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Emanuele Lisa AV, Salgarello M, Huscher A, Corsi F, Piovani D, Rubbino F, Andreoletti S, Papa G, Klinger F, Tinterri C, Testori A, Scorsetti M, Veronesi P, Leonardi MC, Rietjens M, Cortinovis U, Summo V, Rampino Cordaro E, Parodi PC, Persichetti P, Barone M, De Santis G, Murolo M, Riccio M, Aquinati A, Cavaliere F, Vaia N, Pagura G, Dalla Venezia E, Bassetto F, Vindigni V, Ciuffreda L, Bocchiotti MA, Sciarillo A, Renzi N, Meneghini G, Kraljic T, Loreti A, Fortunato L, Pino V, Vinci V, Klinger M. The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres. Breast J 2023; 2023:6688466. [PMID: 37205012 PMCID: PMC10188256 DOI: 10.1155/2023/6688466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 05/21/2023]
Abstract
Purpose In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; p < 0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; p < 0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, p < 0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, p < 0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction. Conclusion Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered.
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Affiliation(s)
- Andrea Vittorio Emanuele Lisa
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA-Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marzia Salgarello
- Department of Plastic Surgery, Director of the Residency Program of Plastic Surgery, IRCCS Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Huscher
- Department of Radiotherapy, Fondazione Poliambulanza “Guido Berlucchi” Hospital, Brescia, Italy
| | - Fabio Corsi
- Breast Unit, Department of Surgery, IRCCS Istituti Clinici Maugeri, Pavia, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Daniele Piovani
- Department of Biomedical Sciences, IRCCS Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Federica Rubbino
- Laboratory of Molecular Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Stefania Andreoletti
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA-Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giovanni Papa
- Department of Plastic Surgery, UCO, University of Trieste, Trieste, Italy
| | | | - Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alberto Testori
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paolo Veronesi
- Division of Senology, Department of Oncology and Oncohematology, IEO, IRCCS European Institute of Oncology, University of Milan, Milan, Italy
| | | | - Mario Rietjens
- Division of Plastic and Reconstructive Surgery, IEO, IRCCS European Institute of Oncology, Milan, Italy
| | - Umberto Cortinovis
- Department of Plastic Reconstructive Surgery, IRCCS National Cancer Institute, Milan, Italy
| | - Valeria Summo
- Department of Plastic Surgery, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Santa Maria della Misericordia Hospital, Udine, Italy
| | - Emanuele Rampino Cordaro
- Department of Plastic Surgery, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Santa Maria della Misericordia Hospital, Udine, Italy
| | | | | | - Mauro Barone
- Department of Plastic Surgery, Policlinico di Modena, University of Modena and Reggio, Modena, Italy
| | - Giorgio De Santis
- Department of Plastic Surgery, Policlinico di Modena, University of Modena and Reggio, Modena, Italy
| | - Matteo Murolo
- Department of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliero Universitaria-Ospedali Riuniti, Ancona, Italy
| | - Michele Riccio
- Department of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliero Universitaria-Ospedali Riuniti, Ancona, Italy
| | - Angelica Aquinati
- Department of Breast Surgery and Integrated Senology Centre, Belcolle Hospital, Viterbo, Italy
| | - Francesco Cavaliere
- Department of Breast Surgery and Integrated Senology Centre, Belcolle Hospital, Viterbo, Italy
| | - Nicola Vaia
- Department of Breast Surgery, AULSS 3 Veneziana, Venice, Italy
| | - Giulia Pagura
- Department of Breast Surgery, AULSS 3 Veneziana, Venice, Italy
| | - Erica Dalla Venezia
- Unit of Plastic Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Franco Bassetto
- Unit of Plastic Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Vincenzo Vindigni
- Department of Breast Surgery and Breast Unit, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Luigi Ciuffreda
- Department of Breast Surgery and Breast Unit, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Foggia, Italy
| | | | - Alberto Sciarillo
- Department of Plastic Surgery, ASUGI Cattinara Hospital, Trieste, Italy
| | - Nadia Renzi
- Department of Plastic Surgery, ASUGI Cattinara Hospital, Trieste, Italy
| | - Graziano Meneghini
- Functional Department Transmural Breast Surgery, AULSS 8 Berica, Vicenza, Italy
| | - Tajna Kraljic
- Department of Breast Surgery, AULSS 8 Berica, Vicenza, Italy
| | - Andrea Loreti
- Department of Plastic Surgery, San Giovanni Addolorata Hospital, Rome, Italy
| | - Lucio Fortunato
- Department of Breast Surgery and Breast Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - Valentina Pino
- Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, IRCCS Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Klinger
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA-Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Caputo GG, Vigato E, Rampino Cordaro E, Parodi PC, Governa M. Comparative study of patient outcomes between direct to implant and two-stage implant-based breast reconstruction after mastectomy. J Plast Reconstr Aesthet Surg 2021; 74:2573-2579. [PMID: 33947651 DOI: 10.1016/j.bjps.2021.03.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 12/04/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Breast reconstruction plays a central role in the outcome management of patients with breast cancer, particularly in terms of quality of life (QoL), which must be weighed carefully when considering the available surgical options. In the context of implant-based breast reconstruction, immediate replacement with prosthesis (direct-to-implant (DTI)) and acellular dermal matrix (ADM) is gaining popularity, at the expense of the traditional two-stage implant-based breast reconstruction with tissue expander (TE), and the literature suggests that patients tend to prefer interventions with "immediate" therapeutic efficacy and aesthetic satisfaction that obviate the need for further invasive surgery. We investigated this hypothesis by administering the BREAST-Q™ questionnaire to two groups of patients who had undergone the respective procedures. METHODS We performed a cross-sectional observational study of 192 consecutive mastectomy patients who received implant-based reconstruction, comparing health-related quality of life (HR-QoL), patient-related outcomes (PROs) and satisfaction in patients who had undergone immediate dual plane DTI with ADM (96) versus the two-stage submuscular approach (96). We also counted the number of surgeries required in each group to achieve a definitive outcome. FINDINGS Our study revealed no major differences in terms of QoL scores, with the two approaches being largely comparable. However, single-stage reconstruction seems to offer the additional advantages of better satisfaction with the care received, sparing the patient temporary body image dissatisfaction and reducing the number of surgeries required, thereby lessening the burden on the patient, the healthcare system and society as a whole.
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Affiliation(s)
- Glenda Giorgia Caputo
- Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Integrata di Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy.
| | - Enrico Vigato
- Plastic and Reconstructive Surgery, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100 Verona, Italy
| | - Emanuele Rampino Cordaro
- Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Integrata di Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - Pier Camillo Parodi
- Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Integrata di Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - Maurizio Governa
- Plastic and Reconstructive Surgery, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100 Verona, Italy
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Mura S, Caputo GG, Miotti G, Contessi Negrini F, Fin A, Rampino Cordaro E, Guarneri GF, Zanin C, D'Angelo M, Tullio A, Parodi PC. Direct-to-implant, prepectoral breast reconstruction with Braxon ® dermal matrix: A single-center experience with 111 cases. Breast J 2021; 27:412-414. [PMID: 33550687 DOI: 10.1111/tbj.14193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Sebastiano Mura
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Glenda Giorgia Caputo
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Giovanni Miotti
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Filippo Contessi Negrini
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Alessandra Fin
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Emanuele Rampino Cordaro
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Gianni Franco Guarneri
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Chiara Zanin
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
| | - Matteo D'Angelo
- DAME (Department of Medical Area), Institute of Hygiene and Clinical Epidemiology, Academic Hospital of Udine, Udine, Italy
| | - Annarita Tullio
- DAME (Department of Medical Area), Institute of Hygiene and Clinical Epidemiology, Academic Hospital of Udine, Udine, Italy
| | - Pier Camillo Parodi
- DAME (Department of Medical Area), Plastic and Reconstructive Surgery, Academic Hospital of Udine, Udine, Italy
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Mura S, Miotti G, Contessi Negrini F, Rampino Cordaro E, Mariuzzi L, Parodi PC. Dermatofibrosarcoma protuberans arising in post-mastectomy irradiated breast after autologous fat-transfer reconstruction. Regen Ther 2020; 15:169-172. [PMID: 33426215 PMCID: PMC7770351 DOI: 10.1016/j.reth.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/08/2020] [Indexed: 10/25/2022] Open
Affiliation(s)
- Sebastiano Mura
- Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
| | - Giovanni Miotti
- Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
| | - Filippo Contessi Negrini
- Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
| | - Emanuele Rampino Cordaro
- Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
| | - Laura Mariuzzi
- Institute of Pathology, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
| | - Pier Camillo Parodi
- Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME (Department of Medical Area), University of Udine, Italy
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Vaienti L, Cottone G, Zaccaria G, Rampino Cordaro E, Amendola F. One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap. INT J LOW EXTR WOUND 2020; 21:436-442. [PMID: 32844700 DOI: 10.1177/1534734620951540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.
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Affiliation(s)
- Luca Vaienti
- IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Giovanna Zaccaria
- Policlinico di Modena Azienda Ospedaliero-Universitaria di Modena, Modena, Emilia-Romagna, Italy
| | - Emanuele Rampino Cordaro
- Presidio Ospedaliero Universitario Santa Maria della Misericordia, Piazzale Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia, Italy
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Zingaretti N, Rampino Cordaro E, Parodi PC, Marega G, Modolo F, Moreschi C, Da Broi U. Determinants of surgeon choice in cases of suspected implant rupture following mastectomy or aesthetic breast surgery: Clinical implications. Medicine (Baltimore) 2020; 99:e21134. [PMID: 32629748 PMCID: PMC7337419 DOI: 10.1097/md.0000000000021134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Implant ruptures may be diagnosed by physical examination, ultrasound (US), and magnetic resonance imaging (MRI). The absence of standard guidelines to approach to implant ruptures may cause unnecessary surgical revisions in the absence of radiological confirmation of prosthetic damages.The purpose of this study was to analyze the diagnostic procedures applied to patients with suspected prosthetic rupture and surgeon choices to perform a revision or to plan a clinical and radiological follow-up.We conducted a retrospective study on 62 women submitted to revision surgery due to radiological diagnosis of suspected implant rupture, following mastectomy or aesthetic reconstruction, and admitted to a Plastic Surgery Department between 2008 and 2018.Seventy-three implants, believed to be ruptured, were explanted. One-third of these were intact and unnecessarily explanted. US associated with MRI evaluation resulted in the most helpful diagnostical method.A standardized clinical and radiological approach is essential to manage breast implant ruptures successfully. An innovative protocol is proposed in order to: ensure the appropriate management of implant ruptures and prevent unnecessary surgical revisions; reduce the risk of claims for medical malpractice in cases of unsatisfactory final aesthetic results or worse than before.
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Affiliation(s)
| | | | | | - Giulia Marega
- Legal Medicine, Udine University Hospital, Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Francesca Modolo
- Legal Medicine, Udine University Hospital, Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Carlo Moreschi
- Legal Medicine, Udine University Hospital, Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Ugo Da Broi
- Legal Medicine, Udine University Hospital, Department of Medical Area (DAME), University of Udine, Udine, Italy
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7
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Zingaretti N, Guarneri GF, De Biasio F, Rampino Cordaro E, Almesberger D, Parodi PC. A Simple and Fast Technique to Perform Submuscular Breast Augmentation. Indian J Surg 2019. [DOI: 10.1007/s12262-019-01886-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Fin A, D'Alì L, Mura S, Cordaro ER, De Biasio F, Mariuzzi L, Parodi PC. Primary cutaneous mucinous carcinoma of the chin: Report of a case. INDIAN J PATHOL MICR 2019; 62:173-174. [PMID: 30706892 DOI: 10.4103/ijpm.ijpm_136_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Alessandra Fin
- Department of Plastic and Recostructive Surgery, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Lorenzo D'Alì
- Department of Pathology, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Sebastiano Mura
- Department of Plastic and Recostructive Surgery, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Emanuele Rampino Cordaro
- Department of Plastic and Recostructive Surgery, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Fabrizio De Biasio
- Department of Plastic and Recostructive Surgery, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Laura Mariuzzi
- Department of Pathology, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
| | - Pier Camillo Parodi
- Department of Plastic and Recostructive Surgery, Ospedale Universitario Santa Maria Della Misericordia, Udine, Italy
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Fin A, Rampino Cordaro E, Guarneri GF, Revesz S, Vanin M, Parodi PC. Experience with gluteal V-Y fasciocutaneous advancement flaps in vulvar reconstruction after oncological resection and a modification to the marking: Playing with tension lines. Int Wound J 2018; 16:96-102. [PMID: 30303301 DOI: 10.1111/iwj.12997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/31/2018] [Indexed: 02/01/2023] Open
Abstract
Many post-vulvectomy vulvar reconstruction solutions, using local fasciocutaneous flaps where possible, have been proposed. We report the use of V-Y advancement flaps from the gluteal fold in medium to large vulvar reconstructions and a simple modification we made to the technique in order to minimise wound-related complications. Between 2006 and 2016, 30 vulvar reconstructions were performed via a total of 59 flaps, 24 of which were raised using the proposed modification to the plasty design. Short- and long-term (24 months) follow-up data were analysed, postoperative flap sensitivity was tested, and any arising complications were recorded. The mean age of patients treated was 75.3 years (51-92 years). The mean monolateral defect dimensions were 7.5 × 4.7 × 2.8 cm. Minor complications were recorded in 23% of patients (14% of flaps). One case of ostial stenosis occurred. Micturition and ambulation recovery was rapid, and flap sensitivity was fully restored 24 months after reconstruction. Scars were well hidden by natural soft tissue folds. The outcomes in this case series confirm that the gluteal V-Y advancement fasciocutaneous flap is a useful and simple technique for reconstructing even large vulvar defects. It has a low functional and aesthetic impact and enables rapid return to autonomy. Moreover, the simple modification to the V-Y flap proposed, designed to reduce tension at the apical part of the wound, appears to reduce the complication rate.
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Affiliation(s)
- Alessandra Fin
- Plastic Surgery Service, Ospedale Santa Maria della Misericordia, Udine, Italy
| | | | - Gianni F Guarneri
- Plastic Surgery Service, Ospedale Santa Maria della Misericordia, Udine, Italy
| | - Susanna Revesz
- Obstetrics and Gynecology Service, Ospedale Civile Sant'Antonio Abate, Udine, Italy
| | - Michele Vanin
- Obstetrics and Gynecology Service, Ospedale Civile Sant'Antonio Abate, Udine, Italy
| | - Pier C Parodi
- Plastic Surgery Service, Ospedale Santa Maria della Misericordia, Udine, Italy
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Mura S, Fin A, Parodi PC, Denton CP, Howell KJ, Rampino Cordaro E. Autologous fat transfer in the successful treatment of upper limb linear morphoea. Clin Exp Rheumatol 2018; 36 Suppl 113:183. [PMID: 29465364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 12/13/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Sebastiano Mura
- Department of Plastic and Reconstructive Surgery, University of Udine, Italy.
| | - Alessandra Fin
- Department of Plastic and Reconstructive Surgery, University of Udine, Italy
| | - Pier Camillo Parodi
- Department of Plastic and Reconstructive Surgery, University of Udine, Italy
| | - Christopher P Denton
- UCL Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK
| | - Kevin J Howell
- Microvascular Diagnostics, Institute of Immunity and Transplantation, Royal Free Hospital, London, UK
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11
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Guarneri GF, Cordaro ER, Semprini G, Cattin F, Parodi PC. A simple way to improve the safety of the surgical field. Indian J Plast Surg 2012; 45:162-4. [PMID: 22754180 PMCID: PMC3385390 DOI: 10.4103/0970-0358.96601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- G F Guarneri
- Department of Plastic and Reconstructive Surgery, University of Udine, Italy
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12
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Parodi PC, De Biasio F, Rampino Cordaro E, Guarneri GF, Panizzo N, Riberti C. Distally-based superficial sural flap: Advantages of the adipofascial over the fasciocutaneous flap. J Plast Surg Hand Surg 2010; 44:37-43. [PMID: 20367063 DOI: 10.3109/02844310903343597] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Pier Camillo Parodi
- Department of Plastic Reconstructive Surgery, University of Udine, Udine, Italy
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13
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Lazzaro L, Guarneri GF, Rampino Cordaro E, Bassini D, Revesz S, Borgna G, Parodi PC. Vulvar reconstruction using a "V-Y" fascio-cutaneous gluteal flap: a valid reconstructive alternative in post-oncological loss of substance. Arch Gynecol Obstet 2010; 282:521-7. [PMID: 20689960 DOI: 10.1007/s00404-010-1603-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 07/11/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We will present our experience in vulvar reconstruction using a local fascio-cutaneous flap, in order to get an easier intra-operative management and a good post-operative outcome. METHODS Between May 2006 and December 2008, eight patients with vulvar carcinomas underwent a vulvar reconstruction, using a V-Y advancement flap of the gluteal fold. This fascio-cutaneous flap, based on the perforator vessels originated from the internal pudendal artery, was used for the reconstructive treatment of patients who had undergone a vulvectomy with medium-size defects. RESULTS All the 16 flaps prepared survived without major complications. Walking and sitting positions were restored in few post-operative days. Length of hospitalisation was 2-3 weeks. The flaps restored sensitivity few months after surgery. In no case the surgical scars needed being revised. CONCLUSIONS The follow-up results proved satisfactory in terms of patients' compliance and morphological results. The flap appeared to be thin, well vascularised and very flexible in its advancement. The post-operative follow-up is characterised by a rapid healing and a low incidence of short- and long-term complications.
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Affiliation(s)
- Lara Lazzaro
- Department of Plastic Reconstructive Surgery, University of Udine, Udine, Italy.
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Parodi PC, Nadalig B, Rampino Cordaro E, Mariuzzi L, Rossi D. Non-traumatic elastofibroma dorsi. Eur J Dermatol 2007; 17:169-70. [PMID: 17337409 DOI: 10.1684/ejd.2007.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Affiliation(s)
- Pier Camillo Parodi
- Department of Plastic Reconstructive Surgery, University of Udine, Udine, Italy.
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Parodi PC, De Biasio F, Guarneri GF, Rampino Cordaro E, Panizzo N, Riberti C. Microsurgical latissimus dorsi flap in a case of breast aplasia caused by radiation therapy. Microsurgery 2005; 25:473-6. [PMID: 16134097 DOI: 10.1002/micr.20151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The use of ionizing radiation in the breast region while a patient is at developmental age is still responsible for most monolateral hypoplasias and iatrogenic-based breast asymmetries. These alterations often involve several anatomical structures, thus causing severe hypoplasia of the breast and muscle tissues and stiffness of soft tissues, with atrophic and cicatricial skin. Reconstruction methods vary from case to case, but most of the time reconstruction with a homolateral latissimus dorsi with or without a breast implant seems most suitable. In some cases, however, this is not a viable alternative due to particular general and local conditions, making it necessary to consider other solutions. We present the case of a young prepubertal patient who came under our observation due to a radiotherapy outcome in the right breast and thoracic region; she had been previously subjected to breast reconstruction elsewhere, with the fitting of a subcutaneous prosthesis. Due to the patient's particular general and local conditions and the pathological involvement of the homolateral thoracic musculature, to improve the clinical picture, we deemed it appropriate to use the microsurgical reinnervated contralateral latissimus dorsi muscle, which so far has enabled us to obtain considerable and lasting results.
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Affiliation(s)
- Pier Camillo Parodi
- Department of Plastic Reconstructive Surgery, University of Udine, Udine, Italy.
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