Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Sep 2011
Review Case ReportsManagement of chyle leak post neck dissection: a case report and literature review.
Chyle leakage post head-and-neck resection is a rare but potentially life-threatening complication. Management may be problematic and prolonged. ⋯ The chyle leak was successfully treated with thoracoscopic ligation of the thoracic duct. In the light of our clinical experience and following a thorough literature review, we have proposed that complicated or high-output chyle leaks (>1000 ml day(-1)) should be treated with early thoracoscopic thoracic duct ligation.
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J Plast Reconstr Aesthet Surg · Sep 2011
Multicenter StudyInformation-seeking behaviour and coping style of women opting for either implant or DIEP-flap breast reconstruction.
High satisfaction rates have been reported after autologous breast reconstruction. Yet, most mastectomy patients receive implant reconstructions (ImBR). Independent and active decision makers have shown mainly to choose for autologous reconstructions, such as the Deep inferior epigastric perforator (DIEP) flap (DiepBR). To further explore the decision making to opt for either ImBR or DiepBR, we investigated patient knowledge, informational resources used, effect of plastic surgeons' advice, coping style and personal independence. ⋯ Women opting for DIEP-flap BR were more active and independent in their decision making regarding the type of BR. Women opting for implant BR seemed less well-informed and more dependent on their physician in their decision compared with women opting for DIEP-flap BR. To undergo a complex type of BR, active and independent information seeking may be required. However, clinical and logistic characteristics need to be considered, as some patients were limited in their reconstruction options.
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J Plast Reconstr Aesthet Surg · Aug 2011
Functional outcome of nerve transfers for upper-type brachial plexus injuries.
The purpose of this study was to present the results of treatment using nerve transfers for elbow and shoulder function in patients with upper-type (C5-C7) brachial plexus injuries. ⋯ Nerve transfer procedures can result in functional recovery of the shoulder and elbow function in patients with upper-type brachial plexus injuries.
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J Plast Reconstr Aesthet Surg · Aug 2011
Surgical management of radiation-associated cutaneous breast angiosarcoma.
The purpose of this study was to investigate the surgical management of radiation-associated cutaneous breast angiosarcoma with an emphasis on surgical margins and choice of reconstruction. Nine cases of angiosarcoma were identified in patients earlier treated with radiotherapy for breast cancer. Breast angiosarcoma was diagnosed a median of 5.25 years following radiotherapy. ⋯ Median follow-up was 81 months. Six patients were alive and disease-free at the end of the study period. Aggressive surgical resection with wide margins is essential to reduce local recurrence and improve survival.