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Breast Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Gaural Patel, Lucy Kate Satherley, Animesh JK Patel, Georgina SA Phillips
If implants are used in reconstruction, there is a higher risk of poor wound healing, rates of infection and later capsular contracture especially with postoperative irradiation of immediate reconstructions. In this situation, an autologous reconstruction may tolerate the effects of radiotherapy better, but there is a risk of causing tissue fibrosis in the flap and this can result in flap volume loss over time.
Urological Trauma
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Davendra M. Sharma, Sanjay Agarwal, Shyam Matanhelia
This patient has a urological injury until proven otherwise. It is essential to determine what injuries exist – right or left ureter, bladder or a combination. Contrast imaging is essential followed by nephrostomy in this sick patient. Once the patient is better, reconstruction can be considered.
Latest trends in breast reconstruction
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
The most common type of breast reconstruction performed in the United States is immediate implant-based reconstruction. In a recent survey, 81% of plastic surgeons reported that they predominantly perform immediate breast reconstruction and two-thirds (64%) of surgical oncologists reported that immediate breast reconstruction was most commonly recommended for their patients.4,5 Moreover, the majority of plastic surgeons nowadays perform implant-based breast reconstruction,4,6 which contrasts with practice in the late 1990s, when autologous reconstruction was the preferred choice of breast reconstruction.7 Over the past two decades, the number of implant-based breast reconstruction have steadily increased, while the number of autologous breast reconstruction have progressively declined.
Updates on Enhanced Recovery after Surgery protocols for plastic surgery of the breast and future directions
Published in Baylor University Medical Center Proceedings, 2023
Nicholas F. Lombana, Ishan M. Mehta, Caiwei Zheng, Reuben A. Falola, Andrew M. Altman, Michel H. Saint-Cyr
Regarding healthcare costs, Oh et al demonstrated savings of $4576 per patient when ERAS protocols were used in microsurgical breast reconstruction.5 Interestingly, Shin et al demonstrated that patients benefitted more from ERAS protocols as their body mass index increased. Specifically, patients with class 1 obesity experienced a 0.99-day decrease (P = 0.048) in LOS, while patients with class 2 or higher obesity experienced a 1.35-day decrease (P = 0.09) in LOS.6 While much of the plastic surgery ERAS literature focuses on inpatient breast reconstruction, many of the same elements have been carried over to outpatient breast procedures.7–10 With a wide array of outcomes being studied and reported, we believe it is helpful to consider ERAS protocols within three phases: preoperative, perioperative, and postoperative.
Peritoneal patch in vascular reconstruction during pancreaticoduodenectomy for pancreatic cancer: a single Centre experience
Published in Acta Chirurgica Belgica, 2023
Vincent De Pauw, Martina Pezzullo, Maria Antonietta Bali, Imad El Moussaoui, Marie-Lucie Racu, Nicky D’haene, Christelle Bouchart, Jean Closset, Jean-Luc Van Laethem, Julie Navez
Venous resection becomes more and more performed during pancreatectomy for cancer, extending surgical indications and potentially improving survival by theoretically enlarging the surgical SMV/PV margin [1,4,15–18]. The type of venous reconstruction depends on several factors, including the length of the resection, the substitute availability, as well as the surgeon expertise. Recently venous reconstruction using a PP substitute was described as feasible and safe with excellent outcome after hepatobiliopancreatic surgeries, but this technique remains poorly described in the current literature [9]. In the present series of PDAC patients presenting SMV/PV tumour contact and/or involvement at diagnostic imaging, we confirmed the feasibility and safety of venous reconstruction using PP during PD, a low rate of complications related to venous reconstruction, and a short-term venous patency loss in 50% of patients but without symptomatic consequences. Concomitant vascular resection resulted in free SMV/PV margin ≥ 1 mm in almost half of the patients. These results encourage us to perform more readily and routinely venous resection in case of tumour-vascular contact, and to reconstruct SMV/PV axis using PP, a quickly harvested, cheap and very helpful vascular substitute. But they also question the need for anticoagulation therapy in such type of venous reconstruction.
Marine sources as an unexplored bone tissue reconstruction material -A review
Published in Egyptian Journal of Basic and Applied Sciences, 2022
Gayatree Nayak, Sanat Kumar Bhuyan, Ruchi Bhuyan, Akankshya Sahu, Dattatreya Kar, Ananya Kuanar
Bone tissue reconstruction is the repairing of damaged fragments during bone fractures, tumor resections, or various bone diseases such as osteoarthritis, osteoporosis, osteomalacia, and osteogenesis imperfect [1]. ‘Bone tissue engineering’ is a multi-disciplinary field as it connects with genetics, clinical medicine, mechanical engineering, and materials science [2]. It is also used as a central tool for the development of regenerative medicines, utilized in biomimetics, cells, and tissue for regeneration [3]. The National Science Foundation (NSF) was the pioneer to introduce this term in the year 1988. The idea of bone tissue regeneration is based on understanding the structural and functional components of the tissues during both the physiologic and pathologic scenarios. To this, the science of engineering techniques, their principle, and their application was amalgamated into tissue engineering [4]. The key objective is to patch the defective region and return it to its original function [5]. This review discusses the marine source as a potential alternative in the field of medicine and dentistry for bone tissue reconstructive indications.