Publications by authors named "Munnoch D"

Lymphoedema and lipoedema can present similarly however have different aetiologies and should be considered as distinct clinical entities. Pain is a distinguishing feature of lipoedema. Liposuction can be used in both conditions to reduce bulk and enhance quality of life.

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Background: Oncoplastic surgery for breast cancer has increased in popularity over the last few years, with oncological safety confirmed in several studies. There are, however, limited published data on patient-reported outcomes from this surgical approach. This study assessed patient-reported outcomes of satisfaction following therapeutic mammoplasty and contralateral symmetrisation (TMCS) as part of breast cancer treatment in relation to other patient and treatment factors.

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Objective: To evaluate outcomes in patients with gynaecological cancer related lymphoedema treated with liposuction.

Methods: A prospective analysis of 21 patients who underwent liposuction followed by compression therapy for chronic unilateral lower limb lymphoedema with up to 8 years follow up was performed.

Results: Duration of lymphoedema prior to liposuction ranged from 4 to 28 years (mean 15.

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Introduction: A case of salvage of an exposed axillo-profunda bypass graft is presented.

Report: Robust coverage of the graft was achieved with a pedicled latissimus dorsi muscle flap and overlying bi-pedicled cutaneous flap.

Discussion: Reconstructive options to salvage an exposed prosthetic graft will depend on the position on the trunk but can be successful if a reconstructive plastic surgery algorithm is followed.

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In the Western world, lymphedema most commonly occurs following treatment of cancer. Limb reductions have been reported utilizing various conservative therapies including manual lymph and pressure therapy, as well as by microsurgical reconstruction involving lymphovenous shunts and transplantation of lymph vessels or nodes. Failure of these conservative and surgical treatments to provide complete reduction in patients with long-standing pronounced lymphedema is due to the persistence of excess newly formed subcutaneous adipose tissue in response to slow or absent lymph flow, which is not removed in patients with chronic non-pitting lymphedema.

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Background: Lymphoedema is a chronic, debilitating condition caused by a compromised lymphatic system. In recent years, the success of treating upper extremity lymphoedema with liposuction has been translated to patients with lower extremity lymphoedema (LEL), yet there remains a paucity of clinical evidence firmly supporting its use within this patient group.

Methods: 69 patients with LEL (72 legs) were consecutively treated with liposuction by a single surgeon.

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Objectives: Breast oedema causes significant morbidity and is historically difficult to quantify. The aim of this study was to identify changes in breast tissue water content from pre-operative levels in the native breast to post-operative levels in mastectomy skin flaps and free flaps in the reconstructed breast.

Materials And Methods: One hundred patients undergoing unilateral mastectomy and immediate free flap breast reconstruction were examined pre-operatively and at three post-operative appointments.

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Upper limb dominance is associated with increased limb volume, however there is a paucity of evidence if this is true for the lower limbs. This study investigated if there is a normative volume difference between the dominant and nondominant leg. Healthy volunteers between the ages of 18-40 years were recruited.

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A 40-year-old woman underwent an elective thyroidectomy for a non-toxic, multinodular goitre. In the early postoperative period, the patient developed a significant unilateral swelling of the right upper limb, which was subsequently confirmed to be lymphoedema. This was eventually treated successfully using liposuction and compression garment therapies.

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Purpose: This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced lymphedema of the upper and lower extremities.

Methods: A prospective clinical study was conducted at an Advanced Lymphedema Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 patients attended the ALAC.

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Introduction: Liposuction for lymphoedematous limbs is an effective treatment for chronic lymphoedema, with excellent long-term results in well-selected patients. In 2008 NICE produced guidelines 'Liposuction for Chronic lymphoedema', acknowledging this treatment modality. However, there remain very few centers that provide this service in the United Kingdom.

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Chronic lower limb lymphoedema is a debilitating condition that may occur as a primary disorder or secondary to other conditions. Satisfactory visualization of the lymphatic vessels to aid diagnosis and surgical planning has been problematic. Historically, direct lymphography was used to visualize lymphatic vessels, although the significant surgical risks involved led to this being largely abandoned as a technique.

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Introduction: The clinical importance of internal mammary (IM) lymph node (LN) metastases in breast cancer remains unclear. The aim of this study was to determine the clinical value of opportunistic IMLN sampling at the time of free flap breast reconstruction using the IM recipient vessels and whether it affected the adjuvant treatment given.

Methods: A prospective study was conducted of IMLN exploration performed by a single surgeon as part of free flap breast reconstruction using IM recipient vessels.

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Background: Neoadjuvant chemotherapy (NC) is increasingly being utilised although the effects on outcomes of free autologous breast reconstruction and adjuvant treatment remain unclear. The aim of this study was to examine the effect of NC on complications following immediate free flap breast reconstruction.

Methods: A prospective study of immediate free flap breast reconstructions comparing patients who received NC with those who did not was conducted in a single specialist regional unit.

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Background: Lymphoedema of the upper limb is a well-recognised complication of axillary surgery for breast cancer. Effective long-term treatment of lymphoedema by liposuction has previously been demonstrated. In this study we present our first five years of experience using this technique in treatment of upper limb lymphoedema.

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Rapidly proliferating haemangiomas of the face may obscure vision with the development of deprivation amblyopia. Early intervention is required to prevent complications. We present a case successfully treated with a combination of pulsed dye laser and intralesional steroid injection.

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The aim of this work was to evaluate the epidemiology of occupational burns referred to the Welsh Regional Burns Unit from 1st January 1995 to 31st December 1996. Three hundred and twenty-four patients were identified as having sustained occupational burns and the case notes of 319 were available for review. Data on age, sex, occupation, aetiology, percentage and site of burn, treatment, complications and length of hospital stay were recorded.

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Hyperpigmentation is an occasional complication of laser therapy. Patients working in an environment with excessive exposure to ultraviolet radiation may be at increased risk.

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