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Changes in the Microcirculation and Physiologic Perfusion Dynamics of Free DIEP Flaps in the First 72 h After Breast Reconstruction.
The autologous reconstruction of the female breast using a microsurgical DIEP flap is a reliable and safe method. To detect impairments early and preserve the microvascular flap through timely revision, a better understanding of physiologic…
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[The Reconstruction of Complex Thoracic Defects with Free Flaps and the Choice of the Appropriate Recipient Vessel].
Extensive thoracic wall defects can arise from the resection of malignant tumours or from sternal osteomyelitis following cardiac surgery. The aim of this study is to analyse the feasibility of reconstruction with free flaps, and considers …
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[Free Flap Reconstruction of Gluteal Defects].
Large and bulky soft tissue defects in the gluteal, perineal and sacral regions are a reconstructive challenge, especially if suitable local flaps are not available. In such cases, a free flap may be necessary, the choice of which depends o…
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[Reconstruction of Perineal and Pelvic Defects: the Inferior Epigastric Artery (DIEA) as a Recipient Vessel for Free Flap Reconstruction].
Extensive defects in the perineal or anterior/lateral pelvic region can occur as a result of tumour-related resections, infections, or postoperative complications. In cases where local or pedicled flap reconstructions are insufficient, micr…
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Platelet-Rich Fibrin Mediates Beneficial Effects on Adipose-Derived Stem Cells via Increased Levels of Key Cytokines.
Recent studies showcased the regenerative potential of Platelet-Rich Fibrin (PRF) combined with Adipose-Derived Stem Cells (ASC). PRF enhances cellular proliferation through sustained growth factor secretion which are continuously released …
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[From Liposuction to Reconstruction: Interdisciplinary Management of Necrotising Fasciitis after Outpatient Liposuction in a Non-Specialist Setting].
This case report describes the clinical course of necrotising fasciitis as a serious complication following outpatient liposuction. The patient required extensive surgical procedures, including radical debridement, negative pressure wound t…
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Macroareolar Changes following Periareolar Mastopexy: A Postoperative Assessment.
[BACKGROUND] Breast-conserving therapy (BCT) combined with periareolar mastopexy aims to optimize oncological safety and aesthetic outcomes. One known complication is postoperative enlargement of the nipple-areola complex (NAC), which may a…
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Microvascular Muscle vs. Fascio-Cutaneous Free Flaps for Reconstruction of Plantar Load-Bearing Foot Defects-An International Survey.
: The reconstruction of plantar load-bearing foot defects faces many plastic surgeons with a major challenge. The optimal patient- and defect-oriented reconstructive strategy must be selected. : To analyze the current trends and recommendat…
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[Robotic-assisted harvesting of a latissimus dorsi muscle flap: a case report].
Having established itself in various other areas of surgery as well as in urology, robotics is increasingly gaining importance in plastic surgery. The case presented in this manuscript describes the first published robotic-assisted harvesti…
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Mind the gap! Interdisciplinary approach to anterior chest wall reconstruction after total sternectomy.
[BACKGROUND] There are various reconstructive methods after total sternectomy. Reproducibility is scarce due to overall small patient numbers. Therefore we present a standardized, interdisciplinary approach for thoracic and plastic surgery.…
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To Shrink or Not to Shrink? An Objective Assessment of Free Gracilis Muscle Volume Change in Lower-Extremity Defect Reconstruction.
The use of free gracilis muscle flaps in reconstructive surgery of the lower leg is common practice to cover defects. However, there is still a lack of understanding of the morphometric changes that occur in the transferred muscle and area …
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Impact of Negative Pressure Wound Therapy on Perfusion Dynamics in Free Latissimus Dorsi Muscle Flaps.
Free muscle flaps can develop significant postoperative edema and wound exudation, thereby increasing interstitial pressure and potentially compromising microcirculation. While concerns exist regarding negative pressure wound therapy (NPWT)…
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Impact of Postoperative Norepinephrine Administration on Free Flap Flow.
The perioperative interplay between blood pressure, vasopressors, and macrocirculation is well established. However, in the context of free flap surgery, the potential impact of these factors on microvascular flow remains elusive. The aim w…
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[Breast implant-associated squamous cell carcinoma: a systematic literature review].
[BACKGROUND] Breast implant-associated squamous cell carcinoma (BIA-SCC) is being discussed as a distinct malignant tumour entity originating from the implant capsule. The FDA and the ASPS published a safety communication on BIA-SCC in 2022…
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Dermatofibrosarcoma protuberans of the scalp: Surgical management in a multicentric series of 11 cases and systematic review of the literature.
[BACKGROUND] Dermatofibrosarcoma protuberans is a rare, slow-growing soft-tissue malignancy originating in the dermis that is characterized by an infiltrating growth pattern with a marked tendency of local recurrence. Complete surgical rese…
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Impact of patients' gender on microvascular lower extremity reconstruction.
The physiological differences between genders have significant implications for health and disease. With regard to microsurgery, results remain elusive as to whether male or female gender is an independent risk factor for free flap reconstr…
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Defect Coverage after Forequarter Amputation-A Systematic Review Assessing Different Surgical Approaches.
Autologous fillet flaps are a common reconstructive option for large defects after forequarter amputation (FQA) due to advanced local malignancy or trauma. The inclusion of osseous structures into these has several advantages. This article …
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Comparing the Time-Dependent Evolution of Microcirculation in Gracilis vs. ALT Flaps Using Laser-Doppler Flowmetry and Tissue-Spectrometry.
Postoperative free flap monitoring is considered a key component of care after microsurgical reconstruction. To achieve successful flap salvage after surgical revision, early recognition of vascular compromise is required. The aim of this s…
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The 72-Hour Microcirculation Dynamics in Viable Free Flap Reconstructions.
[BACKGROUND] The risk for vascular complications is the highest within the first 24 hours after free flap transfer. Clinical signs of critical perfusion are often recognized with time delay, impeding flap salvage. To detect failing flaps a…
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Analysis of Factors Determining Patient Survival after Receiving Free-Flap Reconstruction at a Single Center-A Retrospective Cohort Study.
[BACKGROUND] Microsurgical tissue transfer revolutionized reconstructive surgery after extensive trauma, oncological resections, and severe infections. Complex soft tissue reconstructions are increasingly performed in multimorbid and elderl…
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Identifying the most attractive umbilical position - an eye tracking- and survey-based investigation.
Abdominoplasty is a popular procedure in plastic surgery providing aesthetic, functional and psychological relief for patients suffering from excess abdominal tissue. Correct umbilical positioning is crucial for a successful aesthetic surgi…
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Facial Recognition Pattern before and after Lower Eyelid Blepharoplasty: An Eye Tracking Analysis.
This study investigated eye movement patterns using eye tracking technology when looking at preoperative and postoperative images of patients that underwent bilateral periorbital cosmetic surgery. The sequence of facial recognition before s…
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The Layered Anatomy of the Nose: An Ultrasound-Based Investigation.
[BACKGROUND] An increasing number of soft tissue filler procedures in the nasal region has been reported. Concomitant with demand, the number of complications has risen due to the difficulty in administering filler in a region where soft ti…
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Impact of Intraoperative Hypothermia on Microsurgical Free Flap Reconstructions.
[BACKGROUND] Patients requiring microsurgical defect reconstruction are highly susceptible to intraoperative hypothermia, given oftentimes long operative times and exposure of large skin surface areas. While the impact of hypothermia has b…
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Effect of Radiation Therapy on Microsurgical Deep Inferior Epigastric Perforator Flap Breast Reconstructions: A Matched Cohort Analysis of 4577 Cases.
[INTRODUCTION] Breast reconstruction with autologous tissue is a state-of-the art procedure. Several patient-related factors have been identified with regard to the safety and efficacy of these reconstructions. The presented study investiga…
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[The frequency of performing vascular anastomoses determines the learning curve in a retrospective analysis of 212 participants of the Munich course of microsurgery].
[OBJECTIVE] Microsurgical courses are a widely accepted and common method of acquiring microsurgical skills outside of the operation theatre. In-vivo models are often used to prepare surgeons for vascular microsurgery in patients. Although …
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[Defect coverage after severe soft tissue infections: when and how?].
Severe infections frequently cause large soft tissue defects which require early defect coverage by plastic surgeons. A number of reconstructive treatment options are available, ranging from local flaps to microvascular free flap reconstruc…
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Comparison of Outcomes of End-to-End versus End-to-Side Anastomoses in Lower Extremity Free Flap Reconstructions.
[BACKGROUND] Whether to perform an end-to-end (ETE) versus end-to-side (ETS) arterial anastomosis is an integral part of preoperative planning and intraoperative decision making in free flap-based reconstructions. This study evaluated the …
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Impact of Smoking Status in Free Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction: A Multicenter Study.
[BACKGROUND] Several patient-related factors have been identified with regard to the safety and efficacy of breast reconstructions. Using the largest database available in Europe, the presented study investigated the impact of cigarette sm…
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[The COVID-19 Pandemia and its consequences for plastic surgery and hand surgery].
The first case of a SARS-Cov-2 virus infection was confirmed on January 27th in Munich. For both, plastic and hand surgeons it is crucial to act responsible, minimize the transmission of the virus and aid in reasonable and adequate allocati…