Central perforated VRAM flap and neurostimulated levator augmentation for functional and aesthetical reconstruction after abdominoperineal excision in cancer

2021 ◽  
pp. 1-11
Author(s):  
Silvia Bernuth ◽  
Michael Jakubietz ◽  
Christoph Isbert ◽  
Joachim Reibetanz ◽  
Rainer Meffert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Soft Tissue ◽  
Interdisciplinary Collaboration ◽  
Life Quality ◽  
Objective Evaluation ◽  
Abdominoperineal Excision ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Sphincter Function

BACKGROUND: Preservation of quality of life regarding fecal continence after abdominoperineal excision (APE) in cancer is challenging. Simultaneous soft tissue coverage and restoration of continence mechanism can be provided through an interdisciplinary collaboration of colorectal and plastic reconstructive surgery. OBJECTIVE: Evaluation of surgical procedure and outcome combining soft tissue reconstruction using a central perforated vertical rectus abdominis myocutaneous flap (VRAM), implementing a perineostoma and restoring anorectal angle augmenting the levator ani by neurostimulated graciloplasty. METHODS: 14 Patients underwent APE due to cancer. In all patients coverage was achieved by pedicled VRAM and simultaneous pull-through descendostomy (perineostoma). 10 of those patients received a levator augmentation additionally. Postoperative complications, functional measures of continence as well as quality of life were obtained. RESULTS: Perineal minor complication rate was 43% without need of surgical intervention. All but one VRAM survived. Continence measures and disease specific life quality showed a good preservation of continence in most patients. CONCLUSION: The results present a complex therapy option accomplished by a collaboration of two highly specialized partners (visceral and plastic surgery) after total loss of the sphincter function and consecutive fecal insufficiency after APE.

Quality of Life and Surgical Outcomes After Soft-Tissue Reconstruction of Complex Oncologic Defects of the Spine and Sacrum

2016 ◽  
Vol 98 (2) ◽  
pp. 117-126 ◽  
Author(s):  
Roisin T. Dolan ◽  
Joseph S. Butler ◽  
James Wilson-MacDonald ◽  
Jeremy Reynolds ◽  
Lucy Cogswell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Soft Tissue ◽  
Surgical Outcomes ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

scholarly journals Outcomes of Tissue Reconstruction in Distal Lower Leg Fractures: a Retrospective Cohort Study

2020 ◽  
Author(s):  
Emrah Aydogan ◽  
Stefan Langer ◽  
Christoph Josten ◽  
Johannes Maria Karl Fakler ◽  
Ralf Henkelmann
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Soft Tissue ◽  
Lower Leg ◽  
Soft Tissue Reconstruction ◽  
Patient Reported ◽  
Tissue Reconstruction ◽  
Closed Fractures ◽  
The Mean

Abstract Background:Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures or infections. This study evaluated the outcomes of postoperative qualities ofpatients with open or closed lower leg fractures,related softtissue defects, and subsequent flap coverage.Methods:We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed thepatients treated fromJanuary 2012 through December 2017 and recorded demographics, treatment, and outcome data.The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent softtissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-onepatients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16patients underwent arterial examinations via angiography and sixunderwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, EQ-5DVAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular,quality of life was 32.3± 28.8. The rate of returning to work in our patient groupwas 37.5% after one year.Conclusions:Distal tibial fracturesoften require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life and return to work. Our results imply that the severity of associated soft tissue damage with many revision operations and flap complications lead to a poorer outcome with respect to patients without flap ischemia.

scholarly journals PENINGKATAN KUALITAS HIDUP LANSIA MELALUI AKTIVITAS PADUAN SUARA DI GEREJA

PROMUSIKA ◽  
2013 ◽  
pp. 15
Author(s):  
Endang Ismudiati
Keyword(s):  
Quality Of Life ◽  
Subjective Evaluation ◽  
Life Quality ◽  
The Elderly ◽  
Objective Evaluation ◽  
Positive Contribution ◽  
Social And Emotional ◽  
Study Approach ◽  
Service Programs

The activity relationship between choir practicesand the improvement of elderly’s life quality expresses new understanding in art assessment. Musical experiences that has given a meaning in, and evoke the spirit of the elderly life, also contributes to their personal happiness. Choirs of the elderly that mostly found in Yogyakarta churches has generally contributed tothe elderly’s god quality of life. This study has been based on case study approach by applying Felce &Perry’s theory (1996) concerning the current quality of liferefers to the objective and subjective evaluation. The objective evaluation related to aspects of physical, material, social, and emotional while the subjective evaluation related to the personal satisfaction associated with the condition. This study concluded that choir activities done by the elderly can give positive contribution to the quality of life improvement. Based on thid finding, suggests that private as well as public institutions who carry out the elderly ctivities or nursing home to consider choir to be one of their service programs. Keywords: Choir, Quality of life, elderly

Quality of life of patients with Sjogren’s disease with ongoing therapy with diseasemodifying antirheumatic drugs

2020 ◽  
pp. 33-38
Author(s):  
E. Yu. Gan ◽  
L. P. Evstigneeva
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Life Quality ◽  
Well Being ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Sf 36 ◽  
Disease Modifying ◽  
Sjögren’S Disease

Purpose of the study. Assessing the association between the life quality of patients with Sjogren’s Disease and ongoing therapy with various disease-modifying antirheumatic drugs.Material and methods. The study was conducted on the basis of the regional rheumatology center of the consultative diagnostic clinic of the Sverdlovsk Regional Clinical Hospital No. 1. This work is based on the results of a simultaneous study of 74 patients with primary Sjogren’s Disease (SD), distributed in three comparison groups receiving various disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine. The diagnosis of SD was carried out according to European-American criteria AECGC (2002) [18]. In order to analyze the quality of life of patients with SD, the 36-Item Short Form Health Survey (SF‑36) was used. Statistical data processing was carried out using Statistica 7.0 program.Results. Assessment of the quality of life of patients with SD, which is an integrative criterion of human health and well-being, revealed the absence of statistically significant differences (p > 0.05) on eight scales and two health components of the SF‑36 questionnaire in the analyzed groups that differ in the treatment of disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine.Conclusions. The obtained data indicate an equivalent quality of life in SD patients treated with different disease-modifying antirheumatic drugs methotrexate, chlorambucil and hydroxychloroquine, and therefore hydroxychloroquine can be considered as an alternative basic therapy in patients with SD with certain limitations and contraindications methotrexate and chlorambucil.

Health related quality of life of rosacea patients in China assessed by DLQI and willingness to pay: Cross-Sectional Questionnaire Study (Preprint)

2020 ◽  
Author(s):  
Yaqun Huang ◽  
Sha Yan ◽  
Hongfu Xie ◽  
Ben Wang ◽  
Zhixiang Zhao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Willingness To Pay ◽  
Disease Duration ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

BACKGROUND Rosacea is a chronic inflammatory dermatosis with facial skin involved, leading to physical and emotional problems, which greatly affected quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. OBJECTIVE To investigate HRQoL in Chinese rosacea patients assessed by DLQI and WTP and investigate potential predictors for patients with HRQoL severely affected. METHODS This cross-sectional study was conducted on 973 patients with rosacea. Sociodemographic data, clinical features and DLQI were collected, and WTP was assessed by three standardized items. Multivariable logistic analysis was performed to investigate independent factors influencing QoL. RESULTS 921 questionnaires were accomplished by participants. The mean DLQI score was 11.6 (median 11). Patients were willing to pay an average of $1050.2 or € 896.2 (median $431.4 or € 368.1) for complete cure. 33.3% would like to pay more than 20% of their monthly income to achieve sustainable control. There were positive correlations between WTP with DLQI (P < .05). DLQI could be independently impacted by age (21-30 and 31-40, OR = 3.242 and 3.617, respectively), the occupational requirement of appearance (high, OR = 4.410), disease duration (< 2 years, OR = 1.582), oedema (OR = 1.844) and severity of flushing, burning, stinging and pruritus (severe, OR = 2.003, 1.981, 2.491, 2.249, respectively). There were no significant associations between WTP and most of the clinical factors. CONCLUSIONS The QoL was negatively affected and should not be ignored among rosacea patients in China. Patients aged 21-40y, having occupational requirement of appearance, with the disease duration less than 2 years, and suffering severe flushing and related symptoms were more likely to have severe or very severe limitation of QoL.

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