Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Dec 2018
Nipple-sparing mastectomy with different approaches: surgical incisions, complications, and cosmetic results. Preliminary results of 100 consecutive patients at a single center.
Nipple- and areola-sparing mastectomy is a novel surgical approach that preserves the nipple-areolar complex. Patients with moderate and/or severe breast ptosis are usually not eligible for this surgical approach. In this study, we aimed to demonstrate the feasibility of nonconventional surgical approaches for nipple-sparing mastectomy. ⋯ Among the 117 surgical procedures performed in 100 patients with BC, no significant associations are verified considering clinical and pathological data, complications, pre- and postsurgery satisfactions, and other parameters. Different surgical approaches represent the evolution of "classic" nipple-sparing mastectomy, thus meeting the cosmetic and oncological results. These procedures are safe and also indicated in cases conventionally considered as not eligible for nipple-areola preservation.
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J Plast Reconstr Aesthet Surg · Oct 2018
Meta AnalysisEfficacy of autologous fat transfer for the correction of contour deformities in the breast: A systematic review and meta-analysis.
Autologous fat transfer (AFT), also known as fat grafting or lipofilling, has already become a part of clinical practice for treating contour deformities of the breast, even though evidence regarding its efficacy is still lacking. This is the first meta-analysis on this subject, aimed to facilitate intuitive interpretation of the available data by clinicians, guideline committees and policy makers. ⋯ AFT seems to be an effective procedure in breast reconstruction, reflected by the high patient and surgeon satisfaction and low incidence of clinical and radiological complications. Future research should focus on evaluating the technical and patient factors influencing the rate of fat resorption as well as its oncological safety.
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J Plast Reconstr Aesthet Surg · Sep 2018
Review Historical ArticleHistorical review of Dakin's solution applications.
Dakin's solution and the Carrel-Dakin method were developed and integrated into clinical practice in the early 20th century, which were found to aid in effective wound healing and infection. This historical review briefly outlines highlights with regard to the history of infection management, wartime amputation, and wound treatment dating back to Galen through the early 20th century. ⋯ Additionally, we discuss the history of wound care with the emphasis on the Carrel-Dakin method. Finally, this review discusses and presents contemporary application and utilization of Dakin's solution in two large tertiary care centers.
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J Plast Reconstr Aesthet Surg · Sep 2018
Comparative StudyComparative study of phrenic and partial ulnar nerve transfers for elbow flexion after upper brachial plexus avulsion: A retrospective clinical analysis.
The widely used nerve transfer sources for elbow flexion in patients with upper brachial plexus avulsion (UBPA) include partial ulnar nerve, phrenic nerve, and intercostal nerves. A retrospective review of 21 patients treated with phrenic and partial ulnar nerve transfers for elbow flexion after UBPA was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of the anterior division of the upper trunk; in the partial ulnar nerve transfer group, one fascicle of the ulnar nerve was transferred to the biceps branch. ⋯ The DASH scores after surgery were significantly lower than those before surgery in the two groups. There was no statistical difference between the two groups in the changes of DASH scores before and after surgery. Both of phrenic and partial ulnar nerve transfers had good prognosis for elbow flexion in patients with UBPA.
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J Plast Reconstr Aesthet Surg · Sep 2018
Use of dual-skin paddle anterolateral thigh perforator flaps in the reconstruction of complex defect of the foot and ankle.
Complex soft tissue defect around the ankle and foot remains a reconstructive challenge for orthopedic and plastic surgeons. This study describes our clinical experience with the application of dual-skin paddle anterolateral thigh perforator (ALTP) flap for reconstruction of complex defects around the ankle and foot. ⋯ Our experience showed that the dual-skin paddle ALTP flap can provide two independent skin paddles for complex defect reconstruction while minimizing donor site morbidity. It is a reliable option for the reconstruction of complex defects in the ankle and foot.