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Preserving finger length in a patient with symmetric digital gangrene under local anesthesia:A case report

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World Journal of Clinical Cases 2023年第27期11卷 6640-6645页

作者： Keun Hyung Kim In Chang Ko Hoon Kim Soo Yeon Lim Department of plastic and reconstructive surgery Konyang University Medical CenterKonyang University of College of MedicineDaejeon 35365South Korea Department of plastic and reconstructive surgery Konyang University HospitalKonyang University of College of MedicineMyunggok Medical Research CenterDaejeon 35365South Korea

BACKGROUND Case reports of symmetric digital gangrene resulting from high-dose vasopressors use in patients with alcoholic ketoacidosis,leading to cardiac arrest,are *** date,no specific treatment method for autolysis or surgical amputation or guidelines for determining the level of amputation have been *** SUMMARY In this case report,we describe a treatment method that effectively preserved the function of fingers by surgical treatment under local anesthesia with a minimum operative time,while also preserving finger length to the maximum possible *** Our approach may contribute to improved postoperative quality of life by preserving finger length.

关键词： Acidosis Disseminated intravascular coagulation Ketosis Purpura fulminans Surgical amputation Case report

Chest complications in autologous breast reconstruction

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plastic and Aesthetic Research 2023年第1期10卷 205-215页

作者： Candice M.Leach Meredith S.Collins Department of plastic and reconstructive surgery University of Kansas Medical CenterKansas CityKS 66160USA

Complications from autologous free flap reconstruction of the breast can present with both common surgical complications and unique complications at the chest recipient *** review covers complications at the chest recipient site,including chest wall deformity,chronic pain,mastectomy skin flap necrosis,infection,pyoderma gangrenosum,bleeding complications,pneumothorax,chyle leak,and positive internal mammary lymph node metastasis.

关键词： Autologous breast reconstruction complications chest wall deformity pneumothorax mastectomy skin flap necrosis chyle leak internal mammary node metastasis

First report of polymicrobial necrotizing fasciitis caused by Eggerthia catenaformis and Finegoldia magna

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World Journal of Emergency Medicine 2022年第4期13卷 326-329页

作者： Claudius Illg Jonas Kolbenschlag Ruth Christine Schäfer Adrien Daigeler Sabrina Krauss Department of Hand Plastic and Reconstructive SurgeryBG Unfallklinik TuebingenEberhard Karls UniversityTuebingen 72076Germany

Dear editor,Necrotizing fasciitis is a relatively rare,rapidly advancing,infectious disease with high lethality.[1]It is characterized by subcutaneous and fascial tissue necrosis and can even extend to involve skin and muscle.[2]The initial spread along fascial planes with little visual evidence impedes the crucial early *** often report minor or major trauma preceding the infection,yet in some cases,the disease develops idiopathically.[3]Risk factors,including older age,diabetes,chronic renal failure,and obesity,predispose to impaired immunity and loss of physiological barriers.[2]

关键词： impaired immunity fas

Secondary release of the peripheral nerve with autologous fat derivates benefits for functional and sensory recovery

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Neural Regeneration Research 2021年第5期16卷 856-864页

作者： Natalia E.Krzesniak Anna Sarnowska Anna Figiel-Dabrowska Katarzyna Osiak Krystyna Domanska-Janik Bartłomiej H.Noszczyk Department of plastic and reconstructive surgery Center of Postgraduate Medical EducationProf.W.Orlowski Memorial HospitalWarsawPoland 2Mossakowski Medical Research CenterPolish Academy of SciencesWarsawPoland

The reconstruction of nerve continuity after traumatic nerve injury is the gold standard in hand ***,tension-free,end-to-end nerve suture ensures the best *** recovery is mostly promising;however,in a few cases,insufficient outcomes in motor or sensory function are ***-and extra-fascicular scarring accompanies the nerve regeneration process and limits final *** nerve release in those cases is ***,scarring recurrence cannot be eliminated after secondary revision and *** supportive influences of mesenchymal stem cells in the process of nerve regeneration were observed in many preclinical ***,a limited number of studies in humans have analyzed the clinical usage of mesenchymal stem cells in peripheral nerve reconstruction and *** objective of this study was to evaluate the effects of undifferentiated adipose-derived stromal/stem cell injection during a last-chance surgery(neurolysis,nerve release)on a previously reconstructed *** patients(one female,two males;mean age 59±4.5 years at the time of injury),who experienced failure of reconstructions of median and ulnar nerves,were included in this *** the revision surgery,nerve fascicles were released,and adiposederived stromal/stem cells were administered through microinjections along the fascicles and around the adjacent tissues after external *** 36 months of followup,patients noticed gradual signs of sensory and in consequence functional *** adverse effects were *** nerve release with adipose-derived stromal/stem cells support is a promising method in patients who need secondary nerve release after nerve *** method can constitute an alternative procedure in patients experiencing recovery failure and allow improvement in cases of limited nerve *** study protocol was approved by the Institutional Review Board(IRB)at the Centre of Pos

关键词： nerve release neurolysis stem cells adipose-derived stem cells scar threshold sensation pain hypersensitivity forearm

Assessment of complete lymph node dissection in patients with melanoma:A systemic review and meta-analysis

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Chinese Journal of plastic and reconstructive surgery 2023年第4期5卷 195-204页

作者： Jiangying Xuan Ming Zhu Lu Wang Zixu Gao Kangjie Shen Ming Ren Yanlin Li Chuanyuan Wei Jianying Gu Department of plastic and reconstructive surgery Cancer CenterZhongshan HospitalFudan UniversityShanghai 200032China

Background: Complete lymph node dissection(CLND) for patients with melanoma remains controversial. This meta-analysis aimed to compare the prognoses and complications between the CLND and control groups(patients who receive adjuvant treatment or observation only) in patients with sentinel lymph node(SLN)-positive ***: The Pub Med, Embase, Cochrane, and Web of Science databases were searched for cohort studies and randomized clinical trials(RCTs) conducted between 1964 and 2022, and the quality of the studies was assessed using the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale. Hazard ratios(HR) or risk ratios(RR) with 95%confidence intervals(CIs) were calculated for each outcome. Heterogeneity and sensitivity tests were also conducted, and publication bias tests were performed when the pooled number of studies was >***: Fifteen studies, including 11 cohort studies and 4 RCTs, were enrolled and assessed for quality. Analysis of overall survival showed no significant difference between the CLND and control groups(HR=1.02, 95% CI:0.69–1.51, P=0.922). Similarly, recurrence-free survival(HR=0.84, 95% CI: 0.6–1.16, P=0.287), disease-free survival(HR=1.06, 95% CI: 0.65–1.72, P=0.82), and disease-specific survival(HR=0.84, 95% CI: 0.59–1.21,P=0.355) showed no difference between the two groups. CLND did not reduce the risk of recurrence(RR=0.98,95% CI: 0.8–1.2, P=0.851).Conclusion: Remarkably, patients who underwent CLND were more likely to have complications such as flap necrosis and lymphedema than the controls. CLND does not improve patient prognosis and may increase the incidence of complications.

关键词： Melanoma Complete lymph node dissection Meta-analysis

Animal models of vascularized nerve grafts:a systematic review

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Neural Regeneration Research 2023年第12期18卷 2615-2618页

作者： Francesca Toia Daniele Matta Federico De Michele Roberto Pirrello Adriana Cordova plastic and reconstructive surgery.Department of Surgical Oncological and Oral Sciences.University of PalermoPalermoItaly

The aim of this review is to present and compare the various animal models of vascularized nerve grafts described in the literature as well as to summarize preclinical evidence for superior functional results compared to non-vascularized free nerve grafts. We also will present the state of the art on prefabricated vascularized nerve grafts. A systematic literature review on vascularized nerve graft models was conducted via the retrieval with the Pub Med database on March 30, 2019. Data on the animal, nerve, and vascularization model, the recipient bed, the evaluation time points and methods, and the results of the study results were extracted and analyzed from selected articles. The rat sciatic nerve was the most popular model for vascularized nerve grafts, followed by the rabbit;however, rabbit models allow for longer nerve grafts, which are suitable for translational evaluation, and produced more cautious results on the superiority of vascularized nerve grafts. Compared to free nerve grafts, vascularized nerve grafts have better early but similar long-term results, especially in an avascular bed. There are few studies on avascular receiving beds and prefabricated nerve grafts. The clinical translation potential of available animal models is limited, and current experimental knowledge cannot fully support that the differences between vascularized nerve grafts and free nerve grafts yield a clinical advantage that justifies the complexity of the procedure.

关键词： nerve animal models nerve grafts nerve regeneration peripheral nerves prefabricated vascularized nerve grafts vascularized nerve grafts

Progressive trends in timing and imaging of lower extremity reconstruction

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plastic and Aesthetic Research 2019年第12期6卷 26-36页

作者： Andrew Y.Zhang David Cholok Gordon K.Lee Department of plastic surgery University of Texas Southwestern Medical CenterDallasTXUSA Division of plastic and reconstructive surgery Stanford UniversityPalo AltoCAUSA

The salvage of mangled lower-extremities after severe injury remains a daunting operative dilemma,but one that continues to evolve with advances in microsurgical and orthopedic ***,trends in clinical practice including the decision to salvage and timing of soft-tissue coverage are changing in concordance with improvements in wound care,flap selection for soft-tissue provision,and preoperative *** to these improvements,more complex wounds are increasingly eligible for *** remains unclear,however,whether success in limb salvage confers improved functional patient *** present a review of the literature tracing recent advances in the salvage of mangled extremities following traumatic injury,with a focus on practice trends regarding timing of reconstruction,operative approaches,and preoperative imaging.

关键词： Lower extremity reconstruction propeller flaps amputation microsurgery trauma

Subcutaneous sarcoidosis of the upper and lower extremities: A case report and review of the literature

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World Journal of Clinical Cases 2019年第17期7卷 2505-2512页

作者： Raman Mehrzad Julia Festa Reena Bhatt Department of plastic and reconstructive surgery Rhode Island Hospital the Warren Alpert Medical School of Brown University

BACKGROUND Sarcoidosis is a granulomatous disease of unknown etiology that most often impacts the *** manifestations of sarcoidosis are seen among 9%- 37% of *** sarcoidosis is a rare presentation of cutaneous sarcoidosis with estimates of frequency ranging from 1.4%-16%.To date,very few articles and case reports have been written about this *** this paper,we describe a case of subcutaneous sarcoidosis and perform a review of the literature to determine if there are commonalities among patients who present with subcutaneous *** SUMMARY A 38-year-old female,with a past medical history of arthritis and recurrent nephrolithiasis,presents with an 8-mo history of 4 firm,asymptomatic,skincolored nodules on her left and right upper extremities and *** biopsy and post-excisional pathology report both revealed well-formed,dense,noncaseating granulomas localized to the subcutaneous *** computed tomography revealed mild mediastinal lymphadenopathy.A diagnosis of subcutaneous sarcoidosis was made,and the lesions were surgically *** Commonalities among patients presenting with subcutaneous sarcoidosis include: middle-aged female,lesions localizing to the upper or lower limbs,lymphadenopathy or pulmonary infiltration on chest imaging,elevated serum angiotensin-converting enzyme.

关键词： Subcutaneous sarcoidosis Upper extremity Granulomatous disease Case report

Effectiveness of out-fracture of the inferior turbinate with reduction nasal bone fracture

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World Journal of Clinical Cases 2023年第27期11卷 6374-6382页

作者： Se-Young Kim Ha-Jong Nam Je-Yeon Byeon Hwan Jun Choi Department of plastic and reconstructive surgery Soonchunhyang University Gumi HospitalGumi-si 39371South Korea Department of plastic and reconstructive surgery Soonchunhyang University Cheonan HospitalCheonan-si 31151South Korea

BACKGROUND The nasal bone,being the most protruding bone in the center of the facial bones,is particularly susceptible to *** bone fractures can often result in secondary deformation and dysfunction of the nose,including septal *** on functional or intra-nasal complications have been rarely reported after nasal bone fracture *** To evaluate the severity of nasal obstruction and its improvement following nasal bone fracture reduction using inferior *** We conducted a retrospective review of data from 50 patients with symptomatic nasal obstruction between January to December *** patients underwent preoperative Computed tomography evaluation,and symptom changes and nasal cavity volume were analyzed using a visual analog scale and acoustic rhinometry before and after *** reduction and out-fracture of both inferior turbinates performed by the same *** outcomes were assessed by comparing changes in the nasal airway volume measured using acoustic rhinometry before and after *** minimal cross-sectional area(MCA)was also analyzed based on the Stranc *** Before reduction,the mean MCA for all cases was 0.59±0.06 cm^(2),which represented an 11%decrease compared to the average size of a Korean adult(0.65±0.03 cm^(2)).The MCA for frontal impact was 0.60±0.02 cm^(2) and for lateral impact,it was 0.58±0.03 cm^(2).After reduction via inferior turbinoplasty,the MCA improved to 0.64±0.04 cm^(2).CONCLUSION This study suggests that turbinoplasty is helpful in addressing nasal ***-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.

关键词： Acoustic rhinometry Nasal bone Fracture Turbinate