Publications by authors named "Lellouch A"

Background: Venous congestion due to superficial venous system dominance (SVD) in deep inferior epigastric perforator (DIEP) flap surgery occurs in approximately 2% of cases, with attendant sequelae and increased cost to healthcare systems. This study aimed to describe the predictive factors for SVD in DIEP flap breast reconstruction based on preoperative computed tomography angiography (CTA) findings.

Methods: All women who required takebacks for additional venous anastomosis to the cephalic vein because of SVD after DIEP flap breast reconstruction between 2015 and 2022 were included.

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  • Uterus transplantation is currently the only solution for women with absolute uterine infertility, such as those with Rokitansky syndrome, allowing them to experience pregnancy and childbirth.
  • There are significant challenges with uterus transplantation, including the risks of ischemia-reperfusion injury and a notable thrombotic complication rate of up to 20%, which can lead to graft rejection.
  • This protocol aims to outline the surgical steps for obtaining porcine uteruses and implementing dynamic preservation through machine perfusion, which may reduce hypoxic injury compared to traditional static cold storage methods.
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Background: Profunda artery perforator (PAP) flap following cancer surgery has emerged as a relevant alternative for breast reconstruction but is mainly used in cases where the deep inferior epigastric perforator (DIEP) flap cannot be performed. The aim of this study was to compare the PAP and DIEP flaps' surgical and aesthetics outcomes in breast reconstruction.

Methods: Women who underwent breast reconstruction by DIEP or PAP flap at the Plastic Surgery Department of Georges Pompidou European University Hospital, Paris, France, between January 2012 and December 2020 were included.

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Introduction: Magnetic nanoparticles (MNPs), particularly iron oxide nanoparticles (IONPs), are renowned for their superparamagnetic behavior, allowing precise control under external magnetic fields. This characteristic makes them ideal for biomedical applications, including diagnostics and drug delivery. Superparamagnetic IONPs, which exhibit magnetization only in the presence of an external field, can be functionalized with ligands for targeted affinity diagnostics.

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After skin allotransplantation, intercellular transfer of donor major histocompatibility complex molecules mediated primarily by extracellular vesicles (EVs) released by the allograft is known to contribute to semidirect and indirect activation of alloreactive T cells involved in graft rejection. At the same time, there is ample evidence showing that initiation of adaptive alloimmunity depends on early innate inflammation caused by tissue injury and subsequent activation of myeloid cells (macrophages and dendritic cells) recognizing danger-associated molecular patterns. Among these danger-associated molecular patterns, extracellular adenosine triphosphate plays a key role in innate inflammation by binding to P2X7 receptors (P2X7Rs).

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Vascularized composite allografts (VCA) encompass the face, upper limb, trachea, penis, abdominal wall, and, more recently, uterus transplants. They offer unique reconstructive possibilities to overcome the limitations of traditional reconstructive techniques. Unlike solid organ transplants (heart, liver, kidney, lung, etc.

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Angiosarcomas (AS) are an aggressive subtype of head and neck tumors. Current outcome research is limited to single-surgeon and/or single-institution data. This study analyzes the Surveillance, Epidemiology, and End Results program (SEER) database data to improve outcomes of head and neck AS.

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Introduction: The abscopal effect is a systemic immune response characterized by metastases regression at sites distant from the irradiated lesion. This systematic review aims to explore the immunological mechanisms of action underlying the abscopal effect and to investigate how hyperthermia (HT) can increase the chances of radiotherapy (RT) triggering systemic anti-tumor immune responses.

Methods: This review is created in accordance with the PRISMA guidelines.

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Targeted muscle reinnervation (TMR) was originally developed to enhance prosthetic control in amputees. However, it has also serendipitously demonstrated benefits in reducing phantom pain and neuromas. As a result, it has emerged as a secondary treatment for chronic neuromas in amputees and holds promise for managing neuropathic pain in non-amputee patients, particularly those with neuromas.

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In the past decade, distributed acoustic sensing (DAS) has enabled many new monitoring applications in diverse fields including hydrocarbon exploration and extraction; induced, local, regional, and global seismology; infrastructure and urban monitoring; and several others. However, to date, the open-source software ecosystem for handling DAS data is relatively immature. Here we introduce DASCore, a Python library for analyzing, visualizing, and managing DAS data.

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  • Fournier's gangrene is a serious infection affecting the genital and perineal areas, often requiring extensive surgical and medical treatment, which can leave significant skin defects.
  • There is no clear agreement on the best methods for reconstructive surgery due to the variety of options available, and there is limited research focusing on male black patients.
  • The report discusses two cases of dark-skinned patients with genital defects, detailing their reconstruction using specific surgical techniques—a propeller flap and a skin graft—and reviews the existing literature on the subject.
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Ischemia is a major limiting factor in Vascularized Composite Allotransplantation (VCA) as irreversible muscular injury can occur after as early as 4-6 h of static cold storage (SCS). Organ preservation technologies have led to the development of storage protocols extending rat liver ex vivo preservation up to 4 days. Development of such a protocol for VCAs has the added challenge of inherent ice nucleating factors of the graft, therefore, this study focused on developing a robust protocol for VCA supercooling.

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Introduction: In free flap reconstruction, improving flap tolerance to warm ischemia (WI) is fundamental. WI is the result of a venous or arterial thrombosis, which can only be addressed through surgical revision. No additional treatments have shown superior efficacy at salvaging free flaps after or during WI.

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Drug discovery pipelines rely on the availability of isolated primary hepatocytes for investigating potential hepatotoxicity prior to clinical application. These hepatocytes are typically isolated from livers rejected for transplantation and subsequently cryopreserved for later usage. The gold-standard cryopreservation technique, slow-freezing, is a labor-intensive process, with significant post-storage viability loss.

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This article introduces a novel technique for refining the middle third of the nose in preservation rhinoplasty, adhering to the principles established by Teoman Dogan. The technique, applicable through both open and closed approaches, maintains the integrity of the nasal dorsum. The J-suture technique is particularly significant for addressing the widening of the middle third of the nose, a common issue in preservation rhinoplasty.

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Continuous oxygenation monitoring of machine-perfused organs or transposed autologous tissue is not currently implemented in clinical practice. Oxygenation is a critical parameter that could be used to verify tissue viability and guide corrective interventions, such as perfusion machine parameters or surgical revision. This work presents an innovative technology based on oxygen-sensitive, phosphorescent metalloporphyrin allowing continuous and non-invasive oxygen monitoring of ex-vivo perfused vascularized fasciocutaneous flaps.

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Vascularized composite allotransplantations are complex procedures with substantial functional impact on patients. Extended preservation of VCAs is of major importance in advancing this field. It would result in improved donor-recipient matching as well as the potential for ex vivo manipulation with gene and cell therapies.

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The current gold standard for preserving vascularized composite allografts (VCA) is 4°C static cold storage (SCS), albeit muscle vulnerability to ischemia can be described as early as after 2 h of SCS. Alternatively, machine perfusion (MP) is growing in the world of organ preservation. Herein, we investigated the outcomes of oxygenated acellular subnormothermic machine perfusion (SNMP) for 24-h VCA preservation before allotransplantation in a swine model.

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Vascularized composite allografts (VCA) face ischemic challenges due to their limited availability. Reperfusion following ischemia triggers oxidative stress and immune reactions, and scavenger molecules could mitigate ischemia-reperfusion injuries and, therefore, immune rejection. We compared two scavengers in a myocutaneous flap VCA model.

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Background: Warm ischemia time (WIT) and ischemia-reperfusion injury are limiting factors for vascularized composite allograft (VCA) transplantation. Subnormothermic machine perfusion (SNMP) has demonstrated the potential to extend WIT in organ transplantation. This study evaluates the effect of SNMP on VCA viability after prolonged WIT.

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  • * A new method called perfusion decellularization creates a scaffold from porcine fasciocutaneous flaps that preserves essential properties such as collagen, microvasculature, and growth factors, making it a promising alternative to traditional flaps.
  • * The study found that using 0.2% sodium dodecyl sulfate effectively clears cellular material from the flap while maintaining its structure, indicating biocompatibility as human dermal fibroblasts were able to migrate into the decellularized tissue.
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  • Vascularized Composite Allografts (VCA) face risks of acute rejection due to full histocompatibility mismatch, relying on different immunosuppression therapies and graft preservation quality.* -
  • A systematic review analyzed 211 VCA cases, finding a combination of antithymocyte globulins, mycophenolate mofetil (MMF), tacrolimus, and steroids was most commonly used, with burn patients at a higher risk for acute rejection.* -
  • The field of VCA lacks a standardized immunosuppression regimen, indicating a need for more data and comprehensive reporting to better understand the immune responses and optimize treatment strategies.*
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For major upper limb defects, a wide range of established pedicled and free flap options can be used. These include the latissimus dorsi/thoracodorsal artery perforator, lateral arm, posterior interosseous artery, rectus abdominis, gracilis, and anterolateral thigh flaps. Technical proficiency is essential, and favorable success rates in terms of functional and esthetic outcomes can be achieved.

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Background: Thermography can be used in pre-operative planning of free perforator flap surgeries. Thermography assesses skin temperature by measuring the quantity of infrared radiation observed. In this meta-analysis, authors assess the sensitivity of smartphone-based thermal imaging (SBTI) in the detection of perforators and analyze the difference between static and dynamic imaging.

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Burn wound healing is a complex and long process. Despite extensive experience, plastic surgeons and specialized teams in burn centers still face significant challenges. Among these challenges, the extent of the burned soft tissue can evolve in the early phase, creating a delicate balance between conservative treatments and necrosing tissue removal.

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