Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jan 2006
Case ReportsAcute exacerbation of macroglossia leading to necrosis of the anterior third of the tongue.
Macroglossia is defined as an enlarged tongue that protrudes beyond the teeth or the alveolar ridge in the resting position. Macroglossia may be classified into generalised and localised based on the extent of tongue involvement. Each of these groups can be subdivided into congenital, inflammatory, traumatic, metabolic and neoplastic lesions [Myer III CM, Hotaling AJ, Reilly JS. ⋯ The congenital causes are vascular anomalies such as haemangioma and lymphovenous malformations. We report the case of a large lymphovenous malformation of the tongue in a 17 month old child who developed an acute exacerbation of macroglossia following trauma. This eventually led to necrosis of the anterior third of his tongue requiring a partial glossectomy.
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J Plast Reconstr Aesthet Surg · Jan 2006
Complications analysis of 266 immediate breast reconstructions.
The purpose of this study was to describe the complications of immediate breast reconstruction, to compare their rates with respect to the surgical procedure and to patient's characteristics, in order to improve surgical indications and patient information. We carried out a retrospective study of 266 immediate breast reconstructions (249 women) over a 12-year period (latissimus dorsi myocutaneous flap with implant 61%, autologous latissimus dorsi myocutaneous flap 15%, subpectoral implant 24%). Mean age was 48 and the median follow-up was seven years (2-14). ⋯ In our opinion, latissimus dorsi myocutaneous flap with or without an implant is a good compromise between complication risk and necessity of good cosmetic result requirement. These results have led us to delay or contraindicate reconstruction in the case of obesity or heavy smoking. In the case of probable post-operative radiotherapy, we prefer to delay the breast reconstruction.
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J Plast Reconstr Aesthet Surg · Jan 2006
Capsular contracture around saline-filled and textured subcutaneously-placed implants in irradiated and non-irradiated breast cancer patients: five years of monitoring of a prospective trial.
One hundred and seven breast cancer patients underwent subcutaneous mastectomy and immediate reconstruction with a subcutaneously-placed, round, saline-filled prosthesis with a textured surface. The primary aim of this prospective study was to determine the frequency of capsular contracture in both irradiated and non-irradiated breasts after this operation. Two different types of round implants with different pore sizes on their textured surfaces, Siltex and Microcell, were randomly chosen. ⋯ None of the 16 reoperated patients had a recurrence of capsular contracture within 5 years. The results indicate a high rate of capsular contracture after this operation, especially when followed by radiation. However, a fairly simple procedure to treat capsular contracture seems to give good long-term results.
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J Plast Reconstr Aesthet Surg · Jan 2006
Case ReportsDelayed leech-borne infection with Aeromonas hydrophilia in escharotic flap wound.
Medicinal leeches (Hirudo medicinalis) are commonly used in plastic surgery for the salvage of congested flaps and replanted parts compromised by venous congestion. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20% [De Chalain TM. ⋯ J Reconstr Microsurg 1996;12(3):165-72.1]. We describe a case of delayed leech-borne infection, from the escharotic portion of a latissimus dorsi flap, which developed several days after stopping leech therapy for venous congestion in a reconstructed breast.
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J Plast Reconstr Aesthet Surg · Jan 2006
Randomized Controlled TrialTwenty-four hours or 10 days? A prospective randomised controlled trial in children comparing head bandages following pinnaplasty.
The perceived benefits of bandaging for 10 days following pinnaplasty have been questioned by previous studies. The problems arising from these dressings are many [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. ⋯ Differences between the groups in the number of unscheduled visits (p=0.21) did not reach statistical significance. The findings indicate that it is safe and effective to use head bandage for only 24 h following surgical correction of prominent ears. This study shows no benefit from the application of a formal head bandage for any longer than 1 day.