scholarly journals Prophylactic Mastectomy: Postoperative Skin Flap Thickness Evaluated by MRT, Ultrasound and Clinical Examination

2020 ◽  
Vol 27 (7) ◽  
pp. 2221-2228
Author(s):  
Rebecca Wiberg ◽  
Magnus N. Andersson ◽  
Johan Svensson ◽  
Anna Rosén ◽  
Freja Koch ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Prophylactic Mastectomy ◽  
Skin Flap ◽  
Magnetic Resonance Tomography ◽  
Plastic Surgeon ◽  
General Surgeon ◽  
Skin Flaps ◽  
Significant Difference ◽  
Flap Thickness ◽  
The Mean

Abstract Background Women with an increased hereditary risk of breast cancer can undergo prophylactic mastectomy (PM), which provides a significant, but not total, risk reduction. There is an ongoing discussion about how much skin and subcutaneous tissue should be resected to perform an adequate PM while leaving viable skin flaps. Methods Forty-five women who had undergone PM were examined with magnetic resonance tomography (MRT), ultrasound (US) and clinical examination (CE) by a plastic surgeon and a general surgeon to estimate skin flap thickness. Results The estimated mean skin flap thickness after PM was 13.3 (± 9.6), 7.0 (± 3.3), 6.9 (± 2.8) and 7.4 (± 2.8) mm following MRT, US, and CE performed by a plastic surgeon and a general surgeon, respectively. The mean difference in estimated skin flap thickness was significant between MRT and the other measuring methods, while there was no significant difference between US and CE, nor between CE performed by the surgeons. The mean skin flap thickness was significantly affected by the age at PM. Following PM, necrosis was detected in 7/23 (30.4%) of the breasts in skin flaps ≤ 5 mm and in 5/46 (10.9%) of the breasts in skin flaps > 5 mm (OR 6.29; CI 1.20–32.94; p = 0.03). Conclusion The odds of getting postoperative necrosis was > 6 times higher in skin flaps ≤ 5 mm. Thus, if the degree of remaining glandular tissue is acceptably low, it is desirable to create skin flaps thicker than 5 mm to prevent wound healing problems after the PM procedure.

scholarly journals Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canineadvancement skin flaps

2020 ◽  
Vol 40 (6) ◽  
pp. 474-478
Author(s):  
Grazielle A.S. Aleixo ◽  
Maria C.O.C. Coelho ◽  
Telga L.A. Almeida ◽  
Márcia F. Pereira ◽  
Miriam N. Teixeira ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Skin Color ◽  
Platelet Rich Plasma ◽  
Skin Flap ◽  
Skin Flaps ◽  
Experimental Conditions ◽  
Significant Difference ◽  
Experimental Group ◽  
Prp Gel ◽  
Made In

ABSTRACT: This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.

A study of Madrid sonographicenthesis score Index (MASEI) versus spondyloarthritis research consortium of Canada (SPARCC) in the assessment of early enthesopathy among psoriatic skin patient

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal M Zytoon ◽  
Nadia S Abd El Bar ◽  
Mona G El Husseiny ◽  
Reem M El-mallah ◽  
Nermin H El-Gharbawy
Keyword(s):  
Clinical Examination ◽  
Power Doppler ◽  
Musculoskeletal Ultrasound ◽  
Psoriatic Skin ◽  
P Value ◽  
Early Assessment ◽  
Significant Difference ◽  
The Mean ◽  
Research Consortium ◽  
Score Index

Abstract Objective To compare between Sonographic Madrid score index (MASEI) versus Spondyloarthritis research consortium of canada (SPARCC) for early assessment of enthesopathy among psoriatic skin patients. Patients and Methods This study included fifty psoriatic skin patients. All underwent history, laboratory investigation, clinical examination using SPARCC score, Psoriasis Area and Severity Index (PASI) and musculoskeletal ultrasound using MASEI score with power Doppler (PD) bilaterally for assessment of enthesitis. Results The mean age of fifty patients was 42.00 ± 10.923 years, disease duration of 11.110 ±7.402 and BMI of 29.356 ± 3.753. The mean PASI was 12.950±8.044. SPARCC score was positive in 10 out of 50 patients (20%).MASEI score was positive in 20 out of 50 patients (40%) with 10 out of 50 patients had power Doppler signals. Highly statistically significant difference between MASEI and SPARCC score( pvalue <0.001). Highly statistically significant positive correlation was observed between PASI score and MASEI(r = 0.498, p-value <0.001). Conclusion musculoskeletal ultrasound is useful for early detection of enthesitis and to be a sensitive tool in detecting of enthesitis and subclinical enthesitis that can be missed during routine clinical examination.

scholarly journals Acetylcysteine in random skin flap in rats

2005 ◽  
Vol 20 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Luiz Eduardo Felipe Abla ◽  
Heitor Carvalho Gomes ◽  
Sandro Percario ◽  
Lydia Masako Ferreira
Keyword(s):  
Normal Skin ◽  
Skin Flap ◽  
Control Group ◽  
Distilled Water ◽  
Significant Difference ◽  
Group Control ◽  
The Mean ◽  
Flap Elevation ◽  
Skin Samples

PURPOSE: Analyze the ability of Acetylcysteine to reduce distal necrosis in a random skin flap, in the rat. METHODS: The present study utilized 28 adult male Wistar-EPM rats distributed, at random, in two groups of 14 animals. Control group rats (CG) received distilled water and Acetylcysteine group animals (NACG) received NAC (300 mg/kg) by oral infusion, 15 minutes before flap elevation. On the seventh postoperative day, percentage of distal necrosis was determined and skin samples collected in order to allow determination of MDA levels. RESULTS: The mean necrotic area in CG group (control) was 66 % and in NACG group (Acetylcysteine) 52 %, a statistically significant difference according to the Mann-Whitney test (U calc = 25; U crit = 45). MDA levels were lower in the CG flap skin samples than in the NACG samples (U calc = 24; U crit = 45), the oposite being true in the normal skin samples (U calc = 10; U crit = 45). CONCLUSION: Acetylcysteine was effective, according to the model used, reducing the percentage of distal necrosis in NACG rats.

A study of blood pressure in school children between the age of 6-12 years in Chennai, India: a cross sectional study

2017 ◽  
Vol 4 (6) ◽  
pp. 2205
Author(s):  
Madhivanan S. ◽  
Harikrishnan E. ◽  
Kumarasamy K.
Keyword(s):  
Blood Pressure ◽  
Clinical Examination ◽  
Economic Status ◽  
Blood Pressure Measurement ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Blood pressure measurements in childhood are an important clinical examination. Present study was done to evaluate the normal range of blood pressure (BP) in children aged 6-12 years and to find its relationship with regard to age, sex, height and weight criteria and comparing the values with the available standards.Methods: This prospective cross-sectional study was done in primary and middle schools of Chennai from January 2016 to May 2017. Three readings of blood pressure were recorded for each subject and were correlated with age, gender, socioeconomic status and anthropometry. Data was analysed on SPSS 20.0. P value of <0.05 was considered significantResults: A total of 2002 children (1026 boys, 976 girls) of age between 6-12 years were examined over 18 months. There was an upward trend in both systolic (r = 0.437, P<0.001) and diastolic BP (r = 0.386, P <0.001) with age. There was no statistically significant difference in mean systolic and diastolic BP with gender (P = 0.10), weight (P = 0.10) and height (P = 0.10). There was a statistically significant difference between the mean systolic and diastolic BP between low and high socio-economic groups (P <0.0001). The proportion of children with hypertension was 9.54% with a slight female preponderance.Conclusions: Blood pressure measurement in children is pivotal in clinical examination. It shows a linear relationship with age and varies across socio-economic status. Periodic recording of BP would enable identify hypertension at an early age.

The Relationship of Hematocrit Levels to Skin Flap Survival Length in the Pig

1981 ◽  
Vol 89 (5) ◽  
pp. 750-752 ◽  
Author(s):  
Jeffrey B. Alperstein ◽  
Howard L. Levine ◽  
Harvey M. Tucker
Keyword(s):  
Human Skin ◽  
Control Animal ◽  
Skin Flap ◽  
Random Pattern ◽  
Skin Flaps ◽  
Flap Survival ◽  
Significant Difference ◽  
Skin Flap Survival ◽  
Relationship Of ◽  
The Relationship

The work of several investigators suggests that anemia may increase the survival length of skin flaps in the dog and the rabbit. The following experiment was designed to study the survival of standardized skin flaps of varying lengths in normocythemic, polycythemic, and anemic pigs. The pig was chosen because of the similarity of its skin to that of human skin. Twenty-nine standardized random-pattern flaps and six standardized arterial flaps were studied in pigs with varying hematocrits. A statistically significant increase was found in the survival lengths of skin flaps in the polycythemic animal as compared with the anemic one. No significant difference was found when the flap survival lengths of the normocythemic control animal were compared with those of the polycythemic animal or with those of the anemic animal. These findings suggest that relative polycythemia may allow improved flap length-survival and, in contradistinction to the findings of previous investigators, that anemia does not result in improved survival length.

scholarly journals Effects of hyperbaric oxygen and N-acetylcysteine in survival of random pattern skin flaps in rats

2012 ◽  
Vol 45 (03) ◽  
pp. 453-458 ◽  
Author(s):  
Fernando da Rocha ◽  
Djalma Fagundes ◽  
Jefferson Pires ◽  
Fernanda Salim da Rocha
Keyword(s):  
Hyperbaric Oxygen ◽  
Skin Flap ◽  
Control Area ◽  
Random Pattern ◽  
Skin Flaps ◽  
Significant Difference ◽  
Male Wistar Rats ◽  
Flap Design ◽  
A Site

ABSTRACT Objective: Our aim is to investigate the role of HBO (hyperbaric oxygen), NAC (N-acetylcysteine), and HBO plus NAC on the necrosis area of random rat′s skin flaps of a modified McFarlane flap design. Materials and Methods: Thirty-two male Wistar rats were randomly divided into four groups: G-S (sham: n = 8), G-NAC (NAC: n = 8), G-HBO (HBO: n = 8), and G-HN (HBO plus NAC: n = 8). A rectangular skin flap (2 × 8 cm 2 ) was dissected from the muscular dorsal layer, preserving the cranial pedicle. Polyethylene film was placed over the muscular layer and an interrupted 3.0 nylon suture was employed to fix the flap into the original place. On the eighth day, full-thickness biopsy samples (2 × 1 cm 2 ) were collected from the proximal, middle, and cranial areas of the skin flap, and in a site away from the flap labelled as the control area. Results: The measurements of necrotic areas in the groups were 18.3% in G-S, 24.3% in G-NAC, 12.6% in G-HBO, and 14.9% in G-HN. Significant difference was observed between the groups G-HBO and G-HN as well as G-NAC. Conclusion: HBO is associated with reduced area of necrosis of skin flap. The G-NAC group was associated with poor results when examined in isolation. The association between HBO and NAC did not produce favourable results with respect to the use of HBO alone. These findings suggest that the diffusion of oxygen through the interstitial space was the determining factor of more favourable results of HBO.

The Role of Photoplethysmography in the Prediction of the Experimental Flap Survival

1978 ◽  
Vol 86 (3) ◽  
pp. ORL-492-ORL-497 ◽  
Author(s):  
Janusz Bardach ◽  
Richard J. Voots ◽  
Brian F. McCabe ◽  
Mow Ming Hsu
Keyword(s):  
Skin Flap ◽  
Skin Flaps ◽  
Arterial Blood ◽  
Flap Viability ◽  
Significant Difference ◽  
Blood Density ◽  
Density Scale ◽  
Experimental Flap ◽  
Venous Vasculature

A standard photoplethysmograph, modified to differentiate between arterial and venous vasculature in skin tissue, has been used to measure arterial supply in 100 unipedicle skin flaps in 25 pigs. A datum transform from a light intensity scale to a relative arterial blood density scale has been introduced and empirically labeled the vascular coefficient (VC). Statistical analysis of the VC data shows a significant difference between necrotic and surviving flap group mean data as early as 24 hours. Additional analysis in which a normal ogive was fitted to the sample VC data distributions suggests that statistically significant predictions of the probability of eventual flap necrosis can be made using VC measurements obtained immediately postoperatively. It is concluded that the modified photoplethysmograph, in conjunction with the VC data transform, constitutes a usable measuring technique for skin flap viability prediction in the experimental animal.

scholarly journals Profil Darah Pada Kucing Selama Proses Kesembuhan Luka Melalui Teknik Skin Flaps Rotasi Yang Dirawat Dengan Dry Dressing Dan Moist Dressing

2020 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
Erwin Erwin ◽  
Rusli Rusli ◽  
Fidella Diva Jones
Keyword(s):  
Skin Flap ◽  
Healing Process ◽  
Treatment Method ◽  
Wound Healing Process ◽  
Skin Flaps ◽  
Blood Profile ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group 2 ◽  
Method Group

The skin flap is one of the techniques employed to reconstruct defects and close wounds. This study aims to observe the blood profile in cats during the healing process of rotation skin flaps that were treated with a dry and moist dressing. This study used six male cats within the age of 1-2 years old and weighed among 2-4 kg, divided into two treatment groups. All of the specimens were treated with the following procedure; the fur on the abdominal area was shaved and disinfectant was applied to the area between the os sacrum and os femur, lastly, 2 cm2 triangle wound was deliberately made on the area. The treatment of the wound was done by the rotation skin flaps method. Group 1 was treated with sterile bandage and group 2 was treated with sofratulle®. Blood samples were taken from the cephalica antebrachii vein on the 1st, 3rd, 6th, and 12th days. The erythrocytes, hemoglobin, hematocrit, platelets, leukocytes, neutrophils, basophils, eosinophils, monocytes, and lymphocytes were counted by hematology analyzer. The results showed that there is a significant difference (P<0.05) in the increase of neutrophil levels between the group treated with sterile kassa (P-1) and the group treated with sofratulle® (P-2). The number of the cats’ red blood cells rose on the 3rd day and rose again on the 12th day after the treatment with a significant difference (P<0.05) during the observation. In conclusion, the rotation flaps treatment method with dry dressing and moist dressing in the wound healing process affected the cats’ blood profile and the moist dressing was preferred to the dry dressing. 

scholarly journals The perforator-centralizing technique for super-thin anterolateral thigh perforator flaps: Minimizing the partial necrosis rate

2021 ◽  
Vol 48 (1) ◽  
pp. 121-126
Author(s):  
Young Chul Suh ◽  
Na Rim Kim ◽  
Dai Won Jun ◽  
Jung Ho Lee ◽  
Young Jin Kim
Keyword(s):  
Technical Difficulty ◽  
Necrotic Area ◽  
Perforator Flaps ◽  
Venous Anastomosis ◽  
Partial Necrosis ◽  
Anterolateral Thigh ◽  
Significant Difference ◽  
Extremity Reconstruction ◽  
Flap Thickness ◽  
The Mean

Background Despite the wide demand for thin flaps for various types of extremity reconstruction, the thin elevation technique for anterolateral thigh (ALT) flaps is not very popular because of its technical difficulty and safety concerns. This study proposes a novel perforatorcentralizing technique for super-thin ALT flaps and analyzes its effects in comparison with a skewed-perforator group.Methods From June 2018 to January 2020, 41 patients who required coverage of various types of defects with a single perforator-based super-thin ALT free flap were enrolled. The incidence of partial necrosis and proportion of the necrotic area were analyzed on postoperative day 20 according to the location of superficial penetrating perforators along the flap. The centralized-perforator group was defined as having a perforator anchored to the middle third of the x- and y-axes of the flap, while the skewed-perforator group was defined as having a perforator anchored outside of the middle third of the x- and y-axes of the flap.Results No statistically significant difference in flap thickness and dimension was found between the two groups. The arterial and venous anastomosis patterns of patients in both groups were not significantly different. Only the mean partial necrotic area showed a statistically significant difference between the two groups (centralized-perforator group, 3.4%±2.2%; skewed-perforator group, 15.8%±8.6%; P=0.022).Conclusions The present study demonstrated that super-thin ALT perforator flaps can be elevated safely, with minimal partial necrosis, using the perforator-centralizing technique.

scholarly journals Oral Mucosa vs. Penile Skin Flap in Substitution Urethroplasty for Anterior Urethral Strictures: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yucheng Ma ◽  
Zhong-Yu Jian ◽  
Qibo Hu ◽  
Zhumei Luo ◽  
Tao Jin
Keyword(s):  
Success Rate ◽  
Oral Mucosa ◽  
Meta Analysis ◽  
Skin Flap ◽  
Operation Time ◽  
Skin Flaps ◽  
Penile Skin ◽  
Anterior Urethra ◽  
Significant Difference ◽  
Fixed Model

Background: The purpose of this study is to compare the effectiveness and safety of oral mucosa and penile skin flaps in the treatment of anterior urethral stricture.Methods: This meta-analysis was carried out according to the principle of preferred reporting items for systematic reviews and meta-analysis (PRISMA) and registered at PROSPERO (CRD42021277688). The Cochrane Library, PubMed, Embase, CKNI databases were searched and reviewed up to Sep 2021. Quality evaluation was performed with Newcastle-Ottawa Scale (NOS) system for non-randomized studies and Cochrane stools for randomized studies. Data synthesis was conducted with RevMan 5.4 software (Cochrane) and a Stata 15.0 environment (Stata Corpor, College Station, TX, USA).Results: After the research screening, eight studies (comprising 445 patients) were finally included in the quantitative analysis. In the success rate comparison, there was no significant difference between oral mucosa and penile skin flaps (oral mucosa vs. penile skin flap, Mantel-Haenszel statistic [M-H] fixed model, OR: 0.80, 95% CI: 0.47–1.34, P = 0.39). There was no significant difference in the post-operative complication comparison (oral mucosa vs. penile skin flap, Mantel-Haenszel statistic [M-H] fixed model, OR: 0.68, 95% CI: 0.40–1.16, P = 0.15). However, considering that the site of oral mucosa is far from the anterior urethra, it may have advantages in operation time through simultaneous operations (oral mucosa vs. penile skin flap, MD: −40.05, 95% CI: −79.42, −0.68, P = 0.046).Conclusion: When the oral mucosal graft was used in the anterior urethra urethroplasty, it had a similar success rate and post-operative complication rate, and oral mucosa substitution had a shorter operation time. This evidence-based medical research further supports the view that oral mucosa is the preferred substitution material for the anterior urethra urethroplasty.

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