One versus Two Venous Anastomoses in Anterolateral Thigh Flap Reconstruction after Oral Cancer Ablation

2017

Letter to Editor

Magnetic Resonance Imaging and Ultrasound Evaluation after Breast Autologous Fat Grafting Combined with Platelet-Rich Plasma

2014

Non-Hodgkin B-cell lymphoma involving the palate.

2018

Prophylactic chimera anterolateral thigh/vastus lateralis flap: preventing complications in high-risk head and neck reconstruction

2014

Purpose In high-risk head and neck cases treated with tumor resection and associated radical neck dissection, orocutaneous fistulas and wound breakdowns in the neck are relatively frequent and can have serious consequences, such as carotid blowout syndrome (CBS), the need for salvage reoperations, and prolonged recovery time. The authors present the application of a prophylactic chimeric anterolateral thigh (ALT) and vastus lateralis (VL) flap to prevent complications. Materials and Methods A retrospective review was performed of a historical group (96 patients) of patients with head and neck cancer treated with tumor resection, radical neck dissection, and microsurgical reconstruction of t…

anatomia vascolare e mucosasomi del cavo orale.

2017

Nonostante il concetto di perforante o propeller mucosale non sia stato ben standardizzato e definito, gli studi anatomici dei territori vascolari del cavo orale, hanno dimostrato come la anatomia vascolare della mucosa orale sia costante ed affidabile. 8 i territori vascolari identificati utili per l'allestimento di lembi locali.

Effectiveness of clinical and instrumental follow-up for cutaneous melanoma

2022

Introduction: Follow-up guidelines for melanoma greatly differ in the methods of screening for recurrence, and timing and duration of the follow up, with many areas of controversy and a lack of general consensus. The aims of this study are to present our protocol and case series for follow up and to summarize and discuss current literature on melanoma follow-up guidelines/recommendations in different countries. Methods: We retrospectively reviewed 539 patients operated for melanoma between 2004 and 2013 at the same Institution. Data on the diagnostic role of the different clinical and instrumental detection methods were adjusted for sex, age at diagnosis, staging and evaluated by Fisher's e…

Propeller flap for treatment of a poststernotomy sternal fistula: A case report.

2014

Summary The treatment of post-operative deep sternal wound infections is a real challenge for surgeons. Conservative treatment with debridement and vacuum-assisted closure (VAC) therapy is not always successful. In the most severe and chronic cases, a surgical debridement and reconstruction of the defect is mandatory. In this report, the authors present a case of a 61-year-old female patient with a chronic cutaneous fistula in the sternal region following a median sternotomy after coronary artery bypass. The patient had already undergone treatment with antibiotics, drainage of an abscess and local debridement, but the infection continued to relapse periodically. The authors decided to treat…

U-stitches in microvascular anastomosis in an animal model.

2017

Composite graft: a simple option for nasal lining.

2007

Background  We present our experience in the reconstruction of full-thickness losses of the substance of the nose using a forehead flap and a composite graft (taken from the anterior surface of the concha and adequately shaped) as both support and endonasal lining. This technique has never been described for the reconstruction of large full-thickness losses of the substance of the nose. The donor site of the composite graft in the concha is repaired by a Masson retroauricular flap. Methods  This technique was used on 14 patients (age range, 52–92 years) after full-thickness excision of tumors of the distal third of the nose. Follow-up was from 1 to 4 years. All the composite grafts were rev…

Melanoma Extirpation with Immediate Reconstruction

2017

Letter to Editor

Absence of germline CDKN2A mutation in Sicilian Patients with Familial Malignant Melanoma: could it be a population-specific genetic signature?

2015

Germline CDKN2A mutations have been described in 25% to 40% of melanoma families from several countries. Sicilian population is genetically different from the people of Europe and Northern Italy because of its historical background, therefore familial melanoma could be due to genes different from high-penetrance CDKN2A gene. Four hundred patients with cutaneous melanoma were observed in a 6-years period at the Plastic Surgery Unit of the University of Palermo. Forty-eight patients have met the criteria of the Italian Society of Human Genetics (SIGU) for the diagnosis of familial melanoma and were screened for CDKN2A and CDK4 mutations. Mutation testing revealed that none of the families car…

Transdermal Nitroglycerine Patch: An Optional Device to Reduce Flap Venous Congestion? A Case Report

2013

ABSTRACT Sometimes in free flap there is a venous congestion without an obstruction of the venous anastomosis or other organic causes of reduction venous drainage (haematoma, seroma compressing the pedicle). In these cases the authors suggest the application of nitroglycerine patch in the congested area of the flap few hours before the surgical exploration of the anastomosis. If there is a fast improvement of the clinical feature of the flap, the surgical exploration could be avoided. The authors underline that applying the nitroglycerin patch should not be regarded in any way as a therapy of a free flap venous thrombosis but only as an useful device, an option to be taken only when the sur…

Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Prod…

2012

Abstract: In patients suffering from oral cavity cancer surgical treatment is complex because it is necessary to remove carcinoma and lymph node metastasis (through a radical unilateral or bilateral neck dissection) and to reconstruct the affected area by means of free flaps. The saliva stagnation in the post-operative period is a risk factor with regard to local complications. Minor complications related to saliva stagnation (such as tissue maceration and wound dehiscence) could become major complications compromising the surgery or the reconstructive outcome. In fact the formation of oro-cutaneous fistula may cause infection, failure of the free flap, or the patient’s death with carotid b…

A Rare Case of Giant Basal Cell Carcinoma of the Abdominal Wall: Excision and Immediate Reconstruction with a Pedicled Deep Inferior Epigastric Arter…

2017

Patient: Female, 82 Final Diagnosis: Giant basal cell carcinoma Symptoms: Anemia Medication: — Clinical Procedure: — Specialty: Plastic Surgery Objective: Rare disease Background: Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. Case Report: We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal …

Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

2010

CONCLUSIONS: Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. OBJECTIVES: Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during th…

Laser treatment of giant xanthelasma palpebrarum

2013

Xanthelasma palpebrarum is the most common cutaneous xanthoma. It typically presents in middle-aged and older adults, most often around the eyelids. The diagnosis is made clinically. Giant xanthelasmas palpebrarum are xanthelasmas that extensively affect the superior and inferior bilateral eyelids. Many techniques have been put forward for treating these lesions (surgical, laser, and chemical techniques), but we describe our experience in the treatment of giant xanthelasmas by ultrapulsed CO2 laser. Between 2009 and 2012, in the Division of Plastic and Reconstructive Surgery at the University of Palermo, 12 patients with giant xanthelasmas were treated using a CO2 laser. The laser parameter…

Comparing the Outcomes of Different Agents to Treat Vasospasm at Microsurgical Anastomosis during the Papaverine Shortage.

2017

Letter to Editor

Histology of the Oral Mucosa in Patients With BRONJ at III Stage: A Microscopic Study Proves the Unsuitability of Local Mucosal Flaps.

2012

Background: Bisphosphonate Osteonecrosis of the Jaw (BRONJ) is a newly recognized condition reported in patients treated with aminobisphosphonates (BF). BRONJ is defined as the presence of exposed necrotic alveolar bone that does not resolve over a period of 8 weeks in a patient taking bisphosphonates who has not had radiotherapy to the jaw. Treatment protocols have been outlined, but trials and outcomes of treatment and long-term follow-up data are not yet available. In 2004 an expert panel outlined recommendations for the management of bisphosphonate-associated osteonecrosis of the jaws. Through the histological study of the oral mucosa over the bone necrosis and around the osteonecrosis …

A Difficult Case of Necrotizing Fasciitis Caused By Acinetobacter baumannii

2010

This study reports the case of a 55-year-old woman with diabetes with a necrotizing fasciitis of the right lower limb and the perineum, first admitted at the emergency department for septic shock with cardiac arrest, and later transferred to the department of surgery. Microbiological and histopathological examination confirmed the diagnosis of necrotizing fasciitis caused by Acinetobacter baumanii. A broad-spectrum antibiotic therapy was administered and later readjusted according to the results of microbiological culture. Intensive hemodynamic support was required. Wounds were dressed daily with a 3 percent boric acid solution and a silver sulfadiazine-impregnated dressing. An extensive s…

Poland’s Syndrome

2020

Poland’s syndrome is a sporadic, congenital thoracic deformity, mostly unilateral, with a wide spectrum of presentation. The thoracic malformations are distinguished on the basis of the anatomical site in which an embryological development alteration has occurred after the fourth week of gestation (Table 3.1) [1]. Poland’s syndrome is a rare congenital and complex anomaly of the development of thoracic muscles, characterized by hypoplasia of the breast and nipple, scarcity of subcutaneous tissue, absence of the costosternal portion of the pectoralis major muscle, lack of the pectoralis minor muscle, aplasia or deformity of the costal cartilages or ribs II to IV or III to V, alopecia of the …

Immunomodulation in vascularized composite allotransplantation: What is the role for adipose-derived stem cells?

2019

Hand and face transplants are becoming increasingly common, recording progressively more penile, uterus, abdominal wall, and allotransplantation cases reported worldwide. Despite current protocols allow long-term survival of the allografts, the ultimate goal of donor-specific tolerance has not been achieved yet. In fact, the harmful adverse effects related to the lifelong administration of immunosuppressive agents are the main drawbacks for vascularized composite allotransplantations. Research is very active in investigating alternative methods to induce greater tolerance while minimizing toxicity. Adipose-derived stem cells (ASCs) represent promising cell therapies for immunomodulation in …

Blood Congestion Can Be Rescued by Hemodilution in a Random-Pattern Skin Flap

2017

Can sentinel node biopsy be safely omitted in thin melanoma? Risk factor analysis of 1272 multicenter prospective cases

2019

Background: The indication to sentinel node biopsy (SNB) for thin melanomas (Breslow <1 mm) is still subject to controversies. The aim of this paper is to review all SNB performed for thin melanoma and to analyze factors related to lymphatic metastasis. Moreover, the diagnostic performance of the 5th, 6th, 7th and 8th AJCC classifications for cutaneous melanoma were investigated. Methods: All sentinel node biopsies performed for thin melanomas were selected from a multicentre prospectively-collected database. For each patient the following was collected: age, sex, date of treatment, site of primary melanoma, histopathologic features (Breslow, Clark, number of mitoses/mm2 , presence of ul…

Tecnica Co.Di per la produzione di cartilagine solida umana

2015

Abstract English Tissue or organ transplantation is severely limited by the problems of donor shortage and immune rejection from the patients. The cartilage defects are difficult to reconstruct. In head and neck surgery, as in septal reconstruction, auricular reconstruction for injury or malformation, in laryngotracheal reconstruction, surgeons harvest autologous cartilage from a donor site (of the patient) in order to reconstruct the defect. Today's current therapies to reconstruct cartilage defects involve the use of autologous cartilage grafts or biocompatible implants, but these seem inadequate to restore form and function, have many limits and are related with many complications. Due t…

ANTITHROMBOTIC PROPHYLAXIS IN MICROSURGERY

2016

Background. The most common complication of microsurgical reconstruction is graft failure secondary to thrombosis. It is clear that thromboprophylaxis is helpful for a successful microsurgery. However, it's also obvious that thrombosis can't be avoided in cases of poor microsurgical technique. There is no consensus regarding the use of anticoagulation therapy during and after microsurgery. The authors compared two different antithrombotic prophylaxis protocols used in the past ten years, and analyzed the effectiveness and risks of different pharmacological protocols. Materials and methods. The authors performed a retrospective review of microsurgical patients operated between 2005-2014 by t…

Poliphasic protocol for keloid scar

2009

Il melanoma del distretto cervico-facciale.

2006

Vascularized dermal flap for abdominal wall reconstruction after bariatric surgery

2009

A rare case of malignant transformation of endometrioma

2009

Lembi ALT nella ricostruzione del distretto testa-collo

2016

Impiego della tossina botulinica nella preparazione agli interventi di microchirurgia ricostruttiva del cavo orale

2004

ONE STAGE NOSE RECONSTRUCTION WITH THE SUPRATHROCLEAR ARTERY PROPELLER PERFORATOR FLAP

2010

The chimeric ALT-vastus lateralis free flap in reconstruction of advanced BRONJ of the maxilla.

2015

Introduction Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a dangerous complication of bisphosphonates, a class of pharmaceutical agents used in numerous bone disor- ders. No gold standard therapy exists, but recent literature suggests that, in advanced stages, the best results are achieved with aggressive debridement. In this paper, we report our experience of treatment of stage 3 BRONJ of the maxilla with extensive surgical debridement and reconstruction with a chimeric ALT-Vastus lateralis flap. Methods Five selected patients with stage 3 BRONJ underwent partial maxillectomy with dis- ease-free margins followed by immediate reconstruction with a chimeric ALT-Vastus lateralis…

Tecniche chirurgiche di riparazione del nervo ricorrente.

2004

Melanoma nei BRCA mutation carriers

2016

The "COMMA-flap": a new technique for inner canthus reconstruction.

2007

"Downward steps technique" with CO2 ultrapulsed laser for the treatment of rhinophyma: our protocol.

2013

Abstract BACKGROUND: The rhinophyma is an important soft-tissue hypertrophy of the nose. In literature a wide range of surgical approaches to rhinophyma has been described such as dermoabrasion, scalpel shave, cryosurgery, electrocautery, near total excision with skin grafting, and laser excision. PATIENTS AND METHODS: The authors describe their experience with CO(2) ultrapulsed laser in 14 elderly male patients, using their personal approach, the Downward steps technique. With this technique they removed the pathological hypertrophic tissue using a progressive reduction of the laser power during the treatment. They obtained good results from morphological and aesthetic point of view, in a …

Treatment of stages IIIIV of the Dupuytrens Disease using a personal approach: percutaneous needle fasciotomy (PNF) and minimal invasive selective ap…

2013

Abstract The authors present their experience in treating 23 fingers on 20 patients affected by Dupuytrens Disease in stages III and IV of the Tubiana classification with their personal technique that involves the percutaneous needle fasciotomy followed 40 days after by a selective open aponeurectomy on the previously treated cord, by making a small cutaneous incision. The treatment requires careful selection of the patients. In fact, patients suffering from the disease for more than 5 years and all the cases with a suspicion of joint rigidity are excluded from the study. The average follow up period was approximately 48 months. 18 out of the 20 patients had excellent functional recovery. S…

Le epitesi.

2006

Contemporary diagnosis of mucoepidermoid carcinoma of the hard palate and intracranial cavernous angioma: a case report of a young adult

2017

“Simultaneous Endoscope-Assisted Controlateral Breast Augmentation with Implants in Patiens Undergoing Postmastectomy Breast Reconstruction with abdo…

2007

Bilateral palatal swelling as frst sign of recurrence of a mantle cell lymphoma: a case report

2017

U-Stitches in microsurgery. Why not? Simple manual training or useful technique? Hypothesis and preliminary data of a recent experimentation”,

2006

A rare case of malignant trasformation of endometrioma

2009

Le epitesi

2005

The application of 3d printing in plastic and reconstructive surgery: Case-control study in facial reconstruction

2017

The aim of this study was to explore the efficiency and usefulness of tridimensional printing in plastic and reconstructive surgery for lesions of the maxillofacial region. This was comparison study between two groups of patients. Six patients underwent surgical reconstruction, using a threedimensional model built on the basis of CT scans (group 1); and six patients underwent surgical reconstruction, without the use of a three-dimensional model (group 2). The following variables were evaluated: age, gender, histological diagnosis, cancer location, size of bone lesion, type of reconstruction, complications and surgical timing. A statistically significant difference was found in microsurgical…

Tecniche chirurgiche di riparazione del nervo ricorrente. CAP 35, pp. 403-406

2004