Peroneus Brevis flap in Achilles tendon reconstruction. Clinical, radiological and functional analysis.

Background: We would like to describe our experience with Peroneus Brevis flap in complicated Achilles tendon re-ruptures with fringed stumps.

Methods: Eight patients with monolateral re-rupture of Achilles tendon were selected as eligible for surgical repair with Peroneus Brevis flap. Patients' outcome was evaluated clinically (ATRS and ROM), functionally (Gait analysis) and MRI was performed before and after surgery.

Bacterial biofilm associated with a case of capsular contracture.

Capsular contracture is one of the most common complications of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial although the surface texture of the breast implant, the anatomical position of the prosthesis and the presence of bacterial biofilm could be considered trigger factors. In fact, all medical implants are susceptible to bacterial colonization and biofilm formation.

Percutaneous Fat Transfer to Treat Knee Osteoarthritis Symptoms: Preliminary Results.

 This study aims to evaluate the safety and efficacy of autologous aspirated and purified fat tissue injected percutaneously into the knee joint for the treatment of symptomatic osteoarthritis (OA).  We reviewed 30 patients, who received an autologous percutaneous fat injection for the treatment of knee OA, from January 2012 to March 2015. Mean patients' age was 63.

Preliminary result with incisional negative pressure wound therapy and pectoralis major muscle flap for median sternotomy wound infection in a high-risk patient population.

Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications.

An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft.

Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth.

The effectiveness of negative pressure therapy on infected wounds: preliminary results.

Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains a closed, humid, sterile and isolated environment. Wound infection is considered a relative contraindication. The objective of this study is to extend the indications for VAC therapy to include infected wounds by demonstrating its ability to increase the antibiotic concentration in the damaged and infected tissues.

Cutaneous flaps in the treatment of 338 pressure sores: a better choice.

Aim: Muscular flaps are considered by many surgeons as a treatment of choice for pressure sores. Nevertheless fasciocutaneous and adipofascial flaps are less sensitive to ischemia, more resistant to pressure and have higher mechanical resistance. The aim of this study is to evaluate the results of our integrated rehabilitative and surgical protocol in pressure sore management based on the use of cutaneous flaps.

Muscular gastrocnemius spacer: a two stage reimplantation technique for infected total knee arthroplasty.

Aim: We present a two stage reimplantation technique for infected total knee arthroplasty using a muscular gastrocnemious spacer that allows delivery of high local concentrations of antibiotics in absence of heterologous materials associated with high percentage of infection.

Material Of Study: Between January 2009 and June 2011 we selected 8 patients with diagnosis of total knee arthroplasty deep infection. All patients underwent a surgical protocol that consisted of a two stage procedure with harvesting of medial gastrocnemious rotational flap followed by delayed reimplantation of prosthesis.

Retention of polyurethane foam fragments during VAC therapy: a complication to be considered.

Vacuum-assisted closure (VAC) therapy is a closed-loop, non-invasive active system, characterised by a controlled and localised negative pressure applied on porous polyurethane absorbent foams. It promotes healing of acute and chronic wounds. Therapeutic effects of VAC therapy have been proved and demonstrated; however, this method can have some disadvantages.

Implant infection after augmentation mammaplasty: a review of the literature and report of a multidrug-resistant Candida albicans infection.

Background: Implant breast augmentation is one of the most frequently performed surgical procedures, and fungal infection still is considered exceptional. This report presents a case of bilateral breast implant infection by multidrug-resistant Candida albicans treated with a targeted antifungal therapy.

Methods: A young woman presented with breast pain and asymmetry as well as implant superficialization in the left breast 3 years after bilateral tuberous breast correction with implant insertion.

Development of Buffalo Hump in the course of antiretroviral therapy including raltegravir and unboosted atazanavir: a case report and review of the literature.

Introduction: The availability of raltegravir plus atazanavir provides an alternative antiretroviral strategy that may be equally efficacious and less toxic than those currently recommended in HIV treatment guidelines. In fact, this new combination antiretroviral therapy attracts the attention of the scientific community because both drugs have a good safety profile coupled with potent antiviral activity, and their combined use would avert nucleoside- and ritonavir-related toxicities.

Case Presentation: We describe the case of a 47-year-old, Caucasian woman treated for HIV-1 infection who developed Buffalo Hump during antiretroviral therapy, including raltegravir and unboosted atazanavir.

"Component separation" technique and panniculectomy for repair of incisional hernia.

Background: Primary incisional hernia repair is rarely successful, with recurrence rates ranging from 18% to 62%. We describe the integration of "components separation" herniorrhaphy with panniculectomy.

Methods: Twenty-two patients were treated.

Surgical debridement with muscle flap transposition and systemic teicoplanin therapy for infected hip arthroplasty.

The use of muscle flaps is now accepted as a method for coverage of infected wounds. To obtain complete eradication of infection following hip arthroplasty surgery is combined with antibiotic treatment. Aggressive debridment to remove devitalized tissue followed by vastus lateralis muscle flap transposition may improve the likelihood of success in certain challenging cases.

The use of the Veress needle to drain mammary periprosthetic fluid.

Background: The most common early complications associated with mammary implants are seroma and haematoma formation, and acute infection. The aspiration of fluid around the prosthesis can help to diagnose and correctly treat these complications. The use of a needle with a sharp tip can damage the implant.

Clinical application of autologous three-cellular cultured skin substitutes based on esterified hyaluronic acid scaffold: our experience.

Background: The aim of this work was to present our experience in the use of autologous three-cellular cultured skin substitutes (CSS). This method represents a surgical alternative in the treatment of a variety of pathologies, including burns, ulcers, giant nevi and tumors.

Patients And Methods: CSS were obtained from full-thickness skin biopsies collected after enrolment of 11 patients in a clinical trial protocol approved by the local Institutional Review Boards of the 'La Sapienza' University of Rome and registered in clinicaltrials.

Hemipelvectomy and reconstruction in a patient with advanced Marjolin's ulcer: a case report.

Patients with squamous cell carcinoma of the lower limb may exhibit locally advanced or metastatic disease. Surgical resection to control the primary tumor is often extensive.The case of a 51-year-old man with squamous cell carcinoma on Marjolin's ulcer affected, rapidly growing, and involving soft and bone tissues is described.

Lymphatic fluid fistula: an extremely rare complication of posterior lumbar transpedicular screw fixation. Case report.

The authors describe the unique case of a patient who had undergone posterior stabilization of the lumbar spine complicating the course of a lymphatic fistula. A lymphatic fistula is a rare complication of posterior lumbar surgery. Predisposing factors include individual anatomy, scarring adherences due to previous abdominal operations or surgical maneuvers deep in the plane of the transverse processes.