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[PMID]:29384886
[Au] Autor:Seo SW; Kim KN; Ha W; Yoon CS
[Ad] Endereço:Department of Emergency Medicine, Eulji University Hospital, University of Eulji College of Medicine, Seo-Gu, Daejeon.
[Ti] Título:Validity of the use of a subfascial vessel as the recipient vessel in a second free flap transfer: A retrospective clinical review.
[So] Source:Medicine (Baltimore);97(5):e9819, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Performing a greater number of free flap procedures inevitably results in an increase in the number of cases that experience free flap failure. In cases that require a second free flap after the failure of the first, recipient vessel selection becomes difficult. Furthermore, recipient vessel selection can be complicated if the vessel is deep in the recipient site, or if there is an increased risk of vessel damage during the dissection. Thus, we present our experience where a subfascial vessel beneath the deep fascia was used as a recipient vessel for a second free flap in lower extremity reconstruction due to total or partial first flap failure.Between January 2010 and April 2015, 5 patients underwent second free flap reconstruction using a subfascial vessel as the recipient vessel. The flaps were anastomosed in a perforator-to-perforator manner, using the supermicrosurgery technique. We measured the sizes of the flaps, which varied from 5 × 3 to 15 × 8 cm, and the recipient subfascial vessel diameters.The mean time for the dissection of the recipient perforator was 45 minutes. All the flaps exhibited full survival, although a partial loss of the skin graft at the flap donor site was observed in 1 patient; this defect healed with conservative management.We recommend using a subfascial vessel as the recipient vessel for both first and second free flaps, especially if access to the major vessel is risky or challenging.
[Mh] Termos MeSH primário: Fáscia/irrigação sanguínea
Retalhos de Tecido Biológico
Extremidade Inferior/irrigação sanguínea
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009819


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[PMID]:29369171
[Au] Autor:Liang JL; Liu XY; Qiu T; Fu ZQ; Wang HY; Kong X; Tao K
[Ad] Endereço:Department of Plastic Surgery, General Hospital of Shenyang Military Area Command, PLA, Shenyang, Liaoning, China.
[Ti] Título:Microdissected thin anterolateral thigh perforator flaps with multiple perforators: A series of case reports.
[So] Source:Medicine (Baltimore);97(4):e9454, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The study aimed to explore the effect of microdissected thin anterolateral thigh (MTALT) perforator flap with multiple perforators on patients with complex defects on the hand, elbow, heel, or knee. METHODS: From March 2012 to February 2013, 5 patients with complex defects on the hand, elbow, heel, or knee were included. During the flap preparation, 2 to 3 perforators penetrating the fascia of the anterolateral femoral area were initially detected, and the deep fascia was incised. The superficial fascia layer of the flap and the deep adipose were then dissected, and removed after verifying the distribution of the blood vessels using an operating microscope. The whole flap was then elevated, and transposed to the recipient areas for microsurgical reparation. RESULTS: Two cases of post-burn scar contracture and 3 cases of traumatic tissue defects were successfully reconstructed with these multiple-perforator MTALT flaps. No complication was reported, and secondary operative procedure was not needed in any patient in the follow-up. CONCLUSION: MTALT perforator flap with multiple perforators is safe and reliable for patients with complex defects on the hand, elbow, heel, or knee.
[Mh] Termos MeSH primário: Microdissecção/métodos
Doenças Musculoesqueléticas/cirurgia
Retalho Perfurante/transplante
Alotransplante de Tecidos Compostos Vascularizados/métodos
[Mh] Termos MeSH secundário: Adulto
Queimaduras/cirurgia
Cotovelo/cirurgia
Fáscia/transplante
Feminino
Mãos/cirurgia
Calcanhar/cirurgia
Seres Humanos
Joelho/cirurgia
Masculino
Meia-Idade
Doenças Musculoesqueléticas/etiologia
Retalho Perfurante/irrigação sanguínea
Coxa da Perna/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009454


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[PMID]:29049168
[Au] Autor:van der Woerd BD; MacNeil SD
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
[Ti] Título:Sialocutaneous fistula to the external auditory canal repaired with superficial parotidectomy and temporoparietal flap: A case report.
[So] Source:Medicine (Baltimore);96(42):e7038, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Gustatory otorrhea can lead to cutaneous changes, recurrent infection, and social disruption. We present a case of a late, evolving sialocutaneous fistula to the external auditory canal, managed surgically after failing conservative therapies. This case is unique by late evolution, whereby the symptoms presented with significance 27 years after her operation and 19 years after mild symptoms initially arose. PATIENT CONCERNS: Gustatory, left-sided clear otorrhea with acutely increased volume over 8 months causing social disruption. DIAGNOSES: Sialocutaneous fistula to the external auditory canal. INTERVENTIONS: Superficial parotidectomy and temporoparietal flap for closure of fistula. OUTCOMES: No postoperative complications and resolution of gustatory otorrhea at one-year follow-up. LESSONS: This rare, but important, postoperative complication can present late with evolving symptoms, causing significant social disruption. It can be treated with conservative medical management and several surgical approaches.
[Mh] Termos MeSH primário: Fístula Cutânea/cirurgia
Meato Acústico Externo
Glândula Parótida/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Fístula das Glândulas Salivares/cirurgia
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Adulto
Fístula Cutânea/etiologia
Fáscia/transplante
Fasciotomia/métodos
Feminino
Seres Humanos
Transtornos de Início Tardio/etiologia
Transtornos de Início Tardio/cirurgia
Fístula das Glândulas Salivares/etiologia
Sudorese Gustativa/complicações
Músculo Temporal/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007038


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[PMID]:28953729
[Au] Autor:Lonic D; Yamaguchi K; Chien-Jung Pai B; Lo LJ
[Ad] Endereço:Taoyuan, Taiwan; Munich, Germany; and Osaka and Tokyo, Japan From the Departments of Plastic and Reconstructive Surgery and Craniofacial Orthodontics and the Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University; MFACE KieferGesichtsZentrum München and HELIOS Hospital Munich West; Shonan Beauty Clinic; and Shonan Medical Memorial Hospital.
[Ti] Título:Reinforcing the Mucoperiosteal Pocket with the Scarpa Fascia Graft in Secondary Alveolar Bone Grafting: A Retrospective Controlled Outcome Study.
[So] Source:Plast Reconstr Surg;140(4):568e-578e, 2017 Oct.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Secondary alveolar bone grafting is the gold standard for the treatment of alveolar clefts in cleft lip and palate patients. The authors present a modified method using a Scarpa fascia graft that is placed deep into the mucoperiosteal pocket for watertight sealing of the bone graft chamber and limiting the graft position to the alveolar region for bony stability and tooth support. The outcome was assessed for clinical success in terms of bone graft stability and infection rate. METHODS: Seventy-four unilateral complete cleft lip and palate patients were enrolled in this retrospective study consisting of equal-size Scarpa fascia and control groups of consecutive unilateral complete cleft lip and palate patients undergoing secondary alveolar bone grafting. Occlusal radiographs of the alveolar cleft taken at least 1 year postoperatively were evaluated for Spearman correlated Bergland and Witherow scales. Statistical evaluation was conducted using t test, chi-square test, and odds ratio. RESULTS: The clinical success rate (Bergland types I and II) of the Scarpa fascia procedure was significantly higher (67.6 versus 94.6 percent, respectively), with a significantly lower infection rate (16.2 versus 2.7 percent, respectively) and a high correlation of Bergland and Witherow scales (0.964; p < 0.001). There was no wound dehiscence, fistula, bone graft exposure, or additional donor-site morbidity in the Scarpa fascia group. CONCLUSION: The authors' new method of alveolar bone grafting with the Scarpa fascia graft is safe and effective, and has one of the highest documented success rates. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
[Mh] Termos MeSH primário: Enxerto de Osso Alveolar/métodos
Fenda Labial/cirurgia
Fissura Palatina/cirurgia
Fáscia/transplante
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Criança
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003696


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[PMID]:28922187
[Au] Autor:Rodriguez IM; Cuevas M; Silvero A; Cañete-Portillo S; Sanchez DF; Barreto J; Cubilla AL
[Ad] Endereço:*Pathology and Research Institute †School of Medicine, National University of Asunción, Asunción, Paraguay.
[Ti] Título:Novel Histologic Finding: Adipose Tissue Is Prevalent Within Penile Tunica Albuginea and Corpora Cavernosa: An Anatomic Study of 63 Specimens and Considerations for Cancer Invasion.
[So] Source:Am J Surg Pathol;41(11):1542-1546, 2017 Nov.
[Is] ISSN:1532-0979
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Adipose tissue, along with arteries, veins, and peripheral nerves, is a normal constituent of mesenchymal tissues encasing the corpora cavernosa at the level of the penile shaft, variously designated as penile fascia or Bucks fascia. To our knowledge, the presence of fat has not been previously reported within the corpora cavernosa. One or 2 transversal histologic sections at the level of the surgical margin at the shaft of 63 consecutive partial penectomy specimens for squamous cell carcinoma were evaluated. From outer to inner tissues, 3 anatomic levels were identified: (1) outer fascia composed of a loose fibrovascular mesenchyme containing some nerve branches. Adipose tissue was present in the majority of the cases. (2) The tunica albuginea, a thick and dense fibroelastic band of tissue separating the outer fascia from the erectile tissues of the corpora cavernosa. Adipose tissue within the albuginea was present in 21 specimens (19%). (3) Erectile tissues of corpora cavernosa. Besides the typical erectile tissues, adipose tissue was present in 33 cases (52%). The fatty tissue was focal or multifocal and scant and peripherally located at the junction of the tunica albuginea with the corpora. In some cases, it was associated with small amounts of fibrous tissue, small vessels, and nerves. We are reporting the presence of adipose tissue in the tunica albuginea and the corpora cavernosa. It is possible that adipose tissue, along with small nutritional vessels and nerves perforates from the fascia, in which fat is usually present, through the tunica albuginea to reach the corpora. In a previous examination of the local routes of cancer spread, we found this pathway to be one of the mechanisms of cancer invading the penile corpora from the penile fascia.
[Mh] Termos MeSH primário: Tecido Adiposo/patologia
Carcinoma de Células Escamosas/patologia
Tecido Elástico/patologia
Neoplasias Penianas/patologia
[Mh] Termos MeSH secundário: Tecido Adiposo/cirurgia
Biópsia
Carcinoma de Células Escamosas/cirurgia
Tecido Elástico/cirurgia
Fáscia/patologia
Seres Humanos
Masculino
Invasividade Neoplásica
Neoplasias Penianas/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170919
[St] Status:MEDLINE
[do] DOI:10.1097/PAS.0000000000000953


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[PMID]:28904662
[Au] Autor:Arer IM; Yabanoglu H; Aytac HO; Ezer A; Caliskan K
[Ad] Endereço:Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey.
[Ti] Título:Long-term results of retromuscular hernia repair: a single center experience.
[So] Source:Pan Afr Med J;27:132, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Incisional hernia (IH) is one of the most frequent postoperative complications after abdominal surgery. There are multiple surgical techniques described for IH repair. The aim of the study is to evaluate the effect of primary fascial closure on long-term results in retromuscular hernia repair (RHR) for incisional hernias. METHODS: A total of 132 patients underwent RHR for IH were included in our study. 109 patients were evaluated in 2009 and 55 patients in 2015 for short and long-term results. RESULTS: Among 132 patients perfromed RHR, fascia was closed in 107 (81%) and left open in 25 (19%) patients. The mean age of patients was 57.9 ± 11.8 years. Average mesh area was 439.8 ± 194.6 cm , hernia area was 112 ± 77.5 cm and open area after repair was 40.8 ± 43.3 cm . Mean follow-up of 104 patients regarding postoperative complications evaluated in 2009 was 30.7 ± 14.1 months. Recurrent IH was observed in 6 (4.5%) patients according to data collected in 2009. Long-term results were; mean follow-up period was 91 ± 20.2 months (20-112 months) and recurrent IH was observed in 4 (7.3%) patients. CONCLUSION: Retromuscular repair for incisional hernia regardless of the fascial closure gives high patient satisfaction, less recurrence rates and complications in long-term follow-up.
[Mh] Termos MeSH primário: Herniorrafia/métodos
Hérnia Incisional/cirurgia
Satisfação do Paciente
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Fáscia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Telas Cirúrgicas
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.132.9367


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[PMID]:28682889
[Au] Autor:Wang X; Sun Y; Wang L; Hao X
[Ad] Endereço:Anesthesiology Department, The First Hospital of Hebei Medical University, Hebei, China.
[Ti] Título:Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty: A meta-analysis from randomized controlled trials.
[So] Source:Medicine (Baltimore);96(27):e7382, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties. METHODS: A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study. Cochrane Hand book for Systematic Reviews of Interventions was used for assessment of the included studies and risk of bias was shown. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software. RESULTS: Five RCTs including 308 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = -0.080, 95% CI: -0.306 to 0.145, P = .485), 24 hours (SMD = 0.098, 95% CI: -0.127 to 0.323, P = .393), and 48 hours (SMD = -0.001, 95% CI: -0.227 to 0.225, P = .993). No significant differences were found regarding opioid consumption at 12 hours (SMD = 0.026, 95% CI: -0.224 to 0.275, P = .840), 24 hours (SMD = 0.037, 95% CI: -0.212 to 0.286, P = .771), and 48 hours (SMD = -0.016, 95% CI: -0.265 to 0.233, P = .900). In addition, no significant increase of complications was identified between groups. CONCLUSION: There is no significant differences of VAS scores at 12-48 hour and opioids consumption at 12-48 hour between two groups following total joint arthroplasty. No increased risk of nausea, vomiting and pruritus was observed in both groups. More high-quality large RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of FNB with FIB. The present meta-analysis exists some limitations that should be noted: (1) Only five articles were included in present meta-analysis, although all of them are recently published RCTs, the sample size are relatively small; (2) Functional outcome is an important parameter, due to the insufficiency of relevant data, we cannot perform a meta-analysis. (3) Dose and types of local anesthetics are varied, which may influence the results; (4) The duration of follow up is relatively short which leads to underestimating complications. (5) Publication bias in present meta-analysis may influence the results.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Bloqueio Nervoso
Dor Pós-Operatória/terapia
[Mh] Termos MeSH secundário: Fáscia/inervação
Nervo Femoral
Seres Humanos
Ílio/inervação
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007382


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[PMID]:28598983
[Au] Autor:Ulrich D; Le Teuff I; Huberlant S; Carteron P; Letouzey V; de Tayrac R
[Ad] Endereço:Medical University Nimes, 4 Rue du Professeur Robert Debré, Nîmes, France.
[Ti] Título:A preclinical evaluation of polypropylene/polylacticacid hybrid meshes for fascial defect repair using a rat abdominal hernia model.
[So] Source:PLoS One;12(6):e0179246, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh. METHODS: 72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties. RESULTS: No differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups. CONCLUSION: A PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates.
[Mh] Termos MeSH primário: Fáscia/patologia
Poliésteres
Polipropilenos
Telas Cirúrgicas
[Mh] Termos MeSH secundário: Animais
Materiais Biocompatíveis
Fenômenos Biomecânicos
Colágeno/metabolismo
Feminino
Hérnia Abdominal/cirurgia
Implantes Experimentais
Masculino
Teste de Materiais
Complicações Pós-Operatórias
Ratos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Polyesters); 0 (Polypropylenes); 459TN2L5F5 (poly(lactide)); 9007-34-5 (Collagen)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179246


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[PMID]:28598978
[Au] Autor:De Groef A; Van Kampen M; Vervloesem N; De Geyter S; Dieltjens E; Christiaens MR; Neven P; Geraerts I; Devoogdt N
[Ad] Endereço:Department of Rehabilitation Sciences, KU Leuven-University of Leuven and Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
[Ti] Título:An evaluation tool for myofascial adhesions in patients after breast cancer (MAP-BC evaluation tool): Development and interrater reliability.
[So] Source:PLoS One;12(6):e0179116, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To develop a tool to evaluate myofascial adhesions objectively in patients with breast cancer and to investigate its interrater reliability. METHODS: 1) Development of the evaluation tool. Literature was searched, experts in the field of myofascial therapy were consulted and pilot testing was performed. 2) Thirty patients (63% had a mastectomy, 37% breast-conserving surgery and 97% radiotherapy) with myofascial adhesions were evaluated using the developed tool by 2 independent raters. The Weighted Kappa (WK) and the intra-class correlation coefficient (ICC) were calculated. RESULTS: 1) The evaluation tool for Myofascial Adhesions in Patients with Breast Cancer (MAP-BC evaluation tool) consisted of the assessment of myofascial adhesions at 7 locations: axillary and breast region scars, musculi pectorales region, axilla, frontal chest wall, lateral chest wall and the inframammary fold. At each location the degree of the myofascial adhesion was scored at three levels (skin, superficial and deep) on a 4-points scale (between no adhesions and very stiff adhesions). Additionally, a total score (0-9) was calculated, i.e. the sum of the different levels of each location. 2) Interrater agreement of the different levels separately was moderate for the axillary and mastectomy scar (WK 0.62-0.73) and good for the scar on the breast (WK >0.75). Moderate agreement was reached for almost all levels of the non-scar locations. Interrater reliability of the total scores was the highest for the scars (ICC 0.82-0.99). At non-scar locations good interrater reliability was reached, except for the inframammary fold (ICC = 0.71). CONCLUSIONS: The total scores of all locations of the MAP-BC evaluation tool had good to excellent interrater reliability, except for the inframammary fold which only reached moderate reliability.
[Mh] Termos MeSH primário: Neoplasias da Mama/complicações
Fáscia/patologia
Músculos/patologia
Aderências Teciduais/diagnóstico
Aderências Teciduais/etiologia
[Mh] Termos MeSH secundário: Neoplasias da Mama/cirurgia
Neoplasias da Mama/terapia
Tomada de Decisão Clínica/métodos
Terapia Combinada/efeitos adversos
Feminino
Seres Humanos
Mastectomia/efeitos adversos
Mastectomia/métodos
Variações Dependentes do Observador
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179116


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[PMID]:28577852
[Au] Autor:Baujat B; Struk S; Lesnik M; de Crouy Chanel O; Barbut J; Lefevre M; Périé S; Lacau St Guily J
[Ad] Endereço:Head and Neck Surgery Department, Tenon Hospital, Paris, France; Department of Medicine, Paris VI University, Paris, France. Electronic address: bertrand.baujat@aphp.fr.
[Ti] Título:Fascia Temporalis Free Flap for Cricotracheal Reconstruction: A Novel Approach.
[So] Source:Ann Thorac Surg;104(3):1040-1046, 2017 Sep.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of tracheal reconstruction is to provide an airtight and noncollapsible airway covered with a suitable epithelial lining. To date, no ideal treatment is available for large tracheal defects. METHODS: We report 4 patients who underwent one-stage reconstruction for a cricotracheal stenosis with a free temporoparietal fascia flap and costal cartilage grafts. RESULTS: Closure of tracheostoma was achieved for all patients. The main advantage of this flap compared with the free radial forearm flap is that it supplies a more suitable lining allowing the reepithelialization process with respiratory epithelium. CONCLUSIONS: This one-stage procedure provides a reliable construct to substitute for large tracheal defects, even in areas previously exposed to an operation or radiotherapy.
[Mh] Termos MeSH primário: Cartilagem Cricoide/cirurgia
Fáscia/transplante
Retalhos de Tecido Biológico
Microcirurgia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Traqueia/cirurgia
Estenose Traqueal/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE



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