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Lombardo GAG, Ciancio F, Violini H, Sapuppo C, Zagami S, Vena A, Giardina M, Donia C, Ranno R. Implementing Nexobrid for Burn Debridement in a Major Italian Burn Center: A Retrospective Review of Patient Outcomes. J Burn Care Res 2024; 45:432-437. [PMID: 37897805 DOI: 10.1093/jbcr/irad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Indexed: 10/30/2023]
Abstract
This retrospective study examines the implementation of Nexobrid, an enzymatic debriding agent developed from bromelain, for burn debridement in a major Italian burn center. With previous research showing encouraging results for Nexobrid in terms of reducing the need for surgical intervention and faster eschar removal, the current study aims to add to the growing body of evidence regarding its potential benefits and limitations. The patient database was utilized to identify patients who received Nexobrid treatment between October 2019 and June 2023. A retrospective analysis was conducted to gather demographic information, burn causes, procedural details, and patient outcomes. Of the 30 patients treated with Nexobrid, 10% did not require further surgical intervention, showcasing Nexobrid's potential to improve patient outcomes. However, over 80% of patients still required additional surgical intervention, demonstrating that Nexobrid's effectiveness varies across patients and should be considered a tool rather than a definitive solution in burn wound management. A few patients developed complications, and about 10% of patients succumbed to systemic complications. The study results reveal both the potential benefits and limitations of using Nexobrid in burn debridement. While it successfully eliminated the need for further surgical intervention in a small percentage of patients, the majority still required additional surgical procedures. These findings not only highlight Nexobrid's role as a tool in burn wound management but also point toward the discrepancies with previous studies. The authors suggest future research should include randomized controlled trials, direct comparisons between Nexobrid and traditional debridement methods, and studies incorporating larger and more diverse patient groups.
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Affiliation(s)
- Giuseppe A G Lombardo
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
- Università Unikore di Enna, Piazza dell'Università, 94100 Enna EN, Italy
| | - Francesco Ciancio
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Hillary Violini
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Claudia Sapuppo
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Santo Zagami
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Adelina Vena
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Maria Giardina
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Claudio Donia
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Rosario Ranno
- Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy
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Lombardo GAG, Donia C, Ciancio F, Russo A, Stivala A, Ranno R. Temporal Fascia Free Flap for Thumb Coverage in Electrical Burn Injuries: A Case Series Analysis With DASH Score Outcomes Evaluation. J Burn Care Res 2024; 45:493-498. [PMID: 37982657 DOI: 10.1093/jbcr/irad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Indexed: 11/21/2023]
Abstract
Electrical burns pose unique challenges in reconstructive surgery due to the extensive tissue damage they cause. The thumb is particularly susceptible to electrical burns, leading to severe functional impairment. This case series introduces the use of the temporal fascia free flap for thumb coverage in patients with electrical burn injuries. The study aims to assess the functional outcomes of this approach using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Six male patients underwent thumb reconstruction using temporal fascia free flaps following electrical burn injuries. The extent of the injury was assessed, and necrotic tissue was debrided. Functional outcomes were evaluated using the DASH questionnaire 6 months postoperation. All procedures were conducted in accordance with ethical guidelines, and informed consent was obtained from all patients. All patients achieved successful transplants using temporal fascia free flaps. The average DASH score at the 6-month follow-up indicated satisfactory functional recovery. Patients reported improvements in thumb mobility and functionality, and the cosmetic appearance of the thumb was acceptable. The appearance of the scar in the donor area was well-received. The temporal fascia free flap proved to be an effective method for thumb reconstruction following electrical burn injuries. Its thin and flexible nature allows for optimal contouring and improved range of motion. Although one case of partial flap loss was observed, overall functional and aesthetic outcomes were satisfactory. Further research with larger sample sizes is warranted to optimize surgical techniques and postoperative care for better outcomes.
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Affiliation(s)
- Giuseppe A G Lombardo
- Burn and Plastic, Reconstructive and Aesthetic Surgery Department, Azienda Ospedaliera Cannizzaro, Catania 95100, Italy
- Università Unikore di Enna, Piazza dell'Università, Enna, EN 94100, Italy
| | - Claudio Donia
- Burn and Plastic, Reconstructive and Aesthetic Surgery Department, Azienda Ospedaliera Cannizzaro, Catania 95100, Italy
| | - Francesco Ciancio
- Burn and Plastic, Reconstructive and Aesthetic Surgery Department, Azienda Ospedaliera Cannizzaro, Catania 95100, Italy
| | - Arcangelo Russo
- Università Unikore di Enna, Piazza dell'Università, Enna, EN 94100, Italy
| | - Alessio Stivala
- Nord Plastic and Reconstructive Surgery Hand Surgery, Polyclinique Lyon Rillieux-la-Pape 69140, France
| | - Rosario Ranno
- Burn and Plastic, Reconstructive and Aesthetic Surgery Department, Azienda Ospedaliera Cannizzaro, Catania 95100, Italy
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Botti G, Botti C, Ciancio F. A Single Center's Clinical Experience With Ergonomix Breast Implants. Aesthet Surg J 2022; 42:NP312-NP318. [PMID: 34919632 DOI: 10.1093/asj/sjab422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This retrospective study reports on the early experience of a private surgical center with Motiva Ergonomix SilkSurface breast implants. OBJECTIVES The aim of this study was to examine the incidence of complications and satisfaction levels in women who received primary and revision breast augmentation or augmentation-mastopexy with Ergonomix SilkSurface breast implants. METHODS A total of 356 consecutive patients received Ergonomix SilkSurface breast implants between April 2014 and October 2018 by 3 different surgeons and were followed-up for a minimum of 12 months. Complications were assessed by measuring the rate of rupture, capsular contracture, malposition, late seroma, double capsule, reoperation, symmastia, ptosis, extrusion, and infection. Satisfaction with aesthetic results was assessed on a Likert scale by both surgeon and patient. RESULTS Only 6 major complications were observed in these 356 patients (712 implants): 1 unilateral implant ptosis ("bottoming out") at 12 months (0.14%) and 2 capsular contractures (0.28%), 1 at 14 months and 1 at 2 years. At all time points, 98% of the patients were "extremely satisfied or very satisfied" with the aesthetic results, and the surgeons categorized the outcomes as "very important or important improvement" in 96% of the cases. CONCLUSIONS Motiva Ergonomix SilkSurface devices provided high patient satisfaction up to more than 5 years postoperatively with very few complications. These data are consistent with other reports in the literature. The observed favorable outcomes might be attributed, at least in part, to the bioengineered "cell-friendly" surface of these implants. LEVEL OF EVIDENCE: 4
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Lembo F, Parisi D, Cecchino LR, Ciancio F, Innocenti A, Portincasa A. Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove: the Foggia experience. Orphanet J Rare Dis 2021; 16:52. [PMID: 33509245 PMCID: PMC7845051 DOI: 10.1186/s13023-021-01697-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 01/19/2021] [Indexed: 12/17/2022] Open
Abstract
Background Epidermolysis bullosa (EB) comprises a heterogeneous group of rare genetic diseases associated with skin blistering caused by minimal trauma. A major and common EB subtype, recessive dystrophic EB (RDEB), is characterized by altered wound healing, inflammatory dysbalance and fibrotic changes associated with reduced to absent collagen VII. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represent a challenging field in hand surgery practice. Methods The authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with an innovative “glove protocol” using Integra® dermal regeneration template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications. Results A total of 34 procedures were performed on 24 RDEB patients with hand deformities. Compared with the dressing with vaseline gauze, microsurgery followed by application of dermal regeneration template gloves allowed a significant reduction of hospital stay, healing time, and dressing pain as well as an increased recurrence-free interval. Conclusions The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients.
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Affiliation(s)
- Fedele Lembo
- Department of Plastic and Reconstructive Surgery, Ospedali Riuniti University of Foggia, Viale Pinto1, 71100, Foggia, Italy.
| | - Domenico Parisi
- Department of Plastic and Reconstructive Surgery, Ospedali Riuniti University of Foggia, Viale Pinto1, 71100, Foggia, Italy
| | - Liberato Roberto Cecchino
- Department of Plastic and Reconstructive Surgery, Ospedali Riuniti University of Foggia, Viale Pinto1, 71100, Foggia, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, Ospedali Riuniti University of Foggia, Viale Pinto1, 71100, Foggia, Italy
| | - Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Aurelio Portincasa
- Department of Plastic and Reconstructive Surgery, Ospedali Riuniti University of Foggia, Viale Pinto1, 71100, Foggia, Italy
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Ciancio F, Elia R, Nacchiero E, Perrotta RE. Current management of regional lymph nodes in patients with melanoma. J Surg Oncol 2019; 119:1184-1185. [PMID: 30864235 DOI: 10.1002/jso.25443] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/22/2019] [Accepted: 02/23/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, Italy
| | - Rossella Elia
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, Italy
| | - Eleonora Nacchiero
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, Italy
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Portincasa A, Cecchino L, Trecca EMC, Lembo F, Annacontini L, Ciancio F, Corsi F, Cassano M, Parisi D. A rare case of Brooke-Spiegler syndrome: integrated surgical treatment of multiple giant eccrine spiradenomas of the head and neck in a young girl. Int J Surg Case Rep 2018; 51:277-281. [PMID: 30241087 PMCID: PMC6146587 DOI: 10.1016/j.ijscr.2018.08.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/23/2018] [Accepted: 08/14/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The authors present a "four-step" integrated surgical protocol to treat a rare case of multiple giant eccrine spiradenoma (ES) of the head and neck in a young patient. PRESENTATION OF CASE An 18-year-old female patient presented with multiple swellings in the head and neck regions. The patient had a severe psychological trauma with a negative impact on her social life. Physical examination revealed multiple papulo-nodular swellings measuring between 5 cm × 8 cm and up to 10 cm × 20 cm in size with cerebriform aspect and soft consistency. Major lesions were located in the scalp, frontal area, neck, occipitotemporal, and retroauricular regions. Tissue biopsy found a benign composite adnexal neoplasm consisted in ES, trichoepithelioma, and cylindroma, a typical feature of Brooke-Spiegler Syndrome. A staged excision was planned, and available reconstructive options were considered. Scalp reconstruction included tissue expansions, advancement flaps, skin grafts, and dermal regeneration template (Integra®). All treatments were successful, and no recurrence was observed. The patient returned to a normal social life, and a radical excision with satisfying aesthetic results was achieved. DISCUSSION Although adnexal tumors are benign in most of the cases, these lesions are prone to arise in the craniofacial region, thereby causing aesthetic discomfort associated with pain, hemorrhage, and infection to the patient every day. Furthermore, there is a potential risk of malignant transformation. These concerns demonstrate the need to establish a surgical protocol for the treatment of adnexal tumors. CONCLUSIONS Our integrated surgical approach showed excellent aesthetic and functional results with benefits to the patient's life and complete oncological excision.
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Affiliation(s)
- A Portincasa
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - L Cecchino
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - E M C Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy.
| | - F Lembo
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - L Annacontini
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - F Ciancio
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - F Corsi
- Department of Pathology, University Hospital of Foggia, Foggia, Italy
| | - M Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - D Parisi
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
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Abstract
Injection of dermal fillers, like hyaluronic acid (HA), is a safe procedure, with few and transient side effects such as erythema, bruising and swelling etc. The aim of this report is to provide our protocol for the early treatment of necrotic complications after facial treatment with dermal fillers. We present two cases of skin suffering of the face after dermal infiltration of HA, treated successfully with our early protocol. Our protocol includes the early infiltration of hyaluronidase in the treated areas. We start with infiltration of hyaluronidase distributed over the area to be treated through micro-injections with dosage 40 IU per cm 2. Our protocol includes the use of systemic corticosteroids for 4 days, anti-aggregation therapy, oral antibiotic, topical cream with nitric oxide and compresses with gauze and warm water. In the skin complications after dermal filler treatment, marked pain and characteristic reticulated erythema in the skin distribution of the affected vessels is often developed. Due to the implementation of our protocol in these patients, we managed to avoid an irreversible necrotic complication of the face in both cases. In this report, our protocol was compared with results published in the literature and allowed us to avoid complications such as skin necrosis with permanent damage.
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Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, 70124, Italy
| | - Maria Stella Tarico
- Department of Plastic and Reconstructive Surgery, University of Catania, Catania, 95100, Italy
| | - Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, 70124, Italy
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Abstract
Injection of dermal fillers, like hyaluronic acid (HA), is a safe procedure, with few and transient side effects such as erythema, bruising and swelling etc. The aim of this report is to provide our protocol for the early treatment of necrotic complications after facial treatment with dermal fillers. We present two cases of skin suffering of the face after dermal infiltration of HA, treated successfully with our early protocol. Our protocol includes the early infiltration of hyaluronidase in the treated areas. We start with infiltration of hyaluronidase distributed over the area to be treated through micro-injections with dosage 40 IU per cm 2. Our protocol includes the use of systemic corticosteroids for 4 days, anti-aggregation therapy, oral antibiotic, topical cream with nitric oxide and compresses with gauze and warm water. In the skin complications after dermal filler treatment, marked pain and characteristic reticulated erythema in the skin distribution of the affected vessels is often developed. Due to the implementation of our protocol in these patients, we managed to avoid an irreversible necrotic complication of the face in both cases. In this report, our protocol was compared with results published in the literature and allowed us to avoid complications such as skin necrosis with permanent damage.
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Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, 70124, Italy
| | - Maria Stella Tarico
- Department of Plastic and Reconstructive Surgery, University of Catania, Catania, 95100, Italy
| | - Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Bari, 70124, Italy
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Innocenti A, Melita D, Ghezzi S, Ciancio F. Stenotic Breast Malformation and Its Reconstructive Surgical Correction: A New Concept from Minor Deformity to Tuberous Breast. Aesthetic Plast Surg 2018; 42:911-912. [PMID: 29282490 DOI: 10.1007/s00266-017-1054-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 12/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
| | - Serena Ghezzi
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Foggia, Bari, Italy
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Iannelli A, Ciancio F, Annoscia P, Vestita M, Perrotta RE, Giudice G, De Robertis M. Abdominoplasty with "Scarpa Fascia" preservation: Case Report. Int J Surg Case Rep 2018; 47:100-103. [PMID: 29754033 PMCID: PMC5994735 DOI: 10.1016/j.ijscr.2018.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/29/2018] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Abdominoplasty is one of the most performed operations in Plastic Surgery in the world. Postoperative seroma is one of the most frequently cited complications in literature. The aim of this study is to propose our experience with abdominoplasty with Scarpa Fascia preservationand compare it with recent scientific literature. PRESENTATION OF CASE We present the case of a 55-year-old woman underwent bariatric surgery in 2014, after which she lost 55kg of weight. We decided to perform an abdominoplasty with transposition of the umbilicus and preservation of the Scarpa Fascia. In fact, this technique seems to have a positive impact on reducing seroma formation, reducing the amount of drained fluids and the drainage time. DISCUSSION The saving of the adipose-fascial layer according to different Authors would allow the reduction of the volume of drained fluid, of the time spent by the drains and the average hospital stay. CONCLUSION The abdominoplasty with the Scarpa Fascia preservation is a safe, repeatable technique with good aesthetic results. The saving of deep adipose tissue allows to reduce the time and the quantity of drained liquids. In our experience patient undergoing this technique has shorter hospital stays with no complications.
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Affiliation(s)
- Antonio Iannelli
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy.
| | - Paolo Annoscia
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | | | | | - Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
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Giudice G, Vestita M, Robusto F, Annoscia P, Ciancio F, Nacchiero E. Breast cancer cutaneous metastases mimicking Papilloma Cutis Lymphostatica. Biopsy to avoid pitfalls. Int J Surg Case Rep 2018; 46:31-33. [PMID: 29674005 PMCID: PMC6000767 DOI: 10.1016/j.ijscr.2018.03.025] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/19/2018] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Secondary lymphedema is the most frequent long-term complication of axillary lymphadenectomy. It can result in complication as erysipelas, warts, Papilloma Cutis Lymphostatica (PCL), or angiosarcomas. Moreover, in women affected by breast cancer an accurate differential diagnosis among these conditions or complication related to radiation dermatitis or cutaneous metastasis is essential. PRESENTATION OF CASE We report the case of a 60-year-old postmenopausal Caucasian woman affected by secondary lymphedema following complete mastectomy for breast cancer. The patient after surgery was treated with radiotherapy, chemotherapy and hormone therapy, developing a lympedema of left arm after few months. These lesions had clinical typical features of PCL, but histopathological analysis revealed dermo-hypodermic metastasis of breast carcinoma. DISCUSSION The presence of skin lesions in secondary lymphedema after oncological lymphadenectomy requires an accurate differential diagnosis. In fact, these lesions can emulate degenerative or infective skin diseases; anyway, in patients affected by secondary lymphedema other less common conditions - as PLC, nodular-type lichen myxedematosus or Gottron's carcinoid papillomatosis - should be taken into account. CONCLUSION Our case reports the possibility that metastases of breast cancer might also mimic these conditions.
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Affiliation(s)
- Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | | | - Fabio Robusto
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Paolo Annoscia
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy.
| | - Eleonora Nacchiero
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
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Ciancio F, Innocenti A, Annoscia P, Vestita M, Giudice G. Discussion: Optimizing Patient Selection for Direct-to-Implant Immediate Breast Reconstruction Using Wise-Pattern Skin-Reducing Mastectomy in Large and Ptotic Breasts. Aesthetic Plast Surg 2018; 42:340-341. [PMID: 29101433 DOI: 10.1007/s00266-017-0995-8] [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] [Received: 10/05/2017] [Accepted: 10/07/2017] [Indexed: 10/18/2022]
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Portincasa A, Trecca EMC, Ciancio F, Annacontini L, Bufo P, Fortunato F, Cecchino L, Parisi D, Cassano M. The role of lipofilling in reconstructions with dermal regeneration template: clinical and histological assessment. J BIOL REG HOMEOS AG 2018; 32:171-176. [PMID: 29504384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Skin and soft tissue reconstruction represents one of the most debated issues of plastic surgery. The advent of regenerative medicine has shown new pathways with the use of lipofilling and dermal regeneration templates. The aim of this study was to investigate the histological and clinical modifications occurring after lipofilling in the areas previously reconstructed with Integra® and an autologous thin dermal-epidermal graft. Histological and immunohistochemical analysis were performed on nine patients to compare skin before and after lipofilling. Pre- and post-operative examinations (POSAS, VAS scale) were carried out as well as taking clinical photographs. The authors detected an overall clinical and histological improvement in all cases. Data obtained from POSAS and VAS scale showed a statistically significant (p less than 0.05) improvement concerning all variables investigated before surgery. The biopsies revealed qualitative modifications with hematoxylin-eosin and Masson trichrome stain. Immunohistochemistry with CD31 antibody also demonstrated quantitative changes with an increased number of vessels. The photographs enabled to compare the clinical situation before and after lipofilling with better aesthetic outcomes. Lipofilling gave good functional and aesthetic results in the areas treated with Integra® and autologous thin dermal-epidermal grafts.
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Affiliation(s)
- A Portincasa
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - E M C Trecca
- Department of Otorhinolaryngology, University of Foggia, Foggia, Italy
| | - F Ciancio
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - L Annacontini
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - P Bufo
- Department of Pathology, University of Foggia, Foggia, Italy
| | - F Fortunato
- Section of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - L Cecchino
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - D Parisi
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - M Cassano
- Department of Otorhinolaryngology, University of Foggia, Foggia, Italy
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Ciancio F, Innocenti A, Cagiano L, Portincasa A, Parisi D. Skin-reducing mastectomy and direct-to-implant reconstruction in giant phyllodes tumour of breast: case report. Int J Surg Case Rep 2017; 41:356-359. [PMID: 29149740 PMCID: PMC5695607 DOI: 10.1016/j.ijscr.2017.11.009] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/03/2017] [Accepted: 11/03/2017] [Indexed: 02/06/2023] Open
Abstract
We present a singular case of early breast cancer and reconstruction with prosthesis. The giant phylloides tumors are often malignant, but in this case the histological examination has been atypical. The technique we offer allows for effective reconstruction in a single time. Few cases in literature have dealt with this issue.
Background The phyllodes tumour of the breast comprises about 0.5% of all neoplasms of the breast. Case report we present the case of a female patient (55 years old) suffering from giant phyllodes tumour (>10 cm) of the left breast, who underwent Skin Reducing Mastectomy (SRM) and reconstruction with silicone breast implant (Bostwick Technique). Discussion and conclusion In selected patients with large sized breasts (C-D cup) and poor surface area of skin involved, a valid technique in the treatment of this pathology is the Skin-Reducing Mastectomy and immediate reconstruction with implants (DTI = direct to implant).
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Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy.
| | - Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Luigi Cagiano
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - Aurelio Portincasa
- Department of Plastic and Reconstructive Surgery, University of Foggia, Italy
| | - Domenico Parisi
- Department of Plastic and Reconstructive Surgery, University of Foggia, Italy
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Salval A, Ciancio F, Margara A, Bonomi S. Impending Facial Skin Necrosis and Ocular Involvement After Dermal Filler Injection: A Case Report. Aesthetic Plast Surg 2017; 41:1198-1201. [PMID: 28567474 DOI: 10.1007/s00266-017-0898-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/07/2017] [Indexed: 11/30/2022]
Abstract
Demand for non-surgical rejuvenating procedure is constantly increasing due to the aging population, increasing expense of aesthetics and beauty procedures, introduction of new applications and rising demand for noninvasive aesthetic procedures over surgical procedures. Skin necrosis is a rare but severe potential complication. It is caused by impediment of the blood supply to the skin area by compression and/or obstruction of the vessel with filler material, and/or direct injury to the vessel. We report the case of a young patient who presented an acute and severe complication after a dermal filler injection by an unlicensed therapist. High-dose corticosteroids i.v. therapy among others helped in the process of healing. Skin necrosis left the patient with a full thickness scar on the forehead region. Dermal fillers are to be considered safe only when handled by trained doctors. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- André Salval
- Plastic and Post Bariatric Surgery Unit, Clinica San Pio X Humanitas, Milan, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Viale Luigi Pinto n 1, 71122, Foggia, Italy.
| | - Andrea Margara
- Plastic and Post Bariatric Surgery Unit, Clinica San Pio X Humanitas, Milan, Italy
| | - Stefano Bonomi
- Plastic Surgery Unit, Istituto Nazionale dei Tumori, Milan, Italy
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Ciancio F, Parisi D, Portincasa A, Innocenti A. Innovative Management of Implant Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy. Aesthetic Plast Surg 2017; 41:1237-1238. [PMID: 28374296 DOI: 10.1007/s00266-017-0850-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/06/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Viale Luigi Pinto n 1, 71122, Foggia, Italy.
| | - Domenico Parisi
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - Aurelio Portincasa
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
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Innocenti A, Ciancio F, Francesco M, Melita D, Innocenti M. Comment to "No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia". Aesthetic Plast Surg 2017; 41:990-991. [PMID: 28204934 DOI: 10.1007/s00266-017-0821-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Largo Palagi 1, 50139, Florence, Italy.
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - Mori Francesco
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Largo Palagi 1, 50139, Florence, Italy
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Largo Palagi 1, 50139, Florence, Italy
| | - Marco Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Largo Palagi 1, 50139, Florence, Italy
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Innocenti A, Melita D, Mori F, Ciancio F, Parisi D, Innocenti M. Discussion: Objective Outcome Measurement After Upper Blepharoplasty: An Analysis of Different Operative Techniques. Aesthetic Plast Surg 2017; 41:987-988. [PMID: 28204932 DOI: 10.1007/s00266-017-0813-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
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Innocenti A, Ciancio F, Portincasa A, Parisi D. Discussion: Surgical Management of Gynecomastia-Subcutaneous Mastectomy and Liposuction. Aesthetic Plast Surg 2017; 41:983-984. [PMID: 28204929 DOI: 10.1007/s00266-017-0811-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 01/29/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - Aurelio Portincasa
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - Domenico Parisi
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
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Innocenti A, Melita D, Mori F, Ciancio F, Innocenti M. Comment to "Postero-Inferior Pedicle Surgical Technique for the Treatment of Grade III Gynecomastia". Aesthetic Plast Surg 2017; 41:747-748. [PMID: 28374294 DOI: 10.1007/s00266-017-0849-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/06/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
- , Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Francesco Mori
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - Marco Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
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Innocenti A, Mori F, Melita D, Dreassi E, Ciancio F, Innocenti M. Evaluation of Long-term Outcomes of Correction of Severe Blepharoptosis with Advancement of External Levator Muscle Complex: Descriptive Statistical Analysis of the Results. ACTA ACUST UNITED AC 2017; 31:111-115. [PMID: 28064228 DOI: 10.21873/invivo.11032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 10/31/2016] [Revised: 11/25/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022]
Abstract
AIM Evaluation of long-term results after aponeurotic blepharoptosis correction with external levator muscle complex advancement. PATIENTS AND METHODS We carried out a retrospective study with medical record review of 20 patients (40 eyes) affected by bilateral aponeurotic moderate and severe ptosis who underwent primary surgery between January 2010 and December 2013. Criteria for outcome evaluations included 3-year postoperative follow-up of upper margin reflex index (uMRD) and symmetry. RESULTS 3-Year postoperative follow-up showed 17 (85%) cases of successful correction of ptosis and three cases (15%) showed partial success. Two eyes showed hypocorrection, while one eye was overcorrected. The symmetry was maintained in all patients except for the oldest. CONCLUSION External superior levator advancement is an effective procedure for moderate and severe aponeurotic blepharoptosis correction, and establishes good long-term eyelid position and symmetry.
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Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Francesco Mori
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
| | - Emanuela Dreassi
- Department of Statistics, Informatics, Applications "G.Parenti" DiSIA, University of Florence, Florence, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - Marco Innocenti
- Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy
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Ciancio F, Parisi D, Portincasa A, Innocenti A. Discussion: A New Method of Salvaging Breast Reconstruction After Breast Implant Using Negative-Pressure Wound Therapy and Instillation. Aesthetic Plast Surg 2017; 41:466-467. [PMID: 28032169 DOI: 10.1007/s00266-016-0734-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 11/09/2016] [Indexed: 12/20/2022]
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Ciancio F, Portincasa A, Parisi D, Innocenti A. MowA®: A simple and economic way of monitoring chronic wounds outcome with your mobile devices. Ann Ital Chir 2017; 88:94. [PMID: 28447962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The treatment of skin ulcers of the lower extremities is a difficult challenge for surgeons as demonstrated in the literature 1,2. Furthermore objective monitoring of skin ulcers represts an important necessity for the plastic surgeon who has to update the treatment over time. In the past we had to write about systems and applications designed to catalog and manage digital libraries 3, so we have gone looking for a system to catalog and manage date related skin in ulcers. I present an application for mobile devices that allows to calculate , evaluate and analyze, the both surface area and tissue quality of skin ulcers m in a fast and practical way. The application is called "Mowa®"and it is available both for Apple and Android devices. Often we have to treat chronic injuries to the skin for several weeks and the evaluation needs to takes place in a periodic manner. An important problem for a surgeon, in the treatment of chronic wounds of the skin, is to evaluate the effectiveness of the cure in terms of "reduction of the lesion" and "quality of tissue". That is, it would be useful having s way to assess the size(area) of the wound an quality if tissues inside the lesion. This would make it objectively easier to measure the progress if the treatment in the past there have been many proposed systems 4-6. We tried in the past, to use theVisa-track system (smith & Nephew) with good outcomes, but this is limited because it can be used by a single patient at atime. The need to find a more affordable way led us to experience Mora application in our devices. This simple application allows, through a photograph, to quantify in quare centimeters the surface of the lesion. Furtermore Mowa® provides a system for detecting the fibrin percentage of granulation and necrotic tissue. The analysis of the chronic lesion of the skin is also completed by the insertion of the main characteristics of the qound, for esample, the exudate (in small quantities,moderate or a lot). The suspicion of infection, bleeding and the depth of the lesion. The application also offers a treatment algorithm based in the data entered and follows the EPUAP and NPUAP guidelines 7. Once the assessment of chronic skin lesion takes place, it is possible to produce a PDF or JPEG file with photography and the characteristics of the wound.The producted files can be shared via email. The use of this simple application is of interest to those surgeons who want a quick way to evaluate in size and percentage skin ulcers. The ability to store and search Ptients data in a fast and practice way is the strongest point of this application. Through this application you can monitor and compare both size and outcome of chronic wound over time, When using the applicatiom, if you want, there is need to include any sensitive information relates to the patients, No author has economic interest and financed by the the advertising of this application.
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Parisi D, Ciancio F, Cagiano L, Rucci M, Annacontini L, Portincasa A. Hemangioma of the oral and perioral region: Nd:YAG vs surgery. Ann Ital Chir 2016; 2578:S2239253X16025780. [PMID: 27830673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Hemangiomas are very commonly diagnosticated in childhood. The area most affected by this disease is the head and neck. In recent decades, the laser therapy has changed the treatment of hemangiomas through special techniques with advantages in bleeding risk management. MATERIALS AND METHODS Object of this study is comparing Nd:YAG laser and surgical excision, in terms of aesthetic outcomes, in the treatment of hemangiomas of oral and perioral region. The aim is the comparison between the two techniques in terms of aesthetic outcomes through photographic reportage and clinical supervision by three expert plastic surgeons (observers), unrelated to treatment, through the use of Patient and Observer Scar Assessment Scale. RESULTS The results of the investigation with POSAS show a better aesthetic result with the use of the Nd:YAG laser compared with excisional treatment with cold blade, both for the patient and for the external examiners. CONCLUSIONS Nd:YAG laser treatment for hemangiomas of the perioral region is a safe, fast and low complications choice. The lower risk of bleeding allows to use the laser technique even in the clinics not equipped for surgeries offering an important advantage to the operator. The main indication is represented by hemangiomas that cause a psychological and functional discomfort to the patient, such as frequent possibility of ulcerations and bleeding, in which it is clear the benign nature of the lesion. KEY WORDS Hemangiomas, Laser Therapy, Nd:YAG, Vascular lesions.
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Pajardi G, Rapisarda V, Somalvico F, Scotti A, Russo GL, Ciancio F, Sgrò A, Nebuloni M, Allevi R, Torre ML, Trabucchi E, Marazzi M. Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study. Int Wound J 2016; 13:44-52. [PMID: 24517418 PMCID: PMC7950180 DOI: 10.1111/iwj.12223] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/20/2013] [Accepted: 01/02/2014] [Indexed: 01/01/2023] Open
Abstract
Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.
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Affiliation(s)
- Giorgio Pajardi
- Unità Operativa Complessa di Chirurgia della Mano, Università degli Studi di Milano, Ospedale San Giuseppe Milan /IRCCS MultiMedica, Milano, Italy
| | - Vicenzo Rapisarda
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | | | - Andrea Scotti
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Giulia Lo Russo
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Francesco Ciancio
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Arturo Sgrò
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Manuela Nebuloni
- Struttura Complessa di Anatomia Patologica, Polo Universitario "A.O. Ospedale Luigi Sacco", Milano, Italy
| | - Raffaele Allevi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Maria L Torre
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
| | - Emilio Trabucchi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Mario Marazzi
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
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Annacontini L, Ciancio F, Parisi D, Innocenti A, Portincasa A. Management of nipple-areolar complex complications in skin-sparing mastectomy with prosthetic reconstruction A case report. Ann Ital Chir 2016; 87:S2239253X16024440. [PMID: 26829374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION AND OBJECCTIVES Venous congestion of the NAC (Nipple-Areola Complex) is not an uncommon complication of Skin-Reducing Mastectomy (SRM). The correct and prompt evaluation of the NAC's vitality in the first hours after surgery is important for the survival of the same, in fact the possibility of early intervention allows avoiding the use of invasive and radicals techniques to the advantage of simpler rapid procedures. MATERIALS AND METHODS DM, 57yr, multiple invasive ductal carcinoma of the right breast, underwent a SRM and immediate reconstruction with implant in August 2014 In the immediate post-operative appeared a venous stasis of the NAC. Treatment started with Negative Pressure Wound Therapy (NWPT) through VAC-Systems to 75 mmHg. RESULTS The use of the VAC-Therapy was in total 12 days and allowed the partial rescue of the NAC (85%). the vacuum pump is put into a portable bag so the patient's mobility is not limited. DISCUSSION NWPT permitted a rapid resolution of NAC's complication in SRM in order to guarantee an optimal timing for the start of adjuvant chemotherapy. The VAC-Therapy is a cost effective and simple to use in cases of suffering venous NAC in patients undergoing breast surgery. KEY WORDS NAC, NWPT, Skin-Reducing Mastectomy, VAC-Therapy.
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Ciancio F, Lo Russo G, Innocenti A, Portincasa A, Parisi D, Mondaini N. Penile length is a very important factor for cosmesis, function and psychosexual development in patients affected by hypospadias: Results from a long-term longitudinal cohort study. Int J Immunopathol Pharmacol 2015; 28:421-5. [DOI: 10.1177/0394632015576857] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 02/17/2015] [Indexed: 11/15/2022] Open
Abstract
Few studies of long-term outcome of hypospadias treatment in terms of voiding, surgical complications, sexual functioning, intimate relationships and cosmetic results have been investigated and contrasting results have been obtained so far. The aim of our study is to investigate the long-term outcome of urinary and sexual function, cosmesis and the quality of intimate relationships in a series of hypospadias. In this study, 42 patients who underwent surgery for hypospadias were prospectively followed for 15 years. Medical records provided the hypospadias data, the number of reconstructive operations and the reconstruction technique that was used. Patients underwent physical examination, including penile length measurement and completed International Prostatic Symptoms Score (I-PSS), International Index Of Erectile Function (IIEF 15) and the Penile Perception Score questionnaire (PPPS). Twenty patients agreed to participate in the study. At the enrolment, the median value of HOSE was 13, as regards PPPS, 18/20 (90%) were satisfied, while in 1998 only 80% were satisfied. No significant statistical difference has been reported from the results obtained at enrolment and those obtained at follow-up, in terms of PPPS (P = 0.81), IPSS and IIEF-15. Penile length was 6.5 cm flaccid and 10.5 cm stretched. Our data show how cosmesis, function and psychosexual development for these patients are highly connected to surgical outcome, which is understood to be a decrease in penile size.
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Affiliation(s)
- Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy
| | - G Lo Russo
- Department of Plastic and Reconstructive Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - A Innocenti
- Department of Plastic and Reconstructive Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - A Portincasa
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - D Parisi
- Department of Plastic and Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - N Mondaini
- Department of Urology, Santa Maria Annunziata Hospital, University of Florence, Florence, Italy
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Innocenti A, Amodeo CA, Ciancio F. Wide-undermining neck liposuction: tips and tricks for good results. Aesthetic Plast Surg 2014; 38:662-9. [PMID: 24902909 DOI: 10.1007/s00266-014-0330-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Neck rejuvenation is one of the most sought after procedures in the restoration of the facial contour. Numerous techniques to improve the aesthetic outcome and reduce downtime have been described. In our experience, wide undermining and local anesthesia are key to obtaining good results in selected patients who want a quick recovery. This article presents our experience with liposuction of the neck and proposes some tips and tricks to master wide-undermining neck liposuction. METHODS From January 2005 to September 2012, a total of 118 patients (34 males, 84 females) underwent neck liposuction. Patient selection was based mainly on age and neck-aging features. The procedure was performed with the patients under local anesthesia. A wide rhomboid-shaped skin undermining of the submandibular and neck area was performed and a very thin fat layer was preserved. Dressing was applied for 3 days. RESULTS Improvement of the neck's contour was observed in all patients. Redefinition of the cervicomandibular angle and skin redraping of the cervical area occurred in all cases. No further touch-ups were needed. Edema and ecchymosis resolved in a few days. No major complications were observed. CONCLUSIONS Our results show that wide-undermining neck liposuction performed under local anesthesia is an effective and safe procedure. Patient selection based on age and anatomical features was fundamental to obtain impressive improvement of neck contour. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Chlapanidas T, Tosca MC, Faragò S, Perteghella S, Galuzzi M, Lucconi G, Antonioli B, Ciancio F, Rapisarda V, Vigo D, Marazzi M, Faustini M, Torre ML. Formulation and characterization of silk fibroin films as a scaffold for adipose-derived stem cells in skin tissue engineering. Int J Immunopathol Pharmacol 2013; 26:43-9. [PMID: 24046948 DOI: 10.1177/03946320130260s106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Skin substitutes are epidermal, dermal or complete bilayered constructs, composed by natural or synthetic scaffolds and by adherent cells such as fibroblasts, keratinocytes or mesenchymal stem cells. Silk fibroin is a promising polymer to realize scaffolds, since it is biocompatible, biodegradable, and exhibits excellent mechanical properties in terms of tensile strength. Moreover, fibroin can be added of others components in order to modify the biomaterial properties for the purpose. The aim of this work is to prepare silk fibroin films for adipose-derived stem cell (ADSCs) culture as a novel feeder layer for skin tissue engineering. Pectin has been added to promote the protein conformational transition and construct strength, while glycerol as plasticizer, providing biomaterial flexibility. Eighteen formulations were prepared by casting method using fibroin, pectin (range 1-10% w/w), and glycerol (range 0-20% w/w); films were characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry assay, to select the optimal composition. A stable fibroin conformation was obtained using 6% w/w pectin, and the best mechanical properties were obtained using 12% w/w glycerol. Films were sterilized, and human ADSCs were seeded and cultured for 15 days. Cells adhere to the support assuming a fibroblastic-like shape and reaching confluence. The ultrastructural analysis evidences typical active-cell features and adhesion structures that promote cell anchorage to the film, thus developing a multilayered cell structure. This construct could be advantageously employed in cutaneous wound healing or where the use of ADSCs scaffold is indicated either in human or veterinary field.
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Affiliation(s)
- T Chlapanidas
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
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Cavallini M, Antonioli B, Gazzola R, Tosca M, Galuzzi M, Rapisarda V, Ciancio F, Marazzi M. Hyaluronidases for treating complications by hyaluronic acid dermal fillers: evaluation of the effects on cell cultures and human skin. Eur J Plast Surg 2013. [DOI: 10.1007/s00238-013-0855-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Narducci F, Ciancio F, Coutty N, Jouve E, Collinet P, Querleu D, Leblanc E. [For... systematic interrogation about para-aortic lymphadenectomy in endometrial carcinoma]. ACTA ACUST UNITED AC 2008; 37:83-5. [PMID: 19110460 DOI: 10.1016/j.gyobfe.2008.11.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- F Narducci
- Département de gynécologie, centre Oscar-Lambret (CLCC), Lille cedex, France.
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Donati M, Gandolfo L, Cavallaro G, Ciancio F, Brancato G. [Endometriosis of the abdominal wall (authors' experience)]. Ann Ital Chir 2004; 75:29-34; discussion 34. [PMID: 15283384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Endometriosis is a very common gynecological disease, although the abdominal wall localization is a rare clinical problem in the everyday practice and this explains the incomplete reports in literature and the difficulty of a standard treatment. The authors report four cases of abdominal wall endometriosis, underlining how the surgical therapy represents the golden standard of decisive treatment, thanks also to prosthetic reconstruction techniques who allow more radical demolitions. On the contrary, the medical treatment should be reserved to selected cases such as especially the less symptomatic umbilical primitive diseases.
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Affiliation(s)
- M Donati
- Università degli Studi di Catania, Policlinico Universitario, Unità Operativa di Chirurgia Generale I
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Sesti F, Ciancio F, Bancheri C, Iannarilli P, Silvestri C, Piccione E. [Chemotherapy of carcinoma of the vulva and vagina. Current approaches]. G Ital Oncol 1989; 9:117-20. [PMID: 2693347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In the present work, on the basis of the most recent knowledges, the Authors analyse and discuss the current status of the chemotherapeutical treatment of epidermoid carcinomas of the vulva and vagina, both in case of in situ forms (topical chemotherapeutic administration) and in case of invasive tumors (systemic chemotherapeutic administration).
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