Angular Effects of Z-Plasty Technique on Extent of Relaxation of Contracted Scar, Cosmetic Appearance and Tip Necrosis in Dogs
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Optimizing Breast Reconstruction After Mastectomy University of Antwerp Faculty of Medicine and Health Sciences
Optimizing breast reconstruction after mastectomy mastectomy after reconstruction Optimizing breast Filip Thiessen University of Antwerp Faculty of Medicine and Health Sciences Optimizing breast reconstruction after mastectomy The use of dynamic infrared thermography Filip THIESSEN 2020 Antwerp, 2020 Thesis submitted in fulfilment of Promoters: Prof. dr. Wiebren Tjalma the requirements for the degree of Prof. dr. Gunther Steenackers Doctor in Medical Sciences at the Prof. dr. Guy Hubens University of Antwerp Co-promoter: Prof. dr. Veronique Verhoeven University of Antwerp Faculty of Medicine and Health Sciences Optimizing breast reconstruction after mastectomy: The use of dynamic infrared thermography Optimaliseren van borstreconstructies na mastectomie: Het gebruik van dynamic infrared thermography Thesis submitted in fulfilment of the requirements for the degree of Doctor in Medical Sciences at the University of Antwerp to be defended by Filip THIESSEN Proefschrift voorgelegd tot het behalen van de graad van doctor in de Medische Wetenschappen aan de Universiteit Antwerpen te verdedigen door Antwerpen, 2020 Promotoren: Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens Begeleider: Prof. dr. Veronique Verhoeven Promotoren Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens Begeleider Prof. dr. Veronique Verhoeven Members of the jury Internal Prof. dr. Jeroen Hendriks Prof. dr. Manon Huizing Prof. dr. Wiebren Tjalma Prof. dr. Gunther Steenackers Prof. dr. Guy Hubens External Prof. dr. Emiel Rutgers Prof. dr. Assaf Zeltzer © Filip Thiessen Optimizing breast reconstruction after mastectomy: The use of dynamic infrared thermography / Filip Thiessen Faculteit Geneeskunde, Universiteit Antwerpen, Antwerpen 2020 Thesis Universiteit Antwerpen – with summary in Dutch Lay-out and cover : Dirk De Weerdt (www.ddwdesign.be) Cover figure: Cold challenge to bilateral DIEP in skin sparing mastectomy (top), rapid and overall rewarming of the skin islands of the DIEP flap (bottom). -
Thin Anterolateral Thigh Perforator Flaps: Minimizing the Partial Necrosis Rate
Extremity/Lymphedema Original Article The perforator-centralizing technique for super- thin anterolateral thigh perforator flaps: Minimizing the partial necrosis rate Young Chul Suh, Na Rim Kim, Dai Won Jun, Jung Ho Lee, Young Jin Kim Department of Plastic and Reconstructive Surgery, Bucheon St. Mary Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea Background Despite the wide demand for thin flaps for various types of extremity recon- Correspondence: Young Chul Suh struction, the thin elevation technique for anterolateral thigh (ALT) flaps is not very popular Department of Plastic and Reconstructive Surgery, Bucheon St. because of its technical difficulty and safety concerns. This study proposes a novel perforator- Mary Hospital, College of Medicine, centralizing technique for super-thin ALT flaps and analyzes its effects in comparison with a The Catholic University of Korea, 327 skewed-perforator group. Sosa-ro, Wonmi-gu, Bucheon 14647, Methods From June 2018 to January 2020, 41 patients who required coverage of various Korea Tel: +82-32-340-2095 types of defects with a single perforator-based super-thin ALT free flap were enrolled. The in- Fax: +82-32-340-7227 cidence of partial necrosis and proportion of the necrotic area were analyzed on postopera- E-mail: [email protected] tive day 20 according to the location of superficial penetrating perforators along the flap. The centralized-perforator group was defined as having a perforator anchored to the middle third of the x- and y-axes of the flap, while the skewed-perforator group was defined as having a perforator anchored outside of the middle third of the x- and y-axes of the flap. -
Burn Contracture Surgery
Burn Contracture Surgery Stuart Watson Canniesburn Unit Glasgow Royal Infirmary Glasgow United Kingdom [email protected] 1 Table of Contents Prevention of Contractures ................................................................................................. 4 Contracture Definitions ....................................................................................................... 4 Timing of Contracture Surgery: Indications ....................................................................... 5 Urgent ............................................................................................................................. 5 Early ................................................................................................................................ 5 Late ................................................................................................................................. 5 General Principles and Technical Tips ............................................................................... 6 Approach to Contracture Surgery ....................................................................................... 8 Split Skin Grafts .................................................................................................................. 8 Full Thickness Grafts .......................................................................................................... 9 Dermal Substitutes ............................................................................................................. -
The Use of the Thoracodorsal Artery Perforator Flap in Both Autologous and Implant Based Breast Reconstruction Salvage Surgery
Research Article Clinics in Surgery Published: 28 Nov, 2020 The Use of the Thoracodorsal Artery Perforator Flap in Both Autologous and Implant Based Breast Reconstruction Salvage Surgery Nizamoglu M1*, Hardwick S1, Coulson S1 and Malata CM1,2,3 1Department of Plastic and Reconstructive Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK 2Cambridge Breast Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK 3Anglia Ruskin University School of Medicine, UK Abstract Introduction: Since its introduction by Angrigiani the Thoracodorsal Artery Perforator (TDAP) flap has become a popular choice in partial breast reconstruction for volume replacement. Although mainly used to provide volume, it has also been reported as an adjunct to implant-based breast reconstruction. Methods: Patients undergoing salvage breast reconstruction surgery with the TDAP flap in the last 20 years were identified from the senior author’s logbook and their clinical data collected from EpicTM, the hospital electronic medical records system. Results: Two such patients, aged 44 and 52 years, were identified. The first had “impending failure” of a subpectoral implant reconstruction following severe cutaneous radiation reaction and poor quality soft tissues overlying the implant, coupled with recurrent seromas. The second had partial SIEA abdominal free flap fat necrosis, leading to volume loss, severe cutaneous scarring and significant deformity. The flap dimensions were 10 ×cm 25 cm and 8 cm × 25 cm, respectively. They OPEN ACCESS were each based on a single vascular perforator– one arising from the horizontal and the other from the vertical branch of the thoracodorsal vessels. Both flap transfers were successful and resulted in *Correspondence: viable reconstructions despite the challenging indications. -
Liposuction Contouring After Head and Neck Free Flap Reconstruction
plastol na og A y Ibrahim AE, et al., Anaplastology 2015, 4:2 Anaplastology DOI: 10.4172/2161-1173.1000145 ISSN: 2161-1173 Review Article Open Access Liposuction Contouring After Head and Neck Free Flap Reconstruction Amir E Ibrahim*, Hamed Janom, Mohamad Raad Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon *Corresponding author: Amir E Ibrahim, Faculty Member, Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, Lebanon, Tel: +9613720594; E-mail: [email protected] Received date: May 28, 2014, Accepted date: April 22, 2015, Published date: April 27, 2015 Copyright: © 2015 Ibrahim AE et al. 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 author and source are credited. Abstract Resection of bulky head and neck tumors is typically followed by microvascular free flap reconstruction. The latter has shown an acceptable success rate but often requires a secondary revision with a free tissue transfer reconstruction to improve outcome; both cosmetic and functional. Direct surgical revision via electrocautery/scalpel poses a high risk of flap perfusion compromise. Suction assisted lipectomy on the other hand is a feasible and safe technique that offers favorable contouring with comparable restoration cosmetic and functional outcomes. In this article, we review the indications and advantages of this technique and provide an outlook on its safety and pitfalls. Keywords: Liposuction; Free Flap; Reconstruction theoretically minimal since fibrous structures containing blood vessels remains unharmed as the fat is removed with liposuction [8]. -
49Th Annual Medical Student Research Conference
Program of Events 49th Annual Medical Student Research Conference September 13-15, 2017 University of Iowa Roy J. & Lucille A. Carver College of Medicine Free to University of Iowa Students Medical Student Research Conference Welcome to the 49th Annual Carver College of Medicine Student Medical Research Conference. This Conference provides an opportunity for medical students who have conducted research to present their results, receive feedback, and compete for awards. September 13, 2017 8:00 – 10:00 AM Oral Presentations (concurrent sessions) 1117, 2117, 2123, 2135, 2155, 2165, 2189 MERF 12:00 – 12:50 PM Poster Session #1 Medical Student Poster Presentations in MERF Atrium September 14, 2017 12:00 – 12:50 PM Poster Session #2 Medical Student Poster Presentations in MERF Atrium September 15, 2017 Awards Banquet 5:30 – 6:00 PM Social Time Second Floor Ballroom, IMU 6:00 – 8:00 PM Buffet Dinner, Keynote, and Awards Second Floor Ballroom, IMU Keynote Speaker Lucy Wibbenmeyer, MD Clinical Professor of Surgery- Acute Care Surgery For student presenters, research mentors, & invited guests AWARDS BANQUET Friday, September 15, 2017 There are several Research Day awards, including three Foundation Awards, given to outstanding oral and outstanding poster presentations, and departmental and college sponsored general awards given to the top oral and poster presentations in eligible categories. FOUNDATION AWARDS THE BORTS AWARD The Borts Award was established by the Alpha Psi Chapter of Alpha Kappa Kappa Medical Fraternity in 1974 to honor Dr. I. H. Borts, a graduate of the University of Iowa College of Medicine and long-time supporter of the AKK. He is a distinguished scientist who has long been associated with the State Hygienic Laboratory. -
Axillary Hidradenitis Suppurativa
C.J. Chuang, C.H. Lee, T.M. Chen, et al BRIEF COMMUNICATIONS USE OF A VERSATILE TRANSPOSITIONAL FLAP IN THE SURGICAL TREATMENT OF AXILLARY HIDRADENITIS SUPPURATIVA Chia Jueng Chuang, Chiu Heng Lee, Tim Mo Chen, Hsian Jenn Wang, and Shyi Gen Chen Abstract: Axillary hidradenitis suppurativa is a chronic recurrent disorder characterized by abscessing inflammation, fistulating sinus tracts, and scarring. This is not only a medical disease, but also a complicated problem necessitating surgical intervention. While various management strategies have been reported, the results are frequently unsatis- factory. Primary closure of the defect after radical excision is often impossible and results in poor wound healing. Skin graft on the soft tissue defect often results in obvious scar contracture and limitation of movement. Local muscle flap can fill in the defect but the range of adduction of the arm will be limited by its muscle bulk. Free flap transfer is a choice of management but this technique calls for a trained team, laborious execution, expensive instruments and plenty of time. We describe the use of transpositional fasciocutaneous flap, which can provide a reliable flap of variable size of skin and soft tissue coverage with good elastic properties. The technique is easily adapted to the reconstruction of resultant defects. This technique was used to transfer 8 transpositional fasciocutaneous flaps in 7 patients for the closure of axillary defects resulting from radical excision of chronic hidradenitis suppurativa. No flap complication or disease recurrence was observed during 2 years of follow-up. The technique had satisfactory esthetic and functional results as well as low donor site morbidity. -
Current Progress in Understanding the Molecular Pathogenesis of Burn Scar Contracture Jianglin Tan1 and Jun Wu2*
Tan and Wu Burns & Trauma (2017) 5:14 DOI 10.1186/s41038-017-0080-1 REVIEW Open Access Current progress in understanding the molecular pathogenesis of burn scar contracture Jianglin Tan1 and Jun Wu2* Abstract Abnormal wound healing is likely to induce scar formation, leading to dysfunction, deformity, and psychological trauma in burn patients. Despite the advancement of medical care treatment, scar contracture in burn patients remains a challenge. Myofibroblasts play a key role in scar contracture. It has been demonstrated that myofibroblasts, as well as inflammatory cells, fibroblasts, endothelial cells, and epithelial cells, secrete transforming growth factor-β1(TGF-β1) and other cytokines, which can promote persistent myofibroblast activation via a positive regulation loop. In addition to the cellular contribution, the microenvironments, including the mechanical tension and integrin family, are also involved in scar contracture. Most recently, eukaryotic initiation factor 6 (eIF6), an upstream regulator of TGF-β1, has been demonstrated to be involved in myofibroblast differentiation and contraction in both in vitro fibroblast-populated collagen lattice (FPCL) and in vivo external mechanical stretch models. Moreover, the data showed that P311 could induce the transdifferentiation of epidermal stem cells to myofibroblasts by upregulating TGF-β1 expression, which mediated myofibroblast contraction. In this review, we briefly described the most current progress on the biological function of myofibroblasts in scar contracture and subsequently summarized the molecular events that initiated contracture. This would help us better understand the molecular basis of scar contracture as well as to find a comprehensive strategy for preventing/managing scar contracture. Keywords: Scar, Contracture, Burn, Molecular pathogenesis Background which meant 33% of patients had dysfunction in their It is commonly accepted that scars are a pathologic joints after burn injuries [5]. -
Review Paper: Burn Coverage Technologies: Current Concepts and Future Directions Clifford Pereira, Warren Gold, David Herndon
Review Paper: Burn Coverage Technologies: Current Concepts and Future Directions Clifford Pereira, Warren Gold, David Herndon To cite this version: Clifford Pereira, Warren Gold, David Herndon. Review Paper: Burn Coverage Technologies: Current Concepts and Future Directions. Journal of Biomaterials Applications, SAGE Publications, 2007, 22 (2), pp.101-121. 10.1177/0885328207081690. hal-00570785 HAL Id: hal-00570785 https://hal.archives-ouvertes.fr/hal-00570785 Submitted on 1 Mar 2011 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Review Paper: Burn Coverage Technologies: Current Concepts and Future Directions 1, 2 2 CLIFFORD PEREIRA, *WARREN GOLD AND DAVID HERNDON 1Department of Surgery, Harbor UCLA Medical Center 1000 W Carson Street, Torrance, Los Angeles, California, USA 90502 2Department of Surgery, Shriners Hospital for Children 815 Market Street, Galveston, Texas, USA 77550 INTRODUCTION kin serves as a protective barrier against the environment. Loss of S integrity of the skin through burn injuries can lead to major disability and even death [1]. The accomplishments of the past decade have placed us in the midst of an exciting paradigm shift from what used to be of primary concern (i.e., mortality) to areas that focus on improving the quality of life of burn survivors. -
GARY DANIEL MOTYKIE, MD 9201 Sunset Blvd
GARY DANIEL MOTYKIE, MD 9201 Sunset Blvd. Ground Floor Los Angeles, CA 90069 Phone: (310) 246-2355 E-mail: [email protected] CURRENT: PRIVATE PRACTICE [January 2005 – present] • 9201 W. Sunset Blvd, Ground Floor, Los Angeles, CA CURRENT BOARD CERTIFICATION AND LICENSURE • Board Certified in Plastic Surgery (American Board of Plastic Surgery): 2009, 2012 • Licensed by the California Board of Medicine • Licensed by the Illinois Board of Medicine • Licensed by the Nevada Board of Medicine PROFESSIONAL AWARDS and RECOGNITION • America’s Top Plastic Surgeons, Consumer Research Council of America: 2006, 2007, 2008, 2009, 2010, 2011 and 2012 • Patient’s Choice Award, American Registry: 2009 • American Medical Association, Physician’s Recognition Award, 2009, 2005 • Marquis Who’s Who in Science and Engineering, 2011-12 • Celebrate Life Foundation, Physician Recognition Award, Received for Helping Breast Cancer Survivors Live Life Beyond Cancer, June 2007 • Cambridge, Who’s Who Among Executives and Professionals in Healthcare, “Honors Edition” of the Registry, 2007, 2008, 2009, 2010, 2011 and 2012 • “The Leading Physicians of the World” The international Association of Plastic Surgeons. Doctors of Excellence, 2012 Page 1 of 16 EDUCATION Fellowship in Advanced Cosmetic Surgery [July 2004 – December 2004] • Beverly Hills Body by Dr. Richard Ellenbogen, West Hollywood, CA Plastic Surgery Residency [1999-2004] • University of Texas Medical Branch, Galveston, TX • Externships: o Aesthetic Surgery, 2003, James M. Stuzin, Thomas & Tracy Baker, Miami, -
Treatment of Ischemia-Reperfusion Injury of the Skin Flap Using Human
LAB/IN VITRO RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2017; 23: 2751-2764 DOI: 10.12659/MSM.905216 Received: 2017.05.08 Accepted: 2017.05.19 Treatment of Ischemia-Reperfusion Injury Published: 2017.06.06 of the Skin Flap Using Human Umbilical Cord Mesenchymal Stem Cells (hUC-MSCs) Transfected with “F-5” Gene Authors’ Contribution: G 1 Xiangfeng Leng* 1 Department of Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, Study Design A ADE 1 Yongle Fan* Shandong, P.R. China Data Collection B 2 Department of Nephrology, Qingdao Municipal Hospital, Qingdao, Shandong, Statistical Analysis C E 1 Yating Wang P.R. China Data Interpretation D B 2 Jian Sun 3 Tianjin University, Tianjin, P.R. China Manuscript Preparation E D 1 Xia Cai 4 The Eighth People’s Hospital of Qingdao, Qingdao, Shandong, P.R. China Literature Search F Funds Collection G F 1 Chunnan Hu C 3 Xiaoying Ding B 4 Xiaoying Hu AG 1 Zhenyu Chen * These authors contributed equally to this work Corresponding Author: Zhenyu Chen, e-mail: [email protected] Source of support: Natural Science Foundation of Shandong Province, China (ZR2014HM113) Background: Recent studies have shown that skin flap transplantation technique plays an important role in surgical pro- cedures. However, there are many problems in the process of skin flap transplantation surgeries, especially ischemia-reperfusion injury, which directly affects the survival rate of the skin flap and patient prognosis after surgeries. Material/Methods: In this study, we used a new method of the “stem cells-gene” combination therapy. The “F-5” gene fragment of heat shock protein 90-a (Hsp90-a) was transfected into human umbilical cord mesenchymal stem cells (hUC- MSCs) by genetic engineering technique. -
Abdominal Pedicle Flaps to the Hand & Forearm
Abdominal Pedicle Flaps To The Hand And Forearm John C. Kelleher M.D., F.A.C.S. Global-HELP Publications Chapter Two: HISTORICAL REVIEW OF FLAP RECONSTRUCTION OF THE HAND From 1890 to 1945 During this period of time, eleven case reports were found in the English written literature describing abdominal pedicle flaps for reconstruction of the hand. I found that throughout the history of pedicle flap coverage of the hand the problems that existed with early reconstructions are still some of the problems that plague us today. 1898: Biggs, M.D., of Boston, described a flap to a contracted palmar burn scar of the left hand. The case was presented before the Boston Society for Medical Improvement on May 7, 1900. It was then reported in the Boston Medical and Surgical Journal of October 25, 1900. The article describes a release of palmar scar and coverage with an abdominal flap that was based just below the sternum. It is interesting to note that the surgeon used a paper pattern to define what limits of the flap, a technique that is still used today. 1900: W. E. Schroeder, M.D. described two cases performed by Christian Fenger, M.D., as well as cases of his own. Dr. Schroeder was Associate Professor of Surgery at Northwestern University Medical School. These cases were reported in the American Journal of Medical Sciences, 120:435, 1900. One of the cases described was that of Dr. Fenger’s, which was performed around 1890. In this report, Dr. Schroeder noted a number of principles and precautions: 1.