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Maire C, Trigano C, Belkhou A, Guerreschi P. Correction of Cleft Lip Sequelae by Hyaluronic Acid Injections: Clinical and Ultrasonographic Evaluation of Efficacy and Safety in a Series of 7 Patients. Dermatol Surg 2024; 50:393-395. [PMID: 38382083 DOI: 10.1097/dss.0000000000004085] [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] [Indexed: 02/23/2024]
Affiliation(s)
- Cyril Maire
- Department of Dermatology Lille, CHU Lille, Hauts-de-France, France
- Saint-Jean Medical Center, Dermatology, Arras, France
| | - Camille Trigano
- Department of Plastic and Reconstructive Surgery Lille, CHU Lille, Hauts-de-France, France
- Reference Center Rare Diseases, Clefts and Facial Malformations Lille, France
| | - Anissa Belkhou
- Department of Plastic and Reconstructive Surgery Lille, CHU Lille, Hauts-de-France, France
- Reference Center Rare Diseases, Clefts and Facial Malformations Lille, France
| | - Pierre Guerreschi
- Department of Plastic and Reconstructive Surgery Lille, CHU Lille, Hauts-de-France, France
- Reference Center Rare Diseases, Clefts and Facial Malformations Lille, France
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Jordao A, Cléret D, Dhayer M, Le Rest M, Cao S, Rech A, Azaroual N, Drucbert AS, Maboudou P, Dekiouk S, Germain N, Payen J, Guerreschi P, Marchetti P. Engineering 3D-Printed Bioresorbable Scaffold to Improve Non-Vascularized Fat Grafting: A Proof-of-Concept Study. Biomedicines 2023; 11:3337. [PMID: 38137558 PMCID: PMC10741522 DOI: 10.3390/biomedicines11123337] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Autologous fat grafting is the gold standard for treatment in patients with soft-tissue defects. However, the technique has a major limitation of unpredictable fat resorption due to insufficient blood supply in the initial phase after transplantation. To overcome this problem, we investigated the capability of a medical-grade poly L-lactide-co-poly ε-caprolactone (PLCL) scaffold to support adipose tissue and vascular regeneration. Deploying FDM 3D-printing, we produced a bioresorbable porous scaffold with interconnected pore networks to facilitate nutrient and oxygen diffusion. The compressive modulus of printed scaffold mimicked the mechanical properties of native adipose tissue. In vitro assays demonstrated that PLCL scaffolds or their degradation products supported differentiation of preadipocytes into viable mature adipocytes under appropriate induction. Interestingly, the chorioallantoic membrane assay revealed vascular invasion inside the porous scaffold, which represented a guiding structure for ingrowing blood vessels. Then, lipoaspirate-seeded scaffolds were transplanted subcutaneously into the dorsal region of immunocompetent rats (n = 16) for 1 or 2 months. The volume of adipose tissue was maintained inside the scaffold over time. Histomorphometric evaluation discovered small- and normal-sized perilipin+ adipocytes (no hypertrophy) classically organized into lobular structures inside the scaffold. Adipose tissue was surrounded by discrete layers of fibrous connective tissue associated with CD68+ macrophage patches around the scaffold filaments. Adipocyte viability, assessed via TUNEL staining, was sustained by the presence of a high number of CD31-positive vessels inside the scaffold, confirming the CAM results. Overall, our study provides proof that 3D-printed PLCL scaffolds can be used to improve fat graft volume preservation and vascularization, paving the way for new therapeutic options for soft-tissue defects.
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Affiliation(s)
- Amélia Jordao
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Damien Cléret
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Mélanie Dhayer
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
| | - Mégann Le Rest
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Shengheng Cao
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Alexandre Rech
- University of Lille, Faculté de Pharmacie, Plateau RMN, UFR3S, F-59000 Lille, France
| | - Nathalie Azaroual
- University of Lille, ULR 7365–GRITA–Groupe de Recherche Sur Les Formes Injectables Et Les Technologies Associées, F-59000 Lille, France;
| | - Anne-Sophie Drucbert
- U 1008 Controlled Drug Delivery Systems and Biomaterials, Inserm, F-59000 Lille, France
| | | | - Salim Dekiouk
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
| | - Nicolas Germain
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
| | - Julien Payen
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Pierre Guerreschi
- U 1008 Controlled Drug Delivery Systems and Biomaterials, Inserm, F-59000 Lille, France
- Service de Chirurgie Plastique, CHU Lille, F-59000 Lille, France
| | - Philippe Marchetti
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
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Gagnerie P, Sanges S, Guerreschi P, Wiel E, Lebuffe G, Sanctorum T, Jourdain M, Morell-Dubois S, Zéphir H. Training first-year medical residents to break bad news using healthcare role-play and trainees as simulated patients: Experience of the "ADIAMED" program from Lille University School of Medicine. Rev Med Interne 2023; 44:632-640. [PMID: 37923588 DOI: 10.1016/j.revmed.2023.10.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Several studies suggest the relevance of healthcare simulation to prepare future doctors to deliver bad news. A such, we designed a role-play workshop to train first-year residents enrolled in Lille University School of Medicine to break bad news. The objective of this work is to report on our experience of this training and to assess its educational value through its capacity to satisfy residents' expectations, to induce a feeling of ease towards bad news disclosure, and to change trainees' preconceptions regarding these situations. METHODS The training consisted of a 45-minute heuristic reflective activity, aimed at identifying residents' preconceptions regarding bad news disclosure, followed by 4 30-min role-plays in which they played the parts of the physician, the patient and/or their relatives. Trainees were asked to answer 2 questionnaires (pre- and post-training), exploring previous experiences, preconceived ideas regarding bad news disclosure and workshop satisfaction. RESULTS Almost all residents felt very satisfied with the workshop, which they regarded as formative (91%) and not too stressful (89%). The majority felt "more capable" (53% vs. 83%) and "more comfortable" (27% vs. 62%) to deliver bad news, especially regarding "finding the right words" (12% vs. 22%). Trainees tended to overestimate their skills before the workshop and lowered their assessment of their performance after attending the training, especially when they played the role of a patient in the simulation. CONCLUSION Healthcare role-play seems an interesting technique for training to breaking bad news. Placing residents in the role of patients or relatives is an active approach that encourages reflexivity.
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Affiliation(s)
- P Gagnerie
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Centre de Simulation PRESAGE, Université de Lille, 59000 Lille, France
| | - S Sanges
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Centre de Simulation PRESAGE, Université de Lille, 59000 Lille, France; Université de Lille, Inserm, CHU de Lille, Département de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France.
| | - P Guerreschi
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Département de Chirurgie Plastique, Inserm, CHU de Lille, 59000 Lille, France
| | - E Wiel
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Université de Lille, CHU de Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France; Pôle de l'Urgence, CHU de Lille, 59000 Lille, France
| | - G Lebuffe
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Centre de Simulation PRESAGE, Université de Lille, 59000 Lille, France; Pôle d'anesthésie réanimation - ULR 7365-GRITA - groupe de recherche sur les formes injectables et les techniques associées, Université de Lille, CHU de Lille, 59000 Lille, France
| | - T Sanctorum
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Centre de Simulation PRESAGE, Université de Lille, 59000 Lille, France
| | - M Jourdain
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Centre de Simulation PRESAGE, Université de Lille, 59000 Lille, France; Université de Lille, Inserm, CHU de Lille, U1190, Department of Intensive Care Medicine, 59000 Lille, France
| | - S Morell-Dubois
- Université de Lille, Inserm, CHU de Lille, Département de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - H Zéphir
- UFR3S Médecine, Université de Lille, 59000 Lille, France; Département de Neurologie, CHU de Lille, 59000 Lille, France; Université de Lille, Inserm U 1172, CHU de Lille, 59000 Lille, France
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Ngô B, Barry L, Bonte A, Belkhou A, Calibre C, Pasquesoone L, Guerreschi P, Duquennoy-Martinot V. [Gynécomastia. Management of diagnosis and therapy. Apropos of 148 cases]. ANN CHIR PLAST ESTH 2022; 67:382-392. [PMID: 36058764 DOI: 10.1016/j.anplas.2022.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Gynecomastia is the most frequently breast lesion in males. 148 patients (mean age 24,7 years) operated in our department were reviewed with a mean follow-up of five years. Gynecomastia occurred most frequently during puberty (77,7 %), was bilateral (86,5%) and idiopathic (89,9%). The size of the enlargement was evaluated according to Simon's-classification based on breast-volume and skin-redundancy. 17 (11,5%) stage 1, 77 (52%) stage 2A, 32 (21,6%) stage 2B, 22 (14,9%) stage 3. Clinical examination and mammography determined the consistency of gynecomastia: adipose or firm. 4 different surgical managements were used: 17 (11,5%) subcutaneous mastectomies, 4 (2,7%) liposuctions, 110 (74,3%) liposuctions associated with subcutaneous mastectomy, 17 (11,5%) total mastectomy. All techniques gave good morphologic results. Nonetheless, the authors recommend the combination «liposuction and subcutaneous mastectomy», as this technique presents many advantages: small intraoperative blood loss, good skin redraping, short hospital stay, complete histologic examination of the material removed.
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Affiliation(s)
- B Ngô
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France.
| | - L Barry
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - A Bonte
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - A Belkhou
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - C Calibre
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France
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Duquennoy-Martinot V, Calibre C, Guerreschi P, Belkhou A, Barry L. [Is it legitimate to propose surgery of the breast area before the end of puberty?]. ANN CHIR PLAST ESTH 2022; 67:425-437. [PMID: 35879119 DOI: 10.1016/j.anplas.2022.06.007] [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: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/01/2022]
Abstract
Breast surgery is usually recommended for women who have completed puberty. Indeed, during adolescence the breast is constantly changing, the patient's weight is often unstable, the risk of inflammatory scars (hypertrophic or keloid) is higher and disturbances of areolar sensitivity can affect the patient's quality of sexual life. In addition, the risk of infection is not negligible, especially during an acne outbreak. In case of early implant placement, iterative changes should be planned. Finally, the result obtained is not always stable but above all the lack of psychological maturity and the legal need to obtain the agreement of both parents are obstacles to early surgery. However, the authors argue for the possibility of surgical correction of the breast around puberty, in particular because of the very clear positive psychological impact. Other arguments are also detailed: to ensure a breast reconstruction in successive stages started early, to limit the repercussions of hypertrophy, to correct thoracic or skin anomalies. These indications are illustrated by numerous clinical cases demonstrating the need for customized surgery on a case-by-case basis.
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Affiliation(s)
- V Duquennoy-Martinot
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - C Calibre
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - P Guerreschi
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - A Belkhou
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - L Barry
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
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Lacroix G, Duquennoy-Martinot V, Guerreschi P. Le muscle buccinateur : une nouvelle cible pour les injections de toxine botulique dans le traitement des séquelles de paralysie faciale. ANN CHIR PLAST ESTH 2022; 67:125-132. [DOI: 10.1016/j.anplas.2022.04.001] [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] [Received: 03/16/2022] [Accepted: 04/04/2022] [Indexed: 11/24/2022]
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Vinchon M, Guerreschi P, Karnoub MA, Wolber A. Linear craniectomy for early posterior decompression in craniosynostoses: technique and results. Childs Nerv Syst 2021; 37:3113-3118. [PMID: 33713165 DOI: 10.1007/s00381-021-05117-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Early decompressive posterior linear craniectomy (PLC) can be indicated in very young infants with complex multisuture synostosis, which often involve the lambdoid suture (LS). The literature data on the surgical technique and its results are scarce. MATERIAL AND METHODS Based on our experience with PLC during the last 10 years, we detail our surgical technique for PLC, the possible pitfalls, and complication avoidance. RESULTS We review seven observations, 5 girls and 2 boys, 6 of these with identified mutations, operated for PLC at a mean age of 3.19 months (6 days to 6.1 months). One patient died of unexplained cardiac arrest on postoperative day two, the others had a favorable outcome with good development and no visual loss. Three of these required additional cranioplasty at a later age, one of these with craniofacial distraction. DISCUSSION PLC can be a salvage operation in very young patients with complex synostosis involving the LS, and with proper preparation and careful technique, allows favorable outcome. The approach must be versatile in order to anticipate further surgeries in these complex, most often syndromic cases.
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Affiliation(s)
- Matthieu Vinchon
- Department of Pediatric Neurosurgery, Lille University Hospital, Lille, France.
| | - Pierre Guerreschi
- Department of Plastic Surgery, Lille University Hospital, Lille, France
| | | | - Alexis Wolber
- Department of Plastic Surgery, Lille University Hospital, Lille, France
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Vinchon M, Guerreschi P, Karnoub MA, Wolber A. Morphological and surgical results in sagittal synostosis: early craniectomy versus later cranioplasty. Childs Nerv Syst 2021; 37:2335-2341. [PMID: 33884481 DOI: 10.1007/s00381-021-05178-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/18/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Morphological correction is one of the main aims of surgery for sagittal synostosis (SSO). Different surgical techniques have been developed; however, few studies have compared the different surgical protocols. The morphological outcome is poorly documented, because a consensual evaluation tool is lacking. MATERIAL AND METHODS We performed a prospective study of children operated for SSO in our institution. Children were operated whenever possible at 4 months for craniectomy; by default, children underwent cranioplasty at or after 9 months. The morphological outcome of all children was evaluated using traditional craniometry with head circumference (HC) and the cephalic index (CI), and with the Rotterdam scaphocephaly morphology score (RSMS), a total of semi-quantitative assessments of morphological hallmarks. RESULTS Craniectomy was significantly associated with a shorter operation time and hospital stay, and a better impact on HC and CI measurements, compared with cranioplasty. The RSMS was markedly improved after surgery in both groups; however, we found no significant difference in improvement between the two groups. Although the transfusion rate and the prevalence of developmental delay were lower in the craniectomy group, and reoperations for calvarial lacunae or complex craniosynostosis occurred only this group, these differences were not significant. CONCLUSIONS Our results support early surgery with craniectomy whenever possible; however, cranioplasty at a later age is a very acceptable by-default indication. In addition to classical craniometry, morphological evaluation using the RSMS or a similar quantitative scale appears highly desirable for future studies.
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Affiliation(s)
- Matthieu Vinchon
- Department of Pediatric Neurosurgery, Lille University Hospital, Lille, France.
| | - Pierre Guerreschi
- Department of Plastic Surgery, Lille University Hospital, Lille, France
| | | | - Alexis Wolber
- Department of Plastic Surgery, Lille University Hospital, Lille, France
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Farhat MM, Guerreschi P, Morell-Dubois S, Deken V, Labreuche J, Sanges S, Sobanski V, Hachulla E, Cottencin O, Launay D. POS1454-HPR AESTHETIC IMPAIRMENT IN PATIENTS WITH SYSTEMIC SCLEROSIS: A CASE CONTROL STUDY USING A SEMI-QUANTITATIVE SCALE FOR BODY IMAGE ASSESSMENT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic sclerosis (SSc) is a fibrotic autoimmune disease characterized by dermatological involvement. Skin involvement can alter appearance, which can have a psychological impact(1). Assessment of body image could be central in optimizing care. Yet, data are scarce(2).Objectives:The main objective of our study was to assess aesthetic impairment measured on a visual aesthetic scale (AES) (3) in patients with SSc compared to a group of healthy subjects. Secondary objectives were to assess associations between aesthetic impairment and standardized questionnaires for aesthetic impairment as well as clinical, biological, psychological/quality of life, and functional parameters of SSc.Methods:The “Sclero-esthet” study is a descriptive single-center study of two populations: patients with SSc, included in a referral center for systemic and autoimmune diseases at Lille Hospital, France, and healthy controls.Results:This study, from January 2017 to October 2017, included 88 patients (69 [78.4%] women) with a median age of 52 years (range: 43 to 59) and 88 controls (49 [55.7%] women) with a median age of 45 years (range: 32 to 55). Perception of physical changes assessed using the AES was greater in cases than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p=0.028), with statistical correlation with ASWAP. SSc patients with anxiety or depressive symptoms had significantly higher AES scores. Cases presented poorer quality of life than controls.Conclusion:The AES appears to be a good tool to evaluate aesthetic impairment. Correlations found with psychological and quality of life parameters support the need to improve patient management in this field.References:[1]Cash TF. Body image: past, present, and future. Body Image 2004;1(1):1–5.[2]Benrud-Larson LM, Heinberg LJ, Boling C, Reed J, White B, Wigley FM. Body image dissatisfaction among women with scleroderma: extent and relationship to psychosocial function. Health Psychol mars. 2003;22(2):130–9.[3]Nguyen C, Ranque B, Baubet T, Bérezné A, Mestre-Stanislas C, Rannou F, et al. Clinical, Functional and Health-Related Quality of Life Correlates of Clinically Significant Symptoms of Anxiety and Depression in Patients with Systemic Sclerosis: A Cross-Sectional Survey. PLoS ONE 2014;9(2).[4]Heinberg LJ, Kudel I, White B, Kwan A, Medley K, Wigley F. Assessing body image in patients with systemic sclerosis (scleroderma): Validation of the Adapted Satisfaction with Appearance Scale. Body Image 2007;4(1):79–86.Disclosure of Interests:None declared
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Abstract
PURPOSE Lambdoid synostosis (LS) is a rare condition, which is either isolated; associated with sagittal synostosis, the "Mercedes-Benz" syndrome (MBS); or with synostosis of the coronal sutures (oxycephalic form). In addition, LS is part of the phenotype of a growing number of genetic diseases. The nosology, pathophysiology, and management are controversial. We decided to review our experience with LS. METHODS We reviewed retrospectively pediatric cases of LS proved on CT-scanner, isolated or associated with other conditions, followed in our craniofacial center during the last 15 years, regarding clinical presentation, anatomical lesions, syndromic associations, surgical management, and outcome. RESULTS We reviewed 48 cases: 6 isolated LS, 22 MBS, and 20 oxycephalic. A syndromic context was present in 72% (up to 80% of oxycephalic cases), and faciostenosis was present in 23%, mostly oxycephalic cases (40%). Transverse sinus agenesis was found in 61% of documented patients. A total of 31% of children had a dystocic birth, up to 45% of MBS. Decompressive craniectomy or cranioplasty was needed in a majority of patients, often young infants, while posterior fossa decompression was mostly performed in older children. CONCLUSION LS is rarely isolated and non syndromic; most cases are found in a wide spectrum of diseases, and LS is often associated with sagittal or coronal synostosis. Genetic evaluation is mandatory for LS; conversely, geneticists may require neurosurgical advice for LS in an increasing number of very rare diseases. The surgical management of LS should be tailored according to clinical presentation, age, and syndromic context.
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Affiliation(s)
- Matthieu Vinchon
- Department of Pediatric Neurosurgery, Lille University Hospital, 59 037, Lille Cedex, France.
| | - Pierre Guerreschi
- Department of Plastic Surgery, Lille University Hospital, Lille, France
| | - Melodie-Anne Karnoub
- Department of Pediatric Neurosurgery, Lille University Hospital, 59 037, Lille Cedex, France
| | - A Wolber
- Department of Plastic Surgery, Lille University Hospital, Lille, France
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Bertrand N, Guerreschi P, Basset-Seguin N, Saiag P, Dupuy A, Dalac-Rat S, Dziwniel V, Depoortère C, Duhamel A, Mortier L. Vismodegib in neoadjuvant treatment of locally advanced basal cell carcinoma: First results of a multicenter, open-label, phase 2 trial (VISMONEO study): Neoadjuvant Vismodegib in Locally Advanced Basal Cell Carcinoma. EClinicalMedicine 2021; 35:100844. [PMID: 33997740 PMCID: PMC8093898 DOI: 10.1016/j.eclinm.2021.100844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Surgery is the primary treatment for basal cell carcinoma (BCC). In locally advanced basal cell carcinoma (laBCC), surgery may cause functional or aesthetic damage. In laBCC, neoadjuvant administration of vismodegib, an inhibitor of the Hedgehog signaling pathway, may reduce tumor size, facilitate resection, and reduce functional and aesthetic consequences of surgery. The VISMONEO study assessed efficacy and safety of vismodegib in neoadjuvant treatment of laBCC. METHODS VISMONEO (NCT02667574) is an open-label, noncomparative, multicenter, phase 2 study. Patients with ≥1 histologically confirmed facial BCC, inoperable or operable with functional or major aesthetic sequelae risk, were included. Oral vismodegib 150 mg was administered once daily for 4 to 10 months before planned surgery, which was performed once the best response under vismodegib was observed. Primary endpoint was percentage of patients with BCC with tumor downstaging following surgical resection after neoadjuvant vismodegib. Downstaging was defined according to a 6-stage surgical classification related to the aesthetic and functional consequences of surgery. FINDINGS 55 patients (median age: 73 years) with laBCC were included from November 2014 to June 2015. At inclusion, 4 patients were inoperable, 15 were operable with a major functional risk, and 36 were operable with a minor functional risk or a major aesthetic risk. Mean size of target lesion was 47.3 mm (SD: 27.2 mm). 44 patients presented with downstaging after vismodegib treatment (80%; 95% confidence interval [CI], 67 to 90). Of these 44 patients, 27 had a complete response (25 proved by biopsy). Mean treatment duration was 6.0 months. Overall Response Rate according to RECIST 1.1 criteria was 71% (95% CI, 59 to 88). At 3-years of follow-up, 16/44 patients had known recurrence (36%; 95%CI, 22 to 51). INTERPRETATION Neoadjuvant vismodegib allows for a downstaging of the surgical procedure for laBCCs in functionally sensitive locations. FUNDING VISMONEO was funded by F. Hoffmann-La Roche Ltd.
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Affiliation(s)
| | - Pierre Guerreschi
- Univ. Lille, CHU Lille, Plastic and Reconstructive Surgery Department, Lille, France
| | | | - Philippe Saiag
- Hôpital Ambroise Paré AP-HP, Dermatology Department, Boulogne‐Billancourt, France
| | - Alain Dupuy
- CHU Rennes, Dermatology Department, Rennes, France
| | | | | | - César Depoortère
- Univ. Lille, CHU Lille, Plastic and Reconstructive Surgery Department, Lille, France
| | | | - Laurent Mortier
- Univ. Lille, INSERM U1189, CHU Lille, Dermatology Department, Lille, France
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12
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Chevalier T, Pasquesoone L, Guerreschi P, Duquennoy-Martinot V. [Violence against women through burns, about two cases]. ANN CHIR PLAST ESTH 2021; 66:273-275. [PMID: 33824026 DOI: 10.1016/j.anplas.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- T Chevalier
- Service de chirurgie plastique, reconstructrice et esthétique, Centre de traitement des brûlés, Hôpital Salengro, Centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
| | - L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, Centre de traitement des brûlés, Hôpital Salengro, Centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, Centre de traitement des brûlés, Hôpital Salengro, Centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, Centre de traitement des brûlés, Hôpital Salengro, Centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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13
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Gradwohl M, Chai F, Payen J, Guerreschi P, Marchetti P, Blanchemain N. Effects of Two Melt Extrusion Based Additive Manufacturing Technologies and Common Sterilization Methods on the Properties of a Medical Grade PLGA Copolymer. Polymers (Basel) 2021; 13:572. [PMID: 33672918 PMCID: PMC7917935 DOI: 10.3390/polym13040572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Although bioabsorbable polymers have garnered increasing attention because of their potential in tissue engineering applications, to our knowledge there are only a few bioabsorbable 3D printed medical devices on the market thus far. In this study, we assessed the processability of medical grade Poly(lactic-co-glycolic) Acid (PLGA)85:15 via two additive manufacturing technologies: Fused Filament Fabrication (FFF) and Direct Pellet Printing (DPP) to highlight the least destructive technology towards PLGA. To quantify PLGA degradation, its molecular weight (gel permeation chromatography (GPC)) as well as its thermal properties (differential scanning calorimetry (DSC)) were evaluated at each processing step, including sterilization with conventional methods (ethylene oxide, gamma, and beta irradiation). Results show that 3D printing of PLGA on a DPP printer significantly decreased the number-average molecular weight (Mn) to the greatest extent (26% Mn loss, p < 0.0001) as it applies a longer residence time and higher shear stress compared to classic FFF (19% Mn loss, p < 0.0001). Among all sterilization methods tested, ethylene oxide seems to be the most appropriate, as it leads to no significant changes in PLGA properties. After sterilization, all samples were considered to be non-toxic, as cell viability was above 70% compared to the control, indicating that this manufacturing route could be used for the development of bioabsorbable medical devices. Based on our observations, we recommend using FFF printing and ethylene oxide sterilization to produce PLGA medical devices.
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Affiliation(s)
- Marion Gradwohl
- U1008 Controlled Drug Delivery Systems and Biomaterials, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Lille (CHU Lille), University of Lille, F-59000 Lille, France; (M.G.); (F.C.); (P.G.)
- UMR 9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, Institut de Recherche contre le Cancer de Lille, University Lille, CNRS, Inserm, CHU Lille, F-59000 Lille, France;
- LATTICE MEDICAL, F-59120 Loos, France;
| | - Feng Chai
- U1008 Controlled Drug Delivery Systems and Biomaterials, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Lille (CHU Lille), University of Lille, F-59000 Lille, France; (M.G.); (F.C.); (P.G.)
| | | | - Pierre Guerreschi
- U1008 Controlled Drug Delivery Systems and Biomaterials, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Lille (CHU Lille), University of Lille, F-59000 Lille, France; (M.G.); (F.C.); (P.G.)
- Service de Chirurgie Plastique Reconstructrice et Esthétique, CHU de Lille, F-59037 Lille, France
| | - Philippe Marchetti
- UMR 9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, Institut de Recherche contre le Cancer de Lille, University Lille, CNRS, Inserm, CHU Lille, F-59000 Lille, France;
- Banque de Tissus, Centre de Biologie-Pathologie, CHU Lille, F-59000 Lille, France
| | - Nicolas Blanchemain
- U1008 Controlled Drug Delivery Systems and Biomaterials, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Lille (CHU Lille), University of Lille, F-59000 Lille, France; (M.G.); (F.C.); (P.G.)
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14
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Germain N, Hatzfeld AS, Pasquesoone L, Danze PM, Guerreschi P, Sendid B, Gaillot O, Marchetti P. How to improve donor skin availability: Pragmatic procedures to minimize the discard rate of cryopreserved allografts in skin banking. Burns 2020; 47:387-396. [PMID: 32788056 DOI: 10.1016/j.burns.2020.07.004] [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: 03/11/2020] [Revised: 05/28/2020] [Accepted: 07/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Microbial contamination of human skin allografts is a frequent cause of allograft discard. Our purpose was to evaluate the discard rate of skin bank contaminated allografts and specific procedures used to reduce allograft contamination without affecting safety. METHODS We conducted at the Lille Tissue Bank a retrospective study of all deceased donors (n = 104) harvested from January 2018 to December 2018. Skin procurement was split into 3 zones: the back of the body and the two legs that were processed separately. It represented 433 cryopreserved skin allograft pouches of approximatively 500 cm² each. Donors were almost equally split between brain-dead (53%, 55/104) and cadaveric (47%, 49/104) donors. RESULTS Out of all donors, 42 (40.5%) had at least one sampling zone with a positive microbiological test resulting in 106 (24%) contaminated skin pouches. The contamination rate did not vary according to the harvested zone or type of donor. Traumatic deaths showed significantly less contamination rates than other death types (p < 0.05). Contamination rate decreased with time spent in the antibiotic solution. The risk of having contaminated allografts was five-fold higher when the skin spent less than 96 h in the antibiotic cocktail (p < 0.05). According to our validation protocol, most donors (32/42, 76%) had skin allografts contaminated with bacteria (mainly Staphylococcus spp) compatible with clinical use. No recipient infection was recorded as a result of skin graft contaminated with saprophytic or non-pathogenic germs. By harvesting 3 separate zones per donor, the total surface area for clinical use increased by 53% for contaminated donors. Overall, the proportion of contamination-related discarded allografts was 3.2% (14/433 of pouches). CONCLUSION Few simple pragmatic measures (including skin incubation in the antibiotic bath for at least 96 h at 4 °C, splitting the skin harvesting areas to minimize the risk of cross-infection and clinical use of allografts contaminated with saprophytic and non-pathogenic germs) can reduce the discard rate of contaminated allografts without affecting clinical safety.
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Affiliation(s)
- Nicolas Germain
- CHU Lille, Lille Tissue Bank, Biology Pathology Center, F-59000 Lille, France; Univ. Lille, CNRS, Inserm, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille, France
| | | | - Louise Pasquesoone
- CHU Lille, Department of Plastic Surgery and Burn Care Unit, F-59000 Lille, France
| | - Pierre-Marie Danze
- CHU Lille, Lille Tissue Bank, Biology Pathology Center, F-59000 Lille, France
| | - Pierre Guerreschi
- CHU Lille, Department of Plastic Surgery and Burn Care Unit, F-59000 Lille, France
| | - Boualem Sendid
- CHU Lille, Department of Mycology and Parasitology, Université Lille, LIRIC - Inserm UMR 995- Team 2, F-59000 Lille, Lille, France
| | - Olivier Gaillot
- CHU Lille, Department of Bacteriology, CNRS, INSERM, CHU Lille, U1019-UMR 8204, Center for Infection and Immunity, F-59000 Lille, Lille, France
| | - Philippe Marchetti
- CHU Lille, Lille Tissue Bank, Biology Pathology Center, F-59000 Lille, France; Univ. Lille, CNRS, Inserm, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille, France.
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15
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Deveaux C, Calibre C, Duquennoy-Martinot V, Guerreschi P, Dumont A. [New surgical strategy in breast reconstruction with implants for bilateral prophylactic mastectomies with BRCA gene mutation]. ANN CHIR PLAST ESTH 2020; 65:284-293. [PMID: 32482352 DOI: 10.1016/j.anplas.2020.05.004] [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: 05/02/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND For the past decades, number of prophylactic bilateral mastectomies using reconstruction with implants increases. We describe a new surgical strategy and analyse its safety and feasability. METHOD It is a retrospective, descriptive and monocentric study. The first step of surgery consisted in obteining a peri-prosthetic capsule with implants and if there was a mammary hypertrophy and/or ptosis, it was corrected at the same time. The second step of surgery was the nipple-sparing mastectomy with change of implants for bigger ones. Third step consisted in a lipofilling. RESULTS Seven patients were included. 6 women had a BRCA1 gene mutation. Mean age was 35.6 year-old [29.6; 41.6], mean BMI was 23.8kg/m2 [20.6; 27], mean chest circumference was 93.7cm [87.4; 100], mean cup was C- [B-; D-]. 4 women had mammary hypertrophy and/or ptosis. Mean number of procedure per woman was 3.6 [2.5; 4.7]. Mean volume of implants used at the first step was 248.6ml [211.3; 285.9]. The second step was performed mean 33.9 weeks [22.3; 45.5] later. Mean increase of implants volume was 120ml [80.4; 159.6]. 4 patients had complications including 1 who had implant exposure. Six patients had lipofilling of mean volume per breast of 175ml [116; 234]. CONCLUSION This new strategy could decrease complication rate, improve aesthetic outcome and decrease psychological impact of surgery.
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Affiliation(s)
- C Deveaux
- Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France.
| | - C Calibre
- Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France
| | - A Dumont
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier de Boulogne-sur-Mer, rue Jacques-Monod, 62200 Boulogne-sur-Mer, France
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16
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Labbé D, Guerreschi P. [Facial paralysis sequelae: Long term follow-up revision surgery, redo, continuing care]. ANN CHIR PLAST ESTH 2019; 64:531-539. [PMID: 31492441 DOI: 10.1016/j.anplas.2019.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 11/17/2022]
Abstract
Facial paralysis sequelae have an intense psycho-social impact which imposes an optimal care in the long run. The surgical challenges are numerous, and the therapeutic weapons are multiple. We propose an analysis of these treatments by the prism of their pitfalls and their limits. The complications of the main surgical procedures are described as well as the details of the rework necessary to cope with them or to quickly correct the defects. Moreover, the result limits are detailed with suggestions to improve them. Finally, we develop the necessary iterative treatments or new therapeutic proposals that are essential for the long-term care of these patients whose sequelae of facial paralysis evolve with time and aging. The surgery of facial paralysis is not unequivocal. It requires humility, patience and tenacity to support the patient throughout his life.
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Affiliation(s)
- D Labbé
- Hôpital privé Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France
| | - P Guerreschi
- Service de chirurgie plastique et reconstructrice, CHU de Lille, hôpital Roger Salengro, 59000 Lille, France.
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17
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Hatzfeld AS, Pasquesoone L, Germain N, Danzé PM, Drucbert AS, Tardivel M, Bongiovanni A, Duquennoy-Martinot V, Guerreschi P, Marchetti P. Benefits of cryopreserved human amniotic membranes in association with conventional treatments in the management of full-thickness burns. Int Wound J 2019; 16:1354-1364. [PMID: 31429202 DOI: 10.1111/iwj.13198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/18/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/25/2022] Open
Abstract
The use of split-thickness skin autografts (STSA) with dermal substitutes is the gold standard treatment for third-degree burn patients. In this article, we tested whether cryopreserved amniotic membranes could be beneficial to the current treatments for full-thickness burns. Swines were subjected to standardised full-thickness burn injuries, and then were randomly assigned to treatments: (a) STSA alone; (b) STSA associated with the dermal substitute, Matriderm; (c) STSA plus human amniotic membrane (HAM); and (d) STSA associated with Matriderm plus HAM. Clinical and histological assessments were performed over time. We also reported the clinical use of HAM in one patient. The addition of HAM to classic treatments reduced scar contraction. In the presence of HAM, skin wound healing displayed high elasticity and histological examination showed a dense network of long elastic fibres. The presence of HAM increased dermal neovascularization, but no effect was observed on the recruitment of inflammatory cells to the wound. Moreover, the use of HAM with classical treatments in one human patient revealed a clear benefit in terms of elasticity. These results give initial evidence to consider the clinical application of HAM to avoid post-burn contractures and therefore facilitate functional recovery after deep burn injury.
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Affiliation(s)
| | | | - Nicolas Germain
- Tissue Bank of Lille, Biology Pathology Center, CHU of Lille, Lille, France.,Inserm UMR-S-1172, University of Lille, Lille, France
| | - Pierre-Marie Danzé
- Tissue Bank of Lille, Biology Pathology Center, CHU of Lille, Lille, France
| | | | | | | | | | | | - Philippe Marchetti
- Tissue Bank of Lille, Biology Pathology Center, CHU of Lille, Lille, France.,Inserm UMR-S-1172, University of Lille, Lille, France
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18
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Mortier L, Bertrand N, Basset-Seguin N, Saiag P, Dupuy A, Dalac-Rat S, Guillot B, Templier C, Desmedt E, Duhamel A, Depoortère C, Guerreschi P. Vismodégib en traitement néoadjuvant du carcinome basocellulaire localement avancé : premiers résultats de l’essai de phase 2 multicentrique VISMONEO. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Diakité C, Bénateau H, Dakpé S, Guerreschi P, Galinier P, Veyssière A. Management of nasopharyngeal teratomas associated with cleft palate. Int J Oral Maxillofac Surg 2018; 48:291-297. [PMID: 30243829 DOI: 10.1016/j.ijom.2018.07.024] [Citation(s) in RCA: 3] [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: 02/04/2018] [Revised: 05/29/2018] [Accepted: 07/11/2018] [Indexed: 12/29/2022]
Abstract
Nasopharyngeal teratomas are rare tumours, responsible for a high birth mortality rate from acute respiratory distress. Palatine localization can lead to an embryopathogenic mechanical obstacle responsible for a cleft palate. The aim of this study was to update current knowledge concerning the management of this rare pathological association. We conducted a multicentre, retrospective study by case analysis. The inclusion criteria were patients of any age under care for a nasopharyngeal teratoma associated with a velopalatine cleft. The diagnosis of the teratoma was confirmed by histological analysis. Seven cases were included in the study: three cases from the University Hospital of Lille, one from the University Hospital of Caen, one from of the University Hospital of Toulouse, and two from of the University Hospital of Amiens. Approximately 30% of patients experienced acute respiratory distress at birth, necessitating oro- or nasotracheal intubation. The surgical excision was performed in the first 5 months of life for all patients and in a single operative time for 70%. There was no recurrence. Therapeutic management of nasopharyngeal teratomas associated with cleft palate at birth is multidisciplinary and is based on surgical excision. In the absence of other associated pathologies, the prognosis is favourable.
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Affiliation(s)
- C Diakité
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, 14000 Caen, France.
| | - H Bénateau
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, 14000 Caen, France
| | - S Dakpé
- Department of Maxillofacial Surgery, Amiens University Hospital, 80000 Amiens, France
| | - P Guerreschi
- Department of Plastic Surgery, Lille University Hospital, 59000 Lille, France
| | - P Galinier
- Department of Pediatric Surgery, Toulouse University Hospital, 31000 Toulouse, France
| | - A Veyssière
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, 14000 Caen, France
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20
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Duquennoy-Martinot V, Depoortère C, Calibre C, Guerreschi P, Patenotre P. [Gluteal flap harvest for breast reconstruction]. ANN CHIR PLAST ESTH 2018; 63:498-504. [PMID: 29914690 DOI: 10.1016/j.anplas.2018.05.003] [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: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 11/15/2022]
Abstract
The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm. The two operative positions, the relative shortness of the pedicle and the firm tissues transferred are balanced by the discretion of the sequelae of the donor site and the volume which is always enough even in the slim woman. The best indication of this technique is two-sided breast reconstruction but it also provides a solution in case of contraindication of other autologous flaps, especially DIEP.
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Affiliation(s)
- V Duquennoy-Martinot
- Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.
| | - C Depoortère
- Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.
| | - C Calibre
- Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.
| | - P Guerreschi
- Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.
| | - P Patenotre
- Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.
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21
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Mortier L, Bertrand N, Basset-Seguin N, Saiag P, Dupuy A, Dalac-Rat S, Guillot B, Templier C, Desmedt E, Duhamel A, Guerreschi P. Vismodegib in neoadjuvant treatment of locally advanced basal cell carcinoma: First results of a multicenter, open-label, phase 2 trial (VISMONEO study). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9509] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Laurent Mortier
- Université Lille, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | | | - Nicole Basset-Seguin
- Dermatology Department, Hôpital Saint-Louis, Assistance-Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Saiag
- Dermatology department, CHU Ambroise Paré, AP-HP, Paris,, Boulogne-Billancourt, France
| | - Alain Dupuy
- Dermatology department, Centre d'Oncodermatologie CLCC/CHU de Rennes, Rennes, France
| | - Sophie Dalac-Rat
- Dermatology department, CHU Dijon Bourgogne, CHU Le Bocage, Dijon, France
| | - Bernard Guillot
- Dermatology department, Universitary hospital of Montpellier, CHU Montpellier,, Montpellier, France
| | | | - Eve Desmedt
- Dermatology department, University of Lille, CHRU Lille, Lille, France
| | - Alain Duhamel
- Department of Biostatistics, University Lille Nord de France, CHRU de Lille, Lille, France
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Simon A, Bocquet E, Pellerin P, Vinchon M, Dhellemmes P, Martinot V, Wolber A, Calibre C, Charlier P, Guerreschi P. Three-dimensional study of 31 cases of synostotic anterior plagiocephaly before and after surgical management the Lille protocol. J Craniomaxillofac Surg 2018; 46:958-966. [PMID: 29661661 DOI: 10.1016/j.jcms.2018.03.014] [Citation(s) in RCA: 3] [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: 06/12/2017] [Revised: 02/15/2018] [Accepted: 03/20/2018] [Indexed: 11/28/2022] Open
Abstract
Synostotic anterior plagiocephaly is a rare pathological cranial malformation. Therapeutic options are rarely studied due to the rarity of the malformation and difficulties in diagnosis and care management. The objective of this study was to analyze the results obtained with the Lille protocol based on 62 CT-scans done before and after surgery in 31 patients. A specific analysis was designed for this work. Nine cephalometric measures enabled to evidence on each CT-Scan the corrections made on the fronto-orbital bandeau and the potential impact of surgery on the craniofacial structures. Results show that surgical symmetry of the fronto-orbital bandeau in the transversal plane, according to the symmetrical axis of the semicircular canals, allows a normalization of the skull's growth and morphogenesis for the surgically affected structures but also adjacent ones.
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Affiliation(s)
- Ambre Simon
- Forensic and Forensic Anthropology Team (UVSQ/EA4569 Paris-Descartes), 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France.
| | | | - Philippe Pellerin
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Matthieu Vinchon
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Patrick Dhellemmes
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Véronique Martinot
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Alexis Wolber
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Clotilde Calibre
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Philippe Charlier
- Forensic and Forensic Anthropology Team (UVSQ/EA4569 Paris-Descartes), 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France; Department of Consultations and Public Health/Health Unit (Hôpital Max Fourestier/Maison d'Arrêt des Hauts-de-Seine), 403 Avenue de la République, 92014, Nanterre, France
| | - Pierre Guerreschi
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
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Devinck F, Deveaux C, Bennis Y, Deken-Delannoy V, Jeanne M, Martinot-Duquennoy V, Guerreschi P, Pasquesoone L. [Deep alkali burns: Evaluation of a two-step surgical strategy]. ANN CHIR PLAST ESTH 2018; 63:191-196. [PMID: 29653673 DOI: 10.1016/j.anplas.2018.03.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/16/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Chemical burns are rare but often lead to deep cutaneous lesions. Alkali agents have a deep and long lasting penetrating power, causing burns that evolve over several days. The local treatment for these patients is excision of the wound and split thickness skin graft. Early excision and immediate skin grafting of alkali burns are more likely to be complicated by graft failure and delayed wound healing. We propose a two-step method that delays skin grafting until two-three days after burn wound excision. RESULTS Our population included 25 controls and 16 cases. Men were predominant with a mean age of 41.9 years. In 78% of cases, burns were located on the lower limbs. The mean delay between the burn and excision was 16.5 days. In cases, the skin graft was performed at a mean of 11.3 days after the initial excision. We did not unveil any significant difference between both groups for the total skin surface affected, topography of the burns and the causal agent. Wound healing was significantly shorter in cases vs controls (37.5 days vs 50.3 days; P<0.025). Furthermore, we observed a decreased number of graft failures in cases vs controls (13.3% vs 46.7%; P=0.059). CONCLUSION Our study shows the relevance of a two-step surgical strategy in patients with alkali chemical burns. Early excision followed by interval skin grafting is associated with quicker wound healing and decreased rate of graft failure.
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Affiliation(s)
- F Devinck
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France.
| | - C Deveaux
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
| | - Y Bennis
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
| | - V Deken-Delannoy
- EA 2694-santé publique : épidémiologie et qualité des soins, CHU de Lille, université de Lille, 59000 Lille, France
| | - M Jeanne
- Pôle d'anesthésie réanimation, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
| | - V Martinot-Duquennoy
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
| | - L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlures, hôpital R. Salengro, CHU de Lille, 59000 Lille, France
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24
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Corazao-Rozas P, Guerreschi P, André F, Gabert PE, Lancel S, Dekiouk S, Fontaine D, Tardivel M, Savina A, Quesnel B, Mortier L, Marchetti P, Kluza J. Mitochondrial oxidative phosphorylation controls cancer cell's life and death decisions upon exposure to MAPK inhibitors. Oncotarget 2018; 7:39473-39485. [PMID: 27250023 PMCID: PMC5129946 DOI: 10.18632/oncotarget.7790] [Citation(s) in RCA: 53] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/05/2016] [Indexed: 12/24/2022] Open
Abstract
Although MAPK pathway inhibitors are becoming a promising anticancer strategy, they are insufficient to fully eliminate cancer cells and their long-term efficacy is strikingly limited in patients with BRAF-mutant melanomas. It is well established that BRAF inhibitors (BRAFi) hamper glucose uptake before the apparition of cell death. Here, we show that BRAFi induce an extensive restructuring of mitochondria including an increase in mitochondrial activity and biogenesis associated with mitochondrial network remodeling. Furthermore, we report a close interaction between ER and mitochondria in melanoma exposed to BRAFi. This physical connection facilitates mitochondrial Ca2+ uptake after its release from the ER. Interestingly, Mfn2 silencing disrupts the ER–mitochondria interface, intensifies ER stress and exacerbates ER stress-induced apoptosis in cells exposed to BRAFi in vitro and in vivo. This mitochondrial control of ER stress-mediated cell death is similar in both BRAF- and NRAS-mutant melanoma cells exposed to MEK inhibitors. This evidence reinforces the relevance in combining MAPK pathway inhibitors with mitochondriotropic drugs to improve targeted therapies.
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Affiliation(s)
- Paola Corazao-Rozas
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Pierre Guerreschi
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Fanny André
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Pierre-Elliott Gabert
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Steve Lancel
- University Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, Lille, France
| | - Salim Dekiouk
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Delphine Fontaine
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Meryem Tardivel
- Bioimaging Center, Lille Nord de France-Campus HU, Université de Lille 2, Lille, France
| | | | - Bruno Quesnel
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Laurent Mortier
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
| | - Philippe Marchetti
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France.,Centre de Bio-Pathologie, Plate-forme de Biothérapie, Banque de Tissus, CHRU Lille, Lille, France
| | - Jérome Kluza
- University Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France.,SIRIC OncoLille, Lille, France
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25
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Stella I, Vinchon M, Guerreschi P, De Berranger E, Bouacha I. Case update on cranial osteopetrosis: which is the role of the neurosurgeon? Childs Nerv Syst 2017; 33:2181-2186. [PMID: 28762040 DOI: 10.1007/s00381-017-3553-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/19/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE Osteopetrosis (OP) is a rare skeletal disease, which can affect the skull base and calvaria. A multidisciplinary approach is mandatory and patient may need neurosurgical care. Few observations have been published, and optimal management of OP is not established yet. METHOD We report a case of an infant with OP diagnosed at 5 months, who presented signs of intracranial hypertension associated with unilateral blindness. Bone marrow allograft was performed at 6 months of age. At neurosurgical first examination at 11 months, the child was hypotonic, with severe amblyopia; features of bicoronal synostosis were appreciated, with tense anterior fontanel bulging indicating synostotic oxycephaly. Head circumference had decreased from +3 SD to +1SD. Cerebral CT scan showed reduction of intracranial volume, inward thickening of the calvaria, bilateral stenosis of optic canal, ventricular dilatation, enlarged arachnoid spaces, and tonsillar herniation. We performed cranial vault expansion with frontal advancement and bi parietal decompression, thinning of the inner table, unroofing of the left orbit and optic canal in order to obtain optic nerve decompression. RESULTS Postoperative course was uneventful, and the patient was discharged on day 8. Vision was unchanged but rapid improvement of axial tonus was noted. The CT scan showed satisfactory calvarial expansion with regression of tonsillar herniation. CONCLUSIONS Neurosurgical evaluation and care are necessary in the context of a multidisciplinary approach to the patient affected by osteopetrosis. Cranial vault remodeling and expansion should be considered in patients with sign of intracranial hypertension. Timing of optic canal decompression is to be defined.
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Affiliation(s)
- Irene Stella
- Pediatric Neurosurgical Unit, Lille Regional University Hospital - Roger Salengro Hospital, rue Emile Laine, 59037, Lille Cedex, France.
| | - Matthieu Vinchon
- Pediatric Neurosurgical Unit, Lille Regional University Hospital - Roger Salengro Hospital, rue Emile Laine, 59037, Lille Cedex, France
| | - Pierre Guerreschi
- Plastic and Reconstructive Surgery, Lille Regional University Hospital Center, Lille, France
| | - Eva De Berranger
- Department of Pediatric Hematology, Lille Regional University Hospital Center , Lille, France
| | - Ikram Bouacha
- Departement of Neuro-ophtalmology, Lille University Hospital, Lille, France
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26
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Pasquesoone L, Belkhou A, Gottrand L, Guerreschi P, Duquennoy-Martinot V. [Management of purpura fulminans lesions in children]. ANN CHIR PLAST ESTH 2016; 61:605-612. [PMID: 27289551 DOI: 10.1016/j.anplas.2016.05.003] [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: 04/21/2016] [Accepted: 05/05/2016] [Indexed: 11/29/2022]
Abstract
Purpura fulminans is a pediatric life-threatening emergency with a significant mortality, combining: septic shock, extensive purpuric lesions and disseminated intravascular coagulation. The most frequent bacterial pathogen is the meningococcus. The medical management includes antibiotics, corticoids, vascular filling and catecholamines. Purpura fulminans is characterized by the extent of hemorrhagic and mainly thrombotic lesions, attributed to the alteration in the vascular endothelium functions. Damage of soft tissues combines large necrotic areas and more or less extensive distal ischemic lesions. Necrotic lesions can be deep, reaching skin, subcutaneous tissue, fascia, muscle and sometimes even the bone. The importance of the aesthetic and functional sequelae as well as future quality of life, depend on the quality of surgical management for these wide and deep lesions. Fasciotomy is sometimes urgently needed in the case of a clinical compartment syndrome, confirmed by a high-pressure measurement in the muscle compartments. Debridement of necrotic lesions and amputations are only performed after a clear delineation of necrotic areas, between 10 days and 3 weeks of evolution. If an amputation is necessary, it must focus on the residual bone length, considering the child's growth potential. The coverage of tissue loss uses all the plastic surgery techniques, more or less complex, in order to reduce scars to minimum for these children. Rehabilitation follow-up includes physical and psychological care, which are essential until adulthood.
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Affiliation(s)
- L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France.
| | - A Belkhou
- Clinique de chirurgie et orthopédie de l'enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - L Gottrand
- Centre de rééducation Marc-Sautelet, 10, rue du Petit-Boulevard, 59650 Villeneuve-d'Ascq, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France
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27
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Pasquesoone L, Aljudaibi N, Ellart J, Guerreschi P, Duquennoy-Martinot V. [Emergency management of extravasation in children]. ANN CHIR PLAST ESTH 2016; 61:598-604. [PMID: 27614718 DOI: 10.1016/j.anplas.2016.07.016] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
Abstract
The subcutaneous diffusion of intravenous drips, or extravasation, is a frequent iatrogenic complication in children, mainly in the neonatal period. This potentially severe pathology can lead to local ischemia that sometimes mimics compartment syndrome. It can also evolve towards vast soft-tissue necrosis. Nursing staff often underestimate the risk of functional, aesthetic, and psychological consequences. The speed and quality of the initial medical and surgical management can greatly decrease morbidity associated with extravasation. Prevention is fundamental, such as raising awareness in and training medical and paramedical staffs and creating efficient protocols. Surgical management involving aspiration and washing the site as early as possible improves the prognosis. Aspiration and washing can be done on a larger area if one criteria of severity is met, particularly in cases of extravasation using a vesicant or hyperosmolar agent. If necrotic lesions appear, it is wise to wait until they become delimited. Debridement and coverage can be performed using classical methods.
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Affiliation(s)
- L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France.
| | - N Aljudaibi
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France
| | - J Ellart
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France
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28
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Duquennoy-Martinot V, Belkhou A, Pasquesoone L, Depoortère C, Guerreschi P. [Scar revision in children: Clinical situations and solutions]. ANN CHIR PLAST ESTH 2016; 61:578-588. [PMID: 27346752 DOI: 10.1016/j.anplas.2016.05.009] [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: 05/08/2016] [Accepted: 05/11/2016] [Indexed: 12/15/2022]
Abstract
The scar of soft tissues is a permanent stigma of a trauma but it can sometimes be improved. It is more or less accepted by the patient and may be the source of a significant physical and psychosocial impact that leads to a request for a scar revision. Even if the child presents generally an excellent ability to heal, the quality of the scar depends on many factors such as the age, the type of scar or trauma and the affected body area. Thus, its aesthetic impact, functional but also on the growth of the child will be different. Moreover, these scars have a number of origins: neonatal surgery, natural history of congenital lesions or after a surgical management; surgeries for orthopedic, cardiac, craniofacial or hand birth defects and congenital malformations; or infectious or traumatic as in the case of burns and animal bites. We have many ways to try to correct or improve these scars, which use all the plastic surgery techniques. However, we need to establish for each case an appropriate management strategy with the objective of not inducing additional sequelae, respecting the growth of the child. Several techniques can be combined and the chronology of the surgical procedures must consider the school, social and family integration of the child.
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Affiliation(s)
- V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU Lille, rue Emile-Laine, 59037 Lille cedex, France
| | - A Belkhou
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU Lille, rue Emile-Laine, 59037 Lille cedex, France.
| | - L Pasquesoone
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU Lille, rue Emile-Laine, 59037 Lille cedex, France
| | - C Depoortère
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU Lille, rue Emile-Laine, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU Lille, rue Emile-Laine, 59037 Lille cedex, France
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Depoortère C, François C, Belkhou A, Duquennoy-Martinot V, Guerreschi P. [Features of skin graft in pediatric plastic surgery]. ANN CHIR PLAST ESTH 2016; 61:722-731. [PMID: 27545657 DOI: 10.1016/j.anplas.2016.07.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
Abstract
Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc. Specific skin graft techniques in children are developed: donor sites, sampling technique and procedure, early postoperative care. Especially in children, the scalp is a perfect site for split skin graft and technique is actively developed. Refinements and special cases are discussed: use of dermal matrices, allografts, xenografts, negative pressure therapy, prior skin expansion of the donor site. Results of skin graft in children are exposed: taking of graft, growth and shrinkage, pigmentation. Skin graft sometimes allows to stay the complex movement and get the best final benefit, permanent or at least temporary, in a growing being.
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Affiliation(s)
- C Depoortère
- Service de chirurgie plastique, esthétique et reconstructrice, hôpital Salengro, rue Émile-Laine, 59037 Lille cedex, France.
| | - C François
- Service de chirurgie plastique, esthétique et reconstructrice, hôpital Salengro, rue Émile-Laine, 59037 Lille cedex, France
| | - A Belkhou
- Service de chirurgie plastique, esthétique et reconstructrice, hôpital Salengro, rue Émile-Laine, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, esthétique et reconstructrice, hôpital Salengro, rue Émile-Laine, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, esthétique et reconstructrice, hôpital Salengro, rue Émile-Laine, 59037 Lille cedex, France
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30
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Guerreschi P, Wolber A, Bennis Y, Vinchon M, Martinot-Duquennoy V. [Rational use of distraction osteogenesis in craniofacial surgery]. ANN CHIR PLAST ESTH 2016; 61:764-769. [PMID: 27528515 DOI: 10.1016/j.anplas.2016.07.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/19/2022]
Abstract
Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks. Distraction is the result of the inventiveness of the pioneers then the work to always adapt to the multiple complex clinical situations. The surgeon has to choose between internal or external materials allowing a mono- or multi-vectorial extension, in osseous and/or dental anchoring. The mandibular distraction is very effective for the treatment of the secondary obstructive syndromes in the unilateral or bilateral severe hypomandibular malformations. She also allows desobstruction of the superior airways within the framework of the mediofacial hypoplasies as well as the secondary treatment of the growth defects in cleft lips and palates. Finally, the distraction osteogenesis enhanced reliability of the fronto-facial advancement in early and secondary treatment of craniofaciosynostosis. This is a real support of the facial growth, which has to be included in a plan of global treatment.
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Affiliation(s)
- P Guerreschi
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France
| | - A Wolber
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France
| | - Y Bennis
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France.
| | - M Vinchon
- Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France; Service de neurochirurgie pédiatrique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France
| | - V Martinot-Duquennoy
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France
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Abstract
Facial palsy (FP) in children is congenital or acquired. When present at birth (congenital), etiologies are mostly traumatic and rarely developmental. Acquired FP needs investigation. Research on the etiology helps to determine prognostic and treatment. At most times, no specific cause is found. Treatment of idiopathic FP consists of early oral corticosteroid therapy and ocular protection. Treating the sequelae is essential and the physician has to consider the dynamic balance of both sides of the face. Dynamic rehabilitation should mainly concern the inferior facial third. We recommend the lengthening temporalis myoplasty (LTM). This relevant technique ensures replicable and reliable results with a harmonious smile. Facial dynamic rehabilitation after surgical procedure (muscle tranfer or free muscle flap) must be directed toward control of voluntary movement, to move from a mandibular smile to a spontaneous and voluntary smile, thanks to brain plasticity. Furthermore, botulinum toxin is well tolerated and remains a great tool to treat a child who can support injections.
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Affiliation(s)
- P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France.
| | - P-E Gabert
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France
| | - D Labbé
- 4, place Fontette, 14000 Caen, France
| | - V Martinot-Duquennoy
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France
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Basset-Seguin N, Dupuy A, Saiag P, Dalac-Rat S, Guillot B, Routier E, Leccia M, Duhamel A, Mirabel X, Benbouta I, Mirakovska L, Meddour D, Dib M, Mahmoudi A, Guerreschi P, Mortier L. VISMONEO - a phase II study assessing vismodegib in the neoadjuvant treatment of locally advanced basal cell carcinoma - Patients characteristics. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.49] [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] [Indexed: 11/13/2022] Open
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33
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Bennis Y, Wolber A, Vinchon M, Belkhou A, Duquennoy-Martinot V, Guerreschi P. Les craniosténoses non syndromiques. ANN CHIR PLAST ESTH 2016; 61:389-407. [DOI: 10.1016/j.anplas.2016.07.004] [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: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 01/02/2023]
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34
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Duquennoy-Martinot V, Depoortère C, Deveaux C, Capon A, Abdelwahab O, François C, Guerreschi P. Indications de l’expansion chez l’enfant. Expérience de 30ans d’activité et revue de la littérature. ANN CHIR PLAST ESTH 2016; 61:740-749. [DOI: 10.1016/j.anplas.2016.06.008] [Citation(s) in RCA: 4] [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: 06/16/2016] [Accepted: 06/19/2016] [Indexed: 11/28/2022]
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35
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Belkhou A, François C, Bennis Y, Duquennoy-Martinot V, Guerreschi P. Aplasia cutis congenita : mise au point et prise en charge. ANN CHIR PLAST ESTH 2016; 61:450-461. [DOI: 10.1016/j.anplas.2016.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
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36
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Ellart J, François C, Calibre C, Guerreschi P, Duquennoy-Martinot V. Asymétrie mammaire de l’adolescente et de la jeune adulte. Stabilité du résultat dans le temps. À propos de 144 patientes. ANN CHIR PLAST ESTH 2016; 61:665-679. [DOI: 10.1016/j.anplas.2016.06.003] [Citation(s) in RCA: 4] [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: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]
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37
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Gottrand L, Devinck F, Martinot Duquennoy V, Guerreschi P. [Contribution of the physical and rehabilitation medicine in pediatric plastic surgery]. ANN CHIR PLAST ESTH 2016; 61:589-597. [PMID: 27499255 DOI: 10.1016/j.anplas.2016.07.007] [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: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/16/2022]
Abstract
Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the reeducation care, is to improve the physical abilities of the skin, to restore the function and avoid the deformations. Reeducation uses various techniques (i.e. sensitive-motility, massage and mobilizations) with or without physical agent (water, aspiration and touch-drive technique). Posture and positioning rely on the small or major aids, from orthosis to prosthesis. Compression is obtained by the adjustment of aids on molding and compression garment. Indications of the reeducation treatment depend on the timing of cutaneous covering and the advance of the healing process. It also depends on the underlying condition including skin traumas (frictions, wounds, burns), skin surgeries (purpura fulminans consequences, skin graft reconstruction after giant nevus resection, malignant lesion or vascular malformations). The final goal is the rehabilitation and development of the child and the adolescent in its entire somatopsychic dimension.
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Affiliation(s)
- L Gottrand
- Service de médecine physique et réadaptation, centre Marc-Sautelet, 59650 Villeneuve d'Ascq, France
| | - F Devinck
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille, France.
| | - V Martinot Duquennoy
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille, France
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38
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Risoud M, Aljudaibi N, Duquennoy-Martinot V, Guerreschi P. Long-term sequelae treatment of peripheral facial paralysis with botulinum toxin type A: Repartition and kinetics of doses used. ANN CHIR PLAST ESTH 2016; 61:10-5. [DOI: 10.1016/j.anplas.2015.04.002] [Citation(s) in RCA: 7] [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: 03/16/2015] [Accepted: 04/05/2015] [Indexed: 12/18/2022]
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39
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Riot S, Devinck F, Aljudaibi N, Duquennoy-Martinot V, Guerreschi P. [Tattooing of the nipple-areola complex in breast reconstruction: Technical note]. ANN CHIR PLAST ESTH 2015; 61:141-4. [PMID: 26740462 DOI: 10.1016/j.anplas.2015.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 11/11/2015] [Accepted: 11/30/2015] [Indexed: 11/16/2022]
Abstract
The reconstruction of the nipple-areola complex is an essential step in breast reconstruction. It announces the end of the reconstruction process, which is often long and sometimes difficult to live for the patient and will significantly improve the perception of body image. Concerning the reconstruction of the areola, tattooing is one of the preferred techniques. It's a simple, quick and safe procedure with a high satisfaction rate. This technique is still perfectible in our opinion, because the random lifetime of pigmentation is a recognized disadvantage of this procedure. We propose a modification of the conventional technique for improving the quality of dermopigmentation while reducing its completion time. Our method is to perform a dermabrasion before starting the tattoo. Indeed, dermabrasion allows better penetration of the pigments inside the dermis and thus offers two advantages: a more durable result over time and reduced operation time by reducing the number of passing of the machine tattoo. Finally, our tattooing technique seems relevant and totally appropriate: its realization is simple, reproducible, does not increase the overall cost of reconstruction, provides timesavings and gives a better long-term result.
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Affiliation(s)
- S Riot
- Service de chirurgie plastique et reconstructrice, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
| | - F Devinck
- Service de chirurgie plastique et reconstructrice, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - N Aljudaibi
- Service de chirurgie plastique et reconstructrice, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique et reconstructrice, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique et reconstructrice, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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40
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Guerreschi P, Scalbert C, Qassemyar A, Kluza J, Ravasi L, Huglo D, Martinot-Duquennoy V, Formstecher P, Marchetti P, Mortier L. Patient-derived tumor xenograft model to guide the use of BRAF inhibitors in metastatic melanoma. Melanoma Res 2015; 23:373-80. [PMID: 23852164 DOI: 10.1097/cmr.0b013e328363ed92] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recently, the BRAF V600 inhibitor, vemurafenib, has revolutionized the therapeutic management of metastatic melanoma. However, adverse effects and the onset of resistance are frequently observed, limiting the efficacy of this treatment. Patient-derived tumor xenografts (PDTX) engrafted in immunocompromised mice have been proposed as valuable preclinical models that can predict clinical response to treatments. Here, we established a PDTX model of BRAF V600E melanoma useful for testing the efficacy of vemurafenib. First, we validated the stability of the model that was similar to the original tumor with respect to histology, immunohistochemistry, mutational status, and fluorine-18 fluorodeoxyglucose ([(18)F]FDG)-PET/computed tomography (CT). Next, the sensitivity of the xenografts to vemurafenib was determined by tumor growth inhibition and decreased in standardized uptake value on [(18)F]FDG-PET/CT. Finally, this result, using personalized PDTX, allowed successful rechallenge with vemurafenib in a patient who was administered a lower dose of vemurafenib because of the onset of adverse events. Overall, we found that PDTX provides 'real-time' results in an animal that phenocopies the biology and expected vemurafenib responses of the tumor in a patient with BRAF V600E melanoma. Thus, this 'coclinical' trial using PDTX can help guide vemurafenib treatment for metastatic melanoma.
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Affiliation(s)
- Pierre Guerreschi
- Inserm Unit 837 Team 4, University of Medicine, Lille, Cedex, France.
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41
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Guerreschi P, Labbé D. La myoplastie d’allongement du muscle temporal : raffinements techniques. ANN CHIR PLAST ESTH 2015; 60:393-402. [DOI: 10.1016/j.anplas.2015.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
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42
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Guerreschi P, Martinot-Duquennoy V, Labbé D. Re: ‘Lenghtening temporalis myoplasty: Outcome and radiographic anatomical evaluation of length required’. J Plast Reconstr Aesthet Surg 2015; 68:1468-70. [DOI: 10.1016/j.bjps.2015.05.040] [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: 05/18/2015] [Accepted: 05/23/2015] [Indexed: 10/23/2022]
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43
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Bonnet A, Devienne M, De Broucker V, Duquennoy-Martinot V, Guerreschi P. Operating room fire: Should we mistrust alcoholic antiseptics? ANN CHIR PLAST ESTH 2015; 60:255-61. [DOI: 10.1016/j.anplas.2015.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/19/2015] [Indexed: 11/30/2022]
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44
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Aljudaibi N, Risoud M, Duquennoy-Martinot V, Guerreschi P. Re: 'Is there an ideal outcome scoring system for facial reanimation surgery? A review of current methods and suggestions for future publications'. J Plast Reconstr Aesthet Surg 2015; 68:1466-8. [PMID: 26076591 DOI: 10.1016/j.bjps.2015.05.028] [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: 05/08/2015] [Accepted: 05/18/2015] [Indexed: 11/25/2022]
Affiliation(s)
- N Aljudaibi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France; Department of Plastic, Reconstructive and Aesthetic Surgery, King Fahad Hospital (MOH), Jeddah, Saudi Arabia.
| | - M Risoud
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
| | - V Duquennoy-Martinot
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
| | - P Guerreschi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
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45
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Affiliation(s)
- Daniel Labbe
- Department of Plastic and Reconstructive Surgery, Clinique Saint Martin, Caen, France
| | - Pierre Guerreschi
- Department of Plastic and Reconstructive Surgery, Hospital Roger Salengro, Lille Cedex, France
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46
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Bennis Y, Becquart C, Aljudaibi N, Patenotre P, Guerreschi P, Delaporte E, Duquennoy-Martinot V. [Massive panniculectomy and bilateral subtotal mastectomy in a case of calciphylaxis: A case report and up date]. ANN CHIR PLAST ESTH 2015; 60:527-32. [PMID: 25799428 DOI: 10.1016/j.anplas.2015.02.004] [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: 01/25/2015] [Accepted: 02/18/2015] [Indexed: 12/17/2022]
Abstract
Calciphylaxis or calcific arteriolopathy is a rare, life-threatening obstructive pathology of the small cutaneous and subcutaneous vessels. It mainly affects patients with chronic renal failure but it also has been described in patients with normal renal function. The principal risks factors apart from renal failure and phosphocalcic metabolism imbalance are: the female sex, obesity, peripheral vascular disease, diabetes and oral anti-coagulation. We present a very rare case of abdominal, mammarian and upper thighs calciphylaxis in a patient with normal renal function. She presented a severe obesity with a recent important loss of weight and had been treated by oral anticoagulants for a long time. She benefited of a multidisciplinary approach with dermatologists, plastic surgeons and anesthesists permitting a recovery in fourteen weeks. Multidisciplinary approach is necessary but the place of the surgery is not well defined. We report a case in which early and wide surgical approach permitted to obtain a favourable evolution of the pathology. Then, we propose a therapeutic strategy after review of the literature.
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Affiliation(s)
- Y Bennis
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU, 59037 Lille, France.
| | - C Becquart
- Clinique dermatologique, hôpital Claude-Huriez, CHRU, 59037 Lille, France; Faculté de médecine Henri Warembourg, université de Lille, 59045 Lille, France
| | - N Aljudaibi
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU, 59037 Lille, France
| | - P Patenotre
- Chirurgie générale et vasculaire, hôpital Claude-Huriez, CHRU, 59037 Lille, France; Faculté de médecine Henri Warembourg, université de Lille, 59045 Lille, France
| | - P Guerreschi
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU, 59037 Lille, France; Faculté de médecine Henri Warembourg, université de Lille, 59045 Lille, France
| | - E Delaporte
- Clinique dermatologique, hôpital Claude-Huriez, CHRU, 59037 Lille, France; Faculté de médecine Henri Warembourg, université de Lille, 59045 Lille, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU, 59037 Lille, France; Faculté de médecine Henri Warembourg, université de Lille, 59045 Lille, France
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47
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Marchetti P, Guerreschi P, Kluza J, Mortier L. Metabolic features of melanoma: a gold mine of new therapeutic targets? Curr Cancer Drug Targets 2015; 14:357-70. [PMID: 24720363 DOI: 10.2174/1568009614666140407113124] [Citation(s) in RCA: 7] [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] [Received: 08/25/2013] [Revised: 01/30/2014] [Accepted: 04/03/2014] [Indexed: 11/22/2022]
Abstract
In recent years, our knowledge regarding the metabolism of melanoma has greatly advanced and consequently new therapeutic strategies are being developed. This review is focused on metabolic pathways contributing to melanoma proliferation, the influence of BRAF inhibitors on those metabolic pathways and finally a presentation of potential therapeutic strategies aimed at blocking metabolic signaling pathways and therefore melanoma development.
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Affiliation(s)
| | | | | | - Laurent Mortier
- INSERM U 837 Faculte de Medecine, 1, place Verdun F- 59045 Lille Cedex, France.
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48
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Ellart J, Trimaille A, Catteau B, Guerreschi P, Duquennoy-Martinot V. [Medaillon-like dermal dendrocyte hamartoma: A case report]. ANN CHIR PLAST ESTH 2014; 61:80-3. [PMID: 25544379 DOI: 10.1016/j.anplas.2014.12.003] [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: 11/30/2014] [Accepted: 12/07/2014] [Indexed: 11/16/2022]
Abstract
Medaillon-like dermal dendrocyte hamartomas are rare congenital cutaneous lesions. They are present at birth as asymptomatic, benign, round, erythematous, well-circumscribed, atrophic patches. Typically, they have characteristic pliable, wrinkled surface; subtle telangiectases may also be appreciated. They are localized on the upper trunk or the neck. They may be misdiagnosed as atrophoderma, cutis aplasia, or anetoderma. Characteristic histologic findings include epidermal atrophy and the presence of CD34-positive spindle cell proliferation in the dermis. Little is known about the pathophysiology of medaillon-like dermal dendrocyte hamartomas. The main diagnosis pitfall is atrophic congenital dermatofibrosarcoma protuberance due to clinical and histological similarities. We emphasize that molecular studies to eliminate the t(17;22)(q22;q13) translocation of dermatofibrosarcomas may provide determinant elements for diagnosis in order to avoid unnecessary mutilating surgery. We present a case of medaillon-like dermal dendrocyte hamartoma with a local recurrence.
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Affiliation(s)
- J Ellart
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Lille, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France.
| | - A Trimaille
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - B Catteau
- Service de dermatologie, pôle des spécialités médico-chirurgicales et pôle enfants, CHRU de Lille, hôpital Claude-Huriez, rue Michel-Polonovski, 59037 Lille cedex, France
| | - P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Lille, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France
| | - V Duquennoy-Martinot
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Lille, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France
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49
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Bonnet A, Mulliez E, Andrieux S, Duquennoy-Martinot V, Guerreschi P. Suspension of abdominal apron in massive panniculectomy: a novel technique. J Plast Reconstr Aesthet Surg 2014; 68:272-3. [PMID: 25456288 DOI: 10.1016/j.bjps.2014.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 10/01/2014] [Indexed: 10/24/2022]
Affiliation(s)
- A Bonnet
- Obesity Management Unit, General Hospital, Arras, France; Plastic, Reconstructive and Aesthetic Surgery Unit, General Hospital, Arras, France; Plastic, Reconstructive and Aesthetic Surgery Unit, Regional and Universitary Hospital, Lille, France.
| | - E Mulliez
- Obesity Management Unit, General Hospital, Arras, France
| | - S Andrieux
- Obesity Management Unit, General Hospital, Arras, France
| | - V Duquennoy-Martinot
- Plastic, Reconstructive and Aesthetic Surgery Unit, Regional and Universitary Hospital, Lille, France
| | - P Guerreschi
- Plastic, Reconstructive and Aesthetic Surgery Unit, Regional and Universitary Hospital, Lille, France
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50
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Corazao-Rozas P, Guerreschi P, Jendoubi M, André F, Jonneaux A, Scalbert C, Garçon G, Malet-Martino M, Balayssac S, Rocchi S, Savina A, Formstecher P, Mortier L, Kluza J, Marchetti P. Mitochondrial oxidative stress is the Achille's heel of melanoma cells resistant to Braf-mutant inhibitor. Oncotarget 2014; 4:1986-98. [PMID: 24161908 PMCID: PMC3875764 DOI: 10.18632/oncotarget.1420] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Vemurafenib/PLX4032, a selective inhibitor of mutant BRAFV600E, constitutes a paradigm shift in melanoma therapy. Unfortunately, acquired resistance, which unavoidably occurs, represents one major limitation to clinical responses. Recent studies have highlighted that vemurafenib activated oxidative metabolism in BRAFV600E melanomas expressing PGC1α. However, the oxidative state of melanoma resistant to BRAF inhibitors is unknown. We established representative in vitro and in vivo models of human melanoma resistant to vemurafenib including primary specimens derived from melanoma patients. Firstly, our study reveals that vemurafenib increased mitochondrial respiration and ROS production in BRAFV600E melanoma cell lines regardless the expression of PGC1α. Secondly, melanoma cells that have acquired resistance to vemurafenib displayed intrinsically high rates of mitochondrial respiration associated with elevated mitochondrial oxidative stress irrespective of the presence of vemurafenib. Thirdly, the elevated ROS level rendered vemurafenib-resistant melanoma cells prone to cell death induced by pro-oxidants including the clinical trial drug, elesclomol. Based on these observations, we propose that the mitochondrial oxidative signature of resistant melanoma constitutes a novel opportunity to overcome resistance to BRAF inhibition.
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Affiliation(s)
- Paola Corazao-Rozas
- Unit 837 Equipe 4 Inserm and Faculté de Médecine, Université de Lille II 1 Place Verdun 59045 Cedex, France
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