scholarly journals One injection for a great projection: a quick and simple procedure for nipple reconstruction

2021 ◽  
Vol 48 (2) ◽  
pp. 179-184
Author(s):  
Sara Tanini ◽  
Sara Calabrese ◽  
Elena Lucattelli ◽  
Giulia Lo Russo
Keyword(s):  
Simple Procedure ◽  
Donor Site ◽  
Three Dimensional ◽  
Donor Site Morbidity ◽  
Single Step ◽  
Nipple Reconstruction ◽  
Breast Cancer Patients ◽  
Reconstruction Process ◽  
Areolar Complex ◽  
Wound Matrix

Women attach great importance to the presence of a three-dimensional nipple upon completion of the breast reconstruction process. To meet patients’ expectations, nipple-areolar complex reconstruction should achieve symmetry in position, size, shape, texture, and color, as well as minimizing donor-site morbidity. However, it is well known that regardless of the reconstructive technique, loss of nipple projection can be reasonably expected. We developed and evaluated a quick, simple, and innovative technique using injectable Integra Flowable Wound Matrix to increase nipple projection after reconstruction. Twenty breast cancer patients who underwent nipple reconstruction resulting in unsatisfactory projection were enrolled in our retrospective study. Nipple projection was measured at the time of surgery and after 6 and 12 months. A visual analogue scale was used to assess patients’ satisfaction. Our technique yielded reliable results in terms of the long-lasting maintenance of nipple projection. This method is high-priced, but cost-effective, since one kit may suffice for three patients. Furthermore, our patients were very appreciative of this technique as a single-step, minimally invasive, painless procedure with no reported necessity of re-intervention.

scholarly journals Nipple Reconstruction Techniques: Which is the Best Choice?

2018 ◽  
Vol 5 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Nicolò Bertozzi ◽  
Francesco Simonacci ◽  
Marianna Pesce ◽  
PierLuigi Santi ◽  
Edoardo Raposio
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Contralateral Side ◽  
Skin Thickness ◽  
Nipple Reconstruction ◽  
Areolar Complex ◽  
Long Term Follow Up ◽  
Case Basis

Nipple-Areolar Complex (NAC) reconstruction represents the final, concluding journey of breast reconstruction by being able to give to reconstructed breasts the shape of a natural breast mound. Nevertheless an enormous amount of nipple reconstruction techniques are described in literature, given the fact that most reconstructive options fail to give satisfactory outcomes in relation to the long-term nipple projection. In this review, the authors will browse most common nipple reconstruction techniques, taking into account: Indication, outcome, and side effect. Composite nipple grafts, traditional flaps, flaps with autologous graft augmentation, flaps with allograft augmentation, and flaps with alloplastic augmentation are the main strategies employed nowadays. Composite nipple grafts give the best guarantee of color-texture match with the contralateral side and show satisfactory nipple projection even at long-term follow-up. Skate, star, C-V, and arrow flap are by far the most commonly employed and the most reliable local flaps, however loss of projection of up to 70 percent are reported in literature. Alloplastic grafts were associated with the lowest rates of projection loss followed by autologous and allogenic ones. Nevertheless allogenic grafts are also associated with the highest complication rate, while autologous and allogenic ones have similar rates. Infection, seroma, and fat necrosis are the more commonly reported complications of autologous grafting along with donor site morbidity, while allogenic and alloplastic augmentation grafts may also experience the risk of overcorrection and graft exposure. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn’t been found yet. Whereas it should be chosen on case to case basis depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients’ expectations to ensure the best cosmetic outcome.

Full Thickness Skin Graft for Nail Unit Reconstruction

2005 ◽  
Vol 30 (2) ◽  
pp. 194-198 ◽  
Author(s):  
A. LAZAR ◽  
P. ABIMELEC ◽  
C. DUMONTIER
Keyword(s):  
Skin Graft ◽  
Simple Procedure ◽  
Donor Site ◽  
Skin Grafting ◽  
Malignant Tumour ◽  
Donor Site Morbidity ◽  
Full Thickness ◽  
Full Thickness Skin Graft ◽  
Full Thickness Skin ◽  
Thickness Skin

A retrospective study of 13 patients assessed the use of a full thickness skin graft for nail unit reconstruction after total nail unit removal for nail bed malignancies. No failures of the graft were observed and no patient had recurrence of the malignant tumour at 4 year follow-up. Full thickness skin grafting is a simple procedure which provides a good cosmetic outcome and does not produce significant donor site morbidity.

scholarly journals Sole Reconstruction Using Anterolateral Thigh Free Flap: A Review of 4 Cases

1970 ◽  
Vol 2 (3) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Afriyanti Sandhi
Keyword(s):  
Free Flap ◽  
Weight Bearing ◽  
Donor Site ◽  
Three Dimensional ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Common Procedure ◽  
Anterolateral Thigh ◽  
Protective Sensation ◽  
And Function

Background: The ideal technique for sole reconstruction should meet such requisite as a durable and comfortable weight-bearing surface, solid anchoring to deep tissue for resistance to shear force and adequate protective sensation. The anterolateral thigh (ALT) perforator free flap provides a large, pliable skin island and sufficient bulk, allowing three-dimensional tailoring to complex defects. The present article is about our experience of sole reconstruction ALT perforator free flap. Patient and Method: Total of 4 flaps in the foot defects was performed in February 2009 to December 2012. We reconstructed soft tissue defects in the sole using ALT free flaps, the complications, aesthetic and function results were monitored. Result: ALT perforator free flap provided stable and durable long-term wound cover in all patients, resulting in early rehabilitation and function outcomes were completely achieved. Complications were few and manageable in all cases. Summary: ALT perforator free flap has become common procedure in many centers around the world. The numerous advantages include stable wound coverage; improve aesthetic and functional outcomes, and minimal donor site morbidity. In our experiences, we found that the use of ALT perforator free flap in sole defect reconstruction, to be technically affordable, reliable and have resulted in excellent outcomes.

Nano-Mechanical Properties of Bioceramic Bone Scaffolds Fabricated at Three Sintering Temperatures

2011 ◽  
Author(s):  
Juan Vivanco ◽  
Josh Slane ◽  
Heidi Ploeg
Keyword(s):  
Donor Site ◽  
Three Dimensional ◽  
Ceramic Materials ◽  
The United States ◽  
Bone Defects ◽  
Donor Site Morbidity ◽  
Autogenous Bone ◽  
Common Procedure ◽  
Bioactive Ceramic ◽  
Autogenous Bone Grafts

Bone grafting is an exceptionally common procedure used to repair bone defects within orthopaedics, craniofacial surgery and dentistry. It is estimated that 2.2 million grafting procedures are performed annually worldwide [1] and maintain a market share of $7 billion in the United States alone [2]. There has been a considerable rise in the interest of using bioactive ceramic materials, such as hydroxyapatite and tricalcium phosphate (TCP), to serve as synthetic replacements for autogenous bone grafts, which suffer from donor site morbidity and limited supply [3]. These ceramic materials (which can be formed into three-dimensional scaffolds) are advantageous due to their inherent biocompatibility, osteoconductivy, osteogenecity and osteointegrity [2].

THE "LOCAL DORSAL ADIPOFASCIAL FLAP" FOR VOLAR DIGITAL DEFECTS: A CASE REPORT

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 379-381
Author(s):  
Emmanuel P. Estrella ◽  
Ruth A. Padua
Keyword(s):  
Simple Procedure ◽  
Donor Site ◽  
Early Mobilization ◽  
Donor Site Morbidity ◽  
Single Patient ◽  
Second Stage ◽  
Adipofascial Flap ◽  
Good Healing ◽  
Surgical Options ◽  
The Ideal

The coverage of volar digital defects can be achieved by a variety of surgical options. Although frequently used and reliable, these procedures entail the need for a second stage for flap release, meticulous dissection, sacrifice of a digital artery of the uninvolved digit, or delayed mobilization resulting in digital stiffness. The ideal surgical procedure for such defects should be a simple, single-stage surgery that allows early mobilization and return to function and at the same time avoiding unnecessary donor site morbidity from an uninvolved digit. The "local dorsal adipofascial flap" is a simple procedure that does not need a secondary procedure for flap release and affords early range of motion and return to function. We used this new flap technique in two digits with volar defects in a single patient. At ten months after flap coverage, the fingers were fully functional with good healing of the "local dorsal adipofascial flap."

scholarly journals Recent Developments of Functional Scaffolds for Craniomaxillofacial Bone Tissue Engineering Applications

2013 ◽  
Vol 2013 ◽  
pp. 1-21 ◽  
Author(s):  
Yukihiko Kinoshita ◽  
Hatsuhiko Maeda
Keyword(s):  
Tissue Engineering ◽  
Bone Tissue Engineering ◽  
Bone Tissue ◽  
Donor Site ◽  
Three Dimensional ◽  
Bone Substitutes ◽  
Bone Defects ◽  
Donor Site Morbidity ◽  
Autogenous Bone ◽  
Recent Developments

Autogenous bone grafting remains a gold standard for the reconstruction critical-sized bone defects in the craniomaxillofacial region. Nevertheless, this graft procedure has several disadvantages such as restricted availability, donor-site morbidity, and limitations in regard to fully restoring the complicated three-dimensional structures in the craniomaxillofacial bone. The ultimate goal of craniomaxillofacial bone reconstruction is the regeneration of the physiological bone that simultaneously fulfills both morphological and functional restorations. Developments of tissue engineering in the last two decades have brought such a goal closer to reality. In bone tissue engineering, the scaffolds are fundamental, elemental and mesenchymal stem cells/osteoprogenitor cells and bioactive factors. A variety of scaffolds have been developed and used as spacemakers, biodegradable bone substitutes for transplanting to the new bone, matrices of drug delivery system, or supporting structures enhancing adhesion, proliferation, and matrix production of seeded cells according to the circumstances of the bone defects. However, scaffolds to be clinically completely satisfied have not been developed yet. Development of more functional scaffolds is required to be applied widely to cranio-maxillofacial bone defects. This paper reviews recent trends of scaffolds for crania-maxillofacial bone tissue engineering, including our studies.

A New Technique for Reconstruction of Medium-Sized Eyelid Defects (A Modification of Tessier Nasojugal Flap)

2018 ◽  
Vol 34 (06) ◽  
pp. 657-662 ◽  
Author(s):  
Awat Yousefiazar ◽  
Mohsen Hassanzadazar
Keyword(s):  
Donor Site ◽  
Lower Eyelid ◽  
Donor Site Morbidity ◽  
Single Step ◽  
Surrounding Tissue ◽  
Congenital Defects ◽  
Lateral Canthus ◽  
Local Modification ◽  
A New Technique ◽  
Age Range

AbstractEyelid reconstructions are considered challenging surgical procedures, which are mostly performed due to trauma, tumor resections, and congenital defects. Several techniques can be used to reconstruct the lower eyelid defects. In this study, the authors aimed to introduce a new single-step technique for the reconstruction of medium-sized lower eyelid defects while preventing ectropion. A modified nasojugal flap was designed and harvested after making a complete incision. A dermal extension from the nasolabial area was added to the end of the nasojugal flap. A tunnel was created under the orbicularis oculi muscle, and the dermal tail was passed through this tunnel toward the lateral canthus. The flap was fixed in its new position by suturing. The defect in the nasojugal area was repaired by bilateral advancement of the surrounding tissue. The recovery of the patients was followed up for 6 months, which included assessment of the eyelid position and donor site morbidity. A total of four patients with an age range of 64 ± 8 years who suffered from basal cell carcinoma were treated using the technique introduced in this study. No ectropion or abnormal eyelid position nor donor site morbidity was observed during the follow-up period. Reconstruction of a medium-sized lower eyelid defect using nasolabial flap with local modification combined with orbital canthus fixation resulted in appropriate functional and cosmetic outcomes and limited the risk of complications and morbidity.

3D Bioprinting: The Imminent Future of Maxillofacial Rehabilitation

2021 ◽  
Vol 13 (3) ◽  
pp. 220-226
Author(s):  
P Roshan Kumar ◽  
N Kalavathy ◽  
Mitha M Shetty ◽  
Archana K Sanketh ◽  
Rutuja Tidke
Keyword(s):  
3D Printing ◽  
Reconstructive Surgery ◽  
Donor Site ◽  
Three Dimensional ◽  
Donor Site Morbidity ◽  
Biologically Active ◽  
Organ Shortage ◽  
3D Bioprinting ◽  
Future Prospects ◽  
Maxillofacial Prosthesis

Three dimensional (3D) printing is the most widely used technology in reconstructive surgery to fabricate complex maxillofacial prosthesis. 3D Bioprinting, a combination of 3D printing and tissue engineering is a rapidly expanding technology in the field of regenerative medicine for autograft production. It is an additive manufacturing process in which there is computer-aided deposition of living cells with extracellular matrix (ECM) components with a biomaterial in particular combinations, for the fabrication of 3D biologically active tissue. In this review, we introduced the techniques, principles, limitations and future prospects of 3D bioprinting, a method that can open up new avenues in reconstructive surgery, by solving the problem of organ shortage and decreasing the donor site morbidity.

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