Bruno Azzena - Academia.edu (original) (raw)

Papers by Bruno Azzena

Research paper thumbnail of Anatomo-radiological study of the superficial musculo-aponeurotic system of the face

Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia

The aim of the study was to analyse the appearance of the superficial muscolo-aponeurotic system ... more The aim of the study was to analyse the appearance of the superficial muscolo-aponeurotic system (SMAS) in radiological images (Magnetic Resonance -MR- and Computed tomography -CT- scans, 10M, 10F randomly selected) in the three regions of the face (the parotid and cheek regions and the nasolabial fold). In axial CT images, the SMAS appears as a relatively hyperdense tortuous line between the hypodense superficial fibroadipose tissue (SAT) and the hypodense deep adipose tissue (DAT). In parotid region SAT is well represented (mean thickness 4.32 +/- 2.9 mm), whereas DAT is very thin (0.33 +/- 0.48 mm); SMAS appears as a thin hyperdense line, close to the parotid gland (0.76 +/- 0.43 mm). In cheek region, SAT is well represented (5.57 +/- 1.17 mm), whereas DAT is thinner (2.94 +/- 0.62 mm), and SMAS is well recognisable (1.69 +/- 0.52 mm). At the level of the nasolabial fold, the SAT is poorly represented (0.37 +/- 0.06 mm); the SMAS continues in the mimic muscles (2.41 +/- 0.05 mm),...

Research paper thumbnail of MANAGER'S NOTICES

Research paper thumbnail of Geometric Reconstruction of the Right Hemi-Trunk After Resection of Giant Chondrosarcoma

We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and e... more We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and extending to the abdomen. An extensive resection of the right lower chest wall, most of the right hemidiaphragm, and most of the anterior abdominal wall on the right side was carried out. A long titanium plate was used to reconstruct the right costal margin. This plate gave attachment to two polytetrafluoroethylene meshes that were used to cover the abdominal and chest wall defects. The patches were covered with pedicled muscles and omental flaps and subsequently with rotational skin flap.

Research paper thumbnail of Combined use of homologous fascia lata graft and acellular dermal substitute for the repair of a complex abdominal wound

European Journal of Plastic Surgery, 2012

ABSTRACT Full-thickness abdominal wall defects complicated with bowel exposure require a stable r... more ABSTRACT Full-thickness abdominal wall defects complicated with bowel exposure require a stable reconstruction that may be achieved with mesh repair, muscle rotational flaps, pedicled flaps, freeflaps or any combination of these techniques. We present a case report of a complex abdominal wound caused by a gunshot trauma in an elderly patient. His general health condition and local disruption of the left rectus, external, internal oblique and transverse abdominis muscles prevent local flaps or major surgical reconstruction procedures. The combined use in multiple stages of a homologous fascia lata graft, negative pressure therapy and acellular dermal substitute template followed by skin graft allowed stable wound healing. Level of Evidence: Level V, therapeutic study

Research paper thumbnail of Comparison of different techniques in personalized post-mastectomy breast reconstruction

European Journal of Plastic Surgery, 1994

Patients undergoing breast reconstruction often ask the plastic surgeon which is the surgical pro... more Patients undergoing breast reconstruction often ask the plastic surgeon which is the surgical procedure that gives the best results. In order to answer this question, the results of three different techniques of breast reconstruction in 62 cases were compared and evaluated. In 37 cases, the reconstruction was performed by tissue expansion followed by insertion of silicone prostheses (EXP), in 9

Research paper thumbnail of Microvascular Anastomosis Timing in Digital Replantations

Plastic and Reconstructive Surgery, 2006

Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled... more Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.

Research paper thumbnail of Primary Hypotension: A Contraindication to Free Tissue Transfer?

Plastic and Reconstructive Surgery, 2006

Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled... more Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.

Research paper thumbnail of The contribution of a dermal substitute in the three-layers reconstruction of a nose tip avulsion

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2012

Through and through defects of the nasal ala still remains debated challenge in plastic reconstru... more Through and through defects of the nasal ala still remains debated challenge in plastic reconstructive surgery. We present a 36 y.o. woman who suffered by a through and through nose tip avulsion subsequently a dog bite. She refused the use of traditional auricular composite graft or the multiple stages midline forehead flap due to the secondary visible scars. We treated her with the combined use of mucoperichondrial septal flap, cartilage graft and dermal substitute Integra graft, followed by a secondary, full-thickness skin graft. We consider the Integra(®) as a useful option for the treatment of a complex trauma of the nose with through and through tip and alar avulsion when, due to scar or consent problem, it&#39;s not possible the use of other techniques.

Research paper thumbnail of <article-title aid="1474634">Reversed Gracilis Pedicle Flap for Coverage of a Total Knee Prosthesis<xref ref-type="fn" rid="fn2">*</xref></article-title>

The Journal of Bone and Joint Surgery (American), 2010

Poor wound-healing and skin necrosis are potentially devastating complications after total knee a... more Poor wound-healing and skin necrosis are potentially devastating complications after total knee arthroplasty. Primary soft-tissue coverage with a medial or lateral gastrocnemius transposition flap is typically the first choice for reconstruction. The aim of this study was to evaluate the use of a distally based secondary-pedicle flap of the gracilis muscle for reconstruction of a soft-tissue defect. The characteristics of the distally based (secondary) pedicles of the gracilis muscle were studied with use of dissection (ten cadavers) and computed tomographic angiograms (fifty patients). On the basis of the anatomical features, an extended reversed gracilis flap based on the secondary pedicles was used in three patients with severe soft-tissue complications of total knee arthroplasty. The mean number of secondary pedicles was 1.8 (range, one to four). The pedicles originated from the superficial femoral or popliteal artery. The most proximal pedicle was often the largest (mean caliber, 2.0 mm), and its point of entry into the gracilis muscle was an average (and standard deviation) of 21 +/- 3.6 cm (range, 16 to 28 cm) from the ischiopubic branch. A significant positive association (p = 0.001; r(2) = 0.49) was found between the caliber of the proximal secondary pedicle and the number of other secondary pedicles. In all three patients, the adequate caliber of the secondary pedicles (as shown on preoperative computed tomographic angiograms) and good muscle vascularization confirmed the utility of the gracilis as a distally based pedicle flap. For the treatment of large soft-tissue defects of the patella or the proximal part of the knee, or for soft-tissue reconstruction over an exposed total knee prosthesis, the reversed gracilis pedicle flap may be an alternative to, or may be integrated with, a lateral or medial gastrocnemius flap.

Research paper thumbnail of Histotopographic Study of the Fibroadipose Connective Cheek System

Cells Tissues Organs, 2010

The purpose of this study was to investigate the morphology of the superficial musculoaponeurotic... more The purpose of this study was to investigate the morphology of the superficial musculoaponeurotic system (SMAS). Eight embalmed cadavers were analyzed: one side of the face was macroscopically dissected; on the other side, full-thickness samples of the parotid, zygomatic, nasolabial fold and buccal regions were taken. In all specimens, a laminar connective tissue layer (SMAS) bounding two different fibroadipose connective layers was identified. The superficial fibroadipose layer presented vertically oriented fibrous septa, connecting the dermis with the superficial aspect of the SMAS. In the deep fibroadipose connective layer, the fibrous septa were obliquely oriented, connecting the deep aspect of the SMAS to the parotid-masseteric fascia. This basic arrangement shows progressive thinning of the SMAS from the preauricular district to the nasolabial fold (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). In the parotid region, the mean thicknesses of the superficial and deep fibroadipose connective tissues were 1.63 and 0.8 mm, respectively, whereas in the region of the nasolabial fold the superficial layer is not recognizable and the mean thickness of the deep fibroadipose connective layer was 2.9 mm. The connective subcutaneous tissue of the face forms a three-dimensional network connecting the SMAS to the dermis and deep muscles. These connective laminae connect adipose lobules of various sizes within the superficial and deep fibroadipose tissues, creating a three-dimensional network which modulates transmission of muscle contractions to the skin. Changes in the quantitative and qualitative characteristics of the fibroadipose connective system, reducing its viscoelastic properties, may contribute to ptosis of facial soft tissues during aging.

Research paper thumbnail of Burn care in relation to burn epidemiology in Italy

Burns, 2011

Burn centres are &#39;hubs&#39; of referral for large areas and should be organised in a ... more Burn centres are &#39;hubs&#39; of referral for large areas and should be organised in a network optimised for the needs of their area. Burn centres&#39; organisation and activity in Italy are analysed with reference to burn epidemiology in the country. A questionnaire was submitted to Italian burn centres concerning organisation, activity and epidemiology of burns treated in 2008. A total of 2067 patients were admitted to a burn centre in 2008; 50% of burns were due to flames (21% alcohol); and 25% of patients were &lt;14 years old. Overall mortality was 5.3%. 144 beds in 15 burn centres were available (seven reserved for children; bed/inhabitants ratio, 1/414, .023). However, distribution is not uniform in the country. Bed rotation was 14.4 patients/bed, and hospital stay varied from 11.7 days for &lt;20% total body surface area (TBSA) burns to &gt;120 days for burns &gt;70%. About half (57%) of patients admitted had less than 20% TBSA burns, 32% had 20-50% TBSA burns, 7% from 50% to 70% and 4% over 70% TBSA. A national network coordinating burn centre activity is lacking. Italy seems to have less availability of beds for burn care than other countries, and distribution and organisation of the network may be improved. The high prevalence of child burns should be noticed and this makes prevention campaigns advisable.

Research paper thumbnail of Burn care organization in relation to burns epidemiology in Italy

Research paper thumbnail of Functional microsurgical reconstruction in a severe case of contact burn of the forearm

Research paper thumbnail of Accident proneness and impulsiveness in an Italian group of burn patients

Burns, 2009

C. Pavan). a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e ... more C. Pavan). a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / b u r n s 0305-4179/$36.00 #

Research paper thumbnail of Combined use of free and pedicled skin flaps for the reconstruction of extremities in high voltage electrical injury

Research paper thumbnail of Geometric Reconstruction of the Right Hemi-Trunk After Resection of Giant Chondrosarcoma

The Annals of Thoracic Surgery, 2010

We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and e... more We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and extending to the abdomen. An extensive resection of the right lower chest wall, most of the right hemidiaphragm, and most of the anterior abdominal wall on the right side was carried out. A long titanium plate was used to reconstruct the right costal margin. This plate gave attachment to two polytetrafluoroethylene meshes that were used to cover the abdominal and chest wall defects. The patches were covered with pedicled muscles and omental flaps and subsequently with rotational skin flap.

Research paper thumbnail of Laparoscopy in the abdominal staging of melanoma

European Journal of …, 1989

retrospective study on laparoscopic results in the abdominal staging of 297 patients with melanom... more retrospective study on laparoscopic results in the abdominal staging of 297 patients with melanoma, is reported. In 195 (99.3%) of patients, laparoscopy was technically feasible, and in 10% the clinical stage was changed on the basis of the jndings. In 34% of patients with metastasis of the liver and peritoneum, the tumor had a diameter of under 1 cm and therefore was not detectable with non-invasive techniques. In the light of these results laparoscopy is advisable in patients with Stage I melanoma at a high risk of metastatization (Clark IV-V; Breslow X.76 mm) and in Stage II patients. In Stage III patients, laparoscopy seems indicated for an evaluation of the ef&av of sytemic treatment.

Research paper thumbnail of Autologous Platelet-Rich Plasma as an Adipocyte In Vivo Delivery System: Case Report

Aesthetic Plastic Surgery, 2008

Tissue engineering has emerged as a promising alternative to current clinical treatments for rest... more Tissue engineering has emerged as a promising alternative to current clinical treatments for restoration of soft tissue defects. A key element in the process of tissue engineering is an ideal implant that provides structural support and a favorable environment for growing cells. The authors hypothesized that autologous platelet-rich plasma (APRP) could be used as an in vivo adipocyte delivery system to favor cell survival and to stimulate early recruitment of microcapillaries to the site of implantation. Autologous fat was included in APRP and injected as a gel into a subcutaneous pocket created to correct a painful, adherent scar at the shoulder level in a 75-year-old woman. The surgical outcome was evaluated by histologic and immunohistochemical analysis as well as by ecography before and after surgery. The results were satisfactory, showing fat survival 1 year after surgery. The characteristics of this new material should stimulate research into future clinical applications for such cell constructs in plastic and reconstructive surgery.

Research paper thumbnail of Frequency and prognosis of multiple primary cutaneous melanoma

Research paper thumbnail of Anatomo-radiological study of the superficial musculo-aponeurotic system of the face

Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia

The aim of the study was to analyse the appearance of the superficial muscolo-aponeurotic system ... more The aim of the study was to analyse the appearance of the superficial muscolo-aponeurotic system (SMAS) in radiological images (Magnetic Resonance -MR- and Computed tomography -CT- scans, 10M, 10F randomly selected) in the three regions of the face (the parotid and cheek regions and the nasolabial fold). In axial CT images, the SMAS appears as a relatively hyperdense tortuous line between the hypodense superficial fibroadipose tissue (SAT) and the hypodense deep adipose tissue (DAT). In parotid region SAT is well represented (mean thickness 4.32 +/- 2.9 mm), whereas DAT is very thin (0.33 +/- 0.48 mm); SMAS appears as a thin hyperdense line, close to the parotid gland (0.76 +/- 0.43 mm). In cheek region, SAT is well represented (5.57 +/- 1.17 mm), whereas DAT is thinner (2.94 +/- 0.62 mm), and SMAS is well recognisable (1.69 +/- 0.52 mm). At the level of the nasolabial fold, the SAT is poorly represented (0.37 +/- 0.06 mm); the SMAS continues in the mimic muscles (2.41 +/- 0.05 mm),...

Research paper thumbnail of MANAGER'S NOTICES

Research paper thumbnail of Geometric Reconstruction of the Right Hemi-Trunk After Resection of Giant Chondrosarcoma

We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and e... more We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and extending to the abdomen. An extensive resection of the right lower chest wall, most of the right hemidiaphragm, and most of the anterior abdominal wall on the right side was carried out. A long titanium plate was used to reconstruct the right costal margin. This plate gave attachment to two polytetrafluoroethylene meshes that were used to cover the abdominal and chest wall defects. The patches were covered with pedicled muscles and omental flaps and subsequently with rotational skin flap.

Research paper thumbnail of Combined use of homologous fascia lata graft and acellular dermal substitute for the repair of a complex abdominal wound

European Journal of Plastic Surgery, 2012

ABSTRACT Full-thickness abdominal wall defects complicated with bowel exposure require a stable r... more ABSTRACT Full-thickness abdominal wall defects complicated with bowel exposure require a stable reconstruction that may be achieved with mesh repair, muscle rotational flaps, pedicled flaps, freeflaps or any combination of these techniques. We present a case report of a complex abdominal wound caused by a gunshot trauma in an elderly patient. His general health condition and local disruption of the left rectus, external, internal oblique and transverse abdominis muscles prevent local flaps or major surgical reconstruction procedures. The combined use in multiple stages of a homologous fascia lata graft, negative pressure therapy and acellular dermal substitute template followed by skin graft allowed stable wound healing. Level of Evidence: Level V, therapeutic study

Research paper thumbnail of Comparison of different techniques in personalized post-mastectomy breast reconstruction

European Journal of Plastic Surgery, 1994

Patients undergoing breast reconstruction often ask the plastic surgeon which is the surgical pro... more Patients undergoing breast reconstruction often ask the plastic surgeon which is the surgical procedure that gives the best results. In order to answer this question, the results of three different techniques of breast reconstruction in 62 cases were compared and evaluated. In 37 cases, the reconstruction was performed by tissue expansion followed by insertion of silicone prostheses (EXP), in 9

Research paper thumbnail of Microvascular Anastomosis Timing in Digital Replantations

Plastic and Reconstructive Surgery, 2006

Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled... more Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.

Research paper thumbnail of Primary Hypotension: A Contraindication to Free Tissue Transfer?

Plastic and Reconstructive Surgery, 2006

Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled... more Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.

Research paper thumbnail of The contribution of a dermal substitute in the three-layers reconstruction of a nose tip avulsion

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2012

Through and through defects of the nasal ala still remains debated challenge in plastic reconstru... more Through and through defects of the nasal ala still remains debated challenge in plastic reconstructive surgery. We present a 36 y.o. woman who suffered by a through and through nose tip avulsion subsequently a dog bite. She refused the use of traditional auricular composite graft or the multiple stages midline forehead flap due to the secondary visible scars. We treated her with the combined use of mucoperichondrial septal flap, cartilage graft and dermal substitute Integra graft, followed by a secondary, full-thickness skin graft. We consider the Integra(®) as a useful option for the treatment of a complex trauma of the nose with through and through tip and alar avulsion when, due to scar or consent problem, it&#39;s not possible the use of other techniques.

Research paper thumbnail of <article-title aid="1474634">Reversed Gracilis Pedicle Flap for Coverage of a Total Knee Prosthesis<xref ref-type="fn" rid="fn2">*</xref></article-title>

The Journal of Bone and Joint Surgery (American), 2010

Poor wound-healing and skin necrosis are potentially devastating complications after total knee a... more Poor wound-healing and skin necrosis are potentially devastating complications after total knee arthroplasty. Primary soft-tissue coverage with a medial or lateral gastrocnemius transposition flap is typically the first choice for reconstruction. The aim of this study was to evaluate the use of a distally based secondary-pedicle flap of the gracilis muscle for reconstruction of a soft-tissue defect. The characteristics of the distally based (secondary) pedicles of the gracilis muscle were studied with use of dissection (ten cadavers) and computed tomographic angiograms (fifty patients). On the basis of the anatomical features, an extended reversed gracilis flap based on the secondary pedicles was used in three patients with severe soft-tissue complications of total knee arthroplasty. The mean number of secondary pedicles was 1.8 (range, one to four). The pedicles originated from the superficial femoral or popliteal artery. The most proximal pedicle was often the largest (mean caliber, 2.0 mm), and its point of entry into the gracilis muscle was an average (and standard deviation) of 21 +/- 3.6 cm (range, 16 to 28 cm) from the ischiopubic branch. A significant positive association (p = 0.001; r(2) = 0.49) was found between the caliber of the proximal secondary pedicle and the number of other secondary pedicles. In all three patients, the adequate caliber of the secondary pedicles (as shown on preoperative computed tomographic angiograms) and good muscle vascularization confirmed the utility of the gracilis as a distally based pedicle flap. For the treatment of large soft-tissue defects of the patella or the proximal part of the knee, or for soft-tissue reconstruction over an exposed total knee prosthesis, the reversed gracilis pedicle flap may be an alternative to, or may be integrated with, a lateral or medial gastrocnemius flap.

Research paper thumbnail of Histotopographic Study of the Fibroadipose Connective Cheek System

Cells Tissues Organs, 2010

The purpose of this study was to investigate the morphology of the superficial musculoaponeurotic... more The purpose of this study was to investigate the morphology of the superficial musculoaponeurotic system (SMAS). Eight embalmed cadavers were analyzed: one side of the face was macroscopically dissected; on the other side, full-thickness samples of the parotid, zygomatic, nasolabial fold and buccal regions were taken. In all specimens, a laminar connective tissue layer (SMAS) bounding two different fibroadipose connective layers was identified. The superficial fibroadipose layer presented vertically oriented fibrous septa, connecting the dermis with the superficial aspect of the SMAS. In the deep fibroadipose connective layer, the fibrous septa were obliquely oriented, connecting the deep aspect of the SMAS to the parotid-masseteric fascia. This basic arrangement shows progressive thinning of the SMAS from the preauricular district to the nasolabial fold (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). In the parotid region, the mean thicknesses of the superficial and deep fibroadipose connective tissues were 1.63 and 0.8 mm, respectively, whereas in the region of the nasolabial fold the superficial layer is not recognizable and the mean thickness of the deep fibroadipose connective layer was 2.9 mm. The connective subcutaneous tissue of the face forms a three-dimensional network connecting the SMAS to the dermis and deep muscles. These connective laminae connect adipose lobules of various sizes within the superficial and deep fibroadipose tissues, creating a three-dimensional network which modulates transmission of muscle contractions to the skin. Changes in the quantitative and qualitative characteristics of the fibroadipose connective system, reducing its viscoelastic properties, may contribute to ptosis of facial soft tissues during aging.

Research paper thumbnail of Burn care in relation to burn epidemiology in Italy

Burns, 2011

Burn centres are &#39;hubs&#39; of referral for large areas and should be organised in a ... more Burn centres are &#39;hubs&#39; of referral for large areas and should be organised in a network optimised for the needs of their area. Burn centres&#39; organisation and activity in Italy are analysed with reference to burn epidemiology in the country. A questionnaire was submitted to Italian burn centres concerning organisation, activity and epidemiology of burns treated in 2008. A total of 2067 patients were admitted to a burn centre in 2008; 50% of burns were due to flames (21% alcohol); and 25% of patients were &lt;14 years old. Overall mortality was 5.3%. 144 beds in 15 burn centres were available (seven reserved for children; bed/inhabitants ratio, 1/414, .023). However, distribution is not uniform in the country. Bed rotation was 14.4 patients/bed, and hospital stay varied from 11.7 days for &lt;20% total body surface area (TBSA) burns to &gt;120 days for burns &gt;70%. About half (57%) of patients admitted had less than 20% TBSA burns, 32% had 20-50% TBSA burns, 7% from 50% to 70% and 4% over 70% TBSA. A national network coordinating burn centre activity is lacking. Italy seems to have less availability of beds for burn care than other countries, and distribution and organisation of the network may be improved. The high prevalence of child burns should be noticed and this makes prevention campaigns advisable.

Research paper thumbnail of Burn care organization in relation to burns epidemiology in Italy

Research paper thumbnail of Functional microsurgical reconstruction in a severe case of contact burn of the forearm

Research paper thumbnail of Accident proneness and impulsiveness in an Italian group of burn patients

Burns, 2009

C. Pavan). a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e ... more C. Pavan). a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / b u r n s 0305-4179/$36.00 #

Research paper thumbnail of Combined use of free and pedicled skin flaps for the reconstruction of extremities in high voltage electrical injury

Research paper thumbnail of Geometric Reconstruction of the Right Hemi-Trunk After Resection of Giant Chondrosarcoma

The Annals of Thoracic Surgery, 2010

We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and e... more We present a case of a giant chondrosarcoma arising from the right anterolateral chest wall and extending to the abdomen. An extensive resection of the right lower chest wall, most of the right hemidiaphragm, and most of the anterior abdominal wall on the right side was carried out. A long titanium plate was used to reconstruct the right costal margin. This plate gave attachment to two polytetrafluoroethylene meshes that were used to cover the abdominal and chest wall defects. The patches were covered with pedicled muscles and omental flaps and subsequently with rotational skin flap.

Research paper thumbnail of Laparoscopy in the abdominal staging of melanoma

European Journal of …, 1989

retrospective study on laparoscopic results in the abdominal staging of 297 patients with melanom... more retrospective study on laparoscopic results in the abdominal staging of 297 patients with melanoma, is reported. In 195 (99.3%) of patients, laparoscopy was technically feasible, and in 10% the clinical stage was changed on the basis of the jndings. In 34% of patients with metastasis of the liver and peritoneum, the tumor had a diameter of under 1 cm and therefore was not detectable with non-invasive techniques. In the light of these results laparoscopy is advisable in patients with Stage I melanoma at a high risk of metastatization (Clark IV-V; Breslow X.76 mm) and in Stage II patients. In Stage III patients, laparoscopy seems indicated for an evaluation of the ef&av of sytemic treatment.

Research paper thumbnail of Autologous Platelet-Rich Plasma as an Adipocyte In Vivo Delivery System: Case Report

Aesthetic Plastic Surgery, 2008

Tissue engineering has emerged as a promising alternative to current clinical treatments for rest... more Tissue engineering has emerged as a promising alternative to current clinical treatments for restoration of soft tissue defects. A key element in the process of tissue engineering is an ideal implant that provides structural support and a favorable environment for growing cells. The authors hypothesized that autologous platelet-rich plasma (APRP) could be used as an in vivo adipocyte delivery system to favor cell survival and to stimulate early recruitment of microcapillaries to the site of implantation. Autologous fat was included in APRP and injected as a gel into a subcutaneous pocket created to correct a painful, adherent scar at the shoulder level in a 75-year-old woman. The surgical outcome was evaluated by histologic and immunohistochemical analysis as well as by ecography before and after surgery. The results were satisfactory, showing fat survival 1 year after surgery. The characteristics of this new material should stimulate research into future clinical applications for such cell constructs in plastic and reconstructive surgery.

Research paper thumbnail of Frequency and prognosis of multiple primary cutaneous melanoma