Severe Panfacial Fracture With Facial Explosion: Integrated and Multistaged Reconstructive Procedures

2003 ◽  
Vol 14 (6) ◽  
pp. 893-898 ◽  
Author(s):  
Luigi Clauser ◽  
Manlio Galiè ◽  
Stefano Mandrioli ◽  
Elisabetta Sarti
1998 ◽  
Vol 3 (5) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham

Abstract Accurate measurement of shoulder motion is critical in assessing impairment following shoulder disorders. To this end, measuring and recording joint motion are important steps in diagnosing, determining the severity and progression of a disorder, assessing the results of treatment, and evaluating impairment. Shoulder movement usually is composite rather than in a single plane, so isolating single movements is challenging. Universal goniometers with long arms are used to measure shoulder motion, and testing must be performed and recorded consistently. Passive motion may be carried out cautiously by the examiner; two measurements of the same patient by the same examiner should lie within 10° of each other. Shoulder extension and flexion are illustrated. Maximal flexion of the shoulder also includes slight external rotation and abduction, and controlling or eliminating these components during evaluation is challenging. Abduction and adduction are illustrated. Deficits in external rotation may occur in patients who have undergone reconstructive procedures with an anterior approach; deficits in internal rotation may result from issues with shoulder instability. The authors recommend recording the shoulder's range of motion measurements according to the Upper Extremity Impairment Evaluation Record in the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition.


Swiss Surgery ◽  
2002 ◽  
Vol 8 (2) ◽  
pp. 45-52 ◽  
Author(s):  
Remmel ◽  
Harder

Prophylactic mastectomy is an aggressive strategy for breast cancer risk reduction. The indications and efficiency of this procedures are not yet clearly defined. Randomized, prospective studies, comparing different surgical procedures with other modalities of breast cancer risk reduction are lacking. The report evaluates the existing controversy, based on Medline search in the following sequence: risk factors, possibilities of risk reduction, effectiveness of risk reduction, technical considerations and recommendations. Patient selection is difficult and needs an interdisciplinary approach. The women have to be well informed about all treatment alternatives and various reconstructive procedures. An appropriate risk reduction strategy should be selected individually for each patient. Up to now, there exist only recommendations from different institutions but no definitive guidelines.


2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
T. Yano ◽  
M. Okazaki ◽  
K. Tanaka ◽  
A. Tsunoda ◽  
M. Aoyagi ◽  
...  

2018 ◽  
Author(s):  
J Neymeyer ◽  
AY Weintraub ◽  
S Weinberger ◽  
DE Moldovan ◽  
K Kornienko ◽  
...  

Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.


Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Jan Gödeke

Abstract Purpose Collective evidence from single-centre studies suggests an increasing incidence of pilonidal sinus disease in the last decades, but population-based data is scarce. Methods We analysed administrative case–based principal diagnoses of pilonidal sinus disease and its surgical therapy between 2005 and 2017 in inpatients. Changes were addressed via linear regression. Results The mean rate of inpatient episodes of pilonidal sinus disease per 100,000 men increased from 43 in 2005 to 56 in 2017. In females, the mean rate of inpatient episodes per 100,000 women rose from 14 in 2005 to 18 in 2017. In the whole population, for every case per 100,000 females, there were 3.1 cases per 100,000 males, but the numbers were highly variable between the age groups. There was considerable regional variation within Germany. Rates of inpatient episodes of pilonidal sinus disease were increasing in almost all age groups and both sexes by almost a third. Surgery was dominated by excision of pilonidal sinus without reconstructive procedures, such as flaps, whose share was around 13% of all procedures, despite recommendations of the national guidelines to prefer flap procedures. Conclusion Rates of inpatient episodes of pilonidal sinus disease in Germany rose across almost all age groups and both sexes with relevant regional variation. The underlying causative factors are unknown. Thus, patient-centred research is necessary to explore them. This should also take cases into account that are solely treated office-based in order to obtain a full-spectrum view of pilonidal sinus disease incidence rates.


2021 ◽  
pp. 229255032110300
Author(s):  
Caroline F. Illmann ◽  
Christopher Doherty ◽  
Margaret Wheelock ◽  
Joshua Vorstenbosch ◽  
Joan E. Lipa ◽  
...  

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.


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