Ann Carol BraswellKatherine BuchananGrant WagnerAyaka Fujihashi...
1-10页
查看更多>>摘要：Aim:The purpose of this study was to analyze fat grafting with platelet-rich plasma(PRP)in the context of volume replacement and scar hypertrophy improvement in a variety of different cases.Methods:A retrospective review was conducted on 40 patients who underwent a total of 50 fat grafting with PRP procedures by a single surgeon between October 2019 and October 2022.Fat was generally harvested from the abdomen,thighs,or flanks using an enclosed power-assisted system or Toomey syringes with 3.0 or 3.7 mm cannulas.The fat with PRP was grafted into various sites using a 0.9 mm Tulip single port injection cannula for faces/small defects.Of the 50 cases reviewed,the injection sites were as follows:20 cases of injections into scars(hypertrophic scars,burn/trauma scars,and scars from hidradenitis suppurativa),15 injections to the face[to replenish volume lost by aging and two cases for human immunodeficiency virus(HIV)facial atrophy],6 injections to the breasts,4 injections to keloids,4 injections to buttocks,and 1 case of injection to the nose.Results:Overall,for all sites,the average amount of fat harvested was 360 mL,and the average amount of fat with PRP grafted was 96 mL.Of the face grafts,the average amount of fat grafted was 20 mL.The overall complication rate in our cohort was 2%,occurring only in one patient who developed cellulitis after fat grafting to the breast.There were no cases of embolization.The patients showed excellent improvement in volume and significant cosmetic improvement of scars.Conclusion:Patients who underwent autologous fat grafting with PRP had favorable volume replacement and improvement in scarring deformity following the procedure.Fat grafting with PRP was found to be a safe and reliable technique to address various volume and skin concerns.
查看更多>>摘要：Breast cancer is a leading cause of cancer in women worldwide.With increased public awareness of routine breast cancer screening,the incidence of mastectomy and,therefore,breast reconstruction continues to increase year over year.Value-based healthcare has become a universal priority in medical systems.A systematic review of the literature was performed in March 2024 across four electronic databases(PubMed,Embase,Google Scholar,and MEDLINE)and in accordance with the PRISMA guidelines.Screening was performed at two levels(title/abstract and full text screening)by two independent reviewers.Data items extracted included:year,authors,country,study size,duration,strategy implemented,main aims,area of application,study design and methodology,outcomes,relevant statistical analysis,and follow-up.Eleven articles were identified that met all inclusion criteria.Six were retrospective reviews and five were prospective cohort studies.The efficiency models implemented included Lean Six Sigma,the Four Disciplines of Execution,and process mapping and analysis.Emphasizing efficiency is pivotal in delivering outstanding breast reconstruction services and enhancing the overall patient journey.
Gijs DebeijYasmine JonisEleftheria KaravoliaRené van der Hulst...
23-31页
查看更多>>摘要：Aim:Current microsurgical procedures are limited by the physiological tremor and dexterity of the surgeon.The MicroSurgical Assistant(MUSA,Microsure),the world's first robotic platform for(super)microsurgery can aid in resolving issues encountered during microsurgery.This study presents an overview of the operating times and Structured Assessment of Microsurgery Skills(SAMS)scores to assess the duration and quality of microsurgical anastomoses for three microsurgical procedures currently performed using the MUSA.Methods:This study integrates data from one ongoing randomized controlled trial focusing on robotic-assisted lymphaticovenous anastomosis,along with findings from two separate prospective pilot studies concerning digital nerve repair and free tissue transplantation.SAMS scores and time needed per anastomosis were used to evaluate the quality and learning curve of the MUSA-assisted procedures.Results:Thirty-five robotic-assisted procedures were analyzed,including 18 lymphaticovenous anastomoses,9 digital nerve repairs,and 8 free tissue transplantations.All procedures showed a trend of a decrease in the time needed to perform the procedure.Moreover,the mean overall SAMS scores for all three procedures were rated above'satisfactory',with all procedures demonstrating a consistent trend of increasing SAMS scores over time.Conclusion:The evaluation of anastomosis'quality in the initial cohorts of patients undergoing robotic-assisted microsurgery using MUSA indicates satisfying outcomes across all three types of procedures.The reduction in anastomosis time and the improvement in SAMS scores imply an ongoing learning process among the operating surgeons.Subsequent reports are expected to provide information on reaching a plateau phase in procedural efficiency.
查看更多>>摘要：Free flap autologous breast reconstruction is becoming more and more common for post-mastectomy reconstruction.Abdominally-based tissue flaps are the first choice for many reconstructive breast microsurgeons,but not all patients are candidates,whether due to their leaner habitus or a history of prior abdominal surgery.The gluteal donor site in many patients can provide adequate soft tissue for autologous breast reconstruction,even in lean patients,with a scar that remains well-hidden.This review presents an overview of the superior gluteal artery perforator(SGAP)flap as an invaluable tool for autologous breast reconstruction.
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