Acta chirurgiae plasticae最新文献

This case report presents interventional sialendoscopy treatment in a patient with chronic parotitis based on sialolithiasis and later Stensen's duct stenosis. After sialendoscopic sialolith removal, stricture of Stensen's duct in the distal part developed, with megaduct formation. On MRI, the parotid gland parenchyma was without present pathology. A transoral approach was chosen. Stensen's duct dissection, transposition, sialendoscopy of the proximal duct, and stenting were performed. After surgery, the patient's state improved, no more episodes of swelling were experienced. The stent was removed after 3 weeks. Six weeks after surgery, the neostoma stays functional with clear saliva secretion.

The Department of Plastic and Aesthetic Surgery, St. Anne's University Hospital in Brno, and Faculty of Medicine of Masaryk University, Brno, has a long history of surgical treatment of lymphedema and elephantiasis, which started in 1970s. There were many types of surgeries described and performed at our department - starting with prof. Bařinka's radical operation of elephantiasis, then lower limb end-to-side lymphovenous anastomosis pulled through the wall to the great saphenous vein, and genital lymphedema reduction. We call this era "the first period" of surgical lymphedema treatment. "The second period" started in 2016 by using free flaps with lymph nodes or vascularized lymph nodes and using microsurgical techniques of end-to-end, end-to-side and side-to-end lymphovenous anastomoses to the subcutaneous veins of a small calibre, which then drain the lymph into the blood stream. "The third period" started 2 years ago after the visit of prof. Yang from Taiwan - we started to use the method of single stitch end-to-side anastomosis to big subcutaneous veins like the great saphenous vein or the cephalic vein.

Mycobacterium thermoresistibile (MT) infections are extremely rare in humans. This nontuberculous mycobacterial species has been associated with lung, skin, and soft tissue infections. We present the case of a 37-year-old woman who underwent augmentation mammoplasty at another institution and developed a persistent MT infection in the right breast, requiring removal of the infected breast implant, antibiotic therapy and multiple surgical treatments. After three months of targeted antimicrobial therapy, we planned a secondary augmentation mammoplasty, starting the procedure in the non-infected breast with removal of the prepectoral implant and creation of a subpectoral pocket using a dual plane technique. Subsequently, in the affected breast we performed a placement of a subpectoral implant with the same technique and lipofilling. Finally, an inverted T-shaped resection of skin tissue was required on the left breast. After 12 months of follow-up, we obtained an acceptable aesthetic result and reported no recurrence of infection. This is the first case of MT infection in Latin America and of successful secondary augmentation mammoplasty after MT infection.

Introduction: The aim of this study was to assess the long-term impact and potential effectiveness of our specialized acellular dermal matrix (ADM) in a two-stage breast reconstruction process.

Objective: Opinions regarding the use of ADMs are currently divided. While their positive contribution to reconstructive breast surgery is evident, the results of studies vary depending on specific procedures, patient selection, and techniques employed.

Material and methods: In a retrospective study conducted between January 2015 and October 2023, it was examined a cohort of patients who underwent delayed two-stage breast reconstruction with the addition of ADM prepared by Central Tissue Bank (CTB) the Burn and Reconstructive Surgery Department University Hospital Ružinov. Our primary focus was on the occurrence of significant postoperative complications during both the initial and subsequent reconstruction periods, taking into account patients' medical history, comorbidities, and adjuvant therapy.

Results: We examined a total of 46 patients (49 breasts) who underwent two-stage breast reconstruction. The average age of the patients was 46 and the average BMI was 23.1. The average length of outpatient follow-up for female patients was 32 months. We observed a total of 4 cases of capsular contracture, ranging from grade I to grade III, with 2 cases requiring surgical revision through capsulotomy and implant exchange. Postoperative complications, such as infection and dehiscence leading to expander/implant loss, occurred in one case. The occurrence of seroma was noted in 3 cases. Complications were more frequently observed in the group of patients with post-radiation chest changes and comorbidities such as diabetes or hypertension, and in patients with a lower BMI than the group's average (23.1). In the group of patients who were smokers, we did not observe an increased rate of complications, with the exception of wound dehiscence in cases where there was no expander exposure.

Conclusion: In experienced hands, ADM prepared by CTB and used in delayed two-stage breast reconstruction, can be beneficial as an adjunct to prosthetic breast reconstruction while also reducing costs.

We report a case of trigger wrist diagnosed by ultrasonography. The ultrasound findings showed the mass around the flexor tendon triggering at the transverse carpal ligament during finger flexion. The operative findings were consistent with the ultrasonographic findings. This is practical not only to confirm the diagnosis but also to help preoperative planning.

In this article we would like to present, to our best knowledge, the very first published replantation of a forehead/part of a forehead as a single unit. The patient is a 57-year-old male smoker who sustained an avulsion forehead injury after a dog bite. Replantation was performed using microanastomosis of the supratrochlear vessels with restoration of good blood circulation after the procedure. Unfortunately, 5 days after the surgery, ischemia of the flap occurred followed by successful acute revision surgery. Nevertheless, the day after the ischemia reoccurred due to the time that passed, circumstances and unfavorable conditions affecting the sutured vessels, no further revision surgery was indicated. Observation continued and eventual wound necrosis after demarcation was left to be treated with skin grafting or per secundam intentionem. Only partial necrosis of the flap occurred, approximately 50%, which was subsequently treated with a full-thickness skin graft with very good results leading to the satisfaction of the patient.