DOCSLIB.ORG

Research Article TISSUE EXPANDER in PERIODONTICS

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Research Article TISSUE EXPANDER in PERIODONTICS Available Online at http://www.recentscientific.com International Journal of CODEN: IJRSFP (USA) Recent Scientific International Journal of Recent Scientific Research Research Vol. 11, Issue, 08 (B), pp. 39498-39503, August, 2020 ISSN: 0976-3031 DOI: 10.24327/IJRSR Research Article TISSUE EXPANDER IN PERIODONTICS *Lakshana S., Esther Nalini H., Arun Kumar Prasad P., and Renuka Devi R Department of Periodontology, K.S.R. Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India DOI: http://dx.doi.org/10.24327/ijrsr.2020.1108.5515 ARTICLE INFO ABSTRACT Article History: Periodontitis is a multifactorial inflammatory disease which leads to the destruction of soft and hard tissues surrounding the teeth. Tissue expansion in periodontics was introduced to correct the tissue Received 12th May, 2020 rd (soft and hard) defects, preserve and augment the dimensions of alveolar ridge. It overcomes the Received in revised form 23 complications like soft tissue dehiscence, poor tension free primary closure associated with the June, 2020 conventional augmentation procedures. Materials which are widely used as tissue expanders in Accepted 7th July, 2020 th dentistry are silicon expander, Hydrogel expander, Hydroxyapatite and Chitosan. Hydroxyapatite Published online 28 August, 2020 and chitosan are hard tissue expander, while Silicon and Hydrogel are soft tissue expanders. Hydrogel expander provides a greater advantage compared to silicon expander because of its hydrophilic Key Words: property which cause gradual expansion of the expander. In medicine it is mainly used for breast periodontitis, ridge, augmentation, augmentation after mastectomy, for renewing scar formation after burns, alopecia and to correct any expander, expansion facial deformities. In periodontics soft tissue expander is used in procedures like expansion of alveolar ridge, before bone augmentation procedure and implants dentistry so that it can provide a tension free flap closure and avoid dehiscence. Thus tissue expander is boon in regenerative periodontics since it provides adequate tissue coverage, good esthetics in defect area, with minimal hospital visit and discomfort. Copyright © Lakshana S et al, 2020, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. INTRODUCTION defect area. This new technique which is used for the construction of edentulous alveolar ridges also over comes the Periodontitis is a multifactorial disease infectious disease complications of all previously used techniques.4 resulting in inflammation within the supporting tissue of the teeth with progressive attachment loss and bone loss.1To History correct this defect, bone augmentation procedure is mandatory, The first tissue expander was introduced by NEWMANN in to achieve adequate dimension of alveolar ridge. To preserve the year 1957 for an ear defect which was made up of silicon the ridge many different types of techniques have been rubber. It was a conventional expander where an external port described, such as horizontal or vertical ridge augmentation, was visible and this external port was used for manual guided bone regeneration, onlay grafting, distraction 4 osteogenesis etc. The most common complication of all the inflations The self-inflating tissue expander was then above mentioned procedures is soft tissue dehiscence and poor introduced by AUSTAD and ROSE in 1982. It was semi tension free primary closure over the grafted area.2 To permeable silicon balloon filled with sodium chloride, without overcome this difficulty and unaesthetic failure procedure, soft an external port. The alveolar ridge tissue expander was then tissue expansion procedure was introduced. introduced by LEW ET AL (1989) with hydroxyapatite which was a hard tissue expander4. The novel self-inflating Tissue expansion is defined as, “The ability of at least some osmotically active soft tissue expander was introduced by living tissue such as skin, mucous membrane to accommodate a 3 WEISE in 1993, which was made up of co- polymers of slowly enlarging mass beneath it by increase in surface area”. hydrogel, where the inflation takes by the osmotic gradient.4 As a result tissue expansion procedure aids to achieve, tension and complete free soft tissue closure and thereby it decrease Characteristics of Ideal Expander5 soft tissue dehiscence, for a successful surgical procedure. An ideal expander should be more comfortable and does not provide any damage to tissues and adjacent Soft tissue expander is mainly used for alveolar ridge 5 reconstruction, it aids in formation of new cell and its growth, area of expander placement . provide a good function and texture of skin or mucosa in the *Corresponding author: Lakshana S Department of Periodontology, K.S.R. Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India Lakshana S et al., Tissue Expander in Periodontics Sudden rapid expansion should be avoided since it “xerogel”11The hydrogel has 2 component, the polymer and leads to perforation of the tissues. aqueous component. The polymer component remains constant Henceslow and gradual expansion is advisable5. and the aqueous component varies and the expanders self- The expander should be soft and easy to insert, the inflate through osmotic process.8 size of the soft tissue expander must be comparatively 4 smaller than that of the defect area.5 Phases in Hydrogen Expander T he expander should be able to withstand the external There are 3 phase in hydrogel expander, stimuli, it should not dislocate from its position.5 PHASE 1(“Time switch”): In this phase there is usually a 5 C osteffective,easy to handle for surgeons. delay in the expansion of the expander, immediately after the Itshould be easy to adaptand easy to rem ove before and after placement. This phase last up to 2 weeks of implantation4. 5 surgicalprocedure. PHASE 2: It is the expansion phase, the expander gradually Materials used in tissue Expander starts to expand, which is carefully controlled by the polymer reaction and also helps to prevent the inhibition of unwanted Materials which are widely used as tissue expanders in swelling4. dentistry are silicon expander, Hydrogel expander, 6 Hydroxyapatite and Chitosan. Hydroxyapatite and chitosan PHASE 3: In this phase, completion of swelling is significant, are hard tissue the hydrogel turns inert &removed4. expander, while Silicon and Hydrogel are soft tissue 6 Comparison of silicone balloon expander and hydrogel expanders . 7 Expander Hydroxyapatite Silicone Balloon 9 9 Hydrogel Expander It is a hard tissue expander used for alveolar ridge Expander augmentation. Its characteristics include, It is soft and easy to Hard in consistency, not adaptable to the . Easily carved and molded7. adapt to the 9 9 . Adequate mechanical properties to support a denture7. underlying tissues underlying tissues Soft, sometimes hard to 9 7 9 Hard, easy to push into its pocket . Biocompatible and stable . place in tissue pocket . Bond firmly with bone and soft tissue7. Delayed expansion can 7 sometimes take place Immediate expansion, starts as soon as body . Soft tissue healing after implant exposure . after placement of the 9 fluids touch the hydrogel 9 . Resistance to infection7. expander 9 9 . No adverse effect on the adjacent bone7 Presence of Filling port No filling port Periodic filling moments . Hydroxyapatite is extremely biocompatible in bone and in 9 9 No periodic filling moment soft tissue, and it does not initiate any foreign body needed for expansion 7 Expansion speed can be reaction in the host . handled at the filling Expansion speed cannot be influenced by the moments by the surgeon 9 surgeon 4 9 Hydrogel Expander as its manual inflation More gradual expansion provided it is 9 Before hydrogel expander, conventional expander were used Expansion peaks 9 which was introduced by NEUMAN in 1957, the expander body Enveloped End volume can be 9 is covered with a silicone elastomer and an injection port was 9 End volume pre-defined attached to the body for serial injection, though the convention handled by the filling Leakageof the expander exhibited some positive results, it was always expander can 9 accompanied with some discomfort to the patients like increase Leakage of the expander impossible damage in frequency of hospital visit, expander perforation and cost of 4 the treatment4. Classification of Expanders The above mentioned disadvantage of conventional expander Standard Expanders4 lead to the rise of novel self-inflating expander by WEISE in The expanding volume ranges from, 50cc to 1000cc these the year 1993, which was made up of copolymer of expanders are manufactured in predetermined shapes which methylmetacrylate and n-vinyl-pyrrol this polymeric 4 4 include the shapes like , component, made the expander insoluble in aqueous solution . It is named as “hydrogel” as it has good affinity towards water 1. Cylindrical4. and gels with it and the name is not related to any chemical 4 formulation. It is made up of cross linked hydrogel co polymers 2. Rectangular . of methylmethacrylate and n-vinyl pyrroli, which makes it 3. Crescent4. hydrophilic, before implantation and the expander is referred as 39499 | P a g e International Journal of Recent Scientific Research Vol. 11, Issue, 08 (B), pp. 39498-39503, August, 2020 4. Cupola4. Cupola and cylindrical shape tissue expander are used for soft tissue expansion in
Load more

Recommended publications
  • Complicated Lower Extre.Mity Wound Closure
    CHAPTER 44 COMPLICATED LOWER EXTRE.MITY WOUND CLOSURE, Robefi M, Goecker, D.P.M Dauid M. Whiteman, M.D. The closure of soft tissue defects presents a one. This, however, may be unobtainable for challenging dilemma in reconstr"uctive surgery of clifferent reasons, making the other viscoelastic the lower extremity. Traditionally, local or distal properties of skin extremely important. flaps, or skin grafts have closed large wounds, Biologic creep is evident in situations with however, over the last few decades, substantial slowly expanding subcutaneous forces such as research and development in soft tissue expansion tllmor, obesity, and the gravid uterus or during the has lead to additional options in the reconstructive use of subcutaneous tissue expanders. This is not surgeon's armamentarium. Primary or delayed skin stretching, but rather a slow adaptation of primary closure of wounds involves the use of tissue. The epiclermis responds to expansion with several plastic surgical principles such as under- increased mitotic activity in the basal ceII layer, but mining and stretching. Presented is a review of the the thickness remains constant. Also noted on biomechanical propeties of skin, as well as curent histologic examination ate thickening of the trends in the closure of large wounds utilizing stratum spinosum and flattening of the rete pegs. tissue expanders, skin stretching devices, and a The dermis is substantially affected by expansion. recently developed technique of vaclrum- The dermis decreases in thickness, however, there assisted wound closure. Finally, the indications, are aL increased number of fibroblasts, myofibrob- contraindications, and applications of tissue lasts and bundles of collagen that are formed.
    [Show full text]
  • Placement of Breast Implant Following Breast Reconstruction by Tissue Expansion Informed Consent
    Placement of Breast Implant Following Breast Reconstruction by Tissue Expansion Informed Consent ©2012 American Society of Plastic Surgeons®. Purchasers of the Informed Consent Resource CD are given a limited license to modify documents contained herein and reproduce the modified version for use in the Purchaser's own practice only. All other rights are reserved by American Society of Plastic Surgeonsâ. Purchasers may not sell or allow any other party to use any version of the Informed Consent Resource CD, any of the documents contained herein or any modified version of such documents. Informed Consent – Placement of Breast Implant Following Breast Reconstruction by Tissue Expansion INSTRUCTIONS This is an informed-consent document that has been prepared to help inform you about placement of a breast implant following tissue expansion breast reconstruction, its risks, as well as alternative treatment(s). It is important that you read this information carefully and completely. Please initial each page, indicating that you have read the page and sign the consent for surgery as proposed by your plastic surgeon and agreed upon by you. GENERAL INFORMATION The use of tissue expanders for breast reconstruction involves a two-stage process. A tissue expander is inserted either at the time of the mastectomy (immediate breast reconstruction) or at a later time (delayed reconstruction). The tissue expander is filled over time to increase the size of the breast mound. Once this is accomplished, a second operation is performed to place a breast implant. Additional procedures such as a capsulotomy or capsulectomy may be performed at the time of the insertion of the implant in order to make changes in the space where the breast implant will be located.
    [Show full text]
  • MICHAEL J. BROWN, M.D., P.L.L.C. Aesthetic Cosmetic Plastic Surgery
    Informed Consent – Breast Reconstruction with Tissue Expander MICHAEL J. BROWN, M.D., P.L.L.C. Aesthetic Cosmetic Plastic Surgery Informed Consent – Breast Reconstruction with Tissue Expander INSTRUCTIONS This is an informed-consent document that has been prepared to help inform you about breast reconstruction with a tissue expander, its risks, as well as alternative treatment(s). It is important that you read this information carefully and completely. Please initial each page, indicating that you have read the page and sign the consent for surgery as proposed by Dr. Brown and agreed upon by you. GENERAL INFORMATION There are a variety of surgical techniques for breast reconstruction. Breast cancer patients who are medically appropriate for breast reconstruction may consider tissue expander breast reconstruction, either immediately following mastectomy or at a later time. The best candidates, however, are women whose breast cancer, as far as can be determined, seems to be eliminated by mastectomy and other treatments. Breast reconstruction has no known effect on altering the natural history of breast cancer or interfering with other forms of breast cancer treatment such as chemotherapy or radiation. Breast reconstruction with tissue expansion is a two-stage process. It first involves the use of a silicone rubber balloon-like tissue expander that is inserted beneath the skin and often also beneath chest muscles. Saline or air is gradually injected into the tissue expander to fill it over a period of weeks or months. This process allows the skin on the chest to be stretched over the expander, creating a breast mound. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent breast implant.
    [Show full text]
  • Tissue Expander Breast Reconstruction
    EDWARD EADES, M.D. Board Certified – American Board of Plastic Surgery Member – American Society of Plastic Surgeons ________________________________________________________________ INFORMED CONSENT – TISSUE EXPANDER BREAST RECONSTRUCTION INSTRUCTIONS This informed-consent document has been prepared to help inform you of breast reconstruction with a tissue expander, its risks, and alternative treatment. It is important that you read this information carefully and completely. Please initial each page, indicating that you have read the page, and sign the consent for surgery as proposed by Dr. Eades and agreed upon by you. GENERAL INFORMATION There are a variety of surgical techniques for breast reconstruction. Breast cancer patients who are medically appropriate for breast reconstruction may consider tissue expander breast reconstruction, either immediately following mastectomy or at a later time. The best candidates, however, are women whose breast cancer, as far as can be determined, seems to be eliminated by mastectomy and other treatments. Breast reconstruction has no known effect on altering the natural history of breast cancer or interfering with other forms of breast cancer treatment such as chemotherapy or radiation. Breast reconstruction with tissue expansion is a two-stage process. It first involves the use of a silicone rubber balloon-like tissue expander that is inserted beneath the skin and chest muscle. Saline gradually is injected into the tissue expander to fill it over a period of weeks or months. This process allows the skin on the chest to be stretched over the expander, creating a breast mound. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent breast implant.
    [Show full text]
  • Distraction Osteogenesis: Evolution and Contemporary Applications in Orthodontics
    IBIMA Publishing Journal of Research and Practice in Dentistry http://www.ibimapublishing.com/journals/DENT/dent.html Vol. 2014 (2014), Article ID 798969, 20 pages DOI: 10.5171/2014.798969 Research Article Distraction Osteogenesis: Evolution and Contemporary Applications in Orthodontics George Jose Cherackal and Navin Oommen Thomas Department of Orthodontics, Pushpagiri College of Dental Sciences, Medicity, Tiruvalla, Kerala, India Correspondence should be addressed to: George Jose Cherackal; [email protected] Received Date: 30 June 2013; Accepted Date: 31 July 2013; Published Date: 31 January 2014 Academic Editor: Doǧan Dolanmaz Copyright © 2014 George Jose Cherackal and Navin Oommen Thomas. Distributed under Creative Commons CC-BY 3.0 Abstract Orthodontic tooth movement is brought about by the biomechanical utilization of the physiological mechanisms for bone remodeling in order to achieve optimal occlusion and thereby maximize the esthetic outcome. Distraction osteogenesis is a biomechanical process of bone tissue formation, where the distraction forces which act between the bone segments effect the biological potential of the bone. Though initially used in long bones, through the past years the technique has undergone significant advancements and innovations, that it has had increasing applications in the facial skeleton. The gradual evolution of compact internal appliances has lately led to the use of this concept in the field of orthodontics for moving tooth segments rapidly for an accelerated treatment outcome, and for novel modalities in the treatment of ankylosed teeth. This article is presented under the light of current literature to review the history, evolution and role of distraction in contemporary orthodontics. Keywords: Distraction Osteogenesis; Dentoalveolar Distraction; Canine Retraction; Ankylosed Tooth.
    [Show full text]
  • Tissue Expansion Reconstruction of Head and Neck Burn Injuries in Paediatric Patients —A Systematic Review
    JPRAS Open 18 (2018) 78–97 Contents lists available at ScienceDirect JPRAS Open journal homepage: www.elsevier.com/locate/jpra Tissue expansion reconstruction of head and neck burn injuries in paediatric patients —A systematic review ∗ Martha F I De La Cruz Monroy a,c, Deepak M. Kalaskar a, , Khawaja Gulraiz Rauf b,c a Division of Surgery and Interventional Sciences, University College London, United Kingdom b Department of Plastic Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan c Department of Plastic Surgery, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, England, United Kingdom a r t i c l e i n f o a b s t r a c t Article history: Tissue expansion reconstruction in clinical practice has existed for Received 7 December 2017 over half a century. The technique was initially used for breast re- Revised 10 October 2018 construction but later found its use in reconstruction of excisional Accepted 11 October 2018 defects resulting from a variety of causes including surgery for Available online 26 October 2018 post-burn/post-traumatic deformities, congenital giant naevi, skin cancer, etc. It offers an improved matching of skin colour and tex- Key words: Tissue expansion ture, and avoids the high infrastructure requirements of micro- Head and neck surgery for free flap transfers. We present a systematic literature Burn injury review of 35 worldwide English language articles with represen- Children tative cases of paediatric tissue expansion reconstruction of burn Paediatrics injuries of the head and neck. The review identified 68 children Reconstruction of an average age of 11.3 years.
    [Show full text]
  • On Skin Expansion
    journal of the mechanical behavior of biomedical materials 29 (2014) 655–662 Available online at www.sciencedirect.com www.elsevier.com/locate/jmbbm Research Paper On skin expansion Djenane C. Pamplonaa,n, Raquel Q. Vellosoa, Henrique N. Radwanskib aLaboratory of Membranes and Biomembranes, PUC-Rio, Rio de Janeiro, Brazil bIvo Pitanguy Institute of Plastic Surgery, Rio de Janeiro, Brazil article info abstract Article history: This article discusses skin expansion without considering cellular growth of the skin. An Received 22 January 2013 in vivo analysis was carried out that involved expansion at three different sites on one Received in revised form patient, allowing for the observation of the relaxation process. Those measurements were 18 March 2013 used to characterize the human skin of the thorax during the surgical process of skin Accepted 26 March 2013 expansion. A comparison between the in vivo results and the numerical finite elements Available online 19 April 2013 model of the expansion was used to identify the material elastic parameters of the skin of fi Keywords: the thorax of that patient. Del no's constitutive equation was chosen to model the in vivo Characterization of human skin results. The skin is considered to be an isotropic, homogeneous, hyperelastic, and Finite elements incompressible membrane. When the skin is extended, such as with expanders, the fi Skin expansion collagen bers are also extended and cause stiffening in the skin, which results in Biomembranes increasing resistance to expansion or further stretching. We observed this phenomenon Skin expanders as an increase in the parameters as subsequent expansions continued. The number and Elastic foundation shape of the skin expanders used in expansions were also studied, both mathematically Constitutive equation and experimentally.
    [Show full text]
  • Tissue Expanders in Post-Burn Alopecia: with Or Without Galeotomies? Expansion Cutanee Dans Les Alopecies Post Brûlures: Avec Ou Sans Galeotomie?
    Annals of Burns and Fire Disasters - vol. XXVIII - n. 3 - September 2015 TISSUE EXPANDERS IN POST-BURN ALOPECIA: WITH OR WITHOUT GALEOTOMIES? EXPANSION CUTANEE DANS LES ALOPECIES POST BRÛLURES: AVEC OU SANS GALEOTOMIE? el Sakka D.m. Assistant Professor of Plastic and Reconstructive Surgery, Faculty of medicine, menofia University, egypt SUMMARY. The tissue expansion technique is part of the reconstructive surgeon’s armamentarium. It provides donor skin that is an optimal match in terms of skin colour, texture, sensation and hair-bearing characteristics. Tissue expansion of the scalp is one of the methods used for the management of alopecia. This method allows the expansion of normal hair-bearing scalp to cover the area of alopecia. Unfortunately, the tough galeal layer prevents easy and fast expansion of the scalp and increases the rate of ex - pander extrusion. A prospective and retrospective comparative analysis of the use of subgaleal expanders with or without gale - otomies to manage post-burn alopecia was conducted in the Burn Unit of the Menofia University Hospital, in the period from Sep - tember 2010 to November 2014. Thirty expanders in 30 patients with alopecia were included in the study. These constitute the ex - perience of a single surgeon. Twenty expanders were applied to the subgaleal plane without galeotomies and 10 were applied with galeotomies. Indications for scalp expansion were mainly post-burn alopecia and scarring. Complications and failures were record - ed. Adding galeotomies to subgaleal tissue expander placement for scalp alopecia decreases the time of expansion, allows a larg - er amount of fluid to be injected each time without inducing pain, and decreases the rate of expander extrusion.
    [Show full text]
  • PDF Hosted at the Radboud Repository of the Radboud University Nijmegen
    PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/146302 Please be advised that this information was generated on 2021-10-10 and may be subject to change. SUBPERIOSTEAL PALATAL SOFT TISgUE^EXEANSIOPL ^PY"-**" 33 ίΐί^Γί RI gjffi1'Д: : Jg? '.r Г-І: ж 1996 SUBPERIOSTEAL PALATAL SOFT TISSUE EXPANSION An experimental study in growing domestic cats SUBPERIOSTALE PALATINALE WEEFSELEXPANSIE Een experimenteel onderzoek bij groeiende katten CIP-DATA KONINKLIJKE BIBLIOTHEEK, DEN HAAG Van Damme, Philippus Anne Subperiosteal palatal soft tissue expansion - An experimental study in growing domestic cats / Phihppus Anne Van Damme -[SI s η ] -111 Thesis Nijmegen - With ref -With summary in Dutch ISBN: 90-9009954-9 Subject headings tissue expansion / cleft palate / experimental study / reconstructive surgery / growth & development С Ph A Van Damme, Nijmegen, 1996 No part of this book may be reproduced in any form, by print, photoprint or any other means without written permission from the publisher Niets uit deze uitgave mag worden verveelvoudigd en/of openbaar gemaakt door middel van druk, fotokopie, microfilm of welke andere wijze dan ook, zonder voorafgaande toestemming van de uitgever SUBPERIOSTEAL PALATAL SOFT TISSUE EXPANSION An experimental study in growing domestic cats Een wetenschappelijke proeve op het gebied van de Medische Wetenschappen. PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Katholieke Universiteit Nijmegen, volgens besluit van het College van Decanen in het openbaar te verdedigen op vrijdag 6 december 1996 des namiddags om 1.30 uur precies door Philippus Anne van Damme geboren op 4 juni 1953 te Yerseke 1996 Druk: Drukkerij Elinkwijk b.v., Utrecht Promotores Prof.dr.
    [Show full text]
  • Tissue Expansion for Breast Reconstruction Preparation Instructions
    Tissue Expansion for Breast Reconstruction Preparation Instructions What are my instructions? Shower with Bactoshield the night before and morning of each tissue expansion. What should my activity level be? Do not perform household chores or heavy lifting greater than 5 to 10 pounds for 6 weeks after placement of tissue expanders. Do not soak in hot tubs or swim in lakes while the tissue expander is in place. Be Aware: You cannot have an MRI if you have tissue expanders in place. The tissue expanders may be detected via the security scanners at the airport. You will need a note from your Doctor if you plan to travel indicating you have tissue expanders in place with medal. How should I expect to feel? You may experience minor discomfort for 12 to 24 hours after each tissue expansion. This discomfort usually subsides 2 to 3 days after each tissue expansion. The tissue expander may shift after the first or second expansion. You may experience more discomfort on one side than the other if you have bilateral tissue expanders placed. Your posture may change causing you to have some upper and/or mid back pain as you’re expanded. UMHS Plastic Surgery (734) 998-6022 - 1 - Your shoulder range of motion may become stiff; continue to perform the shoulder exercises during the tissue expansion process to prevent shoulder stiffness and a frozen shoulder. You may find it difficult to sleep because you feel tight across the chest and shoulders. You may find it difficult to fit into certain types of tight fitting clothing.
    [Show full text]
  • Reconstruction of Head and Neck Mucormycosis: a Literature Review and Own Experience in Immediate Reconstruction
    Published online: 2019-11-25 THIEME Original Article e65 Reconstruction of Head and Neck Mucormycosis: A Literature Review and Own Experience in Immediate Reconstruction Julio Juarez Palacios, MD1 Erik Viana Hanson, MD2 Marco Aurelio Medina Rendon, MD3 Raúl-Saldaña López Infante, MD4 1 Department of Plastic and Reconstructive Surgery, Hospital Regional Address for correspondence Erik Hanson-Viana, MD, Hospital General de Alta Especialidad de Ixtapaluca, Estado de México, Mexico de México “Dr. Eduardo Liceaga” Doctor Balmis No. 148, Colonia 2 Department of Surgery, Hospital General de Mexico “Dr. Eduardo Doctores, Delegación Cuauhtémoc, C.P. 06726, Ciudad de México, Liceaga,” Ciudad de México, Mexico México (e-mail: [email protected]). 3 Department of Surgery, Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de México, Mexico 4 Department of Plastic and Reconstructive Surgery, Hospital Ángeles Lomas, Ciudad de México, Mexico J Reconstr Microsurg Open 2019;4:e65–e72. Abstract Background Mucormycosis is a rare invasive and fatal fungal infection. A prompt diagnosis is the most critical aspect for an improved patient outcome. Along with antifungal therapy, radical surgical debridement must be done expeditiously to eradicate this fungus. In this article, we evaluated the feasibility of immediate reconstruction after surgical debridement. Methods A retrospective study was performed at Hospital Regional de Alta Especia- lidad de Ixtapaluca, Estado de México, Mexico, between June 2017 and June 2018. Five patients, three males and two females, with a mean age of 39 years were presented in addition to a literature review based on MEDLINE, Google Scholar, PubMed Central, and Embase platforms until June 2018. Results From our presented series, all five flaps survived and showed no evidence of mucormycosis recurrence or flap loss.
    [Show full text]
  • Breast Reconstruction Post Mastectomy and Poland Syndrome – Commercial Coverage Determination Guideline
    UnitedHealthcare® Commercial Coverage Determination Guideline Breast Reconstruction Post Mastectomy and Poland Syndrome Guideline Number: CDG.003.17 Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policies Coverage Rationale ........................................................................... 1 • Breast Reduction Surgery Documentation Requirements......................................................... 3 • Breast Repair/Reconstruction Not Following Definitions ........................................................................................... 4 Mastectomy Applicable Codes .............................................................................. 5 • Cosmetic and Reconstructive Procedures References ......................................................................................... 9 • Durable Medical Equipment, Orthotics, Medical Guideline History/Revision Information ......................................... 9 Supplies and Repairs/ Replacements Instructions for Use .........................................................................10 • Gender Dysphoria Treatment • Pneumatic Compression Devices • Prosthetic Devices, Wigs, Specialized, Microprocessor or Myoelectric Limbs • Skin and Soft Tissue Substitutes Community Plan Policy • Breast Reconstruction Post Mastectomy and Poland Syndrome Coverage Rationale Indications for Coverage The following are eligible for coverage as reconstructive and medically necessary: In accordance with Women’s Health and Cancer Rights
    [Show full text]