Schwabegger Anton - Academia.edu (original) (raw)
Papers by Schwabegger Anton
Ultraschall in der Medizin - European Journal of Ultrasound, 2009
The minimally invasive correction of the funnel chest deformity utilizing metal struts [1, 9, 10]... more The minimally invasive correction of the funnel chest deformity utilizing metal struts [1, 9, 10] refined by Weber and Huemmer to the new Erlangen technique [25] as well as by Nuss [14] to the so-called MIRPE (Minimally Invasive Reconstruction of Pectus Excavatum) technique nowadays predominantly is carried out in children and adolescents [5]. This type of surgical correction at this age, if indicated by medical reasons, is ideal because the thoracic skeleton in particular the anterior thoracic wall is present with yet sufficient flexibility in order to give way to the pressure by a transsternally implanted metal strut or retrosternally placed pectus bar. The original MIRPE method on the other hand however is the fewer an ideal treatment method, the older patients are. Because with body maturation at adulthood the skeletal structures increase their rigidity thus by methods of internal suspension, likewise with a metal strut, the thoracic wall becomes less moldable [7, 26]. However, ...
Clinics in Plastic Surgery
In breast reconstruction with a free flap, the selection of suitable recipient vessels remains on... more In breast reconstruction with a free flap, the selection of suitable recipient vessels remains one of the most critical decisions for the surgeon. Most surgeons use one of the branches of the axillary vascular system, the thoracodorsal vessels. Because of a number of difficulties using this recipient site, the authors investigated the anatomy and availability of the internal mammary vessels for free flap breast reconstruction. This article describes the anatomic considerations, surgical technique, clinical experience, advantages, and limitations of using these vessels. In recent years, free autogenous tissue transfer for breast reconstruction has become increasingly common. The free transverse rectus abdominis myocutaneous (TRAM) flap and the more recently described deep inferior epigastric artery (DIEA) perforator flap are currently the methods of choice for postmastectomy breast reconstruction. For patients who cannot have a TRAM flap, free flaps from other donor sites (superior g...
Plastic & Reconstructive Surgery
Handchirurgie · Mikrochirurgie · Plastische Chirurgie
Einzeitige mikrovaskuläre Gewebetransplantation mit Jejunum oder fasziokutanen Lappen zur Rekonst... more Einzeitige mikrovaskuläre Gewebetransplantation mit Jejunum oder fasziokutanen Lappen zur Rekonstruktion von ausgedehnten Defekten im Halsbereich nach Laryngektomie gehören zu den etablierten Rekonstruktionsmöglichkeiten. Da der freie Lappen im Falle einer Erhaltung der gesamten Halshaut unter ihr ¹vergrabenª liegt, gestaltet sich die postoperative Durchblutungskontrolle entsprechend schwierig. Als Alternative zu apparativen Messmethoden wird hier eine einfache Möglichkeit der Vitalitätskontrolle vorgestellt. Dabei wird ein Anteil des transplantierten Jejunums als Monitor transkutan ausgeleitet oder bei fasziokutanen/myokutanen Lappen eine Hautinsel gebildet, die in die Halshaut eingenäht wird. Diese Methode ist nicht neu, jedoch gewinnt sie bei derzeit noch beschränkter Zuverlässigkeit und Handhabung von rein technischen Hilfsmitteln für Rekonstruktionen, beispielsweise in der Halsregion, wieder an Beliebtheit. Wir berichten über die Anwendung bei drei autologen Dünndarmtransplantaten, bei einem Oberarmlappen und einem myokutanen Rectus abdominis-Lappen zur Hypopharynx-und Pharynxrekonstruktion.
British Journal of Plastic Surgery
HNO
We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessa... more We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessary by aggressive digestive salivatory and radiation effects 3 weeks after neck-dissection and laser ablation of an epidermoid left tonsil carcinoma. Life threatening intraoral bleeding resulted from the erosion of branches of the external carotid artery. After management of the bleeding, massive blood transfusions and restoration of the patient's general condition, a sandwich patch cover of the transmural pharyngeal defect was achieved using a microvascular lateral arm flap. This aimed at preventing further digestive effects and bacterial colonisation of the neurovascular structures at the carotid triangle. Unfortunately, due to external mechanical forces, the flap became avascular and thus necrotic at the eighth postoperative day; however, until the successful replacement by a myocutaneous latissimus dorsi flap it remained water-tight and fulfilled its sealing task.
The pectus arcuatum deformity [1, 3] with minor or major curvature of the sternum, including eith... more The pectus arcuatum deformity [1, 3] with minor or major curvature of the sternum, including either symmetric excavatum and carinatum features along a longitudinal (Figs. 1 and 2) axis or asymmetrically along a transversal axis (Figs. 3 and 4) needs a comprehensive approach.
European Journal of Plastic Surgery, 1996
ABSTRACT Thoracic duct fistula is a rare but potentially serious complication of head and neck su... more ABSTRACT Thoracic duct fistula is a rare but potentially serious complication of head and neck surgery. Such fistulae may be difficult to treat, and several techniques, both operative and non-operative, have been advocated. A case of successful surgical treatment of a chronic thoracic duct fistula is presented. The fistula occurred in a 51-year-old female following treatment of a solitary supraclavicular breast metastasis by local excision and radiotherapy. The divided duct was ligated and the area was covered with the clavicular head of the sternocleidomastoid muscle.
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 1996
Covering defects of the lower leg is still an exceptional problem when tendons or bone are expose... more Covering defects of the lower leg is still an exceptional problem when tendons or bone are exposed within small defects, particularly in the malleolar region. We present 12 cases of successful wound closure on the lower leg with the versatile bipedicled flap. We had a low incidence of minor complications, whether it was used as a cutaneous, fasciocutaneous, or myo-fasciocutaneous flap, in some cases also based on underlying perforators to guarantee perfusion of the flap. If it is limited to selected indications and patients, the bipedicled flap may be a reliable alternative to other, more sophisticated methods of tissue transfer.
Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen, 2001
Single-stage microvascular reconstruction of neck defects with jejunum or other free flaps are we... more Single-stage microvascular reconstruction of neck defects with jejunum or other free flaps are well established methods. However, these flaps usually are buried subcutaneously and viability surveillance is difficult. Alternatively to technical monitoring devices, we present a simple method using a "sentinel" part of the free jejunum flap transposed outside to the skin surface or sutured into the skin when using fasciocutaneous or myocutaneous flaps. Although this method is not new, it is rarely used. Compared to pure technical monitoring devices, it is easily performed and monitoring of buried free flaps especially in the neck region is reliable.
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 1999
Heterotopic or transpositional replantation of digits is technically feasible with results simila... more Heterotopic or transpositional replantation of digits is technically feasible with results similar to those of conventional replantation procedures. Occasionally in multiple digital amputations not all the digits may be replanted in their correct place as a result of complex injuries proximal to the amputation zone or severe damage to important fingers. In these circumstances the amputated digits that are in the best condition as regards undamaged tissue are used for replantation. The primary priority is an optimal functional outcome and the secondary priority the cosmetic outcome. Amputated long digits will always be used to substitute for a non-replantable thumb rather than to replace a long finger. We present 13 cases of successful transpositional digit or joint replantations in traumatic amputations of more than one digit.
Der Unfallchirurg, 1997
In 31 (out of 48) patients with 43 (out of 63) replanted or revascularized digits or parts of the... more In 31 (out of 48) patients with 43 (out of 63) replanted or revascularized digits or parts of the extremities a study of long-term results was performed. Their ages were below 16 years at the time of injury. The results concerning function, sensitivity, cold intolerance, growth disturbance, patient acceptance and occupational changes were evaluated. Early complications consisted of venous stasis in 10.6% (n = 4), skin necrosis of the wound margin in 5.3% (n = 2) and in finger-tip necrosis in 5.3% (n = 2). One lower arm and one finger replanted (5.3%, n = 2) were lost after several revisions due to venous problems. In no case did arterial problems occur. Tendon adhesions were the most common complication in 28.9% (n = 11), followed by deviation of the axis in a frontal plane of more than 20 degrees in 13.3% (n = 5) and by joint instability in 5.3% (n = 2). Only twice (5.3%) did ankylosis or in another case osteomyelitis of the proximal phalanx result. At amputation level II (between ...
HNO, 2004
ABSTRACT Wir berichten ber den notfallmigen Einsatz einer mikrovaskulren Lappenplastik zum Versch... more ABSTRACT Wir berichten ber den notfallmigen Einsatz einer mikrovaskulren Lappenplastik zum Verschluss eines hohen Pharynxdefektes, entstanden 3Wochen nach radikaler Hals-Lymphknoten-Dissektion, Laserresektion und adjuvanter Therapie eines Tonsillenkarzinoms, kompliziert durch akute intraorale Arrosionsblutung aus der A.carotis. Durch uere Einflsse hervorgerufen kam es nach einer Woche zur Ischmie und nachfolgenden Totalnekrose dieses Oberarmlappens, bis zu diesem Zeitpunkt erfllte das transplantierte Gewebe jedoch die Aufgabe des wasserdichten Verschlusses gegenber bakterieller Kontamination und der agressiv digestiven Wirkung des Speichels. In einem elektiven Eingriff wurde dieser sekundr avaskulre Lappen erfolgreich durch einen myokutanen Latissimus-dorsi-Lappen ersetzt, es traten keine weiteren Komplikationen auf.We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessary by aggressive digestive salivatory and radiation effects 3weeks after neck-dissection and laser ablation of an epidermoid left tonsil carcinoma. Life threatening intraoral bleeding resulted from the erosion of branches of the external carotid artery. After management of the bleeding, massive blood transfusions and restoration of the patient's general condition, a sandwich patch cover of the transmural pharyngeal defect was achieved using a microvascular lateral arm flap. This aimed at preventing further digestive effects and bacterial colonisation of the neurovascular structures at the carotid triangle. Unfortunately, due to external mechanical forces, the flap became avascular and thus necrotic at the eighth postoperative day; however, until the successful replacement by a myocutaneous latissimus dorsi flap it remained water-tight and fulfilled its sealing task.
Congenital Thoracic Wall Deformities, 2011
ABSTRACT Surgery at the anterior thoracic wall can lead to specific problems peri- and also posto... more ABSTRACT Surgery at the anterior thoracic wall can lead to specific problems peri- and also postoperatively because of the complex functional anatomy of the thorax and the complexity of the three-dimensional remodeling intervention. Above all the learning curve is relatively high-angled in the early stage of acquiring different surgical techniques of the individual procedures [27, 43]. Particularly and predominantly operation steps straightened on aesthetic improvements but lack of experience and lack of awareness of the functional anatomy let arise mistakes with more or less undesired or even drastic results for the affected patient. Severe complications were observed in the early period of applications, predominantly due to lack of experience. They usually subside with increasing numbers of patients and frequency of surgery within decreasing timeframes [24, 26, 30]. In this chapter, ample scope is dedicated for the subject of complications that may occur during and after the corrections of the funnel chest deformities and their variations, as well as the keel chest deformities. In specialized clinics, this kind of surgery dealing with congenital deformities of the anterior thoracic wall may represent a routine intervention with generally a poor risk incidence.
European Surgery, 1999
Die Autoren haben in mtihsamer Arbeit eine Standarderhebung der chirurgischen Melanomtherapie in ... more Die Autoren haben in mtihsamer Arbeit eine Standarderhebung der chirurgischen Melanomtherapie in ()sterreich durchgeftihrt (1). Die Ergebnisse sind in bezug auf die QualitSr'der Versorgung zum Grogteil ermutigend, da meist Einigkeit fiber die Therapiemodalitfiten herrscht. Dennoch m6chten wir einige wichtige Tatsachen und Umst~inde ergfinzend hervorheben und nachdrticklich betonen.
Plastische Chirurgie, 2007
Ultraschall in der Medizin - European Journal of Ultrasound, 2009
The minimally invasive correction of the funnel chest deformity utilizing metal struts [1, 9, 10]... more The minimally invasive correction of the funnel chest deformity utilizing metal struts [1, 9, 10] refined by Weber and Huemmer to the new Erlangen technique [25] as well as by Nuss [14] to the so-called MIRPE (Minimally Invasive Reconstruction of Pectus Excavatum) technique nowadays predominantly is carried out in children and adolescents [5]. This type of surgical correction at this age, if indicated by medical reasons, is ideal because the thoracic skeleton in particular the anterior thoracic wall is present with yet sufficient flexibility in order to give way to the pressure by a transsternally implanted metal strut or retrosternally placed pectus bar. The original MIRPE method on the other hand however is the fewer an ideal treatment method, the older patients are. Because with body maturation at adulthood the skeletal structures increase their rigidity thus by methods of internal suspension, likewise with a metal strut, the thoracic wall becomes less moldable [7, 26]. However, ...
Clinics in Plastic Surgery
In breast reconstruction with a free flap, the selection of suitable recipient vessels remains on... more In breast reconstruction with a free flap, the selection of suitable recipient vessels remains one of the most critical decisions for the surgeon. Most surgeons use one of the branches of the axillary vascular system, the thoracodorsal vessels. Because of a number of difficulties using this recipient site, the authors investigated the anatomy and availability of the internal mammary vessels for free flap breast reconstruction. This article describes the anatomic considerations, surgical technique, clinical experience, advantages, and limitations of using these vessels. In recent years, free autogenous tissue transfer for breast reconstruction has become increasingly common. The free transverse rectus abdominis myocutaneous (TRAM) flap and the more recently described deep inferior epigastric artery (DIEA) perforator flap are currently the methods of choice for postmastectomy breast reconstruction. For patients who cannot have a TRAM flap, free flaps from other donor sites (superior g...
Plastic & Reconstructive Surgery
Handchirurgie · Mikrochirurgie · Plastische Chirurgie
Einzeitige mikrovaskuläre Gewebetransplantation mit Jejunum oder fasziokutanen Lappen zur Rekonst... more Einzeitige mikrovaskuläre Gewebetransplantation mit Jejunum oder fasziokutanen Lappen zur Rekonstruktion von ausgedehnten Defekten im Halsbereich nach Laryngektomie gehören zu den etablierten Rekonstruktionsmöglichkeiten. Da der freie Lappen im Falle einer Erhaltung der gesamten Halshaut unter ihr ¹vergrabenª liegt, gestaltet sich die postoperative Durchblutungskontrolle entsprechend schwierig. Als Alternative zu apparativen Messmethoden wird hier eine einfache Möglichkeit der Vitalitätskontrolle vorgestellt. Dabei wird ein Anteil des transplantierten Jejunums als Monitor transkutan ausgeleitet oder bei fasziokutanen/myokutanen Lappen eine Hautinsel gebildet, die in die Halshaut eingenäht wird. Diese Methode ist nicht neu, jedoch gewinnt sie bei derzeit noch beschränkter Zuverlässigkeit und Handhabung von rein technischen Hilfsmitteln für Rekonstruktionen, beispielsweise in der Halsregion, wieder an Beliebtheit. Wir berichten über die Anwendung bei drei autologen Dünndarmtransplantaten, bei einem Oberarmlappen und einem myokutanen Rectus abdominis-Lappen zur Hypopharynx-und Pharynxrekonstruktion.
British Journal of Plastic Surgery
HNO
We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessa... more We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessary by aggressive digestive salivatory and radiation effects 3 weeks after neck-dissection and laser ablation of an epidermoid left tonsil carcinoma. Life threatening intraoral bleeding resulted from the erosion of branches of the external carotid artery. After management of the bleeding, massive blood transfusions and restoration of the patient's general condition, a sandwich patch cover of the transmural pharyngeal defect was achieved using a microvascular lateral arm flap. This aimed at preventing further digestive effects and bacterial colonisation of the neurovascular structures at the carotid triangle. Unfortunately, due to external mechanical forces, the flap became avascular and thus necrotic at the eighth postoperative day; however, until the successful replacement by a myocutaneous latissimus dorsi flap it remained water-tight and fulfilled its sealing task.
The pectus arcuatum deformity [1, 3] with minor or major curvature of the sternum, including eith... more The pectus arcuatum deformity [1, 3] with minor or major curvature of the sternum, including either symmetric excavatum and carinatum features along a longitudinal (Figs. 1 and 2) axis or asymmetrically along a transversal axis (Figs. 3 and 4) needs a comprehensive approach.
European Journal of Plastic Surgery, 1996
ABSTRACT Thoracic duct fistula is a rare but potentially serious complication of head and neck su... more ABSTRACT Thoracic duct fistula is a rare but potentially serious complication of head and neck surgery. Such fistulae may be difficult to treat, and several techniques, both operative and non-operative, have been advocated. A case of successful surgical treatment of a chronic thoracic duct fistula is presented. The fistula occurred in a 51-year-old female following treatment of a solitary supraclavicular breast metastasis by local excision and radiotherapy. The divided duct was ligated and the area was covered with the clavicular head of the sternocleidomastoid muscle.
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 1996
Covering defects of the lower leg is still an exceptional problem when tendons or bone are expose... more Covering defects of the lower leg is still an exceptional problem when tendons or bone are exposed within small defects, particularly in the malleolar region. We present 12 cases of successful wound closure on the lower leg with the versatile bipedicled flap. We had a low incidence of minor complications, whether it was used as a cutaneous, fasciocutaneous, or myo-fasciocutaneous flap, in some cases also based on underlying perforators to guarantee perfusion of the flap. If it is limited to selected indications and patients, the bipedicled flap may be a reliable alternative to other, more sophisticated methods of tissue transfer.
Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen, 2001
Single-stage microvascular reconstruction of neck defects with jejunum or other free flaps are we... more Single-stage microvascular reconstruction of neck defects with jejunum or other free flaps are well established methods. However, these flaps usually are buried subcutaneously and viability surveillance is difficult. Alternatively to technical monitoring devices, we present a simple method using a "sentinel" part of the free jejunum flap transposed outside to the skin surface or sutured into the skin when using fasciocutaneous or myocutaneous flaps. Although this method is not new, it is rarely used. Compared to pure technical monitoring devices, it is easily performed and monitoring of buried free flaps especially in the neck region is reliable.
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 1999
Heterotopic or transpositional replantation of digits is technically feasible with results simila... more Heterotopic or transpositional replantation of digits is technically feasible with results similar to those of conventional replantation procedures. Occasionally in multiple digital amputations not all the digits may be replanted in their correct place as a result of complex injuries proximal to the amputation zone or severe damage to important fingers. In these circumstances the amputated digits that are in the best condition as regards undamaged tissue are used for replantation. The primary priority is an optimal functional outcome and the secondary priority the cosmetic outcome. Amputated long digits will always be used to substitute for a non-replantable thumb rather than to replace a long finger. We present 13 cases of successful transpositional digit or joint replantations in traumatic amputations of more than one digit.
Der Unfallchirurg, 1997
In 31 (out of 48) patients with 43 (out of 63) replanted or revascularized digits or parts of the... more In 31 (out of 48) patients with 43 (out of 63) replanted or revascularized digits or parts of the extremities a study of long-term results was performed. Their ages were below 16 years at the time of injury. The results concerning function, sensitivity, cold intolerance, growth disturbance, patient acceptance and occupational changes were evaluated. Early complications consisted of venous stasis in 10.6% (n = 4), skin necrosis of the wound margin in 5.3% (n = 2) and in finger-tip necrosis in 5.3% (n = 2). One lower arm and one finger replanted (5.3%, n = 2) were lost after several revisions due to venous problems. In no case did arterial problems occur. Tendon adhesions were the most common complication in 28.9% (n = 11), followed by deviation of the axis in a frontal plane of more than 20 degrees in 13.3% (n = 5) and by joint instability in 5.3% (n = 2). Only twice (5.3%) did ankylosis or in another case osteomyelitis of the proximal phalanx result. At amputation level II (between ...
HNO, 2004
ABSTRACT Wir berichten ber den notfallmigen Einsatz einer mikrovaskulren Lappenplastik zum Versch... more ABSTRACT Wir berichten ber den notfallmigen Einsatz einer mikrovaskulren Lappenplastik zum Verschluss eines hohen Pharynxdefektes, entstanden 3Wochen nach radikaler Hals-Lymphknoten-Dissektion, Laserresektion und adjuvanter Therapie eines Tonsillenkarzinoms, kompliziert durch akute intraorale Arrosionsblutung aus der A.carotis. Durch uere Einflsse hervorgerufen kam es nach einer Woche zur Ischmie und nachfolgenden Totalnekrose dieses Oberarmlappens, bis zu diesem Zeitpunkt erfllte das transplantierte Gewebe jedoch die Aufgabe des wasserdichten Verschlusses gegenber bakterieller Kontamination und der agressiv digestiven Wirkung des Speichels. In einem elektiven Eingriff wurde dieser sekundr avaskulre Lappen erfolgreich durch einen myokutanen Latissimus-dorsi-Lappen ersetzt, es traten keine weiteren Komplikationen auf.We report on a case of an emergency free flap cover of a pharyngeal defect which was made necessary by aggressive digestive salivatory and radiation effects 3weeks after neck-dissection and laser ablation of an epidermoid left tonsil carcinoma. Life threatening intraoral bleeding resulted from the erosion of branches of the external carotid artery. After management of the bleeding, massive blood transfusions and restoration of the patient's general condition, a sandwich patch cover of the transmural pharyngeal defect was achieved using a microvascular lateral arm flap. This aimed at preventing further digestive effects and bacterial colonisation of the neurovascular structures at the carotid triangle. Unfortunately, due to external mechanical forces, the flap became avascular and thus necrotic at the eighth postoperative day; however, until the successful replacement by a myocutaneous latissimus dorsi flap it remained water-tight and fulfilled its sealing task.
Congenital Thoracic Wall Deformities, 2011
ABSTRACT Surgery at the anterior thoracic wall can lead to specific problems peri- and also posto... more ABSTRACT Surgery at the anterior thoracic wall can lead to specific problems peri- and also postoperatively because of the complex functional anatomy of the thorax and the complexity of the three-dimensional remodeling intervention. Above all the learning curve is relatively high-angled in the early stage of acquiring different surgical techniques of the individual procedures [27, 43]. Particularly and predominantly operation steps straightened on aesthetic improvements but lack of experience and lack of awareness of the functional anatomy let arise mistakes with more or less undesired or even drastic results for the affected patient. Severe complications were observed in the early period of applications, predominantly due to lack of experience. They usually subside with increasing numbers of patients and frequency of surgery within decreasing timeframes [24, 26, 30]. In this chapter, ample scope is dedicated for the subject of complications that may occur during and after the corrections of the funnel chest deformities and their variations, as well as the keel chest deformities. In specialized clinics, this kind of surgery dealing with congenital deformities of the anterior thoracic wall may represent a routine intervention with generally a poor risk incidence.
European Surgery, 1999
Die Autoren haben in mtihsamer Arbeit eine Standarderhebung der chirurgischen Melanomtherapie in ... more Die Autoren haben in mtihsamer Arbeit eine Standarderhebung der chirurgischen Melanomtherapie in ()sterreich durchgeftihrt (1). Die Ergebnisse sind in bezug auf die QualitSr'der Versorgung zum Grogteil ermutigend, da meist Einigkeit fiber die Therapiemodalitfiten herrscht. Dennoch m6chten wir einige wichtige Tatsachen und Umst~inde ergfinzend hervorheben und nachdrticklich betonen.
Plastische Chirurgie, 2007