1
|
Redi U, Kaciulyte J, Marino D, Nanni J, Lo Torto F, Marcasciano M, Ribuffo D, Alfano C, Mazzocchi M. The role of component separation in the treatment of severe diastasis recti abdominis: a new indication for a known technique. Eur Rev Med Pharmacol Sci 2023; 27:8234-8244. [PMID: 37750652 DOI: 10.26355/eurrev_202309_33584] [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] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Diastasis of the rectus abdominis muscle (DRAM) is a widening of linea alba, it also could be accompanied by abdominal bulging. DRAM is often a cause of quality-of-life impairment, especially when it is of large dimensions. Repair with direct rectus plication is the most common treatment for Diastasis Recti Abdominis (DRA), but it can result in high recurrence rates. The authors aimed to show their results in applying the component separation technique in wide DRA cases. PATIENTS AND METHODS From January 2015 to July 2018, 43 patients with DRA ≥ 10 cm at 3 cm over the umbilicus have been treated with component separation technique associated to panniculectomy. A biologic mesh was positioned onlay in cases of weakness along the semilunaris lines. RESULTS DRA repair was achieved in all cases. All patients completed the 1-year follow-up and no recurrence nor major complication were registered. Minor complications were observed in 12 (27.9%) cases. CONCLUSIONS This is the first study describing the component separation technique use in cases of DRA without hernia, associated to abdominoplasty surgery. Preliminary results were encouraging, but larger series are required.
Collapse
Affiliation(s)
- U Redi
- Department of Surgery "P. Valdoni", Sapienza University of Rome, Policlinico Umberto I Hospital, Unit of Plastic and Reconstructive Surgery, Rome, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Lo Torto F, Di Meglio F, Frattaroli J, Parisi P, Losco L, Marcasciano M, Casella D, Ribuffo D. The concept of bank tissue applied to post bariatric abdominoplasty: The use of autologous dermal mesh for abdominal diastasis repair. J Plast Reconstr Aesthet Surg 2023; 77:167-169. [PMID: 36571962 DOI: 10.1016/j.bjps.2022.11.066] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/24/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022]
Affiliation(s)
- F Lo Torto
- Department of Surgery P. Valdoni, Sapienza University of Rome, U.O.C of Plastic Reconstructive Surgery, Policlinico Umberto I of Rome, 00161 Rome, Italy.
| | - F Di Meglio
- Department of Surgery P. Valdoni, Sapienza University of Rome, U.O.C of Plastic Reconstructive Surgery, Policlinico Umberto I of Rome, 00161 Rome, Italy
| | - J Frattaroli
- Department of Surgery P. Valdoni, Sapienza University of Rome, U.O.C of Plastic Reconstructive Surgery, Policlinico Umberto I of Rome, 00161 Rome, Italy
| | - P Parisi
- Department of Surgery P. Valdoni, Sapienza University of Rome, U.O.C of Plastic Reconstructive Surgery, Policlinico Umberto I of Rome, 00161 Rome, Italy
| | - L Losco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - M Marcasciano
- Experimental and Clinical Medicine Department, Magna Graecia University of Catanzaro, Division of Plastic Surgery, Catanzaro 88100, Italy
| | - D Casella
- U.O.C. of Oncological Breast Surgery, Department of Breast Cancer Surgery, University Hospital of Siena, 53100 Siena, Italy
| | - D Ribuffo
- Department of Surgery P. Valdoni, Sapienza University of Rome, U.O.C of Plastic Reconstructive Surgery, Policlinico Umberto I of Rome, 00161 Rome, Italy
| |
Collapse
|
3
|
Garieri P, Marcasciano M, Greto Ciriaco A, Spagnuolo R, Vitagliano T, Kaciulyte J, Casella D, Lo Torto F, Parisi P, Ribuffo D, Greco M. Pyoderma Gangrenosum and inflammatory bowel disease: a combined medical and surgical approach - case report and literature review. Eur Rev Med Pharmacol Sci 2022; 26:5191-5199. [PMID: 35916817 DOI: 10.26355/eurrev_202207_29308] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Pyoderma Gangrenosum (PG) is an immune-mediated neutrophilic dermatosis, characterized by large painful ulcers occurring in various body segments. It can be associated to Inflammatory Bowel Disease (IBD) including both Ulcerative Colitis and Crohn Disease. Prompt and effective management is fundamental, due to its high morbidity and mortality rates. By presenting our clinical experience, we aimed at showing the efficacy of a combined therapeutic approach, in which the best of every specialty cooperates managing this hazardous disease. PATIENTS AND METHODS We report on two patients attending our outpatient clinic with ulcerative skin lesions at the level of the back. Patient 1 suffered from Crohn disease and Patient 2 presented a positive history of abdominal pain, diarrhea with mucus and blood in the stool. Histological exam was performed with final diagnosis of PG associated with IBD. A Literature review was carried out in order to highlight the role of combined clinical-surgical management of PG in adult patients with IBD. RESULTS Complete resolution of the lesions was achieved in 4 months and 3 months for each patient respectively without relapse. PubMed was searched from 2000 to 2020 with the following keywords: (Pyoderma) AND/OR (Pyoderma Gangrenosum) AND (Inflammatory Bowel Disease) AND/OR (Ulcerative Colitis) AND/OR (Crohn Disease) AND (Management). Seven papers were included (4 case reports, 2 case series, 1 comprehensive review) and reviewed using a descriptive checklist. CONCLUSIONS PG should be treated by dedicated multidisciplinary teams, in which every specialist plays a crucial role from the diagnosis to the treatment and up to the long-term follow-up.
Collapse
Affiliation(s)
- P Garieri
- U.O.C of Plastic, Hand Surgery and Microsurgery, ASST-Monza, San Gerardo Hospital, Monza, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Redi U, Marruzzo G, Codolini L, Chistolini A, Tarallo M, Marcasciano M, Lo Torto F, Grippaudo FR, Casella D, Ribuffo D. Venous thromboembolism prophylaxis in plastic surgery: state of the art and our approach. Eur Rev Med Pharmacol Sci 2021; 25:6603-6612. [PMID: 34787863 DOI: 10.26355/eurrev_202111_27103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The issue of prevention of thromboembolism in plastic surgery is a rather controversial subject. The actual frequency of VTE among plastic surgery patients is probably higher than we know. Although several studies have shown that chemoprophylaxis likely increases rates of re-operative hematoma by less than one percent, surgeons are strongly resistant to adopting chemoprophylaxis due to the fear of increased bleeding and its complications. MATERIALS AND METHODS A literature review was conducted. The 2012 ACCP guidelines suggest the use of the 2005 Caprini score as the most widely used and well-validated individualized risk-stratification tool. We propose a modified 2005 Caprini score, with specific changes pertaining to plastic surgery, in which we combine a patient risk stratification model and a procedure-driven approach explicitly indicating what procedures have to be considered at high or low risk. RESULTS The risk of venous thromboembolism in plastic surgery cannot be disregarded. However, the plastic surgery literature still lacks high-level evidence for appropriate means of VTE prophylaxis, although an increasing amount of attention has been paid to the topic. We suggest the development of an international guideline, based on plastic surgical data, using a validated risk assessment model, which combines the surgical risk with the patient-related risk. CONCLUSIONS Determining the proper venous thromboembolism prophylaxis is a clinical decision that should be made on a patient-to-patient basis. The algorithm presented in this article is meant to simplify this complex problem and to help expedite and clarify the decision-making process.
Collapse
Affiliation(s)
- U Redi
- Department of Surgery "P. Valdoni", Plastic Surgery Unit, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Loreti A, Fanelli B, Spallone D, Arelli F, Marcasciano M, Abate O, Latini C, De Carli M, La Pinta M, Manna E, Meli E, Fortunato L. Nipple sparing mastectomy (NSM) after surgical delay (SD) and prepectoral direct to implant (DTI) reconstruction with polyurethane prostheses: Preliminary results. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30658-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
6
|
Marcasciano M, Kaciulyte J, Mori FLR, Lo Torto F, Barellini L, Loreti A, Fanelli B, De Vita R, Redi U, Marcasciano F, Di Cesare F, Dal Prà G, Conversi A, Elia L, Montemari G, Vaia N, Bernini M, Sordi S, Luridiana G, D'Ermo G, Monti M, De Luca A, Ricci F, Mazzocchi M, Gentilucci M, Greco M, Losco L, Valdatta LA, Raposio E, Giudice G, Maruccia M, Di Benedetto G, Cigna E, Casella D, Ribuffo D. Breast surgeons updating on the thresholds of COVID-19 era: results of a multicenter collaborative study evaluating the role of online videos and multimedia sources on breast surgeons education and training. Eur Rev Med Pharmacol Sci 2020; 24:7845-7854. [PMID: 32744712 DOI: 10.26355/eurrev_202007_22289] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Current trends show a rise of attention given to breast cancer patients' quality of life and the surgical reconstructive result. Along with this trend, surgical training quality and efficacy are gaining importance and innovative training methods such as online videos shared on social media portals, are becoming main updating tools. In hazardous times like COVID-19 pandemic nowadays, online communication becomes of vital importance and adaptation and innovation are fundamental to keep research and education alive. The authors aimed to investigate the role of video and multimedia sources on the daily activity and surgical training of a representative group of surgeons specifically dedicated to oncologic, oncoplastic and reconstructive breast surgeries. MATERIALS AND METHODS A survey was produced and administered to 20 major Italian Breast Centers. Collected data were analyzed with Fisher's Exact Test. RESULTS From October 2019 to March 2020, a total of 320 surveys were collected. Among the responders, there were 188 trainees (intern medical doctors and residents) and 110 faculty, 72% of them belonged to a plastic surgery environment, while 28% to general surgery environment. Almost all respondents have ever watched videos concerning breast surgery. CONCLUSIONS The results of the study show how breast surgeons rely on videos and web platforms, mostly YouTube, when searching for training info about surgical procedures. Social media offer great opportunities for sharing knowledge and diffusion of new ideas but greater attention to their reliability is mandatory.
Collapse
Affiliation(s)
- M Marcasciano
- Unità di Oncologia Chirurgica Ricostruttiva della Mammella, "Spedali Riuniti" di Livorno, "Breast Unit" Integrata di Livorno Cecina, Piombino Elba, Azienda USL Toscana Nord Ovest, Livorno, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Lo Torto F, Marcasciano M, Kaciulyte J, Redi U, Barellini L, De Luca A, Perra A, Frattaroli JM, Cavalieri E, Di Taranto G, Greco M, Casella D. Prepectoral breast reconstruction with TiLoop® Bra Pocket: a single center prospective study. Eur Rev Med Pharmacol Sci 2020; 24:991-999. [PMID: 32096179 DOI: 10.26355/eurrev_202002_20149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In the last decades, immediate breast reconstruction (IBR) raised in frequency, and prepectoral positioning of the implant is becoming the trend nowadays. The aim of this paper is to describe our case series in IBR with prepectoral implant placement and complete coverage of it with the TiLoop® Bra titanium-coated polypropylene mesh (TCPM), pre-shaped as a pocket. PATIENTS AND METHODS Eighteen women with breast tumors were selected and underwent mono- or bilateral mastectomies and prepectoral IBR with tissue expanders or prostheses. After the prepectoral lodge was ready, the implants were inserted into TiLoop® Bra Pocket meshes and positioned over the pectoralis major muscle fascia. The mean surgical time of their positioning was four minutes. RESULTS This preliminary study showed meaningful results in prepectoral IBR with TiLoop® Bra Pocket covering the implants, for we observed a reduction of implant's exposure time and risk of bacterial contamination. Of the 18 patients that underwent this procedure, only three presented complications that resolved in a maximum of four weeks. CONCLUSIONS A considering reduction of surgical time in implant positioning was achieved, lowering exposure time and risk of complications as infection.
Collapse
Affiliation(s)
- F Lo Torto
- Sapienza University of Rome, Policlinico Umberto I, Department of Surgery "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Calabrese C, Casella D, Di Taranto G, Marcasciano M, Kothari A, Sordi S, Barellini L, Lo Torto F, Tarallo M, Perra A, Fausto A, Ribuffo D. Oncoplastic conservative surgery for breast cancer: long-term outcomes of our first ten years experience. Eur Rev Med Pharmacol Sci 2020; 22:7333-7342. [PMID: 30468478 DOI: 10.26355/eurrev_201811_16270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The main goal of oncoplastic breast surgery (OBS) is to optimize cosmetic outcomes and reduce patient morbidity, while still providing an oncologically-safe surgical outcome and extending the target population of conservative surgery. Although the growing number of reported experiences with oncoplastic surgery, few studies account for the long-term outcomes. PATIENTS AND METHODS Between January 2000 and December 2010, 1024 consecutive oncoplastic surgeries were performed and prospectively included in a database. Demographic data, histological and oncological evaluation and surgical complications were recorded. The role of tumor and patients' characteristics on the development of local recurrence and metastases were assessed by multivariate analysis. RESULTS Median follow up was 74.2 months. The average age of patients was 56.24. In 869 patients (84.9%) an invasive tumor and in 155 (15.1%) an in situ tumor (11% DCIS and 4% LIN) was found. The average size of the tumor was 24.5 mm. A positive margin presented in 67 (6.5%) patients. Forty patients (50%) underwent re-excision and 39 (49.4%) underwent mastectomy. The overall breast conservation rate was 96.2%. Reported complications were: 17 wound infections (1.7%); 106 hematomas (10.4%); 94 lymphorrheas (9.2%), 48 partial wound dehiscence (4.7%). Local recurrences (LR) were observed in 49 patients (4.7%). The risk of local recurrence was significantly higher in the group of patients with lymphovascular invasion and with high grade (G) (p < 0.05). 52 (5.07%) distant metastases were reported and the related risk was significantly higher in the group of patients with lymphovascular invasion and with negative receptors (p < 0.05). CONCLUSIONS Oncoplastic surgery provides an acceptable oncological long-term outcome and can be used to treat with conservative surgery also a selected population of patients who would had otherwise undergone mastectomy in the past.
Collapse
Affiliation(s)
- C Calabrese
- Department of Oncologic and Reconstructive Breast Surgery, "Breast Unit Integrata di Livorno, Cecina, Piombino, Elba, Azienda USL Toscana nord ovest", Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Calabrese C, Kothari A, Badylak S, Di Taranto G, Marcasciano M, Sordi S, Barellini L, Lo Torto F, Tarallo M, Gaggelli I, D'Ermo G, Fausto A, Casella D, Ribuffo D. Oncological safety of stromal vascular fraction enriched fat grafting in two-stage breast reconstruction after nipple sparing mastectomy: long-term results of a prospective study. Eur Rev Med Pharmacol Sci 2019; 22:4768-4777. [PMID: 30070312 DOI: 10.26355/eurrev_201808_15610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Autologous fat transfer (AFT) is commonly used to treat implant palpability and prevent fibrosis and thinning in mastectomy skin flaps. A major limit to this procedure is volume retention over time, leading to the introduction of fat enrichment with stromal vascular fraction (SVF+AFT). Oncological concerns have been raised over the injection of an increased concentration of progenitors cells (ASCs) in the SVF. The aim of the study is to evaluate the long-term cancer recurrence risk of SVF+AFT cases compared to AFT, in patients undergoing Nipple Sparing Mastectomy (NSM). PATIENTS AND METHODS A prospective study was designed to compare three groups of patients undergoing NSM followed by SVF+AFT, AFT or none (control group), after a two-stage breast reconstruction. Patients were strictly followed-up for at least 5-years from the second stage reconstructive procedure. Loco-regional and systemic recurrence rate were evaluated over time as the primary outcome. Logistic regression was used to investigate which factors were associated with recurrence events and independent variables of interest were: surgical technique, age above 50 years old, lympho-vascular invasion, oncological stage, adjuvant or neoadjuvant chemotherapy, adjuvant radiotherapy and adjuvant hormone therapy. RESULTS 41 women were included in G1 (SVF+AFT), 64 in G2 (AFT), and 64 in G3 (control group). Loco-regional recurrence rate was 2.4% for G1, 4.7% for G2, and 1.6% for G3. Systemic recurrence was 7.3%, 3.1%, and 3.1%, respectively. Among the variables included, there were no significant risk factors influencing a recurrence event, either loco-regional or systemic. In particular, SVF+AFT (G1) did not increase the oncological recurrence. CONCLUSIONS Our data suggest that both centrifuged and SVF-enhanced fat transfer have a similar safety level in comparison to patients who did not undergo fat grafting in breast reconstruction after NSM.
Collapse
Affiliation(s)
- C Calabrese
- Oncology Department, Oncologic and Reconstructive Surgery Breast Unit, Careggi University Hospital, Florence, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Vergine M, Frusone F, De Luca A, Aceti V, Marcasciano M, Amabile MI, Monti M. Nasal flap or cutaneous grafting in basal cell cancer of the nose. Comparison of two reconstructive possibilities. G Chir 2019; 40:298-303. [PMID: 32011980] [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: 06/10/2023]
Abstract
Basal cell cancer is a malignant tumor of the skin most common in Caucasians and more common in the areas of the head and neck. At the moment there are many suggested treatment methods, however the surgical approach remains the technique most often applied. It includes excision of the oncological safety margins and the subsequent reconstructive phase can utilize local flaps or cutaneous grafts. This study aims to select the best technique for the reconstructive phase after removal of basal cell cancer from the region of the nasal pyramid, evaluation was made in terms of functional performance and aesthetics. We have evaluated 30 patients, of whom 15 treated with cutaneous grafting and 15 with flaps.
Collapse
|
11
|
Casella D, Di Taranto G, Marcasciano M, Lo Torto F, Barellini L, Sordi S, Gaggelli I, Roncella M, Calabrese C, Ribuffo D. Subcutaneous expanders and synthetic mesh for breast reconstruction: Long-term and patient-reported BREAST-Q outcomes of a single-center prospective study. J Plast Reconstr Aesthet Surg 2019; 72:805-812. [DOI: 10.1016/j.bjps.2018.12.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/24/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023]
|
12
|
Casella D, Di Taranto G, Marcasciano M, Sordi S, Kothari A, Kovacs T, Lo Torto F, Cigna E, Ribuffo D, Calabrese C. Nipple-sparing bilateral prophylactic mastectomy and immediate reconstruction with TiLoop® Bra mesh in BRCA1/2 mutation carriers: A prospective study of long-term and patient reported outcomes using the BREAST-Q. Breast 2018; 39:8-13. [DOI: 10.1016/j.breast.2018.02.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/19/2017] [Accepted: 02/06/2018] [Indexed: 11/30/2022] Open
|
13
|
Marcasciano M, Conversi A, Kaciulyte J, Dessy LA. RE: Prosthetic Breast Implant Rupture: Imaging-Pictorial Essay : Full Cooperation Between Surgeon and Radiologist: "The Best of Both Worlds". Aesthetic Plast Surg 2017; 41:1478-1480. [PMID: 28799039 DOI: 10.1007/s00266-017-0942-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
Abstract
Cooperation between plastic surgeons and radiologists is fundamental when breast prosthesis rupture is suspected. We describe our experience managing the case of suspected implant rupture in a patient that underwent CT scan imaging for thoracic pain. Poor clinical information given to radiologists leads to wrong diagnosis: during surgery, both prostheses were checked revealing no signs of rupture. Full communication among different specialists involved in the multidisciplinary approach is always recommended, and an easy-to-use national breast implant register would allow a better management of patients' follow-up and eventual preoperative planning. 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 .
Collapse
|
14
|
Fino P, Spagnoli AM, Ruggieri M, Marcasciano M, Scuderi N. Bilateral hand squamous-cells carcinoma in patient affected with non-Hodgkin lymphoma. Case report and literature review. G Chir 2015; 36:172-82. [PMID: 26712073 DOI: 10.11138/gchir/2015.36.4.172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Squamous-cell skin cancer is the most frequent tumor in the hand. It occurs on sun-damaged skin, especially in lightskinned individuals with a long history of chronic sun exposure. CASE REPORT We describe a case of bilateral hand squamous-cell carcinoma in a elderly patient affected with non-Hodgkin's lymphoma, who underwent several non-successful surgical treatment, radiotherapy and at the least, amputation of right hand for rapid clinical evolution after radiotreatment. Available literature on the subject has been reviewed. RESULTS In our case, after several non-successful treatment, elective amputation at the distal third of forearm was performed. We reviewed 56 items including books, original articles, reviews, cases report. CONCLUSIONS Current evidence on treatment of hand squamouscells carcinoma is to perform a first radical surgical treatment in order to avoid recurrence/metastasis and to achieve a safer level of amputation thus increasing the surface area of healthy tissue available for eventually subsequent reconstruction/prosthesization.
Collapse
|
15
|
Carlesimo B, Lo Torto F, Rossi A, Marcasciano M, Ruggiero M. Long-term result of bilateral pectoralis major muscle advancement flap in median sternotomy wound infections. Eur Rev Med Pharmacol Sci 2014; 18:3767-3772. [PMID: 25555865] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Deep sternal wound infection (DSWI) is an uncommon but serious complication of open heart surgery being characterized by a high mortality rate and a considerable economic weight. Repair of sternal defects, compromised with infection, can be achieved in several ways. The aim of our study is to report our case load in the management of sternal wound infection. PATIENTS AND METHODS In this study, we will report our twelve-year case load with bilateral pectoralis major advancement flap as the sole treatment modality for deep sternal wound infection. RESULTS This surgical approach has given excellent results in terms of resolution of the infection of the sternum, with few complications and a good cosmetic result. CONCLUSIONS We propose bilateral pectoralis major advancement flap as the first choice treatment for deep sternal wound infection.
Collapse
Affiliation(s)
- B Carlesimo
- Department of Plastic and Reconstructive and Aesthetic Surgery, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | |
Collapse
|
16
|
Rinaldi S, Marcasciano M, Pacitti F, Toscani M, Tarallo M, Fino P, Scuderi GL. [Inveterate squamous cell carcinoma of the upper eyelid: a case report]. Clin Ter 2013; 164:e203-5. [PMID: 23868639 DOI: 10.7417/ct.2013.1569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Squamous cell carcinoma (SCC) is a malignant tumor of epithelium that shows squamous cell differentiation. It is the second most common cancer of the skin and usually occurs in areas exposed to the sun but it can rarely arise within the conjunctival epithelium with a deep component. We describe a woman with a history of chronic blepharoconjunctivitis unresponsive to topical medications. Examination disclosed a hyperaemic translucent patch with blurred margins of the upper palpebral conjunctiva. Tarsoconjunctival biopsy revealed intraepithelial squamous cell carcinoma. Management consisted of complete tumor excision with removal of the entire posterior lamella of the left upper eyelid and reconstruction. Histopathologic analysis confirmed primary squamous cell carcinoma arising from conjunctival epithelium, involving the underlying tarsus. Patients with unexplained chronic unilateral blepharoconjunctivitis or papillary hypertrophy of the palpebral conjunctiva should be considered for biopsy to rule out neoplasia, even when there is no sign of an evident mass.
Collapse
Affiliation(s)
- S Rinaldi
- Dipartimento di Chirurgia Plastica, Ricostruttiva, Estetica, Università Sapienza di Roma, Italia
| | | | | | | | | | | | | |
Collapse
|
17
|
Monarca C, Rizzo MI, Corrias F, Marcasciano M, Parisi P, Scuderi N. Supraorbital and supratrochlear nerves block for oncologic surgery of the anterior scalp and forehead in the elderly. Ann Ital Chir 2012; 83:79-80. [PMID: 22352224] [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: 05/31/2023]
|
18
|
Elia L, Feliciano S, Eleuteri M, Serafini P, Marcasciano M. [Filling materials in the repair and esthetic surgery of the breast. Historical notes]. MINERVA CHIR 1989; 44:2013-6. [PMID: 2694010] [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: 01/02/2023]
Abstract
The biological and synthetic materials employed over the years for filling breasts after mastectomy or for congenital malformations are reviewed. At the start of the century, breast shape and volume were changed by adipose tissue grafts. In the 50s and 60s dermo-fibro-adipose grafts and later auto-grafts and grafts of the large epiploon were used. Synthetic materials have also developed, from early century attempts using paraffin injections to the discovery for industrial use of plastics. Following the first polyvinyl prostheses, Cronin developed silicon prostheses for medical purposes and in later years these went through numerous changes in form, volume and design up to the recent skin expanders. Polyurethane has also been used in attempts to reduce capsular retraction.
Collapse
|
19
|
Elia L, Eleuteri M, Feliciano S, Serafini P, Marcasciano M. [Reconstruction of the breast after radical mastectomy in cancer. Reconstruction of the breast volume]. MINERVA CHIR 1989; 44:1717-20. [PMID: 2682363] [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: 01/02/2023]
Abstract
After underlining the serious psychological consequences of radical mastectomy for carcinoma and the importance of breast reconstruction for the patient's complete recovery, the paper briefly reviews the main reconstruction techniques employed in restoring breast volume which is essentially achieved by inserting an artificial prosthesis below a myocutaneous skin flap often taken from the great dorsal. Some mention is also made of recently developed alternative techniques.
Collapse
|
20
|
Elia L, Feliciano S, Eleuteri M, Serafini P, Marcasciano M. [Development of the surgical technics in abdominoplasty]. MINERVA CHIR 1989; 44:1643-6. [PMID: 2528084] [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: 01/01/2023]
Abstract
The entire literature on abdominoplasty is reviewed with a description of the various techniques developed since the introduction of the operation.
Collapse
|
21
|
Elia L, Feliciano S, Eleuteri M, Serafini P, Marcasciano M. [Reconstruction of the breast after radical mastectomy in cancer. Reconstruction of the areola-nipple complex and the symmetry of the 2 breasts]. MINERVA CHIR 1989; 44:1665-8. [PMID: 2771119] [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: 01/02/2023]
Abstract
After pointing out the need for reconstruction of the nipple-areola complex and the restoration of symmetry between the two breasts after radical mastectomy for cancer, the paper briefly examines the techniques currently available for the achievement of these "finishing touches" that usually take longer then the primary and fundamental breast reconstruction.
Collapse
|
22
|
Elia L, Moscati F, Belli A, Marcasciano M, Feliciano S, Eleuteri M, Puccio L, Elia M. [Complications of septorhinoplasty]. MINERVA CHIR 1989; 44:1499-502. [PMID: 2771099] [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: 01/02/2023]
Abstract
A review of the literature on complications in septorhinoplasty is presented. Though rare, complications may arise in the surgical treatment of such a delicate anatomical area as the nasal septum and both theoretical and practical knowledge of the problem is necessary in order to prevent and/or handle such unexpected events. Complications are grouped according to aetiopathogenesis into infectious, haemorrhagic, traumatic, systemic and miscellaneous.
Collapse
|