Secondary Microsurgical Reconstruction of the Cervical Esophagus: Safer Flaps and Practical Tips in a Challenging Situation.

: Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors' experience and the literature review.

Central Mound Technique in Oncoplastic Surgery: A Valuable Technique to Save Your Bacon.

Introduction: Breast-conserving surgery (BCS) is a valid method for the reconstruction of partial breast defects, however, there is a great variety of final aesthetic outcomes depending on the location of the tumor in the breast and also on the initial breast volume and the degree of ptosis. Specifically, defects affecting the upper inner/central quadrant represent a reconstructive challenge with not always satisfactory final results. For this purpose, the authors investigated the use of the central mound technique in breast-conserving surgery.

Prognostic significance of unexplained left ventricular hypertrophy in patients undergoing carpal tunnel surgery.

Aims: Carpal tunnel (CT) syndrome is a recognized red-flag of cardiac amyloidosis (CA) and increased cardiovascular (CV) morbidity. We designed this study to characterize the CV profile of patients with CT syndrome at the time of first surgery and to identify high-risk presentations.

Methods And Results: We retrospectively reviewed 643 patients who underwent CT surgery between 2007 and 2019.

Protocol for Prevention and Monitoring of Surgical Site Infections in Implant-Based Breast Reconstruction: Preliminary Results.

Surgical site infection in implant-based breast reconstruction is a complication with variable incidence reported in the literature. Due to potential loss of implant and reconstruction, it can have a strong psychological impact on patients. This study aimed primarily at analyzing the current status of the surgical site infection (SSI), (type, time of onset, clinical presentation, pathogens and management) in patients who underwent implant-based breast reconstruction at our Breast Unit.

Middle-retroauricular Island Flap: A New Axial Flap for Reconstruction of Non-helical Ear Defects.

Unlabelled: Surgical treatment of ear carcinomas needs the selection of the appropriate reconstructive techniques, which depends on the location and the dimensions of the defect after excision of the cancer and the quality of blood supply to the peri-lesional skin. The aim of this study was to evaluate the efficacy and reliability of a new axial island retroauricular flap (middle-retroauricular island flap M-RIF) for coverage of non-helical ear defects with direct donor site closure.

Methods: All patients, from January 2013 to January 2020, with skin tumors of the non-helix region and undergoing a combined skin-cartilage excision with M-RIF local flap reconstruction under local anesthesia, were enrolled in the study.

New Algorithm for Chest-wall Surgery and Quality of Life Assessment in Female-to-male Reassignment Patients.

Background: Chest-wall contouring surgery (chest-wall reconstructive surgery) is often the first surgical procedure in female-to-male (FtM) gender reassignment surgery (GRS). The main goal of this procedure is to create an aesthetically pleasing male-like chest contour. No universally accepted algorithm exists for detection of the appropriate surgical technique.

5% Lidocaine Hydrochloride Cream for Wound Pain Relief: A Multicentre Observational Study.

Background: Lidocaine hydrochloride is frequently used for management of painful wounds. This prospective, multicentre study examined the effects of 5% lidocaine cream on wound pain relief.

Material And Methods: The study included 78 patients with painful wounds treated with 5% Lidocaine cream for two weeks in two Italian Hospitals.

Reconstruction of penile skin loss using a combined therapy of negative pressure wound therapy, dermal regeneration template, and split-thickness skin graft application.

This study evaluates the use of acellular dermal matrix (ADM) in conjunction with negative pressure wound therapy (NPWT) and delayed split-thickness skin graft (STSG) application as an alternative to free tissue transfer for defect coverage of the penile shaft. Five patients with genital lymphedema and one with penile skin deficiency underwent penile shaft reconstruction with a two-stage surgical procedure. The first procedure aimed to the correction of skin defect and to neodermis regeneration through the use of an ADM (Integra®, Integra Lifesciences Corp.

Reconstruction of the Weightbearing Area of the Foot with Vascularized Chimeric Osteocutaneous Fibular Flap: A Case Report.

Damage to the weightbearing surface of the foot is a challenge for the reconstructive surgeon. The aim is to reconstruct the skeletal tripod and soft tissue, allowing the patient to walk normally. We report the case of a patient admitted with an acute right foot open fracture of the second, third, fourth, and fifth metatarsal bones.

Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature.

Background: Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures.

Is the LICOX® PtO system reliable for monitoring of free flaps? Comparison between two cohorts of patients.

Background: Licox® PtO is a minimally invasive monitoring system for continuous measurement of tissue oxygen tension in all types of free tissue transfers. Our study compares two consecutive series of patients undergoing microsurgical reconstruction monitored with standard clinical bedside surveillance and with the Licox® PtO system regarding flap loss and flap salvage, the sensitivity, specificity, and cost-effectiveness.

Methods: We performed a longitudinal observational prospective study of all patients undergoing microsurgical reconstructions between 2016 and 2017.

How to Make Your Life Easier: Blepharoplasty Markings with Microsurgical Clamps.

Preoperative blepharoplasty markings might be challenging, especially for young surgeons. It takes experience to carefully evaluate the amount of skin excess that can be safely removed. In the current study, we explored the use of microsurgical vascular clamps as a novel and useful tool in the preoperative upper blepharoplasty markings; they made it possible to directly visualize the amount of skin to be removed, facilitating the surgeon (especially the young surgeon) preoperative markings process.

Prognostic indicators of improved survival and quality of life in surgically treated oral cancer.

Objective: No published study has analyzed the prognostic factors of surgically treated oral squamous cell carcinoma (OSCC) in relation to both survival and quality of life (QoL). The aim of this study was to analyze postoperative QoL in relation to survival to identify which parameters can predict the long-term outcome allowing the best QoL.

Study Design: This retrospective cohort study considered 167 patients affected by OSCC treated surgically at the Otolaryngology Department of Cattinara Hospital (Trieste, Italy) by a single surgeon.

Is it possible to calculate surface areas of intraoral structures from preoperative CT scan?

Microsurgical reconstruction of intraoral structures requires accurate planning of flap shape and dimensions. The goal of this study is to describe a method that allows to calculate surfaces of oral structures from preoperative CT-scan in order to determine a precise flap design before the surgery. We created casts of the human mouth from cadavers with a head and neck CT-scan available using an impression material.

Triple-Cut Computer-Aided Design-Computer-Aided Modeling: More Oncologic Safety Added to Precise Mandible Modeling.

Purpose: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem.