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At least 595 records · Page 33Linked to original sources
PubMed2001

Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks?

Breast reconstruction is considered as part of the breast cancer treatment when a mastectomy is required. The techniques available today, allow reconstruction of the breast even in almost all the cases even in poor local conditions. In 60-70% of the cases, the reconstruction can be performed with an implant inserted behind the pectoralis muscle. Special implants called expanders, are inflatable progressively in the postoperative course thanks to a reservoir located subcutaneously. They provide a progressive distention of the teguments and a more natural shape after substitution of the expander with a definitive implant. The symmetry is usually obtained thanks to a contralateral plastic surgery, which allows at the same time histological check up of the glandular tissue of the opposite breast. The nipple areolar complex is usually reconstructed in a second stage under local anesthesia, using local flaps for the nipple and a tattoo for the colour of the areola. In 30% of the cases, especially after radiotherapy when a salvage mastectomy is required, a flap reconstruction is preferred. The autologous tissue reconstruction with the rectus myocutaneous flap gives excellent cosmetic results and the most natural shape for the breast. But it is a more demanding technique requiring a good experience. In some occasions, the reconstruction with the latissimus flap can also be autologous but usually requires the addition of prosthesis. In most cases, the reconstruction can be performed immediately. The delayed reconstruction is usually preferred when the adjuvant chemotherapy should be delivered as soon as possible after the mastectomy. Complications of the reconstruction such as local necrosis or infections, leading to implant removal or revision of the flap could be detrimental to the patient in delaying the start of the chemotherapy. It is not recommended to reconstruct the breast immediately in case of locally advanced breast cancer. Partial breast reconstruction using plastic surgery procedures can also be performed in case of quadrantectomy in order to obtain a better cosmetic result. Local glandular flaps, as well as specific incisions according to the location of the tumor in the breast allow the reshaping of the breast even in case of large resection and, therefore, provide an opportunity to increase the number of conservative treatment indications, especially in case of in-situ carcinomas.

Breast Neoplasms↗
PubMed1999

Plastic surgery.

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Animals↗
PubMed2000

Otolaryngology.

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Face↗
PubMed2006

Otoplasty: experience with a modification using a drill, and literature review.

More than 200 techniques have been described for correction of prominent ears, indicating that there is no single, widely accepted procedure that has been adopted by most surgeons. This article presents a simplified surgical method for correction of prominent ears. One hundred and twenty-eight otoplasties were performed on 70 patients using the described technique. The main modification of the technique was the use of a diamond burr drill to thin the cartilage posteriorly. Good aesthetic results were obtained in most patients.

Child↗
PubMed1999

What's new in plastic surgery?

A review is made of the latest developments in the field of plastic and reconstructive surgery. The subspecialty divisions are more pronounced in the modern era, but are still linked by a unified approach to soft-tissue management. Although cornerstone areas such as microsurgery have seen refinement, other fields, including aesthetic surgery, have been totally redefined by laser technology and the spread of endoscopic techniques.

Craniofacial Abnormalities↗
PubMed1999

A modified technique for tibial interference screw fixation of hamstring anterior cruciate ligament grafts.

This article describes a modified technique for tibial fixation of quadrupled hamstring grafts in anterior cruciate ligament reconstruction. Using this technique common problems with tibial interference screw fixation of hamstring grafts-such as loss of tension of the graft during screw introduction or twisting of the graft in the tunnel around the screw-are avoided.

Anterior Cruciate Ligament↗
PubMed2001

Restoration of functional prehension after radial hemihand amputation in a three-year-old child: rationale for and long-term result after great toe transfer.

Partial hand amputations are rare injuries among children, causing significant functional impairment. Reports on thumb reconstruction in children and adults are used to develop a reconstruction plan for restoring prehension. While either first or second toe transplantation may be indicated to restore prehension in adults with thumb loss, near universal reluctance to use the great toe in children centers around concern regarding the subsequent function and appearance of the foot. This report details the reconstruction of functional prehension after radial hemihand amputation in a 3-year-old child. Great toe transplantation was used and resulted in neither objective nor subjective donor site morbidity. The rationale for use of the great toe in this child and long-term functional outcome are described.

Amputation, Traumatic↗
PubMed2001

Primary shortening of the pollicized long flexor tendon in congenital pollicization.

Primary shortening of the flexor digitorum profundus tendon to the pollicized index finger was routinely performed during all congenital pollicizations over a 3-year period. Interphalangeal joint flexion of the pollicized digit was observed to begin within weeks after pollicization. The rebalancing of the pollicized long flexor musculotendinous unit has the potential for greater long-term strength.

Adolescent↗
PubMed2002

Outcomes of multiple microvascular toe transfers for reconstruction in 2 patients with digitless hands: 2- and 4-year follow-up case reports.

Two farmers who sustained amputations of all digits in the dominant hand had hand reconstructions with 3 toes from both feet. Both patients were monitored with hand function tests and validated outcomes questionnaires (Michigan Hand Outcomes Questionnaire and Short Form-36). Long-term follow-up data showed that both patients were able to use the reconstructed hands for activities of daily living and heavy manual farm labor. Until the immunologic problems associated with hand transplantation are solved, multiple toe transfer for total hand reconstruction is a reliable surgical treatment for these patients.

Activities of Daily Living↗
PubMed2001

Vascularized free fibular flap for mandibular reconstruction: a report of 26 cases.

PURPOSE: Mandibular reconstruction represents a challenge to the oral and maxillofacial surgeon and has been revolutionized by the modern microvascular techniques. Rehabilitation using techniques such as reconstruction plates frequently produce a functional and cosmetic defect. The primary objective of the current study was to evaluate the usefulness of the osteomuscular free fibular flap for this purpose. PATIENTS AND METHODS: The results of 26 vascularized free fibula flaps with or without a skin paddle that were used for mandibular reconstruction is presented. The "double barrel" technique was used in 6 cases. The donor site was closed directly in 2 cases and with an abdominal full-thickness skin graft in 24 cases. RESULTS: All flaps except 1 were viable. There was partial necrosis of the skin island in 1 patient. The average length of the fibula graft was 10.96 cm, and the number of osteotomies ranged from 0 to 3. In the donor site, the most significant problem was unsatisfactory scarring related to the use of a skin graft. There were no long-term functional complications in the lower leg. Two patients have been secondarily rehabilitated with osseointegrated implants. CONCLUSION: The fibula flap provides a successful bone graft for mandibular restoration with an acceptably low complication rate. This method meets most of the requirements for oral and mandibular replacement.

Adult↗
PubMed2002

The posteriorly based platysma flap in oral and facial reconstruction: A case series.

PURPOSE: The purpose of this study was to assess the reliability and use of the posteriorly based platysma flap for oral and facial reconstruction. PATIENTS AND METHODS: This case series consists of 7 patients who were reconstructed with a posteriorly based platysma flap for various tumor resection defects of the oral and facial region. The flaps were monitored for complications, including skin loss and ischemia in the postoperative period. RESULTS: Three of the patients (43%) in this study had no complications. Three patients (43%) had some skin sloughing, but the underlying muscle remained viable and mucosalized normally. One patient (14%) had 40% flap loss of the distal end, possibly due to vascular compromise that occurred during a concomitant neck dissection. CONCLUSION: The posteriorly based platysma flap is a reliable reconstruction option for defects in the facial and oral region. If skin sloughing occurs, it is usually inconsequential for intraoral reconstruction as the underlying muscle remains viable and undergoes epithelialization.

Aged↗
PubMed2003

Unilateral subcutaneous pedicled nasolabial island flap for anterior mouth floor reconstruction.

PURPOSE: This article describes the successful use of unilateral subcutaneous pedicled flaps in the reconstruction of defects of the anterior floor of the mouth by raising the flaps as skin islands, relying on a pedicle of subcutaneous tissue. PATIENTS AND METHODS: Nine flap procedures were performed on 9 patients for reconstruction of small defects of the anterior floor of the mouth. One patient underwent secondary reconstruction to release tongue that was functionally tethered anteriorly. RESULTS: All flaps healed without evidence of infection, dehiscence, or necrosis. This particular choice of unilateral flap seems to provide improved functional integrity of the anterior floor of the mouth. CONCLUSIONS: The unilateral inferiorly and subcutaneously based nasolabial island flap provides reliable coverage of small and intermediate-sized defects of the anterior floor of the mouth when used alone, improving the tongue mobility, articulation, and deglutition.

Aged↗