of treatments.
