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[PMID]: 29523911
[Au] Autor:Fabis-Strobin A; Topol M; Fabis J; Niedzielski K; Podgorski M; Strobin L; Polguj M
[Ad] Address:Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338, Lodz, Poland. anna.m.fabis@gmail.com.
[Ti] Title:A new anatomical insight into the aetiology of lateral trunk of suprascapular nerve neuropathy: isolated infraspinatus atrophy.
[So] Source:Surg Radiol Anat;, 2018 Mar 09.
[Is] ISSN:1279-8517
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Although the pathomechanism of isolated infraspinatus atrophy (ISA) in throwing sports is known to be traction, it is unclear why only some players are affected. One likely explanation is that the infraspinatus pulling force exerted by its contracture generate the compressive resultant component force (Fn) compressing the lateral trunk of the suprascapular nerve (LTSN) against the edge of scapular spine. This paper makes two key assumptions (1) the course of LTSN in relation to the scapular spine, defined as the suprascapular-scapular spine angle (SSSA) is the key individual anatomical feature influencing the Fn magnitude, and thus potentially ISA development (2) SSSA is correlated with scapular notch type. MATERIALS AND METHODS: The bone landmarks of the LTSN course were identified in 18 formalin-fixed cadaveric shoulders, and the SSSA was measured in 101 dry scapulae. The correlation between the SSSA and suprascapular notch type was evaluated. The Fn value was simulated mathematically based on the values of the SSSA of 101 dry scapulae and the prevalence of ISA in chosen throwing sports, as given in the literature: i.e., beach volleyball - 34% (group A1 - 34%; group A2-remaining 66% of scapulae) and tennis - 52% (group B1 - 52%; group B2-remaining 48% of scapulae). RESULTS: The mean SSSA value was 44.57° (± 7.9) and Fn 79 N (± 13.1). No statistically significant correlation was revealed between suprascapular notch type and SSSA. Groups A1 and B1 possessed significantly lower SSSA values (p < 0.000) and significantly higher Fn magnitude (p < 0.000) than groups A2 and B2 respectively. The average difference of Fn was 28.1% between group A1 and A2 and 31% between group B1 and B2. CONCLUSIONS: The SSSA has a wide range of values depending on the individual: the angle influencing the magnitude of the compressive resultant force Fn on the LTSN at the lateral edge of the scapular spine via contraction of the infraspinatus muscle. The prevalence of ISA in throwing sports may be correlated with the SSSA of the LTSN. However, further combined clinical, MRI or/and CT studies are needed to confirm this.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s00276-018-1996-2

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[PMID]: 29523904
[Au] Autor:Yazar S; Karadag EC; Altinkaya A; Kara H; Uras C
[Ad] Address:Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Acibadem Maslak Hospital, Acibadem University, Istanbul, Turkey.
[Ti] Title:Risk Factor Analysis for Survival of Becker-Type Expander in Immediate Breast Reconstruction.
[So] Source:Aesthetic Plast Surg;, 2018 Mar 09.
[Is] ISSN:1432-5241
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Breast reconstruction with a Becker-type expander is a common technique following mastectomy. However, inconsistency remains in the literature regarding risk factors for the survival of a Becker-type expander following immediate breast reconstruction. This study's purpose is to investigate possible risk factors for the Becker-type expander survival and to evaluate the complications related to expander removal following immediate breast reconstruction. METHODS: We performed a retrospective chart review of consecutive women who underwent a mastectomy followed by immediate breast reconstruction with a Becker-type expander from November 2010 to November 2016. Electronic medical records were analyzed retrospectively for demographic, clinical, operative characteristics, and outcomes. Univariate Cox regression analysis was performed to determine the risk factors for the survival of the Becker-type expander following immediate breast reconstruction. RESULTS: A total of 74 Becker-type expanders were used in 72 patients who underwent immediate breast reconstruction. The patients' ages ranged from 27 to 71 years, with a mean ± standard deviation age of 44.6 ± 9.1 years. The most frequent complication was capsular contracture which occurred in 25 breasts (33.8%) followed by mastectomy skin flap necrosis in 6 breasts (8.1%), seroma in 4 breasts (5.4%), nipple-areolar complex necrosis in 4 breasts (5.4%), hematoma in 3 breasts (4.1%), and infection in 2 breasts (2.7%). The mean intraoperative expander fill volume (109.6 ± 66.9 cc [p = 0.039]) and mean total volume (386.5 ± 94.7 cc [p = 0.034]) were both significantly lower for patients with capsular contracture compared with those without capsular contracture. In patients with partial NAC necrosis, the mean mastectomy specimen volume (737.5 ± 242.8 cc) was significantly higher compared with patients without partial NAC necrosis (489.8 ± 219.0 cc; p = 0.027). A univariate Cox regression analysis showed that smoking and neoadjuvant therapy were significantly associated with expander removal (p = 0.023 and p = 0.006, respectively). CONCLUSION: The total volume of the expander and intraoperative fill volume of the expander appear to be predictive factors in the development of capsular contracture. However, there is no statistically significant association between radiotherapy and capsular contracture or expander survival in contrast with other published reports. Our findings reveal that the main risk factors for the survival of Becker-type expanders following immediate breast reconstruction are smoking and neoadjuvant therapy. To our knowledge, this is the first study to evaluate the most likely risk factors associated with Becker-type expander survival in immediate breast reconstruction. LEVEL OF EVIDENCE IV: 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 .
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s00266-018-1111-4

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[PMID]: 29523181
[Au] Autor:Xu X; Lai L; Zhang X; Chen J; Chen J; Wang F; Zheng J; Chen M
[Ad] Address:Department of Plastic and Reconstructive Surgery, The General Hospital of Chinese People's Armed Police Forces, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
[Ti] Title:Autologous chyle fat grafting for the treatment of hypertrophic scars and scar-related conditions.
[So] Source:Stem Cell Res Ther;9(1):64, 2018 Mar 09.
[Is] ISSN:1757-6512
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Scarring is the product of natural restoration, yet its treatment remains challenging. Both collagen and fibroblasts are abnormally abundant in scars, leading to scar hyperplasia or contracture. Several clinical studies have reported that wrinkles at the recipient site are reduced, pores are narrowed, pigmentation is decreased, and skin is softened after autologous fat transplantation. In this study, we investigated the ability of autologous chyle fat injection to normalize the fibroblasts and collagen of scar tissue in 80 adult patients with hypertrophic scars resulting from severe burns received more than 1 year previously. METHODS: The patients underwent autologous chyle fat injection, and scar samples were collected at different time points. Differences in the number of adipocytes before and after chylosis were assessed by cell culture, and changes in the structural organization of the scars were detected via histologic and immunohistochemical analyses. RESULTS: After preparation, the chyle fat contained few autologous adipocytes and large amounts of extracellular matrix. Following the injection of chyle fat, the thickness, color, and elasticity of hypertrophic scar tissue tended toward normalization, and patient satisfaction increased. The three adipose tissue donor sites used for the preparation of chyle fat were the abdomen, buttocks, and inner thigh, of which the inner thigh yielded the best therapeutic outcomes. The density and quantity of fibroblasts in the scars decreased following the injection of chyle fat, and the arrangement, quantity, and shape of type III collagen fibers tended toward normalization. After three treatments, the results of immunohistochemical staining showed that type III collagen was significantly less abundant than before treatment. CONCLUSIONS: Autologous chyle fat transplantation has a good therapeutic effect on hypertrophic scar tissue. The injection of chyle fat into hypertrophic scar tissue reduced the density and quantity of fibroblasts and prompted the arrangement, quantity, and shape of type III collagen to normalize.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1186/s13287-018-0782-8

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[PMID]: 29523044
[Au] Autor:Kim JB; Jeon HJ; Lee JW; Choi KY; Chung HY; Cho BC; Park SH; Park MH; Bae JS; Yang JD
[Ad] Address:a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea.
[Ti] Title:A murine model of radiation-induced capsule-tissue reactions around smooth silicone implants.
[So] Source:J Plast Surg Hand Surg;:1-8, 2018 Mar 09.
[Is] ISSN:2000-6764
[Cp] Country of publication:Sweden
[La] Language:eng
[Ab] Abstract:As the availability of breast reconstruction using implants is becoming widespread and many implant recipients undergo radiation therapy, there is an increasing interest in understanding the potential complications associated with capsule-tissue interactions in response to irradiation. Accordingly, our medical institution designed an animal experiment to investigate the effects of irradiation on capsular contracture. A total of 40 mice (C57BL6) were divided into four groups according to whether or not they received irradiation and the time from implantation to irradiation. After each mouse received a specially-fabricated, 1.5 cm semi-spherical silicone implant inserted into the area below the panniculus carnosus, half of the mice were irradiated using singe administration of a 10 Gy dose of radiation (6 MeV). Subsequently, data from gross inspection, histological analysis and immunohistochemical analysis were obtained at one and three months postoperatively and analyzed. Changes that occurred near the capsule led to the phenomenon of contracture subsequent to encapsulation. Our findings suggest that the inflammation reaction occurring near the implant becomes aggravated by 'radiation toxicity' and creates an environment conducive to capsular contracture. The present study demonstrated the process by which the complication of capsular contracture may occur during the treatment of human breast cancer via radiotherapy. These findings may serve as the basis for research and development of future treatments of capsular contracture.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1080/2000656X.2018.1444617

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[PMID]: 29519629
[Au] Autor:Sanjuán-Cerveró R; Vazquez-Ferreiro P; Gómez-Herrero D; Carrera-Hueso FJ; Fikri-Banbrahim N
[Ad] Address:Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Denia, Alicante, España. Electronic address: sanjuan.rafcer@gmail.com.
[Ti] Title:Evolución al año de tratamiento con CCH para la contractura de Dupuytren: estudio prospectivo. One year follow-up after treatment with CCH for Dupuytren's disease: A prospective view.
[So] Source:Rev Esp Cir Ortop Traumatol;, 2018 Mar 05.
[Is] ISSN:1988-8856
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:Aim Clostridium histolyticum collagenase (CCH) is nowadays an alternative treatment for the contracture of Dupuytren. Our objective is to assess its effectiveness at one year in a series of consecutive patients. MATERIAL AND METHOD: Prospective study with minimum follow-up of one year. Evaluation of results and adverse effects. RESULTS: A total of 75 joints treated in 51 patients were included. The average age was 65.18years (SD: 7.288) and 82.7% were males. The initial mean contraction of the MCP was 34.0 degrees (SD: 27.37), PIP 41.5 degrees (SD: 31.33) and combined impairment (MCF+IFP) of 75.5 degrees (SD: 35.2). Efficacy was achieved in 68 patients (90.7%). Adverse effects were mild and self-limiting. The mean correction for the MCP joint was 28.96 degrees (SD: 26.90) and for PIP it was 28.72 degrees (SD: 24.30). The recurrence rate was 18 (24.0%) joints in 14 patients, being more frequent in severe cases. QuickDASH score showed minimal differences measured before the intervention and once a year. DISCUSSION: Our results show a better outcome in mild cases; the outcome was more favourable and with a higher success rate in the MCP joint. QuickDASH score is not a useful tool for the assessment of Dupuytren's contracture. CONCLUSIONS: Treatment with CCH for Dupuytren's contracture is an effective treatment in the medium term. It has a poorer outcome in combined joint disorders, 5th finger, PIP and severe cases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 18292 MEDLINE  
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[PMID]: 29455110
[Au] Autor:Casella D; Di Taranto G; Marcasciano M; Sordi S; Kothari A; Kovacs T; Lo Torto F; Cigna E; Ribuffo D; Calabrese C
[Ad] Address:Department of Oncologic and Reconstructive Breast Surgery, "Breast Unit Integrata di Livorno, Cecina, Piombino, Elba, Azienda USL Toscana Nord Ovest", Italy.
[Ti] Title: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.
[So] Source:Breast;39:8-13, 2018 Feb 18.
[Is] ISSN:1532-3080
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our Institution. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop ). The BREAST-Q questionnaire was given to patients prior to surgery and at 1 and 2 years follow-up points. Capsular contracture was evaluated by Baker scale. Surgical outcomes along with the changes in BREAST-Q score were analyzed over time. RESULTS: Complications were reported in only one case and after two years the capsular contracture rates were acceptable (grade I: 65,2%; grade II: 32,6%; grade III 2,2%). At one year and two year follow-ups patients reported high rates in the measures of overall satisfaction with breasts (72,5 and 73,7 respectively), psychosocial well-being (78,4 and 78,6), sexual well-being (58,8 and 59,4), physical well-being (77,6 and 80,6) and overall satisfaction with outcome (75,7 and 79,7). A statistically significant increase in all BREAST-domains from the preoperative to the postoperative period was reported at one and two years follow-ups (p < 0,05). CONCLUSION: Following bilateral prophylactic NSM and immediate subcutaneous reconstruction with TiLoop , patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. 2-years outcomes confirmed high patient comfort with increased scores from the preoperative baseline level.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  7 / 18292 MEDLINE  
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[PMID]: 29498977
[Au] Autor:Kim DY; Alfadil LO; Ahn KM; Lee JH
[Ad] Address:Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Republic of Korea.
[Ti] Title:Reconstruction of Thin and Pliable Oral Mucosa After Wide Excision of Oral Cancer Using a Trimmed Anterolateral Thigh Free Flap as an Adipofascial Flap.
[So] Source:J Craniofac Surg;, 2018 Mar 01.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A 21-year-old female patient underwent wide excision of the buccal mucosa and tongue as well as selective neck dissection due to squamous cell carcinoma on the left side of the tongue. She had a severe limitation in opening her mouth, owing to fibrosis of the mucosa and scar contracture after adjuvant radiation therapy. Reconstruction of the oral mucosa and tongue defect was performed after removal of the scar to improve mouth opening. An anterolateral thigh (ALT) flap was used, trimmed to an adipofascial flap for the reconstruction of the thin and pliable oral mucosa and tongue. The maximum mouth opening improved to 40 mm intraoperatively and was 30 mm after surgery. The adipofascial ALT flap had excellent viability and presented neomucosa after secondary healing. An adipofascial flap obtained by trimming an ALT flap could be a reliable option for the reconstruction of thin and pliable oral mucosa after wide excision of oral cancer.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1097/SCS.0000000000004404

  8 / 18292 MEDLINE  
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[PMID]: 29378017
[Au] Autor:Barnea Y; Hammond DC; Geffen Y; Navon-Venezia S; Goldberg K
[Ad] Address:Dr Barnea is Head of the Plastic and Reconstructive Breast Surgery Unit, Department of Plastic Surgery, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
[Ti] Title:Plasma Activation of a Breast Implant Shell in Conjunction With Antibacterial Irrigants Enhances Antibacterial Activity.
[So] Source:Aesthet Surg J;, 2018 Jan 25.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Infection and capsular contracture are two of the most significant complications of breast-implant surgery. Both complications are associated with bacterial contamination of the implant surface. Plasma activation of the surface of a silicone breast implant changes its surface properties from water repelling (hydrophobic) to water absorbing (hydrophilic), thus making it possible for antibacterial irrigants to temporarily adsorb onto the implant surface. Objective: To support our hypothesis that by changing the surface properties we could render antibacterial irrigation more effective in inhibiting bacterial growth on a breast implant shell. Methods: An in-vitro study using silicone discs cut from a textured silicone breast implant shell was performed by treating some of the discs with plasma activation and then exposing the discs to contamination with either Staphylococcus aureus or Pseudomonas aeruginosa and then variously treating the discs with 10% povidone iodine, Cefazolin, or Gentamicin. Bacterial contamination was verified and counted using contact plates as well as culture media. Results: Plasma activation changed the wetting properties of the disc's surface from hydrophobic to hydrophilic. Non-plasma activated contaminated discs demonstrated clear bacterial growth both in the untreated group and in the antibacterial-treated group. Combining antibacterial treatment with plasma activation resulted in complete inhibition of bacterial growth in each of the groups treated with antibacterial irrigants. Conclusions: Combining plasma activation with topical antibacterial irrigants can inhibit the growth of bacteria on implant shell discs. By changing the properties of the surface from hydrophobic to hydrophilic, the adsorption of the antibacterial irrigants is enhanced.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjy020

  9 / 18292 MEDLINE  
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[PMID]: 29365064
[Au] Autor:Gabriel A; Sigalove S; Sigalove NM; Storm-Dickerson TL; Rice J; Pope N; Patrick Maxwell G
[Ad] Address:Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA.
[Ti] Title:Prepectoral Revision Breast Reconstruction for Treatment of Implant-Associated Animation Deformity: A Review of 102 Reconstructions.
[So] Source:Aesthet Surg J;, 2018 Jan 20.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Animation deformity is a direct consequence of subpectoral implant placement for breast reconstruction following mastectomy. Current treatment options ameliorate but do not address the source of the problem. Moving the implant from subpectoral to prepectoral has the potential to eliminate animation deformity. Objectives: Describe the technique and outcomes of prepectoral revision reconstruction in over 100 cases and discuss patient selection criteria for a successful outcome. Methods: Patients who presented with animation deformity following two-stage implant reconstruction were included in this retrospective study. Revision surgery involved removal of the existing implant via the previous incision site along the inframammary fold, suturing of the pectoralis major muscle back to the chest wall, creation of a prepectoral pocket for the new implant, use of acellular dermal matrix to reinforce the prepectoral pocket and completely cover the implant, and fat grafting to enhance soft tissue. Patients were evaluated for resolution of animation deformity and occurrence of complications during follow up. Results: Fifty-seven patients (102 breasts) underwent prepectoral revision reconstruction with complete resolution of animation deformity. Complications occurred in 4 breasts (3.9%) and included seroma (2 breasts), skin necrosis (3 breasts), and wound dehiscence (1 breast). All 4 breasts with complications had their implants removed and replaced. There were no incidences of infection or clinically significant capsular contracture in this series. Conclusions: Revision reconstruction with prepectoral implant placement and complete coverage with acellular dermal matrix resolves animation deformity and results in aesthetically pleasing soft breasts. Patient selection is critical for the success of this technique.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjx261

  10 / 18292 MEDLINE  
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[PMID]: 29190321
[Au] Autor:Hu H; Sleiman J; Johani K; Vickery K
[Ad] Address:Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
[Ti] Title:Hypochlorous Acid Versus Povidone-Iodine Containing Irrigants: Which Antiseptic is More Effective for Breast Implant Pocket Irrigation?
[So] Source:Aesthet Surg J;, 2017 Nov 28.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Capsular contracture induced by chronic subclinical infection is a major cause of poor outcomes and reoperation in breast implant surgery. The use of pocket irrigation with antiseptic/antibiotic has been shown to reduce the incidence of contracture. A new formulation of hypochlorous acid solution PhaseOne has been proposed as potential agent for irrigation. Objectives: This study aimed to test the efficacy of hypochlorous acid solution PhaseOne for use in breast pocket irrigation as an alternative to povidone iodine solution Betadine. Methods: The efficacy of PhaseOne, a hypochlorous acid formulated wound and skin cleanser, was tested in vitro against planktonic and biofilm Staphylococcus aureus with or without biological soil and in an implant attachment assay. Its activity was compared with Betadine containing 10% povidone iodine. Results: Our findings showed that PhaseOne was unable to eradicate planktonic and/or biofilm S. aureus in the presence of either tryptone soy broth or bovine calf serum (protein soil) in a variety of in vitro assays. Conclusions: We advise that povidone iodine containing irrigants are superior to hypochlorous acid containing irrigants in the clinical setting and should remain the recommended solution for pocket irrigation to reduce bacterial contamination at breast implants surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjx213


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