Brice Gérenton | Université Claude Bernard Lyon 1 (original) (raw)

Papers by Brice Gérenton

Annales De Chirurgie Plastique Esthetique, Apr 1, 2019

Pour citer cet article : Gerenton B, et al. Évaluation du risque de saignement postopératoire en ... more Pour citer cet article : Gerenton B, et al. Évaluation du risque de saignement postopératoire en chirurgie de la main sans interruption des anticoagulants de type AntiVitamines K (AVK), étude rétrospective.

Hand, Jul 4, 2019

Background: New generation of total trapeziometacarpal joint prosthesis using double mobility con... more Background: New generation of total trapeziometacarpal joint prosthesis using double mobility concept has been used for several years. The aim of this study was to evaluate the dislocation rate with this implant after a minimal 3 years of follow-up. Methods: From September 2013 to August 2015, 200 trapeziometacarpal prostheses were implanted in 179 patients. Clinico-radiological follow-up was performed with an average of 48.2 months (36-60 months). Survival rate and dislocation rate were analyzed. Loosening of the implants and other intercurrent events were noticed. Results: Visual analog scale, Quick-DASH, strengths and range of motion improved significantly. We report a survival rate of 97% with only 0.5% of dislocation of prosthesis at 48 months of follow-up. Intercurrent events rate were similar to the ones found in literature or other studies. Conclusions: After a minimal of 3 years of follow-up, prosthesis with double mobility seemed to bring better stability in implant for thumb prosthetic replacement.

Clinical practice, 2017

Pigs (Sus scrofa domesticus) were operated under general anesthesia. A myocutaneous latissimus do... more Pigs (Sus scrofa domesticus) were operated under general anesthesia. A myocutaneous latissimus dorsi with skin paddle was performed. Each animal was operated twice (right and left) similarly. 4 groups were made: Group 1 (no flap ligature or control group); Group 2 (flap with final ligation of the artery); Group 3 (flap with final ligation of the two veins); Group 4 (flap with transient ligature of the artery and two veins for 1 hour). An incision was made in the center of the skin paddle to make the measurements. Postoperative monitoring protocol consisted of a triple monitoring: clinical, biological and histological. Results: Eight animals were operated and sixteen flaps were realized. Each flap was clinically and biologically tested 25 times. Clinical, biological and histological monitoring showed significant variations according to the groups. Discussion-Conclusion: Experimentally the intra-capillary measures of lactate and glucose levels associated with clinical monitoring may shorten the delay in diagnosis. Ultimately this will save lives and achieve better functional and aesthetic resultsd.

Hand surgery and rehabilitation, Dec 1, 2016

Shirataki. Le cours théorique du soir est précédé d'une vidéo commentée du programme du lendemain... more Shirataki. Le cours théorique du soir est précédé d'une vidéo commentée du programme du lendemain. Pour l'examen, les épreuves sont dévoilées la veille et font l'objet de la même préparation que les TP habituels avec conseils techniques et vidéos : 2 exercices obligatoires (aorte et carotide) ; 2 facultatifs (artère et veine rénale) + un rattrapage possible le soir même ou le lendemain matin, comme s'il s'agissait d'une reprise d'un lambeau libre ou d'une replantation en clinique humaine. L'efficacité de l'apprentissage concentré sur 35 heures est basée sur la répétitivité rapprochée des exercices et un encadrement serré. Les progrès spectaculaires permettent d'acquérir avec enthousiasme des bases techniques exploitables avec un maximum d'efficacité dans un climat de confiance. Déclaration de liens d'intérêts Bénéfice d'un des auteurs par une firme :-soit directement : oui ;-soit par l'intermédiaire d'une association : oui. Versement par une firme à une association : oui. Sans bénéfice pour aucun des auteurs : oui.

Annales De Chirurgie Plastique Esthetique, Feb 1, 2021

Aesthetic medicine is booming, and expanding Internet delivery is not controlled by health author... more Aesthetic medicine is booming, and expanding Internet delivery is not controlled by health authorities. More than ever, conditions are thus favorable for patient self-injection. We present the case of a 45-year-old woman self-injected in breast with hyaluronic acid purchased on the Internet. She developed a bilateral breast infection treated with antibiotic treatment. Despite the ban on the use of filler in the breast by our health authorities since 2011, we will talk about the management of this type of patient. In light of this complication, we will discuss the public health issue raised by the development of the injectable products market. We wish to emphasize in France the emergency of establishing a strict legal framework for the use of fillers.

Annals of Plastic Surgery, Apr 1, 2018

Introduction: In surgery, certain defects require reconstruction with a microsurgical flap. The f... more Introduction: In surgery, certain defects require reconstruction with a microsurgical flap. The free flap failure rate varies between 2% and 5%. Vascular thrombosis is the most frequent complication and represents 15% to 73% of failures. The success rate of salvage therapy is greater when salvage surgery is early. Currently, clinical monitoring is the criterion standard but many noninvasive or minimally invasive techniques have been developed to improve early diagnosis of complications of vascular thrombosis. The aim of our experimental study was to compare clinical assessments with measurements of capillary glycemia and lactatemia during the monitoring of free flaps. Materials and Methods: Myocutaneous latissimus dorsi flaps with skin paddles were created in pigs under general anesthesia. For each animal, 2 flaps were created (right and left) using the same technique. Four groups were made: group 1 (no flap ligation: control group), group 2 (flap with permanent ligation of the artery), group 3 (flap with permanent ligation of the two veins), group 4 (flap with transient ligation of the artery and 2 veins for 1 hour). The postoperative monitoring protocol consisted of monitoring the clinical, biological (glucose and lactate), and histological parameters. Results: Eight animals were operated on and sixteen flaps were created. Each flap was clinically and biologically tested 25 times. Clinical, biological, and histological monitoring showed significant variations between the groups. The analysis of variance of capillary glycemia and lactatemia showed statistically significant difference between control group and group 2 (P < 0,0001), group 3 (P < 0,0001), or group 4 (P < 0,0001). There were no histological abnormalities after transient ligature at different times contrary to permanent ligature. Discussion-Conclusion: Measuring capillary levels of lactate and glucose associated with clinical monitoring may shorten the time to diagnosis of flap failure. Ultimately, this will save lives and achieve better functional and aesthetic results.

Journal of Plastic Reconstructive and Aesthetic Surgery, May 1, 2019

The cervicofacial lift is a frequently performed procedure in plastic surgery. It is the referenc... more The cervicofacial lift is a frequently performed procedure in plastic surgery. It is the reference technique for facial rejuvenation and restoration of the oval form of the face and it is essential to treat excess skin. One of the most frequent complications of this procedure is the formation of haematomas. The aim of this article is to analyze the incidence of bleeding in the standard cervicofacial lift carried out under pure local anaesthesia. The entire operation, including liposuction and tightening of the SMAS, can be done under local anaesthesia. A total of 1500 patients, who have undergone cervicofacial lift under pure local anaesthesia between November 1995 and January 2016, were included in the study. The incidence of early bleeding (in the first 15 days following the operation) was recorded and analyzed. Pre-intra-and postoperative monitoring of the arterial blood pressure revealed stable pressure in the peri-operative period. The mean difference in blood pressure when comparing the intraoperative to the postoperative periods was 7 mmHg for the systolic BP [range from 3-25] and 4 mmHg [range from 2-12] for the diastolic BP, with lower mean values in the postoperative period. We identified nine bleeding events in 1500 patients (0.6%). The cervicofacial lift under pure local anaesthesia does not radically modify the surgical technique. It allows better control of arterial blood pressure of patients throughout the surgical procedure and avoids fluctuations in blood pressure, which is one of the main causes of bleeding and haematoma formation. The infiltration of xylocaine adrenaline combined with the absence of hypotensive general anaesthesia diminishes the incidence of haematoma and ensures an early return home for the patients.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2018

Annals of Plastic Surgery, 2019

Background: Exclusive breastfeeding is highly recommended by the World Health Organization during... more Background: Exclusive breastfeeding is highly recommended by the World Health Organization during the first 6 months of life. In parallel, breast augmentation with implants is one of the most performed operations in aesthetic surgery. Objective: The goal of our study was therefore to analyze the potential impact of aesthetic breast implants on breastfeeding. Study Design: A retrospective study was carried out in 3 French university hospitals. The main inclusion criterion was adult women of childbearing age (18-50 years old) with bilateral breast hypoplasia. Some features of the surgery, such as the operative indication, the surgical approach, the implant position against the pectoral muscle, and implants features (material, volume, profile), were collected. We conducted a survey by phone about childbirth after the procedure. If the women had children after surgery, we asked them if they breastfed and the characteristics of breastfeeding. Results: In total, 1316 patients received breast implants in the 3 centers from January 2011 to October 2016 and met our inclusion criteria. We included 1073 patients; 998 women had breast implants with no pregnancy. Among the 75 patients (7%) who gave birth after the surgery, 51 wanted to breastfeed (68%). The patients with a retroglandular implant were significantly less able to breastfeed compared with the patients with retromuscular implants (P = 0.0005). No difference was found for age, the type of surgery, the surgical approach, and the shape or type of implant between the successful breastfeeding group and failed breastfeeding group. Conclusion: A woman with aesthetic breast implants has a 75% chance of breastfeeding if desired, regardless of the type and the volume of the implant and the surgical approach. She has an 82% probability of breastfeeding with retromuscular implants and 17% with retroglandular implants.