1
|
Serror K, Boccara D, Chaouat M, Cottone G, Amendola F, Alessandri Bonetti M, De Francesco F, Mimoun M. Dermal substitute: a safe and effective way in surgical management of adults post-burn dorsal foot contractures. Eur Rev Med Pharmacol Sci 2023; 27:29-36. [PMID: 37129333 DOI: 10.26355/eurrev_202304_31319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Neglected dorsal foοt burns may result in typical fοrefοοt defοrmities characterised by cοntractures leading tο hyperextensiοn οf the tοes and gait disturbance. These defοrmities usually cause a significant impairment in daily activities and difficulty in wearing shοes. This article presents a recοnstructiοn series οf severe fοrefοοt defοrmities by means of dermal regeneratiοn templates (also known as dermal substitutes) and split thickness skin grafts. PATIENTS AND METHODS We retrοspectively reviewed οur institutiοnal burn database from 2010 to 2020 focusing on all those dοrsal fοοt cοntractures treated with the use οf a dermal regeneratiοn template. The patients' demοgraphics, burn injury mechanisms, depth, lοcalizatiοn, surface, treatments and fοllοw-up were described. RESULTS Twelve patients underwent this prοcedure and the mean affected area was 75 cm2. The mean time between the dermal regeneratiοn template applicatiοn and the split thickness skin graft was 19.6 days. Just fοr one patient, an additiοnal skin grafting prοcedure was required. The mean fοllοw-up was 4.6 years. We did not register specific cοmplicatiοns at bοth the recipient (forefoot) and dοnοr sites (scalp). All patients were able tο wear shοes and walk after the procedure. Nο recurrence οf cοntractures were οbserved. All patients were satisfied with cοsmetic results, and they did not request any additiοnal prοcedure οf cοsmetic imprοvement. CONCLUSIONS The use οf the dermal regeneratiοn template can be cοnsidered as an extremely safe and efficient treatment οf severe post-burn fοrefοοt defοrmities.
Collapse
Affiliation(s)
- K Serror
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, Paris, France.
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Serror K, Ferrero L, Boismal F, Thery M, Vianay B, Boccara D, Mimoun M, Bouaziz J, Bensussan A, Michel L. 621 Heterogeneity: a new insight in deciphering keloid physiopathology. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.638] [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: 11/19/2022]
|
3
|
Boismal F, Chevreux G, Serror K, Boccara D, Mimoun M, Beauchef G, Dorr M, Vié K, Michel L. 612 Proteomic and secretomic comparison of young and aged fibroblasts highlights cytoskeleton as a key component during aging. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.629] [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: 11/19/2022]
|
4
|
Dobos G, Battistella M, Ram-Wolff C, Seerror K, de Masson A, Boccara D, Mimoun M, Bagot M, Bensussan A. Distinction between CTCL and inflammatory dermatoses using mRNA expression of cancer-associated fibroblast markers from skin biopsies. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00605-0] [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: 11/25/2022]
|
5
|
Barbasse L, Serror K, Boccara D, Mimoun M, Benyamina M, Chaouat M. Repair Of Palm Burns Of The Hand: A Contralateral Inner Arm Bag-Shaped Flap. Ann Burns Fire Disasters 2022; 35:68-73. [PMID: 35582091 PMCID: PMC9020851] [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] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 05/16/2021] [Indexed: 06/15/2023]
Abstract
Hands are one of the most often burnt parts of the body. Deep palmar burns are often the result of an electrical burn or a thermal burn from grasping a hot item. With a deep burn, joints, vasculo-nervous pedicles, tendons or bones can become exposed and lead to amputation. Different surgical repair methods are used depending on the area of the hand that is burnt. Most of the publications to date have described surgical techniques for dorsal hand burns. The abdominal bag-shaped flap is one of the main surgical techniques to cover dorsal deep tissue exposure. Bag-shaped flaps need time to achieve the vascular autonomy of the flap without any movement. Abdominal bagshaped flaps are particularly suitable for dorsal soft-tissue defects, while for palmar defects, it is an uncomfortable position to maintain for three weeks. A contralateral arm bag-shaped flap for palmar burns allows a comfortable position to be achieved as the upper burnt limb is positioned as if the patient has their arms crossed. Furthermore, as stated above, the contralateral arm bag-shaped flap has the advantage of allowing a flap to be used that is thinner than an abdominal bag-shaped flap. At the Saint Louis Burns Center, we recently treated two patients with deep palmar burns and deep tissue exposure. We performed a contralateral arm bag-shaped flap for both of these patients. In our experience, the use of the contralateral arm bag-shaped flap technique to cover palmar lesions resulted in favorable postoperative progression, with complete closure of the lesions, good functional outcomes, as well as other advantages such as a hidden scar at the donor site. This technique allows amputation of fingers to be avoided when pedicles, joints, or tendons are exposed and when the burnt area of the palm is extensive and no other flaps can be used.
Collapse
Affiliation(s)
- L. Barbasse
- Léa Barbasse
Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint LouisAP-HP 1 Avenue Claude Vellefaux, 75010 ParisFrance+33 682634901
| | | | | | | | | | | |
Collapse
|
6
|
Boismal F, Vianay B, Serror K, Boccara D, Mimoun M, Bensussan A, Dorr M, Thery M, Michel L. 364 Mechanical forces of human dermal fibroblasts significantly decrease with age. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.373] [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: 10/20/2022]
|
7
|
Ganon S, Bellity J, Zbili D, Boccara D. Reconstruction strategies after rupture of the extensor pollicis longus tendon: A systematic review. Hand Surgery and Rehabilitation 2020; 39:502-507. [DOI: 10.1016/j.hansur.2020.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/06/2020] [Accepted: 07/30/2020] [Indexed: 10/23/2022]
|
8
|
Sabban R, Serror K, Levy J, Chaouat M, Mimoun M, Boccara D. Head and neck skin expansion: assessment of efficiency for the treatment of lesions in the lower half of the face. Ann Burns Fire Disasters 2020; 33:38-46. [PMID: 32523494 PMCID: PMC7263714] [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] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/16/2019] [Indexed: 06/11/2023]
Abstract
The treatment of sequelae for burns or other loss of perioral tissues is complex due to the site where they occur, its functional importance, and social and esthetic aspects. Functional consequences of burns to this area are cutaneous retraction and a lack of skin that can lead to an inability to close the oral aperture, compromising the provision of dental hygiene and intubation procedures. The aim of the present publication was to evaluate the efficacy of chin, labial and jugal cutaneous expansions for the treatment of perioral lesions and lesions of the lower half of the face in our retrospective series of patients. We collected data and photography from digital files for each patient. Proportion of scarred skin that could be treated by one or several expansion procedures was evaluated. The main outcome was the resection of 50% or more initial lesions. Side effects were assessed. Out of a total of 33 expanders, 28 were at the jugal level, 5 were chin expanders, and none were labial expanders. This equated to the inclusion of fourteen patients. The average percentage of the lesion that was removed after the perioral expansion protocol was 68.9% (40%-100%). 85% of patients had a positive outcome. 12% of procedures were complicated by hematoma, infection or prosthesis exposure. Each time that the lesional area could be fully (i.e. 100%) treated, only a single expansion was used. Head and neck expansion is the technique of choice for reconstruction of the lower half of the face and the horizontal part of the neck in terms of efficiency and safety.
Collapse
Affiliation(s)
- R. Sabban
- Dr Rebecca Sabban
Department of Plastic, Reconstructive and Aesthetic Surgery, Saint-Louis Hospital1 avenue Claude Vellefaux, 75010 ParisFrance+33 142385044
| | | | | | | | | | | |
Collapse
|
9
|
Chatelain S, Mimoun M, Chaouat M, Fournier M, Boccara D. [Quick screening for Body Dysmorphic Disorder in a plastic surgery population in France]. Encephale 2020; 46:190-192. [PMID: 32151455 DOI: 10.1016/j.encep.2019.10.006] [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: 07/09/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION All plastic surgeons are frequently faced with patients with Body Dysmorphic Disorder (BDD). However, no screening test exists in French to help the plastic surgeons to diagnose this disease. The Body Dysmorphic Disorder Questionnaire (BDDQ) is the Gold Standard to easily detect BDD in consultation with any non-psychiatric physician. The aim of this study was to translate and validate the BDDQ into French to help plastic surgeons to detect BDD before the surgery. This way, plastic surgeons will be able to provide an optimal medical care and to reduce the risk of psychiatric collapse. METHODS We asked Katherine Philipps for her approval to use her BDDQ for our study, and thereafter we translated it respecting the criteria of the World Health Organization. We first evaluated the psychometric qualities of the BDDQ in French and then its reproducibility and its sensitivity to change. RESULTS A French version of the BDDQ appeared to be reliable and comprehensible. The questionnaire has been tested on a sample of patients in plastic surgery consultation, at a T moment and a T plus one month to certify its reproducibility and its sensitivity to change. CONCLUSION These results permit to claim that the French version of the BDDQ is now validated to detect patients with a BDD in a plastic surgery consultation.
Collapse
Affiliation(s)
- S Chatelain
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris, France.
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - M Fournier
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - D Boccara
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris, France
| |
Collapse
|
10
|
Boccara D, Chaouat M, Chatelain S, Dutot MC, Bekara F, Mimoun M, Serror K. [Guidelines for antibiotic prophylaxis in plastic, reconstructive, and aesthetic surgery]. ANN CHIR PLAST ESTH 2020; 65:178-179. [PMID: 32046861 DOI: 10.1016/j.anplas.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/16/2020] [Indexed: 11/18/2022]
Affiliation(s)
- D Boccara
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - M Chaouat
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - S Chatelain
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - M-C Dutot
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - F Bekara
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - M Mimoun
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| | - K Serror
- Université Paris-Diderot, Sorbonne Paris-Cité, service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, AP-HP, Hop Saint-Louis, 75475 Paris, France.
| |
Collapse
|
11
|
Sintes M, Beladjine M, Boccara D, Mimoun M, Bouaziz JD, Bensussan A, Bagot M, Agnely F, Huang N, Michel L. Co-encapsulation de molécules immuno-actives et anti-inflammatoires dans une émulsion de pickering pour l’approche thérapeutique de dermatoses inflammatoires. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.308] [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: 10/25/2022]
|
12
|
Romano L, Feng J, Peltier S, Boccara D, Bagot M, Gan X, Liu G, Bensussan A, Michel L. 664 Biological activities of traditional medicinal herbs on skin cells. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.669] [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]
|
13
|
Gonnet J, Meriaux C, Poncelet L, Goncalves E, Soria A, Boccara D, Tchitchek N, Weiss L, Vogt A, Pedruzzi E, Bonduelle O, Hamm G, Ait-Belkacem R, Fournier I, Stauber J, Wisztorski M, Combadiere B. 688 Identification of biomarkers of early innate events during skin reaction following intradermal injection. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.764] [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]
|
14
|
Mimoun M, Almadani O, Boccara D, Chaouat M, Al Saud N, Serror K, Haddad J. Reconstruction Of The Burnt Nose Using A Carved Flap In Four Cases. Ann Burns Fire Disasters 2019; 32:64-69. [PMID: 31285737 PMCID: PMC6588326] [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] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 09/26/2018] [Indexed: 06/09/2023]
Abstract
Techniques for reconstructing nasal defects in burns are very limited because the surrounding scar tissue makes it difficult to use local flaps. The authors report their experience using the Converse scalping flap harvested from scarred skin, placed as a mass on the nasal area, then secondarily carved to shape the nose and covered by a skin graft. This is a retrospective study of 4 patients, 3 men and 1 woman, with an average age of 45 years, who were operated on between 1994 and 2013 using this technique for postburn nasal reconstruction. Patients had 45% burns on average. The flap was weaned from its donor site at the third week and the frontalis donor area grafted. Several months later, the flap was sculpted from the outside to the inside in the three dimensions, removing the scarred epidermal areas to restore the aesthetic units of the nose, which were grafted using a full thickness skin graft. The final aesthetic result of the nasal reconstruction was evaluated by the patient and the surgical team. The four nasal reconstructions were carried out to completion. Three were rated as 'very good' (75%) and one was rated as 'good' (25%). The Converse flap modification, referred to as the "carved flap", to reconstruct the burned nose is a reliable technique, possible on a scarred forehead with no additional donor site morbidity.
Collapse
Affiliation(s)
- M. Mimoun
- Dr Jonathan Haddad
Service de chirurgie plastique esthétique et reconstructrice unités de traitement des grands brûlés, Hôpital Saint Louis1 avenue Claude Vellefaux, 75010 ParisFrance
| | | | | | | | | | | | | |
Collapse
|
15
|
Reinbold C, Serror K, Mimoun M, Chaouat M, Marco O, Boccara D. Electrical Burns and Late Spontaneous Artery Ruptures: About Three Cases. J Burn Care Res 2019; 40:120-127. [PMID: 29767734 DOI: 10.1093/jbcr/irx005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Electrical burns are responsible for arterial and venous thrombosis, as well as weakening of the arteries. Immediate or delayed arterial occlusions, secondary to the aggression of the intima, or aneurysms, secondary to the aggression of the media, sometimes lead to artery ruptures without any warning signs. Such ruptures may trigger a hemorrhagic shock whose period of onset is variable and unpredictable. We are presenting here three cases treated in our department for electrical burns, whose complications were marked by hemorrhagic shock, secondary to late artery ruptures, sometimes occurring several months following the event. These case reports required performance of emergency hemostasis in order to control sudden bleeding, with first approach being placement of a tourniquet at the base of the limb and/or a compression point. Through these cases, we thought it is crucial to closely monitor for a few weeks all patients who were victims of electrical injury, even more so if it was associated with a compartment syndrome of one or more limbs and high rhabdomyolysis, which seem to be predictive factors of late artery ruptures in our case reports.
Collapse
Affiliation(s)
- C Reinbold
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| | - K Serror
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| | - M Mimoun
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| | - M Chaouat
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| | - O Marco
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| | - D Boccara
- Department of Reconstructive, Plastic and Aesthetic Surgery Burn Treatment Center, Saint-Louis Hospital, Paris, France
| |
Collapse
|
16
|
Boismal F, Ly Ka So S, Boccara D, Mimoun M, Zuelgaray E, Léger T, Guere C, Beauchef G, Vie K, Michel L. Étude comparative des profils de réponse sécrétomique et protéique de fibroblastes jeunes et âgés. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.419] [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]
|
17
|
Chossat A, Marco O, Chaouat M, Mimoun M, Boccara D. [Complications with surgical treatment of basal cell carcinomas in individuals over 75 years of age: A retrospective study of prognostic factors in 158 cases]. ANN CHIR PLAST ESTH 2018; 63:299-306. [PMID: 29887383 DOI: 10.1016/j.anplas.2018.05.001] [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: 03/13/2018] [Accepted: 05/13/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is a pathology that evolves locally and it is common in elderly subjects whose frailty could restrict the indications for the reference treatment, which is based on surgery. The aim of this study was to investigate the morbidity and the mortality associated with surgical treatment of BCC in patients over 75 years of age, so as to identify possible prognostic factors for postoperative complications. MATERIALS AND METHODS This was a retrospective study carried out with patients over 75 years of age who were treated surgically for one or several BCC between 2010 and 2015 in the reconstructive and cosmetic plastic surgery unit of the Saint-Louis Hospital in Paris (France). We collated the demographic characteristics, the characteristics of the treatment, as well as the rate of major postoperative complications. We performed a univariate and then a multivariate analysis of the various risk factors that were identified. RESULTS A total of 158 patients were analyzed and they exhibited a rate of major complications of 12%. The statistical analysis identified five significant risk factors: being over 85 years of age (P=0.006), long-term use of anticoagulant treatment (P=0.02), the presence of at least one comorbidity (P=0.018), a conventional hospitalization (P=0.002), and the use of general anesthesia (P=1.2e-10). CONCLUSION Five risk factors for major postoperative complications with the surgical treatment of BCC in patients over 75 years of age were identified. These factors may provide direction to medico-surgical teams in regard to the optimal treatment of BCC in elderly patients.
Collapse
Affiliation(s)
- A Chossat
- Service de chirurgie plastique réparatrice et esthétique, centre hospitalier René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France.
| | - O Marco
- Service de chirurgie plastique réparatrice et esthétique, CHU Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - M Chaouat
- Service de chirurgie plastique réparatrice et esthétique, CHU Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - M Mimoun
- Service de chirurgie plastique réparatrice et esthétique, CHU Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - D Boccara
- Service de chirurgie plastique réparatrice et esthétique, CHU Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| |
Collapse
|
18
|
Schmidt M, Serror K, Chaouat M, Mimoun M, Boccara D. Prise en charge des cicatrices hypopigmentées post-brûlure. ANN CHIR PLAST ESTH 2018; 63:246-254. [DOI: 10.1016/j.anplas.2017.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
|
19
|
Gonnet J, Perrin H, Hutton AJ, Boccara D, Bonduelle O, Mimoun M, Atlan M, Soria A, Combadière B. Interleukin-32 promotes detachment and activation of human Langerhans cells in a human skin explant model. Br J Dermatol 2018; 179:145-153. [PMID: 29806155 DOI: 10.1111/bjd.16721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cross-talk between skin keratinocytes (KCs) and Langerhans cells (LCs) plays a fundamental role in the body's first line of immunological defences. However, the mechanism behind the interaction between these two major epidermal cells is unknown. Interleukin (IL)-32 is produced in inflammatory skin disorders. We questioned the role of IL-32 in the epidermis. OBJECTIVES We aimed to determine the role of IL-32 produced by KCs on surrounding LCs. METHODS We used an ex vivo human explant model from healthy donors and investigated the role of IL-32 on LC activation using imaging, flow cytometry, reverse transcriptase quantitative polymerase chain reaction and small interfering (si)RNA treatment. RESULTS Modified vaccinia virus ankara (MVA) infection induced KC death alongside the early production of the proinflammatory cytokine IL-32. We demonstrated that IL-32 produced by MVA-infected KCs induced modest but significant morphological changes in LCs and downregulation of adhesion molecules, such as epithelial cell adhesion molecule and very late antigen-4, and CXCL10 production. The treatment of KCs with IL-32-specific siRNA, and anti-IL-32 blocking antibody significantly inhibited LC activation, demonstrating the role of IL-32 in LC activation. We also found that some Toll-like receptor ligands induced a very high level of IL-32 production by KCs, which initiated LC activation. CONCLUSIONS We propose, for the first time, that IL-32 is a molecular link between KCs and LCs in healthy skin, provoking LC migration from the epidermis to the dermis prior to their migration to the draining lymph nodes.
Collapse
Affiliation(s)
- J Gonnet
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France
| | - H Perrin
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France
| | - A J Hutton
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France
| | - D Boccara
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France.,Service de Chirurgie Plastique Reconstructrice, Esthétique, Centre des Brûlés, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), 1 avenue Claude Vellefaux, 75010, Paris, France
| | - O Bonduelle
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France
| | - M Mimoun
- Service de Chirurgie Plastique Reconstructrice, Esthétique, Centre des Brûlés, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), 1 avenue Claude Vellefaux, 75010, Paris, France
| | - M Atlan
- Service de Chirurgie Plastique Reconstructrice et Esthétique, Hôpital Tenon, Assistance Publique Hôpitaux de Paris (APHP), 4 Rue de la Chine, 75020, Paris, France
| | - A Soria
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France.,Service de Dermatologie et d'Allergologie, Hôpital Tenon, Hôpitaux Universitaire Est Parisien (HUEP), Assistance Publique Hôpitaux de Paris (APHP), 4 rue de la Chine, 75020, Paris, France
| | - B Combadière
- Sorbonne Universités UPMC Université Paris 06, UMRS CR7, Inserm U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), 91 Boulevard de l'Hôpital, 75013, Paris, France
| |
Collapse
|
20
|
de Runz A, Boccara D, Bertheuil N, Claudot F, Brix M, Simon E. Three-dimensional imaging, an important factor of decision in breast augmentation. ANN CHIR PLAST ESTH 2018; 63:134-139. [DOI: 10.1016/j.anplas.2017.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/26/2017] [Indexed: 10/18/2022]
|
21
|
Levy S, Chaouat M, Malca N, Serror K, Mimoun M, Boccara D. [Not Available]. Ann Burns Fire Disasters 2018; 31:4-9. [PMID: 30174563 PMCID: PMC6116657] [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] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Chemical burns raise diagnostic and treatment issues because they have specific appearances and evolution. Our objective was to study the characteristics of chemical burns and to assess the quality of our treatment. This retrospective observational study examined the records of all patients admitted for chemical burns to the burn treatment center of Saint Louis Hospital in Paris from January 1, 1990, through December 31, 2015. During this period, 162 patients came to our center for chemical burn treatment. Most of them were men (67%). The majority of the burns were caused by alkalis (27%) and resulted from workplace accidents (29%). The average time before consultation was 5.36 days. The areas mainly damaged were the hands (36%) and the burn areas averaged 1.2% of the total body surface area (TBSA). Forty-eight patients had at least one deep patch. In total, 59 patients (36.4%) were hospitalized for an average duration of 4.18 days. Thirty-eight of them underwent surgery. Lastly, 92% of the operations had been anticipated from the first consultation. In our center, the population affected, the circumstances and the topography of our patients' burns were similar to the data from the literature. It appears that the principal specificity of our series is a very low body surface burned. This can be attributed to the prevention measures we have in France and underlines their importance. Only 8% of the patients who had surgery were underestimated or their burns became deeper secondarily. This number is lower than the data from other series.
Collapse
Affiliation(s)
- S. Levy
- Samuel Levy
Centre de Traitement des Brûlés, Hôpital St Louis1, avenue Claude Vellefaux, 75010 ParisFrance+33630212158
| | | | | | | | | | | |
Collapse
|
22
|
Ouar N, Qassemyar Q, Boccara D, Atlan M. Three-stage post-oncological reconstruction of the scalp using a dermal-assisted skin graft, adipose tissue graft and follicular graft: A clinical case. ANN CHIR PLAST ESTH 2018; 64:86-88. [PMID: 29566953 DOI: 10.1016/j.anplas.2018.02.002] [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: 01/02/2018] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
Affiliation(s)
- N Ouar
- Microsurgery Department, Plastic Reconstructive and Aesthetic Surgery, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - Q Qassemyar
- Microsurgery Department, Plastic Reconstructive and Aesthetic Surgery, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - D Boccara
- Burns Unit, Plastic and Reconstructive Surgery, Hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - M Atlan
- Microsurgery Department, Plastic Reconstructive and Aesthetic Surgery, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| |
Collapse
|
23
|
Chatelain S, Serror K, Chaouat M, Mimoun M, Boccara D. Immolation dans notre centre de traitement des brûlés de 2011 à 2016. ANN CHIR PLAST ESTH 2018; 63:41-46. [DOI: 10.1016/j.anplas.2017.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
|
24
|
Malca N, Serror K, Mimoun M, Chatelain S, Kaplan J, Chaouat M, Marco O, Boccara D. Our 35 years' experience on postburn heterotopic ossification: A three-step treatment. ANN CHIR PLAST ESTH 2018; 63:316-322. [PMID: 29289387 DOI: 10.1016/j.anplas.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/25/2017] [Accepted: 11/30/2017] [Indexed: 11/18/2022]
Abstract
Our retrospective study of burn patients presents a three-step treatment of heterotopic ossification: excision surgery, early rehabilitation, and analgesia. We included patients admitted to the department for treatment of postburn heterotopic ossification between January 1, 1979, and September 30, 2015. The mean age at the time of the burn was 43.3 years. Men accounted for the majority of burn patients who developed an osteoma (70.8%). The mean total skin area burned was 38.4%. No osteoma justifying surgery was found for any patient with a total burned skin area less than 19%. The burned zones were related to the osteoma development in 94.3% of cases. On average, the surgery took place 10.8 months after the burn. The osteotomy was accompanied by surgical treatment of a contracture in 37.1% of patients. Most of the osteomata were found at the elbows (30), followed by the shoulders (3), and finally the knees (2). Rehabilitation began on D0 after the surgery, except if a flap or a thin-skin graft was used. Regarding analgesia, opiates were prescribed systematically during the immediate postoperative period. Elbow range of motion on flexion improved by a mean of 84.1°. During the postoperative period, we found 2 recurrences of osteoma and 1 elbow hematoma in two separate patients. There were no postoperative infections or neurological sequelae. Our retrospective French study confirmed results found in the international literature. The three-step treatment - excision surgery, early rehabilitation, and antalgia - seems to be the best means of treating osteoma with satisfactory results. Surgery is indicated only in the case of functional impairment and not simply based on imaging.
Collapse
Affiliation(s)
- N Malca
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - K Serror
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Mimoun
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - S Chatelain
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J Kaplan
- NewYork-Presbyterian hospital, Columbia university medical center, New York, USA
| | - M Chaouat
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - O Marco
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - D Boccara
- Department of plastic surgery, Burn center (centre de traitement des brûlés), hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
25
|
Alvo R, Serror K, Bern R, Chaouat M, Mimoun M, Boccara D. [Not Available]. Ann Burns Fire Disasters 2017; 30:296-302. [PMID: 29983686 PMCID: PMC6033484] [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] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 12/31/2017] [Indexed: 06/08/2023]
Abstract
The hands are the most commonly affected area in burn injuries and are involved approximately 80% of the time. Because of the thinness of the skin and superficial location of critical structures, the dorsum of the hand needs an optimal coverage to preserve maximum articular mobility and range of motion. The aim of this article is to detail the therapeutic alternatives to skin graft in cases of very deep burns on the dorsum of the hand, and to specify the indications. We reviewed all articles referenced on PubMed, and included all the original articles related to the management of acute burned hands and their different coverage techniques (dermal substitutes and flaps). We excluded articles that dealt only with skin grafting techniques, as well as articles about secondary management (sequelae and reconstruction). One hundred and sixteen articles were found and twenty of these were selected. Alternatives to full-thickness skin grafting are dermal substitutes (Alloderm®, Matriderm®, Integra®) and flaps. In cases of immediately usable autologous donor sites, the combination Matriderm® with a thin skin graft is preferred. Otherwise, we use Integra®. In cases of deep exposure of critical structures and doubtful vascularization quality on the wound, flaps can be discussed (cross-arm, abdominal wall flap…).
Collapse
Affiliation(s)
- R. Alvo
- Rémi Alvo
Centre de Traitement des Brûlés, Hôpital St Louisrue Claude Vellefaux, 75010 ParisFrance
| | | | | | | | | | | |
Collapse
|
26
|
Merle R, Serror K, Marco O, Chaouat M, Teissier S, Mimoun M, Boccara D. [Study of satisfaction concerning the navel after abdominal dermolipectomy with transposition: A report of 96 cases]. ANN CHIR PLAST ESTH 2017; 63:215-221. [PMID: 29097008 DOI: 10.1016/j.anplas.2017.09.010] [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: 08/11/2017] [Accepted: 09/28/2017] [Indexed: 11/16/2022]
Abstract
GOAL OF THE STUDY The umbilicus has a major role in the aesthetics of the anterior abdominal wall. Many publications deal with abdominal dermolipectomies but few focus on umbilicoplasty. However, these are essential in assessing the aesthetic result. Umbilicoplasty in "aile de mouette" used in our service is reliable and easily reproducible. In this article, we evaluate the satisfaction of patients with abdominal dermolipectomy with this technique of transposition. MATERIALS AND METHOD In the plastic surgery department of the Saint-Louis Hospital in Paris, we carried out a retrospective study of patients undergoing abdominal dermolipectomy with transposition of the umbilicus, between 1 January 2012 and 31 December 2012. All patients were operated according to our technique of umbilicoplasty: disinsertion of the umbilicus in V, reinsertion of the umbilic in "aile de mouette", a degreasing periumbilical associated with a plication of the umbilical stem. The complications identified in patients medical records and satisfaction were assessed by a telephone questionnaire. RESULTS Ninety-six patients were included. No patient presented umbilical necrosis. The overall result of umbilical transposition was considered good to excellent for 92.7% of patients. CONCLUSION Umbilicoplasty in gull wing has many advantages: it is a simple, easily reproducible, reliable technique, the patients of which are for the most part very satisfied.
Collapse
Affiliation(s)
- R Merle
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, CHU de Nice, 30, voie Romaine, 06001 Nice, France.
| | - K Serror
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - O Marco
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - S Teissier
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, CHU de Nice, 30, voie Romaine, 06001 Nice, France
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - D Boccara
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
27
|
Boccara D, SerroR K, Lefevre J, Mimoun M, Chaouat M. [Reconstruction of abdo-perineal resection by Taylor flap: About 68 patients]. ANN CHIR PLAST ESTH 2017; 63:222-228. [PMID: 29107432 DOI: 10.1016/j.anplas.2017.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 06/26/2017] [Accepted: 09/28/2017] [Indexed: 12/13/2022]
Abstract
PURPOSES Healing after abdomino-perineal resection is often difficult, especially in patients who have undergone radiation therapy. Vaginal reconstruction is also an important issue for the women who undergo this surgery. We describe and analyze here our series of perineal reconstructions with modified Taylor flaps. Between 2010 and 2016, 68 patients (52 women, 16 men) with cancer of the anal canal (53), adenocarcinoma of the lower rectum (9), or other malignant neoplasms of the perineum underwent reconstruction with a rectus abdominis myocutaneous (RAM) flap with an inferior pedicle and an oblique skin paddle. RESULTS This review of records showed that all patients healed, with a median of 30 days. The reoperation rate was 11.7% including 1 for eventration. The principal causes for delayed healing were scar dehiscence, abscess, and partial necrosis. No flap required removal, however. The mean duration of hospitalization was 23.7 days. CONCLUSION Modified Taylor flaps substantially improved the reconstruction of defects resulting from abdomino-perineal resection. They enabled complete and rapid healing with low comorbidity.
Collapse
Affiliation(s)
- D Boccara
- Plastic, Reconstructive and Cosmetic and Burn Surgery unit, hôpital Saint-Louis, 1, avenue Vellefaux, 75010 Paris, France.
| | - K SerroR
- Plastic, Reconstructive and Cosmetic and Burn Surgery unit, hôpital Saint-Louis, 1, avenue Vellefaux, 75010 Paris, France
| | - J Lefevre
- Plastic, Reconstructive and Cosmetic and Burn Surgery unit, hôpital Saint-Louis, 1, avenue Vellefaux, 75010 Paris, France
| | - M Mimoun
- Plastic, Reconstructive and Cosmetic and Burn Surgery unit, hôpital Saint-Louis, 1, avenue Vellefaux, 75010 Paris, France
| | - M Chaouat
- Plastic, Reconstructive and Cosmetic and Burn Surgery unit, hôpital Saint-Louis, 1, avenue Vellefaux, 75010 Paris, France
| |
Collapse
|
28
|
Serror K, Chaouat M, Legrand MM, Depret F, Haddad J, Malca N, Mimoun M, Boccara D. Burns caused by electronic vaping devices (e-cigarettes): A new classification proposal based on mechanisms. Burns 2017; 44:544-548. [PMID: 29056367 DOI: 10.1016/j.burns.2017.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 07/06/2017] [Revised: 08/02/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
Abstract
Introduction With more than 10 million of daily users, e-cigarettes encountered a great success. But in the past few years, the number of medical reports of injuries caused by the explosion of e-cigarettes has significantly increased. This article aims at reporting our series and reviewing the literature to propose a new classification based on the mechanisms of injuries related to e-cigarettes that can guide non-specialists and specialists in the management of these patients. Method We performed a retrospective review of our institutional burn database from June 2016 to July 2017 for injuries caused by or in the context of using an e-cigarette. The patients' demographics (age, gender), burn injury mechanisms, depth, localization, surface and interventions were described. Results Ten patients suffered from burns related to the use of e-cigarettes. The burns were located at the thigh (80%) and the hand (50%) with a mean surface of 3% of TBSA. Four different mechanisms could be described: Type A: thermal burns with flames due to the phenomenon of "thermal runaway", Type B: blasts lesions secondary to the explosion, Type C: chemical alkali burns caused by spreading of the electrolyte solution and Type D: thermal burns without flames due to overheating. These different mechanisms suggest specific surgical and non-surgical management. Conclusion Management of injuries sustained from e-cigarettes' explosions should be approached from the standpoint of mechanisms. Different mechanisms could be associated and should be considered in specific management.
Collapse
Affiliation(s)
- K Serror
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France.
| | - M Chaouat
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Matthieu M Legrand
- Departement of Anesthesiology and Intensive Care Unit, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - F Depret
- Departement of Anesthesiology and Intensive Care Unit, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - J Haddad
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - N Malca
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - M Mimoun
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - D Boccara
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| |
Collapse
|
29
|
Picard F, Niddam J, De Runz A, Chaouat M, Mimoun M, Boccara D. Intraoperative instillation of ropivacaine during the placement of sub-muscular cosmetic breast implants: Is there a clinical benefit? ANN CHIR PLAST ESTH 2017; 63:20-24. [PMID: 29032877 DOI: 10.1016/j.anplas.2017.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 04/02/2017] [Accepted: 07/17/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The sub-muscular placement of cosmetic breast implants leads to substantial pain due to the muscular distention. The aim of this study was to assess the efficiency of intraoperative ropivacaine instillation to reduce postoperative pain the day after surgery. MATERIAL AND METHODS We conducted a prospective, controlled, single-blinded study comparing the intraoperative instillation of 7.5mg of ropivacaine through Redon drains with the standard procedure in 72 patients undergoing sub-muscular cosmetic breast augmentation for the first time. RESULTS Pain at the awakening on postoperative day 1 was 4.8 on a simple numeric pain scale in the treatment group and 5.1 in the control group (P>0.05). On postoperative day 3, pain at awakening was 3.7 in both groups (P>0.05), and on postoperative day 5, pain was 2.8 in the treatment group and 2.7 in the control group (P>0.05). CONCLUSION Local instillation of ropivacaine in the implant pocket during surgery did not decrease postoperative pain on day 1, day 3 and day 5. From now on, we are able to tell to patients that the postoperative pain after sub-muscular cosmetic breast implants surgery is about 5/10 on postoperative day 1, 4/10 at day 3 and 3/10 at day 5. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- F Picard
- Plastic and reconstructive surgery, hôpital Henri-Mondor, 51, avenue du Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - J Niddam
- Plastic and reconstructive surgery, hôpital Henri-Mondor, 51, avenue du Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France
| | - A De Runz
- Plastic and reconstructive surgery, CHRU de Nancy, 29, avenue du Marechal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - M Chaouat
- Plastic and recontructive surgery, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Mimoun
- Plastic and recontructive surgery, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - D Boccara
- Plastic and recontructive surgery, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
30
|
Boccara D, Lavocat R, Soussi S, Legrand M, Chaouat M, Mebazaa A, Mimoun M, Blet A, Serror K. Pressure guided surgery of compartment syndrome of the limbs in burn patients. Ann Burns Fire Disasters 2017; 30:193-197. [PMID: 29849522 PMCID: PMC5946744] [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] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 07/19/2017] [Indexed: 06/08/2023]
Abstract
Compartment syndrome is a serious complication of high voltage electrical burns, limb carbonization and deep circular burns with delayed escharotomy. Without treatment, ischemic tissue damage leads to irreversible necrosis. Treatment is emergency surgical decompression. The burned patient is usually not searchable and cannot always be readily examined because of bulky dressings; diagnosis of compartment syndrome is always hard to make. The pressure transducer used in central arterial catheters is easy available. We used it to measure pressure in muscular compartments. We measured compartment pressure three times at different depths in all cases of electrical burn, carbonization and deep circumferential burns with delayed escharotomy. We also took the pressure in the uninjured limb. The pressure assessment device was composed of a blood pressure transducer commonly used in arterial catheters for arterial pressure monitoring with three connecting branches. The first branch was connected to the 'arterial pressure exit' in the monitoring device. The second, an IV tube, was connected to one litre of physiological serum in a pressure bag inflated to 200 mmHg. The third, also an IV tube with a sterile extension cable, was directly connected to an 18G standard straight needle to be inserted in the tissues for which interstitial pressure had to be measured. In patients with thermal burns, we measured pressure before and after escharotomy. Threshold intracompartmental pressure was 35 mmHg. We carried out pressure assessment of all muscular compartments during and at the end of surgery. The pressure transducer provides a pressure value in all muscular compartments with a time of installation and measuring of less than 5 minutes. Sensitivity is measured at +/- 1 mmHg. Operation is simple, non-operator dependent, and accessible to medical and paramedic teams. The pressure transducer allows accurate diagnosis of early or established compartment syndrome. It requires no additional equipment and its application does not delay therapeutic management. Its use helps with fasciotomy decision, especially after escharotomy, guides the surgeon in the exploration of different compartments and verifies the effectiveness of surgery.
Collapse
Affiliation(s)
- D. Boccara
- David Boccara
Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis1 avenue Vellefaux, 75010 ParisFrance+33 1 42 38 50 44
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Boulart L, Mimoun M, Noel W, Malca N, Chaouat M, Boccara D. Dealing with tattoos in plastic surgery. Complications and medical use. ANN CHIR PLAST ESTH 2017; 62:e23-e29. [DOI: 10.1016/j.anplas.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
|
32
|
Malca N, Boulart L, Noel W, de Runz A, Chaouat M, Mimoun M, Boccara D. Dealing with tattoos in plastic surgery. Tattoo removal. ANN CHIR PLAST ESTH 2017; 62:e15-e21. [DOI: 10.1016/j.anplas.2016.09.005] [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: 07/25/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
|
33
|
de Runz A, Boccara D, Bekara F, Chaouat M, Mimoun M. Outcome of 122 delayed breast reconstruction following post-mastectomy radiotherapy: The scarless latissimus dorsi flap with tissue expansion technique. ANN CHIR PLAST ESTH 2017; 62:23-30. [DOI: 10.1016/j.anplas.2016.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
|
34
|
Guibert M, Chaouat M, Boccara D, Marco O, Lavocat R, Alameri O, Deslandes E, Montlahuc C, Mimoun M. [Not Available]. Ann Burns Fire Disasters 2016; 29:130-134. [PMID: 28149235 PMCID: PMC5286994] [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] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/11/2016] [Indexed: 06/06/2023]
Abstract
Split-thickness meshed skin graft is frequently used in the treatment of acute burns. We studied the effect of the type of basement preparation on graft intake and healing time. We retrospectively analysed 1,129 meshed grafts used in the treatment of acute burns between 1995 and 2005. Intake was significantly better after avulsion (82%) than after tangential excision (75%). Intake was better if avulsion was performed before day 7 (83% vs. 73%). A trend for better intake after tangential excision was seen when performed between day 7 and 21. Healing time was significantly shorter after tangential excision. These results show the paradox that avulsion favours graft intake but delays healing time, contrary to tangential excision.
Collapse
Affiliation(s)
- M. Guibert
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - M. Chaouat
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - D. Boccara
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - O. Marco
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - R. Lavocat
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - O. Alameri
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| | - E. Deslandes
- Hôpital Saint-Louis, Service de biostatistiques, Paris, France
| | - C. Montlahuc
- Hôpital Saint-Louis, Service de biostatistiques, Paris, France
| | - M. Mimoun
- Hôpital Saint-Louis, Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, Paris, France
| |
Collapse
|
35
|
Marco O, Boccara D, Mimoun M, Luini J, Chaouat M. [T plasty for the treatment of skin forehead defects]. ANN CHIR PLAST ESTH 2013; 60:208-13. [PMID: 24051125 DOI: 10.1016/j.anplas.2013.07.006] [Citation(s) in RCA: 3] [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: 05/31/2013] [Accepted: 07/14/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The closure of the skin defect of the forehead area with local flap must prevent the distortions of the eyebrow and hairlines and must limit the visibility of the scars. The H plasty is the most common procedure to treat this kind of defect but the scars are extensive and numerous. The H cutaneous flap presents necrosis risks if the skin is thin and the defect important. The H musculocutaneous flap presents sensitive and motors lesions risks. The T cutaneous flap is a good choice because of its excellent cosmetic result and minimized risks. MATERIALS AND METHODS Twenty-six patients have been treated by the same surgeon between 2006 and 2012 with T cutaneous flap in order to treat forehead and temples' skin defects (the surface goes from 1.5 to 15cm). RESULTS Excisions were completed in the every 26 cases. We had excellent cosmetic result and no complications such as necrosis, infection, sensitive and motor troubles after the surgery. DISCUSSION The T plasty is easy for treating skin forehead defects. The scars are 25% less extensive than with a H plasty. The T flap permits to treat important defects without distortion or risks. CONCLUSION The T cutaneous flap can easily substitute the H plasty for the forehead and temples reconstruction with no risks but good cosmetics results.
Collapse
Affiliation(s)
- O Marco
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 10, avenue Claude-Vellefaux, 75010 Paris, France.
| | - D Boccara
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 10, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Mimoun
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 10, avenue Claude-Vellefaux, 75010 Paris, France
| | - J Luini
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 10, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Chaouat
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 10, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
36
|
Petit A, Boccara D, Chaouat M, Mimoun M. [Reconstruction of transfixing loss of substance from the wing of the nose by composite graft of the controlateral nostril: about three cases]. ANN CHIR PLAST ESTH 2013; 59:280-6. [PMID: 23953676 DOI: 10.1016/j.anplas.2013.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 05/23/2013] [Accepted: 07/08/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Reconstruction of the loss of transfixing substance from the nose wing is one of the most difficult procedures in facial plastic surgery. We propose a new technique consisting of a composite graft of the controlateral nostril among patients having an asymmetry of the nostrils. PATIENTS AND METHODS A clinical study was carried out on three patients who had undergone a composite nasal graft. The graft was harvested from the nostril controlateral to the nasal defect then placed at the level of the previously prepared affected nostril. RESULTS Three patients aged 27, 37 and 39years respectively received a controlateral nasal composite graft for the treatment of transfixing substance loss of the nose wing of less than 1cm. In all three cases, the result was judged to be very satisfactory by the surgeon and by all the patients. CONCLUSION The controlateral nasal composite graft is a straightforward, quick and reliable technique to treat small losses of transfixing substance from the nose wing. However, because of an uncertain cicatricial ransom of the donor site, this technique must be compared to the auricular composite graft that is the technique of reference.
Collapse
Affiliation(s)
- A Petit
- Service de chirurgie plastique, reconstructrice et esthétique, centre des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - D Boccara
- Service de chirurgie plastique, reconstructrice et esthétique, centre des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice et esthétique, centre des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice et esthétique, centre des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
37
|
Luini J, Chaouat M, Uzzan C, Boccara D, Mimoun M. Lambeau musculocutané de grand dorsal à cicatrice unique et palette transversale en reconstruction mammaire. ANN CHIR PLAST ESTH 2013; 58:47-53. [DOI: 10.1016/j.anplas.2012.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 04/25/2012] [Indexed: 10/28/2022]
|