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Syndactyly release with full-thickness skin graft harvested from the wrist: About 24 webspaces. 腕部全厚皮片移植松解并指畸形:约 24 个网络空间。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-09 DOI: 10.1016/j.anplas.2024.10.002
N Cavadore, A Hamel, F Duteille

The management of congenital syndactylies often requires the use of a full-thickness skin graft to reconstruct the affected web space. Traditionally, full-thickness skin grafts are harvested from the groin region, but using the anterior aspect of the wrist may offers benefits in terms of scar quality while simplifying surgical time. This descriptive study evaluates scar quality (at donor and recipient site) associated with full-thickness skin graft harvested from the volar wrist in syndactyly release. We conducted a retrospective single-center study including patients who underwent syndactyly release with full-thickness skin graft harvested from the anterior wrist. Scar assessment was performed using the Observer Scar Assesment Scale, the Vancouver Scar Scale and the Withey Score. Overall, our results show high scores for scars at both donor and recipient sites. In conclusion, harvesting full-thickness skin graft from the volar wrist in syndactyly release is a simple and effective option for covering defects on the digits, while producing high-quality scars.

治疗先天性联合畸形通常需要使用全厚皮肤移植来重建受影响的蹼间隙。传统上,全厚植皮是从腹股沟区域采集,但使用手腕前侧的植皮可能会在简化手术时间的同时提高疤痕质量。这项描述性研究评估了在腕关节联合畸形松解术中从腕关节外侧采集全厚植皮的相关疤痕质量(供体和受体部位)。我们进行了一项回顾性单中心研究,研究对象包括接受腕关节前侧全厚皮片移植腓肠肌松解术的患者。疤痕评估采用了观察者疤痕评估量表、温哥华疤痕量表和 Withey 评分。总体而言,我们的结果显示供体和受体部位的疤痕得分都很高。总之,在腕关节联合畸形松解术中,从腕关节外侧采集全厚皮肤移植是一种简单有效的方法,既能覆盖手指缺损,又能产生高质量的疤痕。
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引用次数: 0
Using 320-slice computed tomography to preoperatively investigate the leg perforator arterial system and design a perforator flap for patients with a soft-tissue defect in the leg. 利用 320 片计算机断层扫描术前研究腿部穿孔动脉系统,并为腿部软组织缺损患者设计穿孔皮瓣。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-05 DOI: 10.1016/j.anplas.2024.09.007
L Khanh, L V Doan, V H Trung, P A Tuan

Purpose: To investigate the leg perforator arterial system, identify the perforator flap's pedicle artery and its projected cutaneous point using a 320-slice computed tomography (CT 320) scanner.

Methods: A total of 24 patients with leg soft-tissue defects unilaterally underwent 320-slice CT angiography scanning (CTA 320) with 47 legs. The used method enabled investigation of the perforator arteries originating from the tibial, peroneal arteries, perforator flap's pedicle artery and its projected cutaneous point. These data were used to preoperatively design an improved flap. Then, the CT-confirmed location and length of the flap's pedicle artery were compared with intraoperative findings.

Results: Findings of the CTA 320 on 47 legs showed that 217 perforator arteries with diameters of ≥0.5mm were detected; the average number of arteries per leg, their average length and diameter were 4.6±2.1, 30.7±10.4mm and 1.16±0.27mm, respectively. The perforator arteries originating from the anterior tibial artery were mainly distributed in the proximal and middle thirds of the leg. Perforators from the posterior tibial and peroneal arteries were distributed abundantly in the middle and distal thirds of the leg. As identified in the CT, the location and length of the flap's pedicle artery and its projected cutaneous point were consistent with those observed during the surgery.

Conclusions: The CTA 320 is a minimally invasive imaging method that provides high-quality images of the leg perforator arterial system and can identify the exact location and projected cutaneous point of the perforator flap's pedicle artery.

目的:使用 320 片计算机断层扫描(CT 320)研究腿部穿孔器动脉系统,确定穿孔器皮瓣的椎动脉及其投影切点:方法:共对 24 名单侧腿部软组织缺损患者的 47 条腿进行了 320 片 CT 血管造影扫描(CTA 320)。所使用的方法可对源自胫、腓动脉的穿孔动脉、穿孔瓣的椎动脉及其投影切点进行研究。这些数据用于术前设计改良皮瓣。然后,将 CT 确认的皮瓣蒂动脉位置和长度与术中发现进行比较:结果:CTA 320 对 47 条腿的检查结果显示,共发现 217 条直径≥0.5 毫米的穿孔动脉;每条腿的平均动脉数量、平均长度和直径分别为 4.6±2.1、30.7±10.4 毫米和 1.16±0.27 毫米。源自胫前动脉的穿孔动脉主要分布在腿的近端和中段。来自胫后动脉和腓动脉的穿孔器则大量分布在腿的中段和远端三分之二处。正如 CT 所确定的那样,皮瓣蒂动脉的位置和长度及其投影切点与手术中观察到的一致:结论:CTA 320 是一种微创成像方法,可提供腿部穿孔动脉系统的高质量图像,并能确定穿孔皮瓣椎动脉的确切位置和投影切点。
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引用次数: 0
LIPOPULP. The impact of fat grafting on pulp sensitivity in fingertip injuries: A retrospective study of seven patients. LIPOPULP.脂肪移植对指尖损伤牙髓敏感性的影响:七名患者的回顾性研究。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-05 DOI: 10.1016/j.anplas.2024.09.006
C Macni, M Witters, N Kachouh, A Mayoly, C Jaloux

Objective: This study analyzes the impact of fat grafting on pulp sensitivity disorders in patients who experienced fingertip injuries and developed cold intolerance and hyperesthesia.

Material/method: Patients over 10 years old were evaluated using the two-point discriminant score (2PDS), the monofilament test, and the McCabe Cold Sensitivity Severity Scale (CSS) before and after surgery at 3, 6, and 12 months. Other evaluations included the Quick Dash scale (Q-dash), the aesthetics and pain improvement, and patient satisfaction. For children under 10 years old, a parent questionnaire was asked about pain reduction and the ability of parents to trim their children's nails.

Result: Seven patients (2<10 years old and 5>10 years old) who all presented sensitivity disorders following a fingertip injury and were operated on for a pulp fat grafting were analyzed. No significant effects were found on the two-point discriminant score (2PDS), the McCabe Cold Sensitivity Severity Scale (CSS scale), the monofilament test, as well as the quality of life. Four patients experienced less pain and aesthetic improvement. No outcome occurred. A small quantity of fat (0.97mL) was injected and patient satisfaction was good at 6.4/10. For the two children, it was easier for parents to cut their children's nails.

Discussion/conclusion: While no statistically significant improvement in pulp sensitivity was observed, there were subjective improvements in pain relief and aesthetic outcomes, particularly in children. For children, positive effects were found on pain and the facility for parents to cut their children's nails. More studies are required for children. Pulp fat grafting may be a therapeutic option for patients who suffer from fingertip injury.

摘要本研究分析了脂肪移植对指尖受伤并出现冷不耐受和过度麻醉的患者牙髓敏感性失调的影响:年龄超过 10 岁的患者在手术前和手术后 3、6 和 12 个月使用两点判别评分 (2PDS)、单丝测试和麦凯布冷敏感性严重程度量表 (CSS) 进行评估。其他评估包括快速冲刺量表(Q-dash)、美学和疼痛改善情况以及患者满意度。对于 10 岁以下的儿童,还对家长进行了问卷调查,以了解疼痛减轻情况和家长为孩子修剪指甲的能力:对七名患者(210 岁)进行了分析,他们都在指尖受伤后出现了敏感性失调,并接受了牙髓脂肪移植手术。结果发现,手术对两点判别评分(2PDS)、麦凯布冷敏感度量表(CSS 量表)、单丝测试以及生活质量均无明显影响。四名患者的疼痛减轻,美观程度提高。无结果发生。注射了少量脂肪(0.97 毫升),患者满意度为 6.4/10。对于两名儿童来说,父母为孩子剪指甲更加容易了:讨论/结论:虽然没有观察到牙髓敏感性有统计学意义的明显改善,但疼痛缓解和美观效果有了主观改善,尤其是对儿童而言。对儿童而言,疼痛感和家长为孩子剪指甲的便利性都有积极影响。需要对儿童进行更多的研究。牙髓脂肪移植可能是指尖损伤患者的一种治疗选择。
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引用次数: 0
Chirurgie carcinologique du front [前额癌手术]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.07.009
K. Bustamante , E. Sorrel Dejerine
Ce chapitre aborde les grands principes de la petite chirurgie carcinologique du front en pratique quotidienne hospitalière et libérale, ainsi que les reconstructions microchirurgicales plus complexes pour les grandes pertes de substance cutanées. Il est l’occasion de rendre hommage aux cas du Professeur Jean Marie Servant, dont les cas n’ont jamais été publiés.
This chapter deals with the guiding principles of small forehead carcinology in routine hospital-based and private practice, as well as more complex microsurgical reconstruction following severe loss of cutaneous substance. This article also affords an occasion to pay tribute to Professor Jean Marie Servant, whose case studies were never published.
本章论述了小额头癌在医院和私人诊所常规治疗中的指导原则,以及皮肤物质严重缺失后更为复杂的显微外科重建。本文也是向让-玛丽-塞尔万教授致敬的机会,他的病例研究从未发表过。
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引用次数: 0
Le MASK lift [MASK电梯]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.07.003
C. Jamin, B. Laure
Le MASK lift ou lifting sous-périosté des tiers supérieur et moyen de la face est un geste qui peut être réalisé seul à visée esthétique mais qui peut aussi être associé à la chirurgie réparatrice de cette région afin d’en améliorer le résultat. Ce geste va permettre de potentialiser de manière globale le résultat dans la prise en charge de pathologies complexes. L’objectif de cet article est de présenter la technique chirurgicale du MASK lift en détail, d’en préciser les indications et de montrer que cette technique chirurgicale a toujours sa place dans notre pratique.
The MASK lift or subperiosteal lift of the upper and middle thirds of the face is a procedure that can be performed alone for aesthetic purposes, but can also be combined with reconstructive surgery of this region to improve the result. This procedure will enable the overall result to be enhanced in the management of complex pathologies. The aim of this article is to present the MASK lift surgical technique in detail, to explain its indications and to show that this surgical technique still has a place in our practice.
面部中上部三分之二区域的 MASK 提拉术或骨膜下提拉术是一种可以单独进行的美容手术,但也可以与这一区域的整形手术相结合,以改善手术效果。在治疗复杂病症时,这种手术可以提高整体效果。本文旨在详细介绍MASK提升术的手术技巧,解释其适应症,并说明这种手术技巧在我们的实践中仍然占有一席之地。
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引用次数: 0
Volumétrie frontotemporale pour rajeunir et re-féminiser le visage [额颞部填充术让面部年轻化和女性化]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.06.016
Patrick Bui
L’auteur s’est intéressé à la volumétrie faciale dès les années 1990, période où il prenait en charge la féminisation du squelette facial afin d’améliorer l’intégration sociale des patients transgenres masculins. Il s’agissait à cette période d’une chirurgie squelettique. Très rapidement, ses techniques ont été étendues aux femmes génétiques souhaitant un visage plus féminin. L’étude du vieillissement facial a permis à l’auteur de définir des critères de vieillissements frontotemporal, en particulier une évolution avec l’âge vers une masculinisation frontotemporale. La correction volumétrique frontotemporale est ainsi devenue un élément important du rajeunissement du visage. L’évolution s’est ensuite naturellement faite vers le concept de beauté frontotemporal.
The author became interested in facial volume in the 1990s, during the period when he oversaw the feminization of the facial skeleton to improve the social integration of male transsexual patients. At that time, it was skeletal surgery. Very quickly, these techniques were extended to genetic women who wanted a more feminine face. The study of facial aging allowed the author to define criteria for frontotemporal aging, particularly an evolution with age towards a frontotemporal masculinization. The volumetric frontotemporal correction has thus become an essential element of facial rejuvenation. The evolution then, naturally took place towards the concept of frontotemporal beauty.
作者在 20 世纪 90 年代开始对面部容积产生兴趣,当时他正在监督面部骨骼的女性化,以改善男性变性患者的社会融合。当时,这是一种骨骼手术。很快,这些技术被推广到希望拥有更女性化面容的遗传女性身上。通过对面部衰老的研究,作者确定了额颞部衰老的标准,特别是随着年龄的增长,额颞部男性化的演变。因此,额颞部的容积矫正成为面部年轻化的一个基本要素。于是,"额颞美 "的概念自然而然地演变而来。
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引用次数: 0
Kystes dermoïdes fronto-zygomatiques [前颧骨皮样囊肿]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.06.024
T. Barré, R. Preud’Homme, P. Mathieu, A. Nuffer, A. Veyssière, H. Benateau
Les kystes dermoïdes sont des dérivés embryologiques des tissus mous. Ils résultent d’une inclusion ectodermique aberrante dans le mésoderme au cours du développement embryonnaire précoce. Ces kystes ont une progression lente, et sont fréquents en pédiatrie. Quatre-vingts pour cent d’entre eux siègent au niveau de la tête, et la plupart se situent à la suture fronto-zygomatique, au niveau de la queue du sourcil. Cliniquement, ils sont superficiels ou profonds. Le diagnostic est fortement suspecté cliniquement, parfois renforcé grâce aux examens complémentaires, et posé une fois l’analyse histologique réalisée. L’exérèse chirurgicale par voie ouverte sans rupture du kyste est le gold standard.
Dermoid cysts are embryological derivatives from soft tissues. They result from an ectodermic inclusion in the mesoderm, during the early embryonic development. These cysts have a slow development and are mostly encountered in the pediatric population. Eighty percent of them are located in the head and neck area, and most of them are on the frontozygomatic suture. They are superficial or deep on clinical examination. The diagnosis is mostly easy, sometimes with the help of radiological examination. The confirmation is histological. Surgical removed by an open approach, without cyst rupture is the gold standard treatment.
皮样囊肿是软组织的胚胎衍生物。它们是在胚胎早期发育过程中由中胚层的外胚层包涵物形成的。这类囊肿发育缓慢,多见于儿童。80%的囊肿位于头颈部,大多数位于前颧骨缝。临床检查时,瘤体有深有浅。诊断大多很容易,有时还需要借助放射学检查。确诊需要进行组织学检查。手术切除是治疗的金标准,采用开放式方法,囊肿不会破裂。
{"title":"Kystes dermoïdes fronto-zygomatiques","authors":"T. Barré,&nbsp;R. Preud’Homme,&nbsp;P. Mathieu,&nbsp;A. Nuffer,&nbsp;A. Veyssière,&nbsp;H. Benateau","doi":"10.1016/j.anplas.2024.06.024","DOIUrl":"10.1016/j.anplas.2024.06.024","url":null,"abstract":"<div><div>Les kystes dermoïdes sont des dérivés embryologiques des tissus mous. Ils résultent d’une inclusion ectodermique aberrante dans le mésoderme au cours du développement embryonnaire précoce<em>.</em> Ces kystes ont une progression lente, et sont fréquents en pédiatrie. Quatre-vingts pour cent d’entre eux siègent au niveau de la tête, et la plupart se situent à la suture fronto-zygomatique, au niveau de la queue du sourcil. Cliniquement, ils sont superficiels ou profonds. Le diagnostic est fortement suspecté cliniquement, parfois renforcé grâce aux examens complémentaires, et posé une fois l’analyse histologique réalisée. L’exérèse chirurgicale par voie ouverte sans rupture du kyste est le gold standard.</div></div><div><div>Dermoid cysts are embryological derivatives from soft tissues. They result from an ectodermic inclusion in the mesoderm, during the early embryonic development. These cysts have a slow development and are mostly encountered in the pediatric population. Eighty percent of them are located in the head and neck area, and most of them are on the frontozygomatic suture. They are superficial or deep on clinical examination. The diagnosis is mostly easy, sometimes with the help of radiological examination. The confirmation is histological. Surgical removed by an open approach, without cyst rupture is the gold standard treatment.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"69 6","pages":"Pages 554-558"},"PeriodicalIF":0.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reconstruction secondaire des pertes de substance du front [前额缺损的二次重建]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.07.011
A. Paasché , S. Testelin , C. Lamy , J. Bettoni , J. Bouquet , S. Dakpe , C. Capel , B. Devauchelle
Le front est le casque protecteur du cerveau, si l’on se réfère à l’étymologie du mot calvaria. Détruit, il convient de le reconstruire ; en priorité son infrastructure osseuse, quand bien même l’on peut vivre sans elle, dès lors que les autres tissus (peau, muscle, aponévrose, méninge) sont intègres. Chantier chirurgical complexe dont il sera fait mention quand la multiplicité des techniques décrites témoigne de leur imperfection et que jusqu’à présent la meilleure restauration d’un tissu manquant impose sa substitution par le même tissu. Invitation à inventer une véritable chirurgie régénératrice.
The forehead is the protective helmet of the brain, if we refer to the etymology of the word calvaria. Destroyed, it must be rebuilt; priority is given to its bone infrastructure, even though we can live without it, as long as the other tissues (skin, muscle, aponeurosis, meninge) are intact. Complex surgical project which will be mentioned when the multiplicity of techniques described demonstrates their imperfection and until now the best restoration of a missing tissue requires its replacement by the same tissue. Invitation to invent a true regenerative surgery.
如果我们参照 calvaria 一词的词源,前额就是大脑的保护头盔。额头一旦被破坏,就必须重建;只要其他组织(皮肤、肌肉、肌腱膜、脑膜)完好无损,即使没有骨骼,我们也可以生存,但优先考虑的是骨骼基础结构。复杂的外科手术项目将在多种技术不完善的情况下被提及,到目前为止,缺失组织的最佳修复需要由相同的组织来替代。发明真正的再生手术。
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引用次数: 0
Le lifting sourcilier par excision directe [直接切除提眉术]。
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.06.017
B. Cornette de Saint-Cyr, H. Prevot Allouch
Cet article explore la technique du lifting sourcilier par excision directe pour traiter la ptose sourcilière et rajeunir l’apparence du visage. Les techniques actuelles de lifting sourcilier incluent les fils tenseurs et les méthodes chirurgicales traditionnelles comme le lifting frontotemporal et le lift endoscopique. L’excision directe se distingue par sa précision et sa capacité à offrir des résultats durables et esthétiquement satisfaisants. En ajustant la quantité de tissu excisé et la technique de suture, les chirurgiens peuvent obtenir un lifting significatif et harmonieux des sourcils. Cependant, cette méthode n’est pas idéale pour tous les patients, notamment ceux avec des sourcils fins ou blonds. L’article souligne également l’importance d’une évaluation minutieuse avant d’associer la blépharoplastie supérieure au lifting sourcilier. En conclusion, l’excision directe est présentée comme la méthode la plus efficace et durable pour le lifting sourcilier, nécessitant une évaluation individualisée pour garantir des résultats esthétiques optimaux.
This article explores the technique of brow lift by direct excision to treat brow ptosis and rejuvenate facial appearance. Current brow lift techniques include thread lifts and traditional surgical methods such as frontotemporal lift and endoscopic lift. Direct excision stands out for its precision and ability to offer long-lasting and aesthetically pleasing results. By adjusting the amount of excised tissue and the suturing technique, surgeons can achieve a significant and harmonious brow lift. However, this method is not ideal for all patients, particularly those with thin or blond eyebrows. The article also highlights the importance of careful evaluation before combining upper blepharoplasty with a brow lift. In conclusion, direct excision is presented as the most effective and durable method for brow lifting, requiring individualized evaluation to ensure optimal aesthetic results.
本文探讨了直接切除提眉术治疗眉下垂和面部年轻化的技术。目前的提眉技术包括线性提眉术和传统手术方法,如额颞部提眉术和内窥镜提眉术。直接切除法因其精确度高、效果持久、美观而脱颖而出。通过调整切除组织的量和缝合技术,外科医生可以获得显著而和谐的提眉效果。不过,这种方法并不适合所有患者,尤其是眉毛稀疏或金黄的患者。文章还强调了在将上睑成形术与提眉术相结合之前进行仔细评估的重要性。总之,直接切除术是提眉术中最有效、最持久的方法,需要进行个体化评估,以确保获得最佳的美学效果。
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引用次数: 0
Développement et croissance du front [额头的发育和成长]
IF 0.4 4区 医学 Q4 SURGERY Pub Date : 2024-11-01 DOI: 10.1016/j.anplas.2024.06.019
M. Taverne , R.H. Khonsari
Les premières étapes du développement du front aboutissent à la formation des centres d’ossification frontaux et à leur croissance centrifuge. La croissance suturaire prend ensuite le relai, avec une importance cruciale des interactions fonctionnelles, représentées surtout par le cerveau en croissance, via des processus de mécanosensation et de mécanotransduction. Dans cet article, nous passons en revue ces différentes étapes et tentons d’en dégager la pertinence clinique pour la compréhension des malformations craniofaciales.
Craniofacial development involves processes leading to the positioning and early growth of the frontal ossification centers. Growth then occurs, mostly secondary to the activity of the sutures, with major interactions with the functional environment, mostly consisting in the growing brain, based on mechanosensation and mechanotransduction mechanisms. Here, we review these processes and assess their relevance in the understanding of craniofacial malformations.
颅面发育包括额骨骨化中心的定位和早期生长过程。随后的生长主要是继发于缝合线的活动,与功能环境(主要包括生长中的大脑)的主要相互作用基于机械感觉和机械传导机制。在此,我们回顾了这些过程,并评估了它们在理解颅面畸形方面的相关性。
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引用次数: 0
期刊
Annales De Chirurgie Plastique Esthetique
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