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Mahé M, Bosc R, Loganadane V G, Grellier N, Billon R, Dao TH, Debbi K, Ouidir N, Schwall C, To NH, Beaussart P, Cherif MA, Assaf E, Li X, Wang S, Rida H, Werkoff G, Boukhobza C, Hersant B, Belkacemi Y. Impact of Post-Mastectomy Radiotherapy on Cosmesis and Quality of Life after Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Single Institution Experience. Int J Radiat Oncol Biol Phys 2023; 117:e192. [PMID: 37784830 DOI: 10.1016/j.ijrobp.2023.06.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Immediate breast reconstruction (IBR) yields better cosmetic results and reduce psychological distress than delayed (DBR). Literature data showed better local cosmesis after reconstruction autologous flaps than prothesis. Our aim is to compare cosmetic results and quality of life (QoL) after PMRT delivered either after IBR or DBR with DIEP flap. MATERIALS/METHODS We reviewed files of 99 patients (100 DIEPs) treated in our department from January 2000 to December 2019. Patients were divided into 2 groups depending on the treatment sequence: IBR (n = 22) versus DBR (n = 78) followed by PMRT. All the patients had their DIEP flap by the same surgical team. All patients had cosmetic evaluation using Harvard/RTOG cosmesis grading scale. Fifty percent (32 in IBR and 14 in DBR group) of the patients responded to the QoL evaluation using auto questionnaires and BREAST-Q to evaluate breast specific HRQoL and satisfaction. The analysis of cosmetic scores was carried out with a Chi2 test and the analysis of QoL scores with a student test. Kaplan Meier (log-rank test) is used for recurrence-free and overall survival. RESULTS Median follow-up was 56 months. Median age of the patients was 48 (28-71). In terms of disease stage: T1-2 (52%), N0 (38%). 86% of the patients had chemotherapy either in neo-adjuvant (26%) or adjuvant (60%) settings. Radiation therapy (RT) delivered a total dose ranged between 45 Gy and 50 Gy using 1.8-2.5 Gy/per fraction. Supra-clavicular and internal mammary chain irradiation was performed in 67% and 33% of the patients respectively. After surgery, 15% had post-operative complications such as DIEP necrosis (n = 8) that delayed RT delivery. Among the 99 patients, 3 died from metastatic evolution and were not included in the cosmetic and QoL analyses. Local recurrence rate was slightly higher after DBR (12.5%) as compared to IBR (3.8%). Loco-regional and metastatic recurrence rates were 4.5% and 4.5% after IBR versus 1.3% and 9% after DBR (p = NS). Disease free and overall survival were 88% and 98% at 5y and 66% and 96% at 10y.Good-to-excellent results were observed in 57% in the IBR vs 67% in the DBR (p = 0.92). There was no impact of previous chemotherapy (p = 0.21), tobacco use at diagnosis (p = 0.27), diabetes (p = 0.86), RT timing (p = 0.53) and endocrine therapy administration (p = 0.67). QoL was evaluated with the BREAST-Q self-evaluation for 5 post operative items: psycho-social, physical, sexual well-being and satisfaction with breast and global cosmetic results. Out of the 99 patients, 46% had responded to the QoL evaluation. We found no statistical difference between the two groups for all the BREAST-Q evaluation items. CONCLUSION Our center is considered expert for DIEP reconstructions since its development in end of the nineties. Our data showed no impact PMRT using conventional fractionation (with mainly 1.8 Gy/fraction) on cosmetic results, QoL, and patients' satisfaction regardless of the timing of the breast reconstruction. Additional studies are in progress with updates.
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Affiliation(s)
- M Mahé
- Hopital Henri Mondor, Créteil, France
| | - R Bosc
- AP-HP. Department of Plastic Surgery and Henri Mondor Breast Center. University of Paris-Est (UPEC), Créteil, France
| | - G Loganadane V
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - N Grellier
- AP-HP. Department of Radiation Oncology. Henri Mondor University Hospital. University of Paris-Est (UPEC), Creteil, France
| | - R Billon
- Hopital Henri Mondor, Créteil, France
| | - T H Dao
- Hopital Henri Mondor, Créteil, France
| | - K Debbi
- AP-HP. Department of Radiation Oncology. Henri Mondor University Hospital. University of Paris-Est (UPEC), Creteil, France
| | - N Ouidir
- Hopital Henri Mondor, Créteil, France
| | - C Schwall
- Hopital Henri Mondor, Créteil, France
| | - N H To
- AP-HP. Department of Radiation Oncology. Henri Mondor University Hospital. University of Paris-Est (UPEC), Creteil, France
| | | | | | - E Assaf
- Hopital Henri Mondor, Créteil, France
| | - X Li
- Department of Radiation Oncology for Gynecologic Tumors, Anti-Cancer Center and Tumor Hospital of the Xinjiang Medical University, Urumqi, China
| | - S Wang
- University of Nebraska Medical Center, Omaha, NE
| | - H Rida
- Hopital Henri Mondor, Créteil, France
| | - G Werkoff
- Hopital Henri Mondor, Créteil, France
| | | | - B Hersant
- Hopital Henri Mondor, Créteil, France
| | - Y Belkacemi
- APHP. Radiation Oncology Department and Henri Mondor Breast Center. Henri Mondor University Hospital. University of Paris East Creteil (UPEC). INSERM U955 (i-Biot), IMRB, Créteil, France
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Botter C, Favier A, Aubry G, Canlorbe G, Méningaud JP, Belghiti J, Hersant B. [How I do…to repair posterior perineal tissue loss with a posterior vaginal mucosa flap after vulvectomy]. Gynecol Obstet Fertil Senol 2022; 50:333-337. [PMID: 34871787 DOI: 10.1016/j.gofs.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 06/13/2023]
Affiliation(s)
- C Botter
- Department of maxillofacial and plastic, reconstructive, and aesthetic surgery, Henri-Mondor hospital, Créteil, France
| | - A Favier
- Department of gynecological and breast surgery and oncology, Pitié-Salpêtrière university hospital, Paris, France.
| | - G Aubry
- Department of gynecological and breast surgery and oncology, Pitié-Salpêtrière university hospital, Paris, France
| | - G Canlorbe
- Department of gynecological and breast surgery and oncology, Pitié-Salpêtrière university hospital, Paris, France
| | - J-P Méningaud
- Department of maxillofacial and plastic, reconstructive, and aesthetic surgery, Henri-Mondor hospital, Créteil, France
| | - J Belghiti
- Department of gynecological and breast surgery and oncology, Pitié-Salpêtrière university hospital, Paris, France
| | - B Hersant
- Department of maxillofacial and plastic, reconstructive, and aesthetic surgery, Henri-Mondor hospital, Créteil, France
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Mongereau M, Hua C, Hersant B, Bosc R, Woerther P, Champy C, De Angelis N, Tomberli F, De Prost N, Chosidow O. Fasciites nécrosantes abdomino-périnéales (gangrènes de Fournier) : étude rétrospective monocentrique de 52 patients incluant la recherche d’une porte d’entrée à moyen terme. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sawan D, Bosc R, La Padula S, Leblanc E, Narducci F, Touboul C, Meningaud JP, Hersant B. Immediate vaginal reconstruction following pelvic exenteration using the pedicled vertical Deep Inferior Epigastric Perforator (DIEP) flap: A technical note. Ann Chir Plast Esthet 2020. [PMID: 32536474 DOI: 10.1016/j.anplas.2019.09.004.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
Abstract
Immediate vaginal reconstruction is usually offered following pelvic exenteration for recurrent cervical cancer in women previously treated with radiotherapy or with severe radiation-induced fistulae. Introduction of muscle-sparing flaps, such as the pedicled vertical deep inferior epigastric perforator (DIEP) flap, provides viable tissues for vaginal reconstruction and is associated with reduced donor-site morbidity. This report describes the surgical technique, which is one of the procedures of choice for vaginal reconstruction. It is safe and beneficial, especially for women with gynecologic cancer who have undergone pelvic exenteration after failed radiation therapy.
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Affiliation(s)
- D Sawan
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France.
| | - R Bosc
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - S La Padula
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - E Leblanc
- Department of Surgical Oncology, Oscar Lambret, 59000 Lille, France
| | - F Narducci
- Department of Surgical Oncology, Oscar Lambret, 59000 Lille, France
| | - C Touboul
- Intercommunal Hospital Center of Creteil, 94000 Créteil, France
| | - J-P Meningaud
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - B Hersant
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
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Sawan D, Bosc R, La Padula S, Leblanc E, Narducci F, Touboul C, Meningaud JP, Hersant B. Immediate vaginal reconstruction following pelvic exenteration using the pedicled vertical Deep Inferior Epigastric Perforator (DIEP) flap: A technical note. ANN CHIR PLAST ESTH 2020; 65:e1-e5. [PMID: 32536474 DOI: 10.1016/j.anplas.2019.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/26/2019] [Indexed: 10/24/2022]
Abstract
Immediate vaginal reconstruction is usually offered following pelvic exenteration for recurrent cervical cancer in women previously treated with radiotherapy or with severe radiation-induced fistulae. Introduction of muscle-sparing flaps, such as the pedicled vertical deep inferior epigastric perforator (DIEP) flap, provides viable tissues for vaginal reconstruction and is associated with reduced donor-site morbidity. This report describes the surgical technique, which is one of the procedures of choice for vaginal reconstruction. It is safe and beneficial, especially for women with gynecologic cancer who have undergone pelvic exenteration after failed radiation therapy.
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Affiliation(s)
- D Sawan
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France.
| | - R Bosc
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - S La Padula
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - E Leblanc
- Department of Surgical Oncology, Oscar Lambret, 59000 Lille, France
| | - F Narducci
- Department of Surgical Oncology, Oscar Lambret, 59000 Lille, France
| | - C Touboul
- Intercommunal Hospital Center of Creteil, 94000 Créteil, France
| | - J-P Meningaud
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
| | - B Hersant
- Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri-Mondor University Hospital, 94000 Créteil, France
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Jafari M, Schneider-Bordat L, Hersant B. Biological mesh used to repair perineal hernias following abdominoperineal resection for anorectal cancer. ANN CHIR PLAST ESTH 2020; 65:e15-e21. [PMID: 32517871 DOI: 10.1016/j.anplas.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 07/25/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aimed to determine the outcome for patients who had undergone perineal hernia repair, via a perineal approach, using a biological mesh post-abdominoperineal excision (APE) for anorectal cancer. METHOD All consecutive patients having undergone perineal hernia repair involving an extracellular matrix of porcine small intestinal submucosa at our hospital between 2015 and 2018 were included. Follow-up clinical examinations and computed tomography scans were performed. RESULTS Six patients were treated surgically for symptomatic perineal hernia after a median of 31 months from APE. The median follow-up after hernia repair was 11 months (interquartile range [IQR], 6-35 months). Three patients (50%) developed a recurrent perineal hernia after a median interval of 6 months. CONCLUSION Perineal hernia repair using a biological mesh resulted in a high recurrence rate in patients who had undergone APE for anorectal cancer.
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Affiliation(s)
- M Jafari
- Service de chirurgie oncologique, centre Oscar-Lambret, 3, rue Combemale, 59020 Lille cedex, France.
| | - L Schneider-Bordat
- Service de chirurgie oncologique, centre Oscar-Lambret, 3, rue Combemale, 59020 Lille cedex, France
| | - B Hersant
- Service de chirurgie plastique, reconstructrice, esthétique, et maxillo-faciale, hôpitaux universitaires Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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Hersant B, Werkoff G, Sawan D, Sidahmed-Mezi M, Bosc R, La Padula S, Kalsoum S, Ouidir N, Meningaud JP, Belkacemi Y. Carbon dioxide laser treatment for vulvovaginal atrophy in women treated for breast cancer: Preliminary results of the feasibility EPIONE trial. ANN CHIR PLAST ESTH 2020; 65:e23-e31. [PMID: 32513482 DOI: 10.1016/j.anplas.2020.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/28/2020] [Accepted: 05/10/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Quality of life preservation after anti-cancer therapy is a major challenge for breast cancer survivors. Approximately 42-70% of patients who receive systemic therapy for breast cancer, including endocrine therapy, will develop vulvovaginal atrophy (VVA). For these patients, the commonly proposed gel-based treatments for topical applications are restrictive. Recently, innovative, non-hormonal therapeutic approaches, such as laser therapy, have emerged. The purpose of this feasibility study is to investigate the safety and efficacy of CO2 laser therapy in women with a history of breast cancer. MATERIAL AND METHODS This prospective monocentric study included 20 patients with vulvovaginal atrophy who were treated at Henri Mondor University Hospital between 2017 and 2018. We included patients with a vaginal health index (VHI) score<15 and a contraindication for hormone administration due to a history of breast cancer. Two carbon dioxide laser sessions were used. The treatment was delivered using the following settings: vaginal tightening, FinePulse (pulse width 0.9ms), and energy density of 11.5J/cm2 that allows coverage of 70% of the targeted vaginal area to be treated. All patients had their follow-up visit at one (M1), three (M3), and six (M6) months after the first treatment to evaluate efficacy of the treatment on vulvovaginal atrophy. Vaginal health index score and female sexual distress (FSD) score were used to assess treatment efficacy and its impact on sexual quality of life. A score≥11 was associated with sexual dysfunction. The vaginal health index and female sexual distress scores were evaluated at baseline, M1, M3, and M6 of follow-up. RESULTS The mean age of the patients was 56.1±8.8 years (range, 27-69 years). Seventeen of the 20 patients had experienced menopause (mean menopausal age, 51.25±1.5 years). At inclusion, the mean vaginal health index and the female sexual distress scores were 10.58±1.71 and 21.36±15.10, respectively. Fourteen out of 20 patients (70%) had FSD scores≥11 at the baseline. At M1, the mean vaginal health index score increased significantly to 13.42±2.3 (P=0.03), which represented an improvement of 21% from the baseline. A persistent and significant improvement in the vaginal health index score was observed at M6, with the score increasing to 16.75±4.23 post-treatment (P<0.0001), representing a 34% improvement from the mean baseline score. The mean female sexual distress at M1 was 19.83±13.57, representing a 7% decrease compared to the baseline scores (P<0.01). At M3, the female sexual distress significantly decreased to 13.88±15.58, representing an improvement of 35% (P=0.006). It increased to 10.35±14.7 at M6, representing an improvement of 52% (P=0.001). At M3, 35% of the patients had a female sexual distress score>11, and at M6, only 15% had a female sexual distress score>11. No side effects were reported during follow-up. CONCLUSION This pilot feasibility study showed that carbon dioxide laser treatment appears to be an effective and safe method to improve the trophicity and decrease vaginal mucosal dryness in women with vulvovaginal atrophy that developed after systemic breast cancer therapy.
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Affiliation(s)
- B Hersant
- Henri-Mondor Breast Center, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; University of Paris East Creteil (UPEC), Créteil, France.
| | - G Werkoff
- Henri-Mondor Breast Center, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Gynecological Surgery Department, Bégin Army Teaching Hospital, 69, avenue de Paris, 94160 Saint-Mandé, France
| | - D Sawan
- Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - M Sidahmed-Mezi
- Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - R Bosc
- Henri-Mondor Breast Center, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; University of Paris East Creteil (UPEC), Créteil, France
| | - S La Padula
- Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - S Kalsoum
- Department of Pathology, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - N Ouidir
- Department of Pathology, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - J-P Meningaud
- Henri-Mondor Breast Center, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Department of Maxillofacial Surgery, Plastic and Reconstructive, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; University of Paris East Creteil (UPEC), Créteil, France
| | - Y Belkacemi
- Henri-Mondor Breast Center, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Department of Radiation Oncology, hôpitaux universitaires Henri-Mondor, 51, avenue Marechal de Lattre de Tassigny, 94010 Créteil, France; Inserm Unit 955, Team 21, IMRB, Créteil, France; University of Paris East Creteil (UPEC), Créteil, France
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Uzan C, Marchand F, Schmidt M, Meningaud JP, Hersant B. Clitoral reduction: Technical note. ANN CHIR PLAST ESTH 2020; 65:e7-e13. [PMID: 32482351 DOI: 10.1016/j.anplas.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/30/2019] [Accepted: 10/10/2019] [Indexed: 11/29/2022]
Abstract
Clitoral hypertrophy is a rare genital malformation that can be congenital or acquired. In congenital forms, the most common cause is adrenal hyperplasia. The acquired forms are caused by endocrinological diseases, benign tumours or cysts. Idiopathic clitoral hypertrophies can be detected after the elimination of secondary causes. A complete assessment is needed to treat the origin of clitoridomegaly. The hypertrophy is often increased or unmasked during sexual arousal with the appearance of a true vulvar appendage in erection. It is often accompanied by a hypertrophy of the clitoral hood and can cause psychological suffering with an impact on the quality of sexual life. When the cause of clitoral hypertrophy is diagnosed, treated or stabilized, the plastic surgeon may be called upon for surgical correction. Reconstructive surgery in this area has evolved considerably since the historical clitoral amputations which led to the current technique of partial resection with sparing the dorsal neurovascular pedicle of the clitoris as described by Professor Paniel. We propose a modified conservative technique to treat clitoral hypertrophy and the clitoral hood and present two clinical cases: ventral reduction clitoridoplasty with preservation of the neurovascular pedicle associated with a chevron plasty of the clitoral hood and a lipofilling of the labia majora. The postoperative follow-up is simple with reports of great satisfaction from patients regarding their quality of life.
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Affiliation(s)
- C Uzan
- Department of Maxillofacial and Plastic & Reconstructive Surgery Henri-Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
| | - F Marchand
- Department of Maxillofacial and Plastic & Reconstructive Surgery Henri-Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - M Schmidt
- Department of Maxillofacial and Plastic & Reconstructive Surgery Henri-Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Department of Maxillofacial and Plastic & Reconstructive Surgery Henri-Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - B Hersant
- Department of Maxillofacial and Plastic & Reconstructive Surgery Henri-Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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Fertitta L, Hotz C, Wolkenstein P, Méningaud JP, Sawan D, Hersant B, Sbidian E. Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2019; 34:839-845. [PMID: 31799758 DOI: 10.1111/jdv.16135] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/20/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Surgery is a radical treatment for hidradenitis suppurativa (HS) and may be considered as the only one potentially curative. OBJECTIVES To characterize HS recurrence in patients after surgery and assess the risk factors of recurrence. METHODS We conducted a monocentric retrospective cohort study. All consecutive patients who had surgery (January 1, 2012 to March 31, 2017) were included. We estimated the rate of recurrence of HS lesions after surgery (<1 cm from the scar), and recurrence-associated factors were analysed by univariate then multivariate logistic regression, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 75 patients [median age 31.4 years (range 16-71); 36 females], corresponding to 115 interventions were included. The Hurley score at surgery was III for 70 (60%) patients. In total, 61/115 (53%) interventions involved wide excision and 50 (43%) limited local excision. The localizations were axillary folds (n = 46; 40%), buttocks (n = 15, 13%), genital area (n = 13; 11%), perineal area (n = 12; 10%) and inguinal folds (n = 18; 16%). We observed 11 (10%) complications and 40 (35%) recurrences. On multivariate analysis, probability of recurrence was associated with only one-stage surgical closure [OR 3.2 (95% CI 1.4-7.3), P = 0.005]. Overall, 44 (52%) patients were completely satisfied and 22 (26%) partially satisfied, and most (81%) considered the surgery the best treatment. CONCLUSIONS Hidradenitis suppurativa recurrence in our study was 35% and associated with one-stage surgical closures, but two-thirds of patients were satisfied with surgical treatment and would recommend surgery.
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Affiliation(s)
- L Fertitta
- Department of Dermatology, Hôpital Henri Mondor, Creteil, France
| | - C Hotz
- Department of Dermatology, Hôpital Henri Mondor, Creteil, France
| | - P Wolkenstein
- Department of Dermatology, Hôpital Henri Mondor, Creteil, France
| | - J P Méningaud
- Department of Plastic Surgery, Hôpital Henri Mondor, Creteil, France
| | - D Sawan
- Department of Plastic Surgery, Hôpital Henri Mondor, Creteil, France
| | - B Hersant
- Department of Plastic Surgery, Hôpital Henri Mondor, Creteil, France
| | - E Sbidian
- Department of Dermatology, Hôpital Henri Mondor, Creteil, France
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Orvain C, Lin YL, Jean-Louis F, Hocini H, Hersant B, Bennasser Y, Ortonne N, Hotz C, Wolkenstein P, Boniotto M, Tisserand P, Lefebvre C, Lelièvre JD, Benkirane M, Pasero P, Levy Y, Hüe S. Un stress réplicatif spontané des cellules souches du follicule pileux serait à l’origine de l’inflammation dans l’hidradénite suppurée. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maria S, Hersant B, Belghiti J, Azaïs H, Gonthier C, Nikpayam M, Etienne M, Bézu C, Uzan C, Canlorbe G. [How I do…a V-Y flap for vulvar reconstruction]. ACTA ACUST UNITED AC 2019; 47:757-760. [PMID: 31421284 DOI: 10.1016/j.gofs.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Indexed: 11/25/2022]
Affiliation(s)
- S Maria
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - B Hersant
- Service de chirurgie maxillo-faciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J Belghiti
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - H Azaïs
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France; Sorbonne université,15-21, rue de l'École de médecine, 75006 Paris, France.
| | - C Gonthier
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - M Nikpayam
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - M Etienne
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - C Bézu
- Service de gynécologie obstétrique, hôpitaux universitaires Pitié Salpêtrière, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - C Uzan
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France; Sorbonne université,15-21, rue de l'École de médecine, 75006 Paris, France
| | - G Canlorbe
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France; Sorbonne université,15-21, rue de l'École de médecine, 75006 Paris, France.
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Haiun M, Cardon-Fréville L, Picard F, Meningaud JP, Hersant B. [Peculiarities of botulinum toxin injections for the aesthetic treatment of men's face. A review of the literature]. ANN CHIR PLAST ESTH 2019; 64:259-265. [PMID: 31005350 DOI: 10.1016/j.anplas.2019.03.002] [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] [Received: 11/06/2018] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Botulinum toxin injections in aesthetic medicine are the most widely used products, ahead of hyaluronic acid, and aesthetic medicine is constantly increasing, including in the male population. The objective of this development was to show the specificities described in the literature concerning botulinum toxin injections in men. MATERIAL AND METHOD A systematic literature search was carried out using the Pubmed search engine. Data were then collected to determine the specificities of botulinum toxin injections in men according to the morphology of the male face and the wishes of these patients. RESULTS The studies conducted show that it is necessary to inject higher doses in men than in women to obtain a satisfactory result, due to a higher muscle mass. This adjustment gives the number of points to be performed per injection site, as well as the number of points to be performed, compared to the female population. CONCLUSION Botulinum toxin injections for aesthetic purposes in men are different from those in women. Taking these particularities into account is essential to patient satisfaction.
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Affiliation(s)
- M Haiun
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
| | - L Cardon-Fréville
- Service de chirurgie plastique, reconstructrice et esthétique, 2, rue Louis-Maurel, 13006 Marseille, France
| | - F Picard
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - J-P Meningaud
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - B Hersant
- Service de chirurgie plastique, reconstructrice et esthétique, et chirurgie maxillofaciale, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
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Belhadia M, Narducci F, Leblanc E, Borghesi Y, Boukerrou M, Hersant B. [How I do… to use indocyanine green to check the flap viability in vaginal reconstruction]. ACTA ACUST UNITED AC 2019; 47:484-486. [PMID: 30818040 DOI: 10.1016/j.gofs.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Indexed: 11/17/2022]
Affiliation(s)
- M Belhadia
- Service de cancérologie gynécologique, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France.
| | - F Narducci
- Service de cancérologie gynécologique, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France
| | - E Leblanc
- Service de cancérologie gynécologique, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France
| | - Y Borghesi
- Service de cancérologie gynécologique, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France
| | - M Boukerrou
- Department of Gynecology and Obstetrics, University Hospital of South Reunion Island, BP 350, 97448 Saint Pierre cedex, Réunion; Faculty of Medicine - University of Réunion, 97490 St Denis, Réunion; CEPOI, Perinatal Center of Study of the Indian Ocean, University Hospital of South Reunion Island, Faculty of medicine, St Pierre 97448, Réunion
| | - B Hersant
- Service de cancérologie gynécologique, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France; Department of plastic and reconstructive surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, Créteil 94010, France
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Bosc R, Fitoussi A, Hersant B, Dao TH, Meningaud JP. Intraoperative augmented reality with heads-up displays in maxillofacial surgery: a systematic review of the literature and a classification of relevant technologies. Int J Oral Maxillofac Surg 2019; 48:132-139. [DOI: 10.1016/j.ijom.2018.09.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/16/2018] [Accepted: 09/24/2018] [Indexed: 12/30/2022]
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La Padula S, Hersant B, Meningaud J, D’Andrea F. Use of autologous fat graft and fractiononal co2 laser to optimize the aesthetic and functional results in patients with severe burn outcomes of the face. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:279-283. [DOI: 10.1016/j.jormas.2018.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/12/2018] [Indexed: 11/30/2022]
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Ganry L, Hersant B, Bosc R, Leyder P, Quilichini J, Meningaud J. Study of medical education in 3D surgical modeling by surgeons with free open-source software: Example of mandibular reconstruction with fibula free flap and creation of its surgical guides. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:262-267. [DOI: 10.1016/j.jormas.2018.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/15/2018] [Accepted: 02/21/2018] [Indexed: 11/29/2022]
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Boulanger L, SidAhmed-Mezi M, Dhollande A, Bouhassira J, Meningaud JP, Chauvet MP, Hersant B. [How I do…for the surgical management of gestational gigantomastia]. ACTA ACUST UNITED AC 2018; 46:550-554. [PMID: 29776839 DOI: 10.1016/j.gofs.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Indexed: 11/24/2022]
Affiliation(s)
- L Boulanger
- Service de chirurgie sénologique, centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France
| | - M SidAhmed-Mezi
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - A Dhollande
- Pôle femme mère nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France
| | - J Bouhassira
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - M-P Chauvet
- Service de chirurgie sénologique, centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France
| | - B Hersant
- Service de chirurgie sénologique, centre Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille, France; Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
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La Padula S, Billon R, Schonauer F, D'Andrea F, Noel W, Belkacémi Y, Bosc R, Hersant B, Meningaud JP. Skin-reducing oncoplasty: A new concept and classification in breast cancer surgery. ANN CHIR PLAST ESTH 2018; 63:285-293. [PMID: 29566954 DOI: 10.1016/j.anplas.2018.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 02/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Breast-conserving surgery and skin-sparing mastectomy are nowadays widely accepted as the standard of care in selected patients with early breast cancer. After an accurate review of the literature, it appeared that no ordered list of the numerous techniques described for conservative breast surgery has been established so far. The aim of this study was to develop a simple classification of the different skin incision patterns that may be used in breast surgery. METHODS A systematic review of the English literature was conducted using the PubMed database to identify all the articles reporting breast-conserving surgery and skin-sparring mastectomy techniques up to the 31st of December 2016. RESULTS Among the 1426 titles identified, 230 were selected for review. Based on the reviewed papers, the skin-reducing oncoplasty incision pattern (SROIP) classification was elaborated. CONCLUSIONS Breast cancer surgery should nowadays optimise aesthetic outcomes by improving the final breast shape, volume and scar location. This may be achieved using different procedures that we grouped together under the term skin-reducing oncoplasty (SRO). Depending on the breast cancer location, the SROIP classification helps in the choice of the best technique to be used.
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Affiliation(s)
- S La Padula
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - R Billon
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - F Schonauer
- Department of plastic, reconstructive and aesthetic surgery, university of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - F D'Andrea
- Department of plastic, reconstructive and aesthetic surgery, university of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - W Noel
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Y Belkacémi
- Radiation oncology department, GH Henri-Mondor Breast center, university Paris-East Créteil (UPEC), AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - R Bosc
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Department of plastic, reconstructive aesthetic and maxillofacial surgery, Henri-Mondor hospital, université Paris Est Créteil (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Ganry L, Hersant B, Sidahmed-Mezi M, Dhonneur G, Meningaud JP. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery. J Stomatol Oral Maxillofac Surg 2018; 119:257-261. [PMID: 29317347 DOI: 10.1016/j.jormas.2017.12.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/28/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Preoperative anxiety may lead to medical and surgical complications, behavioral problems and emotional distress. The most common means of prevention are based on using medication and, more recently, hypnosis. The aim of our study was to determine whether a virtual reality (VR) program presenting natural scenes could be part of a new therapy to reduce patients' preoperative anxiety. MATERIALS AND METHODS Our prospective pilot study consisted of a single-blind trial in skin cancer surgery at the Henri-Mondor teaching hospital in France. In the outpatient surgery department, 20 patients with a score of >11 on the Amsterdam preoperative anxiety and information scale (APAIS) were virtually immersed into a natural universe for 5minutes. Their stress levels were assessed before and after this experience by making use of a visual analog scale (VAS), by measuring salivary cortisol levels, and by determining physiological stress based on heart coherence scores. RESULTS The VAS score was significantly reduced after the simulation (P<0.009) as was the level of salivary cortisol (P<0.04). Heart coherence scores remained unchanged (P=0.056). DISCUSSION VR allows patients to be immersed in a relaxing, peaceful environment. It represents a non-invasive way to reduce preoperative stress levels with no side effects and no need for additional medical or paramedical staff. Our results indicate that VR may provide an effective complementary technique to manage stress in surgery patients. Randomized trials are necessary to determine precise methods and benefits.
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Affiliation(s)
- L Ganry
- Department of maxillofacial, plastic, reconstructive and aesthetic surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - B Hersant
- Department of maxillofacial, plastic, reconstructive and aesthetic surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - M Sidahmed-Mezi
- Department of maxillofacial, plastic, reconstructive and aesthetic surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - G Dhonneur
- Surgical intensive care unit, trauma center, department of anesthesiology and critical care medicine, université Paris-Est Créteil, Assistance publique-Hôpitaux de Paris, Henri-Mondor Hospital, 94010 Créteil, France
| | - J P Meningaud
- Department of maxillofacial, plastic, reconstructive and aesthetic surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Rem K, Bosc R, De Kermadec H, Hersant B, Meningaud JP. Ostéotomies fibulaires et mandibulaires en marche d’escalier. Comment réaliser ses propres guides de coupe pour les reconstructions maxillofaciales ? ANN CHIR PLAST ESTH 2017; 62:652-658. [DOI: 10.1016/j.anplas.2017.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
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21
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Fertitta L, Orvain C, Kervevan J, Hotz C, Jean-Louis F, Aguilar P, Hersant B, Bosc R, Wolkenstein P, Lelievre JD, Boniotto M, Hüe S. Hidradénite suppurée : infiltration de cellules dendritiques plasmacytoïdes dans les lésions. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Khoshim K, Hersant B, Hotz C, SidAhmed-Mezi M, Meningaud JP. Wound healing of cutaneous substance losses based on infectious, inflammatory and traumatic skin disorders: The experience of a center. ANN CHIR PLAST ESTH 2017; 63:330-337. [PMID: 29239728 DOI: 10.1016/j.anplas.2017.10.009] [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] [Received: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is no reference available concerning the standard healing time based on dermatological diseases responsible for cutaneous substance losses. The aim of our study was to assess the healing time after surgical debridement of necrotizing fasciitis (NF), hidradenitis suppurativa (HS) and skin necrosis due to trauma (SNT) based on multiples existing co-morbidities among these patients to provide surgeons with accurate scientific data in order to inform and educate patients and nurses who are practicing care under the supervision of the surgeon. MATERIALS AND METHODS This was a retrospective study. The primary endpoint was the time for complete wound healing, which was calculated from the time of the last surgical procedure to the complete wound healing corresponding to the time of complete reepithelialization, when daily dressings were no longer needed. RESULTS A total of 107 patients were included. The mean time for complete wound healing was 64.94±31.55 days in patients with NF, 45.70±21.40 days in patients with SNT and 75.02±26.41 days in patients with HS (SNT versus NF, P=0.004** and SNT versus HS, P<0.0001**). CONCLUSION The mean time for complete wound healing was 64.94 days in patients with NF, 45.70 days in patients with SNT, 75.02 days in patients with HS. This study can be considered as a referential based on the experience of a reference centre for these 3 pathologies (NF, HS, and SNT) whose aim is to inform plastic surgeons in order to anticipate the management or educate the patient.
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Affiliation(s)
- K Khoshim
- Département de chirurgie plastique et reconstructrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Département de chirurgie plastique et reconstructrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - C Hotz
- Départementde dermatologie, hôpital Henri-Mondor, université Paris-Est, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - M SidAhmed-Mezi
- Département de chirurgie plastique et reconstructrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Département de chirurgie plastique et reconstructrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Picard F, Hersant B, Niddam J, Meningaud JP. Injections of platelet-rich plasma for androgenic alopecia: A systematic review. Journal of Stomatology, Oral and Maxillofacial Surgery 2017; 118:291-297. [DOI: 10.1016/j.jormas.2017.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/25/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
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Ganry L, Quilichini J, Bandini C, Leyder P, Hersant B, Meningaud J. Three-dimensional surgical modelling with an open-source software protocol: study of precision and reproducibility in mandibular reconstruction with the fibula free flap. Int J Oral Maxillofac Surg 2017; 46:946-957. [DOI: 10.1016/j.ijom.2017.02.1276] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/09/2017] [Accepted: 02/28/2017] [Indexed: 11/29/2022]
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Niddam J, Hersant B, Meningaud JP. Aesthetic outcomes of liposuction after breast reconstruction using exclusive fat grafting. J Plast Reconstr Aesthet Surg 2017; 70:1782-1784. [PMID: 28743587 DOI: 10.1016/j.bjps.2017.06.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 06/19/2017] [Accepted: 06/25/2017] [Indexed: 11/27/2022]
Affiliation(s)
- J Niddam
- Department of Maxillo-facial and Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Paris-Est University, Créteil, France.
| | - B Hersant
- Department of Maxillo-facial and Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Paris-Est University, Créteil, France
| | - J P Meningaud
- Department of Maxillo-facial and Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Paris-Est University, Créteil, France
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Contou D, Lecronier M, Bitot V, Hersant B, Zakine A, Hua C, de Prost N. Fatal Clostridium septicum multifocal myonecrosis in a previously healthy 25-year-old man: Role of NSAIDs? Med Mal Infect 2017; 47:432-434. [PMID: 28705640 DOI: 10.1016/j.medmal.2017.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/03/2017] [Accepted: 06/13/2017] [Indexed: 10/19/2022]
Affiliation(s)
- D Contou
- Service de réanimation médicale, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; UPEC-Université Paris-Est Créteil Val de Marne, faculté de médecine de Créteil, CARMAS Research Group, 94010 Créteil, France.
| | - M Lecronier
- Service de réanimation médicale, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - V Bitot
- Service d'anesthésiologie et réanimation chirurgicale, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - B Hersant
- Service de chirurgie plastique, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - A Zakine
- Service des urgences, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - C Hua
- Service de dermatologie, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - N de Prost
- Service de réanimation médicale, groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; UPEC-Université Paris-Est Créteil Val de Marne, faculté de médecine de Créteil, CARMAS Research Group, 94010 Créteil, France
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Chatel H, Hersant B, Bosc R, La Padula S, Meningaud JP. Midface rejuvenation surgery combining preperiosteal midcheek lift, lower blepharoplasty with orbital fat preservation and autologous fat grafting. J Stomatol Oral Maxillofac Surg 2017; 118:283-288. [PMID: 28684338 DOI: 10.1016/j.jormas.2017.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 02/07/2017] [Revised: 05/30/2017] [Accepted: 06/26/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to describe a technique for midface rejuvenation combining lower blepharoplasty, midcheek lift and autologous fat transfer. METHODS All patients who underwent a midface rejuvenation procedure performed by the same surgeon and using a classic subciliary blepharoplasty surgical approach were identified. The technique combined three distinct procedures: lower blepharoplasty with use of a transposition flap of orbital adipose tissue in the medial and central compartment to reduce the subpalpebral bags and attenuate the palpebrojugual sulcus; midcheek lift in the preperiosteal plane with trans-osseous fixation exerting traction on the soft tissues of the cheek along several vectors; autologous fat transfer to offset the loss of volume in the target area. RESULTS Between January 2011 and December 2015, 14 patients were operated with the described technique. Long-term results were good and stable over time. Two complications in the form of ectropion were observed in the series but resolved with daily massages. CONCLUSIONS The combination of lower blepharoplasty, midcheek lift and autologous fat transfer appear to enable treatment of midface ageing. The results were satisfactory and durable, and the procedure was well tolerated. The procedures could be combined with others for the treatment of the upper and lower face during the same surgical procedure.
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Affiliation(s)
- H Chatel
- Department of Plastic, Reconstructive and Maxillo-facial Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Department of Plastic, Reconstructive and Maxillo-facial Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - R Bosc
- Department of Plastic, Reconstructive and Maxillo-facial Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - S La Padula
- Department of Plastic, Reconstructive and Maxillo-facial Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Department of Plastic, Reconstructive and Maxillo-facial Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Abstract
Platelet-rich plasma (PRP) is currently used for its property to improve tissue regeneration and wound healing. Platelet derived growth factors are involved in tissue regeneration and new vessels formation that could improve a free flap survival. Nevertheless to validate the use of regenerative medicine in microsurgery further large and robust human clinical trials are needed.
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Affiliation(s)
- B Hersant
- Department of Maxillo-facial and Plastic and Reconstructive Surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - S La Padula
- Department of Maxillo-facial and Plastic and Reconstructive Surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - M SidAhmed-Mezi
- Department of Maxillo-facial and Plastic and Reconstructive Surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - A M Rodriguez
- Inserm U955, Team 12, université Paris Est, UMR-S955, UPEC, Créteil, France
| | - J P Meningaud
- Department of Maxillo-facial and Plastic and Reconstructive Surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Picard F, Hersant B, La Padula S, Meningaud JP. Platelet-rich plasma-enriched autologous fat graft in regenerative and aesthetic facial surgery: Technical note. J Stomatol Oral Maxillofac Surg 2017; 118:228-231. [PMID: 28576462 DOI: 10.1016/j.jormas.2017.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 03/30/2017] [Accepted: 05/22/2017] [Indexed: 11/19/2022]
Abstract
The goal of adding platelet-rich plasma (PRP) to autologous fat graft is to increase the survival rate of the graft. After their activation, platelets release some important growth factors. As a result, PRP may increase the proliferation and differentiation of Adipose-derived stem cells (ASCs) into adipocytes, improve fat graft vascularisation, and may block the apoptosis of grafted adipocytes. The other benefit expected from the addition of PRP to fat graft is the improvement of cutaneous trophicity above the grafted areas. An exhaustive review of the literature retrieved 11 clinical studies on humans and 7 on animals. A statistically significant increase of the survival rate of fat grafts has been found in 9 comparative studies. Our synthesis allowed us to set up the following protocol: addition of 20% of PRP activated with calcium hydrochloride to fat grafts. It may enhance the results of autologous facial fat graft in regenerative and aesthetic facial surgery.
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Affiliation(s)
- F Picard
- Department of plastic, reconstructive and maxillofacial surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Department of plastic, reconstructive and maxillofacial surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - S La Padula
- Department of plastic, reconstructive and maxillofacial surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - J-P Meningaud
- Department of plastic, reconstructive and maxillofacial surgery, Henri-Mondor hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Ganry L, Hersant B, Quilichini J, Leyder P, Meningaud JP. Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides. J Stomatol Oral Maxillofac Surg 2017; 118:197-202. [PMID: 28365396 DOI: 10.1016/j.jormas.2017.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 12/25/2016] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. PROCEDURE Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX®, Meshlab®, Netfabb® and Blender®. Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. CONCLUSIONS This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique.
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Affiliation(s)
- L Ganry
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
| | - B Hersant
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - J Quilichini
- Department of Plastic & Maxillo-facial Surgery, Robert-Ballanger Hospital, Boulevard Robert Ballanger, 93600 Aulnay-sous-Bois, France; Department of Plastic Surgery, Avicenne Hospital, 125, rue de Stalingrad, 93000 Bobigny, France
| | - P Leyder
- Department of Plastic & Maxillo-facial Surgery, Robert-Ballanger Hospital, Boulevard Robert Ballanger, 93600 Aulnay-sous-Bois, France; Department of Plastic Surgery, Avicenne Hospital, 125, rue de Stalingrad, 93000 Bobigny, France
| | - J P Meningaud
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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Billon R, Hersant B, Meningaud JP. [Hyaluronic acid rheology: Basics and clinical applications in facial rejuvenation]. ANN CHIR PLAST ESTH 2017; 62:261-267. [PMID: 28069316 DOI: 10.1016/j.anplas.2016.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
Hyaluronic acid (HA) is the most widely used dermal filler to treat facial volume deficits and winkles specially for facial rejuvenation. Depending on various areas of the face, filler is exposed to two different forces (shear deformation and compression/stretching forces) resulting from intrinsec and external mechanical stress. The purpose of this technical note is to explain how rheology, which is the study of the flow and deformation of matter under strains, can be used in our clinical practice of facial volumization with fillers. Indeed, comprehension of the rheological properties of HA has become essential in selection of dermal filler targeted to the area of the face. Viscosity, elasticity and cohesivity are the main three properties to be taken into consideration in this selection. Aesthetic physicians and surgeons have to familiarize with those basics in order to select the HA with the right rheological properties to achieve a natural-looking and long-lasting outcome.
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Affiliation(s)
- R Billon
- Service de chirurgie maxillofaciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Service de chirurgie maxillofaciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - J P Meningaud
- Service de chirurgie maxillofaciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Bosc R, Hersant B, Carloni R, Niddam J, Bouhassira J, De Kermadec H, Bequignon E, Wojcik T, Julieron M, Meningaud JP. Mandibular reconstruction after cancer: an in-house approach to manufacturing cutting guides. Int J Oral Maxillofac Surg 2016; 46:24-31. [PMID: 27815013 DOI: 10.1016/j.ijom.2016.10.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 07/15/2016] [Accepted: 10/05/2016] [Indexed: 11/28/2022]
Abstract
The restoration of mandibular bone defects after cancer can be facilitated by computer-assisted preoperative planning. The aim of this study was to assess an in-house manufacturing approach to customized cutting guides for use in the reconstruction of the mandible with osteocutaneous free flaps. A retrospective cohort study was performed, involving 18 patients who underwent mandibular reconstruction with a fibula free flap at three institutions during the period July 2012 to March 2015. A single surgeon designed and manufactured fibula and mandible cutting guides using a computer-aided design process and three-dimensional (3D) printing technology. The oncological outcomes, production parameters, and quality of the reconstructions performed for each patient were recorded. Computed tomography scans were acquired after surgery, and these were compared with the preoperative 3D models. Eighteen consecutive patients with squamous cell carcinoma underwent surgery and then reconstruction using this customized in-house surgical approach. The lengths of the fibula bone segments and the angle measurements in the simulations were similar to those of the postoperative volume rendering (P=0.61). The ease of access to 3D printing technology has enabled the computer-aided design and manufacturing of customized cutting guides for oral cancer treatment without the need for input from external laboratories.
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Affiliation(s)
- R Bosc
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France.
| | - B Hersant
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - R Carloni
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - J Niddam
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - J Bouhassira
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - H De Kermadec
- Department of Head and Neck Surgery, Intercity Hospital of Creteil, Creteil, France
| | - E Bequignon
- Department of Head and Neck Surgery, Intercity Hospital of Creteil, Creteil, France
| | - T Wojcik
- Department of Head and Neck Surgery, Oscar Lambret Cancer Centre, Lille, France
| | - M Julieron
- Department of Head and Neck Surgery, Oscar Lambret Cancer Centre, Lille, France
| | - J-P Meningaud
- Department of Plastic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
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Gao Y, Niddam J, Noel W, Hersant B, Meningaud JP. Comparison of aesthetic facial criteria between Caucasian and East Asian female populations: An esthetic surgeon's perspective. Asian J Surg 2016; 41:4-11. [PMID: 27630035 DOI: 10.1016/j.asjsur.2016.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/30/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022] Open
Abstract
Objective aesthetic criteria are important for patient evaluation and analysis during aesthetic surgeries, while successful aesthetic surgeries must take into account the underlying ethnic differences. The aim of this study is to help surgeons and scientists better plan facial aesthetic surgeries and understand the aesthetic needs according to different patients by reviewing and comparing the current aesthetic principles and preferences in Caucasian and East Asian populations. PubMed and The Cochrane Library were searched using keywords regarding anthropometric measurements. Only original clinical studies and reviews written in English and Chinese and those that focused on the objective assessment of facial aesthetics in Caucasian and East Asian female populations were retained for review. Reference lists of the selected articles were also reviewed for eligible studies. Sixty-five articles that described objective aesthetic criteria in Caucasian and East Asian female populations were found through PubMed, among which 47 included Caucasian populations and 18 included East Asian populations. Compared with White women, East Asian women prefer a small, delicate, and less robust face, lower position of double eyelid, more obtuse nasofrontal angle, rounder nose tip, smaller tip projection, and slightly more retruded mandibular profile. Various differences exist between objective facial aesthetic criteria in Caucasian and East Asian populations. Further studies that focus on the objective aesthetic criteria of facial attractiveness in different ethnicities need to be conducted, especially in Asian countries. Level V: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
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Affiliation(s)
- Y Gao
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France; Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - J Niddam
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France.
| | - W Noel
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - B Hersant
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - J P Meningaud
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
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Iacob S, Hersant B, Mezi MS, Meningaud JP. Factors That May Enhance Longevity: A Literature Review and a Comprehensive Update for Aesthetic Surgeons. Aesthetic Plast Surg 2016; 40:625-31. [PMID: 27234525 DOI: 10.1007/s00266-016-0648-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Received: 01/04/2016] [Accepted: 04/25/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION After surgery, the plastic surgeon is very often questioned about how to maintain the result and more frequently how to slow down the aging process. However, this type of knowledge is not commonly delivered during medical education or at least needs an update. This review could be used as a guide to help plastic surgeons to manage these frequent postoperative consultations. The aim of this literature review was to focus discussion on specific positive factors, identified to have a significant impact on human longevity. MATERIALS AND METHODS A literature review was performed using the automated computerized PubMed search, with the keywords "human longevity." Only papers written in the English language were included. References were screened to identify further relevant articles. Experimental studies based on microorganisms and animals, works published in non-indexed journals, case reports, letters, and viewpoints were excluded. RESULTS One hundred and twenty-four articles reporting factors influencing human longevity were analyzed for data extraction. A total of 59 articles reporting only positive factors were included. Fourteen factors seemed to have a positive impact on longevity: caloric restriction, active effort and sports, happiness, vitamins, vegetarian or Mediterranean diet, oriental practices, socioeconomic status, genetics, sexual activity, sleep, moderate wine consumption, religion, and education. CONCLUSION While some factors with a positive impact on longevity are clearly identified and should be integrated in the postoperative process, further studies are still needed to be able to slow down the aging process. NO LEVEL ASSIGNED 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 .
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Affiliation(s)
- S Iacob
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - B Hersant
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
| | - M SidAhmed Mezi
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - J P Meningaud
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
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Hersant B, Abbou R, SidAhmed-Mezi M, Meningaud JP. Assessment Tools for Facial Rejuvenation Treatment: A Review. Aesthetic Plast Surg 2016; 40:556-65. [PMID: 27178571 DOI: 10.1007/s00266-016-0640-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Received: 12/02/2015] [Accepted: 04/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the field of cosmetic medicine, patient satisfaction is an important and common indicator used to measure the efficacy of the treatment. However, it is insufficient to prove objectively that the benefit of the specific factors involved in the cosmetic outcomes. The practitioner should be aware of these assessment tools, in particular in case of demanding or litigious patients. OBJECTIVE The aim of this review was to establish a list and discuss the subjective and objective methods used to assess facial aesthetic rejuvenation treatments. METHODS A systematic literature search was performed using the Pubmed search engine. Studies published over the last 5 years, i.e. between January 2010 and January 2015 were considered for review. The following keywords were used: "aesthetic treatment", "facial rejuvenation", and "subjective evaluation" or "objective evaluation". RESULTS Of the 446 articles identified by the search strategy, 47 articles focused specifically on facial rejuvenation and on the efficacy of aesthetic medical treatments were retrieved for review. Thirty-seven articles used quantitative methods to assess aesthetic treatment outcomes and only 12 used subjective methods. The different assessment methods were listed according to the tools used and treatment indications. CONCLUSION This review will help in choosing adequate methods to assess facial rejuvenation medical treatment. It is important to combine these tools adequately to improve the assessment. There is no current consensus on assess facial rejuvenation treatments but we noted that objective assessment methods seem helpful. NO LEVEL ASSIGNED 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 .
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Affiliation(s)
- B Hersant
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France.
| | - R Abbou
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
| | - M SidAhmed-Mezi
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
| | - J P Meningaud
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
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Niddam J, Bosc R, Hersant B, Bouhassira J, Meningaud JP. Surgical management of necrotizing cellulitis: Results of a survey conducted in French plastic surgery departments. Med Mal Infect 2016; 46:360-364. [PMID: 27292169 DOI: 10.1016/j.medmal.2016.05.006] [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] [Received: 11/10/2015] [Revised: 01/21/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Necrotizing cellulitis (NC) is a severe infection of the skin and soft tissues, requiring an urgent multidisciplinary approach. We aimed to clarify the surgical management of NC in French plastic surgery departments. PATIENTS AND METHOD Thirty-two French plastic surgery departments were invited to complete a survey sent by email. Questions focused on diagnostic and therapeutic management of NC in France. RESULTS Twenty-five plastic surgery departments completed the survey (78%) and each center had a lead plastic surgeon. Overall, 88% of surgeons declared to have managed at least five NC patients within the year. The plastic surgeon was the lead surgical specialist for NC in 80% of cases. Conversely, 76% of interviewed facilities reported not to have any lead medical specialist. Time between surgical indication and surgical management was less than six hours in 92% of cases. Overall, 24% of responding facilities declared that access to the operating room never delayed management. Finally, 80% of facilities declared to be in favor of dedicated care pathways to improve the management of necrotizing cellulitis patients. CONCLUSION Our study results highlight the heterogeneity of necrotizing cellulitis management in France. The lack of a dedicated care pathway may lead to diagnostic and treatment delays.
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Affiliation(s)
- J Niddam
- Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - R Bosc
- Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J Bouhassira
- Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J-P Meningaud
- Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Lacoste C, Hersant B, Bosc R, Noel W, Meningaud JP. [Use of hyaluronidase to correct hyaluronic acid injections in aesthetic medicine]. ACTA ACUST UNITED AC 2016; 117:96-100. [PMID: 26964838 DOI: 10.1016/j.revsto.2016.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/13/2015] [Accepted: 01/22/2016] [Indexed: 11/25/2022]
Abstract
Hyaluronic acid (HA) is the most commonly used filler in aesthetic medicine. However, overcorrections are frequent even with experienced practitioner. Hyaluronidase is an enzyme that hydrolyzes HA. Hyaluronidase has been recently proposed to correct unsatisfactory results of HA injections in aesthetic medicine (overcorrection, asymmetry, Tyndall effect) and to treat immediate complications such as arterial or venous thrombosis. The objective of this technical note was to summarize the literature data regarding the efficacy, safety and technique of use of hyaluronidase. Hyaluronidase may be responsible for allergies. The practitioner should take this risk and the possible drug interactions into account before using this antidote in order to weigh up the risk/benefit ratio.
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Affiliation(s)
- C Lacoste
- Cabinet Esthelaser, 15, avenue d'Eylau, 75116 Paris, France
| | - B Hersant
- Service de chirurgie maxillo-faciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - R Bosc
- Service de chirurgie maxillo-faciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - W Noel
- Service de chirurgie maxillo-faciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J P Meningaud
- Service de chirurgie maxillo-faciale et de chirurgie plastique, réparatrice et esthétique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Noel W, Hersant B, Meningaud JP. [One-staged surgical technique for scrotal calcinosis]. Prog Urol 2016; 26:176-80. [PMID: 26829881 DOI: 10.1016/j.purol.2015.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/11/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Idiopathic calcinosis cutis is a rare condition involving the development of scrotal nodules in the skin and subcutaneous tissue. Although it is a benign disease, patient's quality of life can be importantly impaired. OBJECTIVE We report herein our experience and surgical management of diffuse scrotal calcinosis. MATERIAL AND METHODS From 2012 and 2015, 7 patients who suffered of diffuse scrotal calcinosis cutis were included in this study. We performed a one-staged resection of the lesions by an elliptic resection centered on the scrotal median raphe as a scrotal lift shape. Outcomes including sexual quality of life and patient's satisfaction were assessed with a questionnaire. RESULTS No postoperative complication occurred. Aesthetic result was high and sexual quality of life was importantly improved. No recurrence was observed in a 2-year follow-up. DISCUSSION This disease is a pathological condition of unknown origin and hence is idiopathic. Multi-staged resection of the nodules are often performed despite being a time-consuming and expensive approach. Our one-staged treatment increased the patient's quality of life and self-esteem. CONCLUSION We present a one-staged treatment of scrotal calcinosis cutis that is simple and effective. Aesthetic and functional results were achieved. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- W Noel
- Service de chirurgie plastique et réparatrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - B Hersant
- Service de chirurgie plastique et réparatrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - J-P Meningaud
- Service de chirurgie plastique et réparatrice, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Aguilar P, Niddam J, Vidal L, Hersant B, Bouhassira J, Bosc R, Meningaud JP. Distally based sural flap: Utility of indocyanine green in the second stage surgery. A case series. J Plast Reconstr Aesthet Surg 2016; 69:577-8. [PMID: 26803567 DOI: 10.1016/j.bjps.2015.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/06/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022]
Affiliation(s)
- P Aguilar
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
| | - J Niddam
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - L Vidal
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - B Hersant
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - J Bouhassira
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - R Bosc
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - J-P Meningaud
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
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Carloni R, Hersant B, Bosc R, Le Guerinel C, Meningaud JP. Soft tissue expansion and cranioplasty: For which indications? J Craniomaxillofac Surg 2015; 43:1409-15. [PMID: 26189146 DOI: 10.1016/j.jcms.2015.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/19/2015] [Accepted: 06/15/2015] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The aim of this study was to better define indications for scalp tissue expansion before cranioplasty, and to describe our methodology for calculate the surface of tissue needed, by combining a preoperative analysis of both the size of the defect and the quality of skin above. MATERIAL AND METHODS A retrospective analysis of patients who underwent expansion before cranioplasty between 2009 and 2015 was conducted. Information was collected on the etiology, size and location of the defect, and reasons of skin contracture. Data concerning expansion and cranioplasty were reviewed. RESULTS Among 47 patients who underwent operation for cranioplasty, five (10.6%) required previous scalp tissue expansion. The etiology of the bone defect was tumoral in three cases, posttraumatic in one case, and a decompressive craniectomy in one case. The mean surface of the bone defect was 69.6 ± 18.7 cm(2). The locations of the defects were fronto-temporo-parietal, frontal, temporo-frontal, on the vertex, and occipital. The cause associated with the skin contracture was an infection in four cases and a delayed cranioplasty in one case. A round-profile expander and a custom-made porous hydroxyapatite implant were used for all patients. CONCLUSIONS The accurate assessment of tissue needed before cranioplasty is as essential as the choice of the material used for bone reconstruction. After previous infected cranioplasty or delayed reconstruction of large defects, scalp tissue expansion should be proposed.
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Affiliation(s)
- R Carloni
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
| | - B Hersant
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - R Bosc
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - C Le Guerinel
- Department of Neurosurgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - J P Meningaud
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
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Doeuk C, Hersant B, Bosc R, Lange F, SidAhmed-Mezi M, Bouhassira J, Meningaud J. Current indications for low level laser treatment in maxillofacial surgery: a review. Br J Oral Maxillofac Surg 2015; 53:309-15. [DOI: 10.1016/j.bjoms.2015.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 02/05/2015] [Indexed: 10/23/2022]
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Stroumza N, Bosc R, Hersant B, Hermeziu O, Meningaud JP. [Benefits of using the cutometer to evaluate the effectiveness of skin treatments in plastic and maxillofacial surgery]. ACTA ACUST UNITED AC 2015; 116:77-81. [PMID: 25817308 DOI: 10.1016/j.revsto.2015.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/13/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Evaluating skin properties is often too subjective. Using the cutometer allows one to take objective measures of certain mechanic properties of the skin such as visco-elasticity. The aim of this article is to evaluate through a review of existing literature the advantages and the limits of the cutometer and to propose an improvement. MATERIAL AND METHODS The selection of articles has been conducted with the PubMed database in order to identify all publications concerning the cutometer up until September 2013. The analysis criteria were: (1) quantitative distribution of articles from the first publication until today; (2) qualitative distribution over the various medical fields. The articles have been organized in 3 groups: medical, surgical and burns; (3) list of biases in the interpretation of results and limits of this measuring tool. RESULTS One hundred and twenty-nine publications have been included. The first article regarding the cutometer was published in 1994. We observe an increase in the number of publications after 2005. Most of the articles were published in medical journals of dermatology or cosmetology (83%), only 9% of articles have been published in burn study journals and 8% in surgical journals. The pressure applied by the experimenter constitutes the main measure bias. DISCUSSION The use of an external device maintaining the probe with an invariable pressure corresponding to its own weight enables more reliable results all the while limiting the inter- and intra-individual variability.
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Affiliation(s)
- N Stroumza
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Tenon, AP-HP, université Pierre et Marie Curie Paris 6, 4, rue de la Chine, 75970 Paris cedex 20, France.
| | - R Bosc
- Service de chirurgie plastique, reconstructrice, esthétique et maxillo-faciale, hôpital Mondor, 94000 Créteil, France; IFR10, groupe Henri-Mondor-Albert-Chenevier, AP-HP, faculté de médecine, université Paris 12, 94000 Créteil, France
| | - B Hersant
- Service de chirurgie plastique, reconstructrice, esthétique et maxillo-faciale, hôpital Mondor, 94000 Créteil, France; IFR10, groupe Henri-Mondor-Albert-Chenevier, AP-HP, faculté de médecine, université Paris 12, 94000 Créteil, France
| | - O Hermeziu
- Service de chirurgie plastique, reconstructrice, esthétique et maxillo-faciale, hôpital Mondor, 94000 Créteil, France; IFR10, groupe Henri-Mondor-Albert-Chenevier, AP-HP, faculté de médecine, université Paris 12, 94000 Créteil, France
| | - J-P Meningaud
- Service de chirurgie plastique, reconstructrice, esthétique et maxillo-faciale, hôpital Mondor, 94000 Créteil, France; IFR10, groupe Henri-Mondor-Albert-Chenevier, AP-HP, faculté de médecine, université Paris 12, 94000 Créteil, France
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Al Ameri O, Chaouat M, Marco O, Azoulay B, Hersant B, Mimoun M. [Major chest wall resection for the treatment of invasive breast carcinoma: A series of 33 patients]. ANN CHIR PLAST ESTH 2013; 59:115-22. [PMID: 24230974 DOI: 10.1016/j.anplas.2013.10.003] [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] [Received: 07/28/2013] [Accepted: 10/13/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Breast cancer can spread to the chest wall. It is an aggressive stage of poor prognosis. We have developed a technique of major chest wall resection extended beyond the breast area in order to reduce the recurrence. PATIENTS AND METHODS This is a retrospective single-center series of 33 patients with breast cancer spread to the chest wall without metastasis (13 patients present with primary breast cancer and 20 patients present with recurrent breast cancer) treated by major chest wall resection between January 1993 and January 2013, by the same surgeon. Analysis of the results was made by another surgeon. RESULTS Patients aged between 27-83years with an average of 55years. The removed parts measured 350cm(2) to 1200cm(2), and the average duration of complete healing was 7.9months. The mean follow-up time was 122months (6months-240months). The 1 year survival was 84.4%, at 2years 72.6%, at 3years 69.5% and at 5 years of 66.4%. CONCLUSION The technique of major chest wall resection is simple and reproducible. Breast cancer with chest wall extension has a poor prognosis. At the end of the study, 20 of 33 patients who benefit from this technique are still alive.
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Affiliation(s)
- O Al Ameri
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - O Marco
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - B Azoulay
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - B Hersant
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
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Chader H, Bosc R, Hersant B, Lange F, Hermeziu O, Zehou O, Chosidow O, Meningaud JP. [Infectious cellulitis of the face complicating injection for esthetic nasolabial sulcus by hyaluronic acid: report of seven cases]. ANN CHIR PLAST ESTH 2013; 58:680-3. [PMID: 23998340 DOI: 10.1016/j.anplas.2013.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 07/22/2013] [Indexed: 11/25/2022]
Abstract
We report a case series of seven patients with bacterial cellulitis of the face complicating a filler injection for cosmetic reason, treated in a university hospital from 2005 to 2012. There were seven women aged 34 to 57 years. Two patients had a deep collection requiring surgical excision combined with antibiotics. Five patients were treated with antibiotics only. In two cases the bacteria was found streptococcus A and in one case Staphylococcus aureus. One patient required hospitalization in an intensive care unit. Only patients who needed surgical treatment showed moderate aesthetic sequelae.
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Affiliation(s)
- H Chader
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Henri-Mondor, centre hospitalier universitaire, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France.
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Hersant B, May P, Battistella M, Pagès C, Lebbe C, Revol M. Reducing surgical margins in dermatofibrosarcoma protuberans using the pathological analysis technique 'vertical modified technique': a 5-year experience. J Plast Reconstr Aesthet Surg 2013; 66:617-22. [PMID: 23419681 DOI: 10.1016/j.bjps.2013.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 12/13/2012] [Accepted: 01/22/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND For the treatment of dermatofibrosarcoma protuberans (DFSP), wide surgical excision has been recommended, with 3-5-cm margins, including the first underlying clear fascia. Since 2006, a technical improvement in pathological analysis called the vertical modified technique (VMT) has allowed us to reduce the surgical margin without increased oncological risk. METHODS Between 2006 and 2011, 66 cases of DFSP were analysed in our hospital, using VMT. We reviewed patient records, considering the initial margin, total margin, number of surgeries and outcomes. Functional and aesthetic consequences were assessed by the surgeon and by the patients. RESULTS Mean initial margin for the first resection was 18 mm (10-30 mm). First resection allowed complete resection of the tumour in 52 cases (78.8%). Mean total surgical margin was 21.3 mm (10-60 mm). There were no cases of local tumour recurrence at a median follow-up of 30 months. Reconstruction was performed using direct sutures in 53 cases (80.3%), split-thickness skin grafts in six cases (9.1%), full-thickness skin grafts in five cases (7.6%) and flaps in two patients (3%). For 90.9% of the patients, the aesthetic result was acceptable, whereas 84.8% patients were satisfied with the functional result. CONCLUSION VMT reduces surgical margins and allows for extensive analysis of margins. This technique represents a safe and reliable strategy in DFSP, without increasing the risk of recurrence. The outcomes of our study have confirmed the data from the literature regarding oncological safety.
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Affiliation(s)
- B Hersant
- Plastic and Reconstructive Surgery Department, Hôpital Saint Louis, Paris, France.
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