Search PubMed⌕ Search

Biomedical subjects

Petra Pülzl

Publications and source records attributed to Petra Pülzl.

16 recordsLinked to original sources
PubMed2006

Nipple reconstruction using a modified arrow flap technique.

Nipple reconstruction is the perfection of breast reconstruction. Although many reconstruction techniques are available, all come with the risk of projection loss. Most of the commonly used local flap techniques give reliable immediate results, but are associated with a loss in projection of 50 to almost 70% over the first three postoperative years. We herein present a modification of the nipple reconstruction technique as presented by Thomas et al. in 1996. By forming a deepithelialized area when closing the skin donor site, a firm foundation plate for the new nipple is created. The authors observed that this solid foundation plate, as well as the separation of the nipple cavity of the subcutaneous fat, results in less nipple projection loss.

Adult↗
PubMed2006

Nerve injury caused by removal of an implantable hormonal contraceptive.

Implanon insertion and removal are relatively uncomplicated procedures in the hands of medical professionals familiar with the technique. However, injury to branches of the medial antebrachial cutaneous nerve during Implanon insertion and removal can result in impaired sensibility, severe localized pain, or the formation of painful neuroma that can be quite devastating to the patient. The best way to avoid injury to the medial antebrachial cutaneous nerve is to better understand its position relative to the standard area of Implanon insertion. In the event that an injury to the nerve is recognized, immediate plastic surgical measures should be undertaken to avoid displeasing sequels of nerve injuries. Therefore, the benefit of this generally well-tolerated, highly effective, and relatively cost-efficient contraception is guaranteed only in the hands of medical professionals familiar with the technique.

Adult↗
PubMed2006

Reduction mammaplasty and axillary-subclavian venous thrombosis.

We present a woman with distinct mammahypertrophy and simultaneous catheter-associated axillary-subclavian venous thrombosis characterized only by chronically dilated collateral vein over the chest. Despite this massively dilated subcutaneous vein covering the chest on the affected side, bilateral reduction mammaplasty of modified Pitanguy method was successfully performed among protection of this collateral vein.

Axillary Vein↗
PubMed2006

Respecting the aesthetic unit in autologous breast reconstruction improves the outcome.

BACKGROUND: In postmastectomy breast reconstruction, a patchwork-like appearance and a double-bubble phenomenon may result from scar contracture and the possible destruction of the normal inframammary fold during mastectomy. Restoring an age-related breast ptosis can be difficult, and often contralateral breast surgery has to be performed to achieve symmetry. The purpose of this article is to present a technique that respects the aesthetic unit in autologous reconstruction, improves the outcome, and minimizes secondary surgery. METHODS: The area between the resected mastectomy scar and the marked inframammary fold is deepithelialized. The inferior skin margin of the flap is sutured to the lower line of the deepithelialized area, which corresponds to the inframammary fold of the contralateral side. The degree of ptosis can be adjusted by insetting greater or lesser amounts of skin. From December of 2000 to June of 2004, 12 patients underwent secondary breast reconstruction using this technique. The patients' ages ranged from 39 to 63 years (median, 51 years). Three patients had reduction mammaplasty of the contralateral breast. RESULTS: Mean patient follow-up was 14.7 months (range, 4 to 45 months). There were no free flap failures. Cosmetic evaluation of the reconstructed breasts by two independent plastic surgeons showed good results with regard to symmetry in 10 patients and fair results in two patients. Concerning visibility of the inferior scar, 11 patients had a good result and one patient had a fair result. All patients had a good result in terms of age-appropriate ptosis. CONCLUSIONS: The authors' technique facilitates the formation of an age-appropriate ptosis. Altogether, the aesthetic unit of the breast is restored.

Adult↗
PubMed2006

Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography.

OBJECTIVE: The purpose of this study was to retrospectively assess the accuracy of gray-scale and color Doppler sonography in the diagnosis of carpal tunnel syndrome. MATERIALS AND METHODS: A total of 206 wrists in 151 patients with a clinical suspicion of carpal tunnel syndrome were examined with high-resolution sonography using a 7-15-MHz linear array transducer. The presence of median nerve swelling, edema, and flattening and increased bowing of the flexor retinaculum was evaluated with gray-scale sonography, and the presence of nerve hypervascularization was evaluated with color Doppler sonography. Sensitivity and specificity were calculated for each sonographic feature in comparison with nerve conduction studies as the standard of reference. Multivariate logistic regression analysis was used to determine variables predictive of carpal tunnel syndrome. RESULTS: Carpal tunnel syndrome was confirmed in 172 wrists at nerve conduction studies. A median nerve cross-sectional area of at least 0.11 cm2 was calculated as a definition of median nerve swelling. In comparison with nerve conduction studies, nerve swelling showed the highest accuracy (91%) among gray-scale sonography criteria, and the presence of intraneural hypervascularization showed the highest accuracy (95%) among all sonography criteria. Logistic regression analysis showed that nerve hypervascularization was the only variable that independently predicted median nerve entrapment (odds ratio, 16.4; 95% confidence interval, 8.7-31.1; p <0.001). CONCLUSION: Color Doppler sonography is more accurate than gray-scale sonography for characterizing median nerve involvement in patients with suspected carpal tunnel syndrome.

Adolescent↗
PubMed2004

Free functional rectus femoris muscle transfer for restoration of extension of the foot after lower leg compartment syndrome.

In severely injured lower extremities with loss of the anterior compartment, the free functional rectus femoris musculocutaneous flap was used to restore extension of the foot and in soft-tissue reconstruction. From June 2000-July 2002, 3 patients were treated with this technique. Mean follow-up of the 3 patients was 27 months. Electromyography and the Stanmore system (recording pain, need for orthosis, ability to wear normal shoes, activity level, muscle power, active extension of the foot, and foot posture) were used to assess results of functional rectus femoris transfer. One patient had an excellent result, one patient had a good result, and one patient had a poor result, as assessed by the Stanmore system. Free functional rectus femoris transfer can obtain excellent results in treating foot-drop and soft-tissue defects due to lower leg compartment syndrome and loss of all muscles of the anterior compartment. (c)

Adolescent↗
PubMed2004

Pregnancy as a tissue expander in the correction of a scar deformity.

Tissue expansion is an established method for the correction of scars and tissue defects. During pregnancy the abdominal skin becomes gradually stretched over the growing uterus, providing a "natural" tissue expander. We present a case of a woman with posttraumatic scarring of the lower abdomen and thigh where tissue expansion during pregnancy was successfully used for scar correction.

Abdominal Injuries↗
PubMed2003

Inframammary fold reconstruction with a deepithelialized skin flap.

Sagging of the remaining breast behind the inframammary fold after breast reduction or breast augmentation may necessitate revisional surgery. The authors achieved inframammary fold reconstruction by reconstruction of the inframammary crease ligament through a deepithelialized skin flap that is anchored to the periosteum of the fifth or sixth rib. They present their simple and safe technique.

Female↗
PubMed2003

Single-stage abdominoplasty and mastopexy after weight loss following gastric banding.

BACKGROUND: With the increasing number of massively obese patients who undergo the implant of a gastric band, there is also a growing demand for a plastic-reconstructive operation of the overstretched skin, now lax after the enormous weight reduction. METHODS: From May 2000 to March 2002, 12 abdominoplasties and 12 mastopexies were performed in patients with an average age of 37.3 years (range 33-44 years) as single-stage procedures after an average weight-loss of 67 kg (range 43-111 kg) after gastric banding. A follow-up examination of all patients was carried out an average of 8.4 months (range 1-23 months) after the operation, to review the duration of hospital stay and assess the period of work disablement as well as the patients' satisfaction, which was judged on a scale from 1 (very dissatisfied) to 7 (very satisfied), based on a written questionnaire. RESULTS: The average duration of hospital stay was 7.4 days. There were 5 complications that healed under conservative management. 8 patients suffered an average work disability of 5.4 weeks. 4 patients who were housewives suffered no impairments that affected their ability to carry on with their household duties. The patients' postoperative satisfaction in regard to psyche, appearance, self-confidence and vitality was strongly improved in each case. CONCLUSIONS: In comparison to multi-stage procedures, single-stage operations resulted in a reduced duration of hospital stay by 4.1 days and thus in diminished medical costs and in a reduction of work disablement by 3.5 weeks. Patients who underwent single-stage operations were postoperatively more satisfied than those with multi-stage operations.

Abdominal Wall↗
PubMed2002

Long-term results of MISTI gold breast implants: a retrospective study.

MISTI Gold breast implants (Bioplasty, St. Paul, Minn.) filled with polyvinylpyrrolidone-hydrogel were developed as a promising alternative to silicone-filled implants. Some studies have reported on the positive effects of the implant, such as improved radiolucency and biocompatibility of the gel; however, there are also reports that such implants increased in volume and were subject to capsular contracture in the human body, resulting in demands for their removal. The purpose of this retrospective study was to analyze the long-term results of a series of patients with MISTI Gold breast implants. Between 1991 and 1993, the authors inserted 83 MISTI Gold implants in 61 patients with an average age of 46 years (range, 16 to 69). The authors were able to follow up 48 patients with 71 MISTI Gold implants. The average follow-up was 68 months (range, 10 to 108 months). The retrospective study found that 59 percent of all MISTI Gold implants were removed after an average period of 4.14 years. The main reason for implant removal was an increase in volume of 38 percent, followed by capsular contracture in 14 percent of all 71 MISTI Gold implants. The average increase in volume of all removed MISTI Gold implants was 43 percent. Capsular contracture was graded as Baker I and II in 63 percent and as Baker III and IV in 37 percent. In conclusion, the authors believe that MISTI Gold implants do not fulfill the criteria of safe breast implants, and they agree with the December of 2000 opinion of the Medical Devices Agency of the Department of Health in London that the hydrogel-filled breast implants should not be used until more information about the filler material and its metabolic fate is available.

Adolescent↗
PubMedDate not supplied

Unilateral breast enlargement 5 years after reduction mammaplasty.

A 26-year-old woman presented with unilateral breast enlargement 5 years after bilateral reduction mammaplasty. After careful physical examination combined with a clinical assessment, mammogram, and histologic tissue examination, the patient underwent bilateral reduction mammaplasty using an inferior wedge resection technique. Histologic examination confirmed the diagnosis of a fibrocystic breast disease in both breasts. The most common differential diagnoses are juvenile fibroadenoma, virginal hypertrophy, fibrocystic disease, and cystosarcoma phylloides.

Adult↗