A. Golash, S. Bera, Aditya V. Kanoi, S. Hanspal, Abhijit Golash
Abstract Background End-to-side (ES) venous anastomosis is an established approach for head and neck reconstruction and has several benefits over conventional end-to-end (EE) anastomosis. However, this is not preferred by all, which may be due to technical preferences for an EE anastomosis by many surgeons. We present here our experience of routine ES venous anastomosis for head and neck reconstruction over the past 8 years. Materials and Methods All consecutive head and neck malignancy patients reconstructed with free flap and our routine ES internal jugular vein (IJV) anastomosis approach between 2015 and 2023 have been included in this study. Flap-related variables are reviewed retrospectively. Results Reconstruction was done with a total of 585 free flaps including 303 radial forearm flaps (RFFs), 143 osteocutaneous fibula flaps (OCFFs), and 139 anterolateral thigh (ALT) flaps. The flap survival rate was 573/585 (97.95%). Re-exploration and salvage rates were 45/585 (7.69%) and 38/45, respectively (84.44%). Conclusion Routine use of ES anastomosis simplifies microvascular anastomosis by avoiding efforts related to the selection of recipient vessels, providing a single large-caliber venous outlet, the favorable geometric orientation of the pedicle, and ease of re-exploration. The vascular anastomosis for RFF, ALT, and OCFF flap is feasible with 7–0 sutures and under 4.5X loupe magnification with this approach quite conveniently with similar outcomes to the reported flap survival rate in the contemporary practice.
摘要 背景 端对侧（ES）静脉吻合术是头颈部重建的一种成熟方法，与传统的端对端（EE）吻合术相比有很多优点。然而，并非所有人都喜欢采用这种方法，这可能是由于许多外科医生在技术上偏好采用 EE 吻合术。我们在此介绍过去 8 年来头颈部重建中常规 ES 静脉吻合术的经验。材料与方法 本研究纳入了 2015 年至 2023 年间所有使用游离皮瓣和我们的常规 ES 颈内静脉（IJV）吻合术重建的连续头颈部恶性肿瘤患者。对皮瓣相关变量进行了回顾性分析。结果 共有585个游离皮瓣进行了重建，包括303个桡侧前臂皮瓣（RFF）、143个骨皮腓骨皮瓣（OCFF）和139个大腿前外侧皮瓣（ALT）。皮瓣存活率为573/585（97.95%）。再次切除率和挽救率分别为 45/585（7.69%）和 38/45（84.44%）。结论 ES吻合术的常规使用简化了微血管吻合术，因为它避免了选择受体血管的相关工作，提供了单一的大口径静脉出口、良好的血管蒂几何方向以及易于再次探查。RFF、ALT 和 OCFF 皮瓣的血管吻合可使用 7-0 缝线，在 4.5 倍放大镜下进行，这种方法非常方便，其结果与当代实践中报道的皮瓣存活率相似。
{"title":"End-to-Side Venous Anastomosis with IJV: Improving Outcomes of Microvascular Anastomosis in Head and Neck Reconstruction","authors":"A. Golash, S. Bera, Aditya V. Kanoi, S. Hanspal, Abhijit Golash","doi":"10.1055/s-0044-1787565","DOIUrl":"https://doi.org/10.1055/s-0044-1787565","url":null,"abstract":"Abstract Background End-to-side (ES) venous anastomosis is an established approach for head and neck reconstruction and has several benefits over conventional end-to-end (EE) anastomosis. However, this is not preferred by all, which may be due to technical preferences for an EE anastomosis by many surgeons. We present here our experience of routine ES venous anastomosis for head and neck reconstruction over the past 8 years. Materials and Methods All consecutive head and neck malignancy patients reconstructed with free flap and our routine ES internal jugular vein (IJV) anastomosis approach between 2015 and 2023 have been included in this study. Flap-related variables are reviewed retrospectively. Results Reconstruction was done with a total of 585 free flaps including 303 radial forearm flaps (RFFs), 143 osteocutaneous fibula flaps (OCFFs), and 139 anterolateral thigh (ALT) flaps. The flap survival rate was 573/585 (97.95%). Re-exploration and salvage rates were 45/585 (7.69%) and 38/45, respectively (84.44%). Conclusion Routine use of ES anastomosis simplifies microvascular anastomosis by avoiding efforts related to the selection of recipient vessels, providing a single large-caliber venous outlet, the favorable geometric orientation of the pedicle, and ease of re-exploration. The vascular anastomosis for RFF, ALT, and OCFF flap is feasible with 7–0 sutures and under 4.5X loupe magnification with this approach quite conveniently with similar outcomes to the reported flap survival rate in the contemporary practice.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141358400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Broken and Retained Tip of Liposuction Cannula in the Scalp","authors":"S. S. Shirol, Lohith Y. N.","doi":"10.1055/s-0044-1787679","DOIUrl":"https://doi.org/10.1055/s-0044-1787679","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Sahu, Kaushik Mahadik, Sanjay Kumar Giri, S. Suba, Mainak Mallik, Ritesh Panda, Aparna Kanungo, Reena Minz, S. Rout
Abstract Background The keystone design perforator island flap (KDPIF) is unique among local flaps because of its high potential for adaptation. We describe our experience with the use of the keystone flap for the reconstruction of a variety of defects in different regions of the body concerning its versatility, surgical outcomes, complications, postoperative pain, operative time, and esthetic outcomes. Methods A prospective observational study was conducted at our institute from June 2021 to June 2023 where the use of KDPIFs in resurfacing soft tissue defects of different etiopathogenesis was evaluated and the data were analyzed. Results Forty-four patients were included in the study with soft tissue defects of various etiologies and at different locations. The largest flap raised was 18 × 10 cm and the smallest was 4 × 2 cm. The average intraoperative time for completion of the procedure was 74.86 minutes (range: 45–120 minutes). The success rate of flap survivability was 95.45% with two patients having total flap loss necessitating another reconstructive option. Partial flap dehiscence which healed secondarily was observed in two patients. Postoperative pain showed a significant fall of 83.7% from baseline and 82.9% of cases were extremely satisfied with the esthetic outcome. Conclusion The keystone flap is a valuable reconstructive tool in the armamentarium of a plastic surgeon. It is technically reproducible, suitable to be done in resource-limited settings, and provides contiguous tissue with good vascularity and fewer complications.
{"title":"Versatility of the Keystone Design Perforator Island Flaps in Resurfacing Soft Tissue Defects","authors":"R. Sahu, Kaushik Mahadik, Sanjay Kumar Giri, S. Suba, Mainak Mallik, Ritesh Panda, Aparna Kanungo, Reena Minz, S. Rout","doi":"10.1055/s-0044-1787177","DOIUrl":"https://doi.org/10.1055/s-0044-1787177","url":null,"abstract":"Abstract Background The keystone design perforator island flap (KDPIF) is unique among local flaps because of its high potential for adaptation. We describe our experience with the use of the keystone flap for the reconstruction of a variety of defects in different regions of the body concerning its versatility, surgical outcomes, complications, postoperative pain, operative time, and esthetic outcomes. Methods A prospective observational study was conducted at our institute from June 2021 to June 2023 where the use of KDPIFs in resurfacing soft tissue defects of different etiopathogenesis was evaluated and the data were analyzed. Results Forty-four patients were included in the study with soft tissue defects of various etiologies and at different locations. The largest flap raised was 18 × 10 cm and the smallest was 4 × 2 cm. The average intraoperative time for completion of the procedure was 74.86 minutes (range: 45–120 minutes). The success rate of flap survivability was 95.45% with two patients having total flap loss necessitating another reconstructive option. Partial flap dehiscence which healed secondarily was observed in two patients. Postoperative pain showed a significant fall of 83.7% from baseline and 82.9% of cases were extremely satisfied with the esthetic outcome. Conclusion The keystone flap is a valuable reconstructive tool in the armamentarium of a plastic surgeon. It is technically reproducible, suitable to be done in resource-limited settings, and provides contiguous tissue with good vascularity and fewer complications.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angiolipomas are de fi ned as benign soft tissue tumors of mesenchymal origin and are made of mature adipocytes with an excessive degree of vascular proliferation. They are often asymptomatic and painless, and as they grow may cause mass effect. They can either be in fi ltrating or non-in fi ltrating (encapsulated). 1 Resection is the fi rst line of treatment for both variants with recurrence more common in in fi ltrating variants. We present a 48-year-old male who presented with a large swelling over the anterior aspect of the left proximal thigh. It gradually increased in size over 10 years. The lesion was a lobulated large exophytic that measured 40cm (cid:1) 20 cm (cid:1) 25cm in size ( ► Fig. 1 ). A contrast-enhanced magnetic resonance imaging showed large soft tissue tumor lesion in a subcutaneous plane with multiple hypertrophied arterial branches from the left super fi cial femoral artery along with multiple dilated veins without any nidus. The lesion was consistent with lipomatous tumor.
{"title":"Suspension Technique for Ease of Operation in a Giant Angiolipoma of Thigh","authors":"Ravikiran Naalla, S. Samantaray","doi":"10.1055/s-0044-1787280","DOIUrl":"https://doi.org/10.1055/s-0044-1787280","url":null,"abstract":"Angiolipomas are de fi ned as benign soft tissue tumors of mesenchymal origin and are made of mature adipocytes with an excessive degree of vascular proliferation. They are often asymptomatic and painless, and as they grow may cause mass effect. They can either be in fi ltrating or non-in fi ltrating (encapsulated). 1 Resection is the fi rst line of treatment for both variants with recurrence more common in in fi ltrating variants. We present a 48-year-old male who presented with a large swelling over the anterior aspect of the left proximal thigh. It gradually increased in size over 10 years. The lesion was a lobulated large exophytic that measured 40cm (cid:1) 20 cm (cid:1) 25cm in size ( ► Fig. 1 ). A contrast-enhanced magnetic resonance imaging showed large soft tissue tumor lesion in a subcutaneous plane with multiple hypertrophied arterial branches from the left super fi cial femoral artery along with multiple dilated veins without any nidus. The lesion was consistent with lipomatous tumor.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Beveled skin incision was proposed 30 years back to improve scar outcome. But we could not find any existing literature that studied the outcomes of beveled excision in a non-hair-bearing skin objectively. Methods Twenty-eight patients undergoing skin excision during various aesthetic procedures were divided equally into two groups. In group I patients, both the apposing edges of skin had beveled incisions, while in group II conventional 90-degree incisions were given. The scar outcomes were measured using Patient and Observer Scar Assessment Scale v 2.0/EN (POSAS 2.0). Results The means of the total score of the patient scale of POSAS had a statistically significant difference ( p = 0.012) between the two groups, so had the means of the observer scale ( p = 0.048). The difference in scores between overall patient opinion in the two groups was statistically significant ( p = 0.0119); however, it was not significant in the overall observer opinion ( p = 0.405). Conclusion The beveled incision group had a better scar outcome than the perpendicular incision group.
{"title":"Dermal Steal Technique: A Single-Surgeon Retrospective Evaluation of Aesthetic Outcomes of Beveled versus Conventional Perpendicular Skin Incisions.","authors":"Manoj Khanna, Sourabh Shankar Chakraborty","doi":"10.1055/s-0044-1787566","DOIUrl":"https://doi.org/10.1055/s-0044-1787566","url":null,"abstract":"Abstract Background Beveled skin incision was proposed 30 years back to improve scar outcome. But we could not find any existing literature that studied the outcomes of beveled excision in a non-hair-bearing skin objectively. Methods Twenty-eight patients undergoing skin excision during various aesthetic procedures were divided equally into two groups. In group I patients, both the apposing edges of skin had beveled incisions, while in group II conventional 90-degree incisions were given. The scar outcomes were measured using Patient and Observer Scar Assessment Scale v 2.0/EN (POSAS 2.0). Results The means of the total score of the patient scale of POSAS had a statistically significant difference ( p = 0.012) between the two groups, so had the means of the observer scale ( p = 0.048). The difference in scores between overall patient opinion in the two groups was statistically significant ( p = 0.0119); however, it was not significant in the overall observer opinion ( p = 0.405). Conclusion The beveled incision group had a better scar outcome than the perpendicular incision group.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ischemic Preconditioning in Pedicled Flap Division: A Cost-Effective Innovative Zip Tie Approach","authors":"Deepthi Batchu, Madhavi Chitta, N. Panse","doi":"10.1055/s-0044-1787176","DOIUrl":"https://doi.org/10.1055/s-0044-1787176","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. P. Jayachandiran, S. Rajendran, Manoj Ananthappan, S. R. V. Mahipathy, Alagar Raja Durairaj
Abstract Background Fingertip injuries with amputation are one of the common hand injury problems. Several reconstructive options are available for fingertip injury. V-Y advancement flap is one of the common flaps. In some cases, their advancement capacities are not sufficient to cover the whole defect, resulting in flexion deformity of the distal interphalangeal (DIP) joint, loss of finger pulp shape, or hooked deformity. The double V-Y flap consists of harvesting two cutaneous flaps on the same neurovascular digital palmar bundle. The first V-Y flap is raised as a neurovascular flap and the second flap is an advancement V-Y plasty. Objectives This article evaluates the outcomes of the double V-Y advancement flap for the fingertip reconstruction. Materials and Methods This is a prospective study on 19 patients with zone II and III fingertip amputation tip defects between December 2021 and June 2023. The majority were workplace injuries. Results There were 16 males and 3 females. The average static two-point discrimination was 6 mm. Average advancement of first flap is 8.5 mm and the average advancement of second flap is 4.3 mm. The average total advancement of a double V-Y flap is 12.94 mm (10–15 mm). All of them had “good” total active motion with movement > 210. One patient had flexion deformity at the DIP joint without causing any functional disturbance. All the flaps settled well except for one patient who had superficial partial necrosis of flap which was managed conservatively. Conclusion This is simple and safe for the reconstruction of zone II and III fingertip amputations with the advantage of like-for-like tissue with near-normal sensation. The second flap increased the advancement of the proximal flap, restoring the pulp shape, and thereby reconstructing a functional and aesthetic fingertip.
{"title":"“Flap-in-Flap” Technique: Double V-Y Flap in Fingertip Injury Management","authors":"A. P. Jayachandiran, S. Rajendran, Manoj Ananthappan, S. R. V. Mahipathy, Alagar Raja Durairaj","doi":"10.1055/s-0044-1787278","DOIUrl":"https://doi.org/10.1055/s-0044-1787278","url":null,"abstract":"Abstract Background Fingertip injuries with amputation are one of the common hand injury problems. Several reconstructive options are available for fingertip injury. V-Y advancement flap is one of the common flaps. In some cases, their advancement capacities are not sufficient to cover the whole defect, resulting in flexion deformity of the distal interphalangeal (DIP) joint, loss of finger pulp shape, or hooked deformity. The double V-Y flap consists of harvesting two cutaneous flaps on the same neurovascular digital palmar bundle. The first V-Y flap is raised as a neurovascular flap and the second flap is an advancement V-Y plasty. Objectives This article evaluates the outcomes of the double V-Y advancement flap for the fingertip reconstruction. Materials and Methods This is a prospective study on 19 patients with zone II and III fingertip amputation tip defects between December 2021 and June 2023. The majority were workplace injuries. Results There were 16 males and 3 females. The average static two-point discrimination was 6 mm. Average advancement of first flap is 8.5 mm and the average advancement of second flap is 4.3 mm. The average total advancement of a double V-Y flap is 12.94 mm (10–15 mm). All of them had “good” total active motion with movement > 210. One patient had flexion deformity at the DIP joint without causing any functional disturbance. All the flaps settled well except for one patient who had superficial partial necrosis of flap which was managed conservatively. Conclusion This is simple and safe for the reconstruction of zone II and III fingertip amputations with the advantage of like-for-like tissue with near-normal sensation. The second flap increased the advancement of the proximal flap, restoring the pulp shape, and thereby reconstructing a functional and aesthetic fingertip.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalia Korableva, Nikolay Romanenkov, Dmitriy Kremlev, Andrei Nekrasov, Maksim Miroshnichenko, Peter Arbekov
Abstract Objective To evaluate the possibility of improving and preventing the formation of postoperative hypertrophic and keloid scars using botulinum toxin type A (BTA). Materials and Methods Scientific articles published in English have been systematically screened in PubMed/MEDLINE database over the entire period. The following information about the studies was analyzed: first author surname; year of publication; number of patients; average age; scar location; dosage of the drug administered; follow-up duration; scar assessment methods; results, incidence of hypertrophic and keloid scars formation. The odds ratio and 95% confidence interval were calculated for each of the estimated parameters. The statistical heterogeneity of publications assessed using the criteria of chi-square test and I 2 . The differences were considered significant at p < 0.05. Results A total of 18 prospective randomized studies were selected for evaluation, containing data on the use of BTA in 363 cases. Patients receiving botulinum toxin had a lower Vancouver scar scale index, higher visual analog scale index, and higher Stony Brook scar evaluation scale score. The use of BTA reduces the risk of perceptible scar formation, the incidence of hypertrophic and keloid scars. Conclusion The use of BTA to obtain imperceptible scar and prevent hypertrophic and keloid postoperative scars demonstrates good prospects. However, there is no consensus regarding the pathophysiological mechanisms underlying the positive effect of BTA on the prevention of hypertrophic and keloid scars.
摘要 目的 评估使用 A 型肉毒毒素（BTA）改善和预防术后增生性瘢痕和瘢痕疙瘩形成的可能性。材料与方法 在 PubMed/MEDLINE 数据库中系统地筛选了整个期间发表的英文科学文章。分析了研究的以下信息：第一作者姓氏、发表年份、患者人数、平均年龄、疤痕位置、用药剂量、随访时间、疤痕评估方法、结果、增生性疤痕和瘢痕疙瘩形成的发生率。计算了每个估计参数的几率比例和 95% 的置信区间。采用卡方检验和 I 2 标准对出版物的统计异质性进行了评估。当 P < 0.05 时，差异被认为是显著的。结果 共选取了 18 项前瞻性随机研究进行评估，其中包含 363 例使用 BTA 的数据。接受肉毒杆菌毒素治疗的患者的温哥华疤痕量表指数较低，视觉模拟量表指数较高，石溪疤痕评估量表评分较高。使用肉毒杆菌毒素可降低明显疤痕形成的风险，减少增生性疤痕和瘢痕疙瘩的发生率。结论 使用 BTA 可获得不易察觉的疤痕，防止术后疤痕增生和瘢痕疙瘩，前景良好。然而，关于 BTA 对预防增生性疤痕和瘢痕疙瘩产生积极影响的病理生理机制，目前尚未达成共识。
{"title":"Prospects for Use of Botulinum Toxin Type A for Prevention of Hypertrophic and Keloid Scars after Surgeries (Meta-analysis)","authors":"Natalia Korableva, Nikolay Romanenkov, Dmitriy Kremlev, Andrei Nekrasov, Maksim Miroshnichenko, Peter Arbekov","doi":"10.1055/s-0044-1787175","DOIUrl":"https://doi.org/10.1055/s-0044-1787175","url":null,"abstract":"Abstract Objective To evaluate the possibility of improving and preventing the formation of postoperative hypertrophic and keloid scars using botulinum toxin type A (BTA). Materials and Methods Scientific articles published in English have been systematically screened in PubMed/MEDLINE database over the entire period. The following information about the studies was analyzed: first author surname; year of publication; number of patients; average age; scar location; dosage of the drug administered; follow-up duration; scar assessment methods; results, incidence of hypertrophic and keloid scars formation. The odds ratio and 95% confidence interval were calculated for each of the estimated parameters. The statistical heterogeneity of publications assessed using the criteria of chi-square test and I 2 . The differences were considered significant at p < 0.05. Results A total of 18 prospective randomized studies were selected for evaluation, containing data on the use of BTA in 363 cases. Patients receiving botulinum toxin had a lower Vancouver scar scale index, higher visual analog scale index, and higher Stony Brook scar evaluation scale score. The use of BTA reduces the risk of perceptible scar formation, the incidence of hypertrophic and keloid scars. Conclusion The use of BTA to obtain imperceptible scar and prevent hypertrophic and keloid postoperative scars demonstrates good prospects. However, there is no consensus regarding the pathophysiological mechanisms underlying the positive effect of BTA on the prevention of hypertrophic and keloid scars.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-30eCollection Date: 2024-06-01DOI: 10.1055/s-0044-1785670
Bilal Ahmed Sheikh, Prateek Porwal
{"title":"Successful Surgical Repair of a 26-Day Old Penile Fracture.","authors":"Bilal Ahmed Sheikh, Prateek Porwal","doi":"10.1055/s-0044-1785670","DOIUrl":"https://doi.org/10.1055/s-0044-1785670","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The flexor hallucis longus (FHL) muscle is crucial in fine motor control of the great toe but the muscle is often sacrificed in free fibula flap (FFF) reconstruction. The aim of this study was to compare great toe movement between complete and partial FHL resection during FFF harvest to see if FHL can be left behind (without undergoing fibrosis) in situ when bulk is not required at the recipient site. Methods A prospective, cross-sectional, observational study was performed including patients undergoing FFF harvest over a 2-year period. Movement of great toe interphalangeal joint was recorded of operated and unoperated legs in patients undergoing partial and complete FHL harvest and data analyzed. Results There was a statistically significant ( p < 0.05) difference between the two groups of patients. Conclusion FHL can be safely left in situ in patients not requiring bulk at the recipient site as blood supply, nerve supply, and muscle function are not compromised in partial FHL harvest. Further image-based and dye-based studies are warranted.
{"title":"Comparative Study of Degree of Great Toe Movement after Complete and Partial Flexor Hallucis Longus Harvest in Free Fibula Flap.","authors":"Ishan Agnihotri, Bibhuti Bhusan Nayak, Puja Lakhotia, Aashish Patnaik, Rasmi Ranjan Mohanty","doi":"10.1055/s-0044-1786989","DOIUrl":"10.1055/s-0044-1786989","url":null,"abstract":"<p><p><b>Background</b> The flexor hallucis longus (FHL) muscle is crucial in fine motor control of the great toe but the muscle is often sacrificed in free fibula flap (FFF) reconstruction. The aim of this study was to compare great toe movement between complete and partial FHL resection during FFF harvest to see if FHL can be left behind (without undergoing fibrosis) in situ when bulk is not required at the recipient site. <b>Methods</b> A prospective, cross-sectional, observational study was performed including patients undergoing FFF harvest over a 2-year period. Movement of great toe interphalangeal joint was recorded of operated and unoperated legs in patients undergoing partial and complete FHL harvest and data analyzed. <b>Results</b> There was a statistically significant ( <i>p</i> < 0.05) difference between the two groups of patients. <b>Conclusion</b> FHL can be safely left in situ in patients not requiring bulk at the recipient site as blood supply, nerve supply, and muscle function are not compromised in partial FHL harvest. Further image-based and dye-based studies are warranted.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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