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Brix E, Prantl L, Anker A, Klein S, Kehrer A. Free neurovascular toe-(joint)-transfers compared to alternative reconstructive procedures for amputation injuries of two and tripartite fingers with substance loss. Clin Hemorheol Microcirc 2024; 86:71-88. [PMID: 37742630 DOI: 10.3233/ch-238114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Complex injuries of the hand frequently result in loss of essential functional features. Common reconstructive procedures for soft tissue defects of the thumb or phalanges are locoregional flaps like Moberg-, Foucher-, Cross-Finger- or Littler flaps. Microneurovascular toe (joint-) transfers complete the arsenal of operative reconstructive procedures and allow for most detailed reconstructions. Our experiences with free toe transplants are reported and diversely discussed regarding contending procedures. METHODS From 2010 until 2019 14 patients who received emergency or elective partial or complete toe transfers were compared with a control group (n = 12) treated with contending reconstructive procedures. Aim of the reconstructions was to cover the defect with well-vascularized, sensate tissue, while preserving length and range of motion in a reliable manner. RESULTS The Kapandji score showed a significant difference (p- value = 0.04) with a score of 9.8 in comparison to control group (Kapandji index = 8.0). CONCLUSION In our heterogenic patient collective free toe transplants have proven to achieve comparable functional results for reconstruction of two and tripartite phalanxes as opposed to common local reconstructive procedures.
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Affiliation(s)
- E Brix
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A Anker
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S Klein
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A Kehrer
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
- Department of Plastic and Reconstructive Surgery, Ingolstadt Hospital, Ingolstadt, Germany
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Brebant V, Lemonnier L, Georgieva M, Anker A, Heine N, Seitz S, Frank K, Prantl L, Eigenberger A. Comparison of analog and digitally evaluated volume of the female breast in reconstructive breast surgery. Validation of a noninvasive measurement method with 3D camera1. Clin Hemorheol Microcirc 2023; 85:277-287. [PMID: 36502309 DOI: 10.3233/ch-229101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Reconstructive surgery is established as a standard treatment option after mastectomy due to cancer. It is crucial to patients to achieve a natural and symmetric looking breast through reconstruction. Anthropometric measurements are used to assess the objective symmetry of the breast, which are prone to errors and difficult to reproduce. OBJECTIVE The aim of this work is to validate breast volumetry using three-dimensional surface imaging. METHODS We compared preoperatively analog and digitally evaluated volume of the breast with our gold standard, direct water displacement measurement of the mastectomy specimen. We examined 34 breast specimens in total. RESULTS Each measurement method (Breast Sculptor, VAM, Breast-V) for breast volume/mass determination demonstrates acceptable agreement ranges when compared with resected volumes and masses. The strongest volumetry instrument is Breast Sculptor (digital), the weakest is Breast-V (analog). CONCLUSIONS 3D surface imaging is a quick, effective, and convenient method to evaluate breast shape and volume. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study.This takes us a step closer to the long-term goal of establishing robust instruments to plan breast reconstructive surgery, achieve better surgical results, and contribute to quality assurance in breast surgery.
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Affiliation(s)
- V Brebant
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - L Lemonnier
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - M Georgieva
- University Medical Center Regensburg, Department of Radiology, Regensburg, Germany
| | - A Anker
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - N Heine
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - S Seitz
- University Medical Center Regensburg, Department of Gynecology and Obstetrics, Caritas Hospital St. Josef, Regensburg, Germany
| | - K Frank
- Division of Hand-, Plastic- and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - L Prantl
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - A Eigenberger
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
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Wenzel C, Brix E, Heidekrueger P, Lonic D, Lamby P, Klein SM, Anker A, Taeger C, Prantl L, Kehrer A. A favorable donor site in microsurgery: Nerve and vein graft harvest from the dorsum of the foot. Clin Hemorheol Microcirc 2021; 83:1-10. [PMID: 34719482 DOI: 10.3233/ch-211135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES In complex hand traumas nerves and vessels are often destructed without the possibility for primary repair. For bridging defects of nerves, veins and arteries grafts are necessary. Commonly nerve and vein grafts from adjacent donor sites as the wrist, forearm or cubital region are harvested. METHODS This study is a retrospective cohort study. Between 2017 and 2019, 10 patients with complex hand injuries were treated. There were 8 males and 2 females, with an average age of 39 years (range 8-63 years). In all cases grafts were used of the dorsum of the foot for reconstructing of the severed digital nerves and arteries. All donor sites could be closed primarily. RESULTS In 100% of cases nerves and veins of the dorsum of the foot showed a good size match as well as adequate length for a sufficient repair. The overall Hand Injury Severity Score (HISS) was determined with a median of 86 (range 57 to 286). In the area of the donor site no relevant complications were seen. CONCLUSIONS In complex hand injuries the dorsum of the foot is a favorable donor site for nerve and vein graft harvest.
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Affiliation(s)
- C Wenzel
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - E Brix
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Heidekrueger
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - D Lonic
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Lamby
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - S M Klein
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Anker
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - C Taeger
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Kehrer
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany.,Department of Plastic and Reconstructive Surgery, Ingolstadt Hospital Ingolstadt, Ingolstadt, Germany
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Allen BL, Fawcett A, Anker A, Engeman RM, Lisle A, Leung LKP. Environmental effects are stronger than human effects on mammalian predator-prey relationships in arid Australian ecosystems. Sci Total Environ 2018; 610-611:451-461. [PMID: 28818660 DOI: 10.1016/j.scitotenv.2017.08.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 08/04/2017] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
Climate (drought, rainfall), geology (habitat availability), land use change (provision of artificial waterpoints, introduction of livestock), invasive species (competition, predation), and direct human intervention (lethal control of top-predators) have each been identified as processes driving the sustainability of threatened fauna populations. We used a systematic combination of empirical observational studies and experimental manipulations to comprehensively evaluate the effects of these process on a model endangered rodent, dusky hopping-mice (Notomys fuscus). We established a large manipulative experiment in arid Australia, and collected information from relative abundance indices, camera traps, GPS-collared dingoes (Canis familiaris) and dingo scats, along with a range of related environmental data (e.g. rainfall, habitat type, distance to artificial water etc.). We show that hopping-mice populations were most strongly influenced by geological and climatic effects of resource availability and rainfall, and not land use, invasive species, or human effects of livestock grazing, waterpoint provision, or the lethal control of dingoes. Hopping-mice distribution declined along a geological gradient of more to less available hopping-mice habitat (sand dunes), and their abundance was driven by rainfall. Hopping-mice populations fluctuated independent of livestock presence, artificial waterpoint availability or repeated lethal dingo control. Hopping-mice populations appear to be limited first by habitat availability, then by food availability, then by predation. Contemporary top-predator control practices (for protection of livestock) have little influence on hopping-mice behaviour or population dynamics. Given our inability to constrain the effects of predation across broad scales, management actions focusing on increasing available food and habitat (e.g. alteration of fire and herbivory) may have a greater chance of improving the conservation status of hopping-mice and other small mammals in arid areas. Our study also reaffirms the importance of using systematic and experimental approaches to detect true drivers of population distribution and dynamics where multiple potential drivers operate simultaneously.
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Affiliation(s)
- Benjamin L Allen
- University of Southern Queensland, Institute for Agriculture and the Environment, Toowoomba, Queensland 4350, Australia.
| | - Alana Fawcett
- University of the Sunshine Coast, Faculty of Science, Health, Education and Engineering, Sippy Downs, Queensland 4556, Australia.
| | - Alison Anker
- Robert Wicks Pest Animal Research Centre, Biosecurity Queensland, Department of Agriculture and Fisheries, Toowoomba, Queensland 4350, Australia
| | - Richard M Engeman
- National Wildlife Research Centre, US Department of Agriculture, Fort Collins, CO 8051-2154, USA.
| | - Allan Lisle
- University of Queensland, School of Agriculture and Food Sciences, Gatton, Queensland 4343, Australia.
| | - Luke K-P Leung
- University of Queensland, School of Agriculture and Food Sciences, Gatton, Queensland 4343, Australia.
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Hurt C, Silliman K, Anker A, Knowlton N. Ecological speciation in anemone-associated snapping shrimps (Alpheus armatusspecies complex). Mol Ecol 2013; 22:4532-48. [DOI: 10.1111/mec.12398] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 04/29/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- C. Hurt
- Cox Science Center; University of Miami; 1301 Memorial Drive Miami FL 33146 USA
| | - K. Silliman
- Cox Science Center; University of Miami; 1301 Memorial Drive Miami FL 33146 USA
| | - A. Anker
- Instituto de Ciências do Mar - Labomar; Universidade Federal do Ceará; Avenida da Abolição 3207 CEP 60.165-081 Fortaleza Brazil
| | - N. Knowlton
- Department of Invertebrate Zoology; National Museum of Natural History; Smithsonian Institution; MRC 163 PO Box 37012 Washington DC 20013-7012 USA
- Center for Marine Biodiversity and Conservation; Scripps Institution of Oceanography; University of California; La Jolla San Diego CA 92093-0202 USA
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Cai Y, Anker A. On a collection of freshwater shrimps (Crustacea Decapoda Caridea) from the Philippines, with descriptions of five new species. Tropical Zoology 2004. [DOI: 10.1080/03946975.2004.10531207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Defects in the skull have presented difficult reconstructive problems. Recently glass-ionomer cement and preformed. implants have been used to repair bony defects in the skull base and in cranio-facial surgery. Three patients are reported to illustrate possible applications for this new material. METHODS Ionocap cement and Ionoroc-skull standardized implants have been used. The cement is available as a two component blister pack. When mixed and blended a gel is produced which can be worked for approximately 5 min before hardening. It can then be contoured and drilled to the required shape. The resultant material is biocompatible and biostable, is non-toxic and permanently bonds to bone with no increase in temperature or shrinkage. RESULTS The material has been used to fill the temporal defect left by transplantation of the temporalis muscle for oral reconstruction, the anterior and lateral walls of the maxilla and following craniofacial resection, the posterior wall of the frontal sinus and anterior skull base. CONCLUSIONS Three patients with different reconstructive problems have been presented to illustrate the use of an alloplastic material that has a tensile strength similar to bone and firmly adheres to it. The material was found to be safe and easy to use. All three patients have now been followed for 12 months with no adverse affects.
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Affiliation(s)
- I Cole
- Department of Otolaryngology, Head & Neck and Facio-Maxillary Surgery, Sutherland Hospital, Caringbah, Sydney, Australia
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Anker A. Möglichkeiten der continuirlichen hybridisation in der schweinezucht. Genetics Selection Evolution 1976. [PMCID: PMC2764610 DOI: 10.1186/1297-9686-8-2-299a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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