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Berkane Y, Giorgino R, Ng ZY, Dukan R, Lellouch AG. Alternative Flap Options for Upper Extremity Reconstruction. Hand Clin 2024; 40:291-299. [PMID: 38553100 DOI: 10.1016/j.hcl.2023.08.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
For major upper limb defects, a wide range of established pedicled and free flap options can be used. These include the latissimus dorsi/thoracodorsal artery perforator, lateral arm, posterior interosseous artery, rectus abdominis, gracilis, and anterolateral thigh flaps. Technical proficiency is essential, and favorable success rates in terms of functional and esthetic outcomes can be achieved. Herein, alternative flap options (both pedicled and free) are introduced and discussed through a few illustrative case examples.
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Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France; Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; UMR U1236-MICMAC, Immunology and Cell Therapy Lab, Rennes University Hospital, 2 Rue Henri Le Guillou, 35000 Rennes, France
| | - Riccardo Giorgino
- Residency Program in Orthopaedics and Traumatology, University of Milan, Via Cristina Belgioioso, 173, 20161 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, 173, 20161 Milan, Italy; Plastic Surgery Research Laboratory, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Zhi Yang Ng
- Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Ruben Dukan
- Department of Hand, Upper Limb & Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 Rue Leblanc, Paris, France
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; Department of Plastic, Reconstructive & Aesthetic Surgery, Georges-Pompidou European Hospital (HEGP), University of Paris, 20 Rue Leblanc, Paris, France; Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006, Paris, France.
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2
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Berkane Y, Watier E, Bertheuil N. Vertical Body Lift: Surgical Technique and Comparison with the Inferior Body Lift Technique. Plast Reconstr Surg 2024; 153:1046e-1048e. [PMID: 37927009 DOI: 10.1097/prs.0000000000011186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
- Vascularized Composite Allotransplant Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- UMR U1236-MICMAC, Immunology and Cell Therapy Laboratory, Rennes University Hospital, Rennes, France
| | - Eric Watier
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
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Berkane Y, Tawa P, Guinier C, Bertheuil N, El Batti S, Lellouch AG. Reconstruction of a septic femoral triangle fistula with a pedicled DIEP flap: A case report and mini-review. ANN CHIR PLAST ESTH 2024; 69:233-238. [PMID: 37932173 DOI: 10.1016/j.anplas.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023]
Abstract
Flap-based reconstruction techniques have shown promise in preventing scar contractures and enhancing healing in fold areas by providing vascularized and thick tissue. We report a septic rupture of the superficial femoral artery treated with an arterial allograft and covered with a contralateral pedicled Deep Inferior Epigastric Artery Perforator (DIEP) flap. The patient presented favorable outcomes, including optimal healing at 8 months, with no functional limitation. A literature review also discusses alternative pedicled perforator flaps. These modern techniques present several advantages, including reliability, and can be of great interest in complex vascular surgery cases.
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Affiliation(s)
- Y Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA, United States; Shriners Children's Boston, Harvard Medical School, Boston, MA, United States; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes, France.
| | - P Tawa
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA, United States; Shriners Children's Boston, Harvard Medical School, Boston, MA, United States
| | - C Guinier
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA, United States; Shriners Children's Boston, Harvard Medical School, Boston, MA, United States
| | - N Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes, France
| | - S El Batti
- Department of Vascular Surgery, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, Paris, France; Inserm UMRS 1140 Innovation thérapeutique en hémostase, université de Paris, Paris, France
| | - A G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA, United States; Shriners Children's Boston, Harvard Medical School, Boston, MA, United States
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Girard P, Berkane Y, Laloze J, Rousseau C, Lupon E, Schutz S, Watier E, Bertheuil N. Superior Pedicle Breast Reduction: Multivariate Analysis of Complication Risk Factors and Building a Predictive Score in 1306 Patients. Plast Reconstr Surg 2024; 153:1011-1019. [PMID: 37335587 DOI: 10.1097/prs.0000000000010828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND Breast reduction surgery for hypertrophy is one of the most commonly performed procedures in plastic surgery. This surgery exposes patients to complications that are well-documented in the literature. The objective of this study is to identify risk factors to establish an estimate of the risk of developing complications. The authors propose the first predictive score of postoperative complications, including continuous preoperative variables such as body mass index (BMI) and suprasternal notch-to-nipple distance (SSN:N). METHODS An analytic observational retrospective cohort study was conducted including 1306 patients who underwent superior pedicle reduction mammaplasty at the Rennes University Hospital (France) between January 1, 2011, and December 31, 2016. The primary endpoint was to study the association between known preoperative risk factors and occurrence of any complications using multivariable logistic regression to identify independent risk factors. A secondary endpoint was to establish a score to estimate a probability of occurrence of complications. RESULTS A total of 1306 patients were analyzed. Multivariable logistic regression showed three independent risk factors: active smoking [OR, 6.10 (95% CI: 4.23, 8.78); P < 0.0001], BMI [OR, 1.16 (95% CI: 1.11, 1.22); P < 0.0001], and SSN:N [OR, 1.14 (95% CI: 1.08, 1.21); P < 0.0001]. The Rennes Plastic Surgery Score estimating the occurrence of postoperative complications was determined, integrating regression coefficients of each risk factor. CONCLUSIONS Active smoking, BMI, and SSN:N distance are independent preoperative risk factors for the occurrence of breast reduction complications. The Rennes Plastic Surgery Score including the continuous values of BMI and SSN:N allows us to provide our patients with a reliable estimation of the risk of occurrence of these complications. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Paul Girard
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery
| | - Yanis Berkane
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery
| | - Jérôme Laloze
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU Limoges
| | | | - Elise Lupon
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU Toulouse
| | | | - Eric Watier
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery
- INSERM U1236, Hospital Sud, University of Rennes 1
- SITI Laboratory
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Van Dieren L, Oubari H, Callens L, Berkane Y, Quisenaerts T, Saget F, Tjalma W, Steenackers G, Cetrulo Jr CL, Lellouch AG, Thiessen EF F. Smartphone-based thermography in flap surgery: A systematic review and meta-analysis of perforator identification. Heliyon 2024; 10:e26806. [PMID: 38515684 PMCID: PMC10955199 DOI: 10.1016/j.heliyon.2024.e26806] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Background Thermography can be used in pre-operative planning of free perforator flap surgeries. Thermography assesses skin temperature by measuring the quantity of infrared radiation observed. In this meta-analysis, authors assess the sensitivity of smartphone-based thermal imaging (SBTI) in the detection of perforators and analyze the difference between static and dynamic imaging. Materials and methods Authors followed the PRISMA guidelines for systematic reviews and meta-analyses. The meta package in R was used to conduct the meta-analysis. The "metaprop" function was used to calculate the overall sensitivity estimate and 95% confidence interval. The "metaprop.one" function was used to calculate subgroup estimates for static and dynamic study types. The "metareg" function was used to conduct meta-regression analyses to explore sources of heterogeneity. Results This study includes seven articles with 1429 perforators being evaluated. The overall proportion of the sensitivities was estimated to be 0.8754 (95% CI: 0.7542; 0.9414) using a random effects model. The heterogeneity of the studies was high, as indicated by the tau^2 value of 1.2500 (95% CI: 0.4497; 8.4060) and the I^2 value of 92.6% (95% CI: 88.1%; 95.4%). The pooled sensitivity for static imaging was 0.8636 (95%CI: 0.6238-0.9603) with a tau^2 of 2.0661 and a tau of 1.4374, while the pooled sensitivity for dynamic imaging was slightly higher (p = 0.7016) at 0.8993 (95%CI: 0.7412-0.9653) with a smaller tau^2 of 0.8403 and a tau of 0.9167. Conclusion Further studies need to confirm that SBTI is a reliable and convenient technique for detecting perforators for the pre-operative planning of free perforator flap surgeries.
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Affiliation(s)
- Loïc Van Dieren
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Faculty of Medicine and Health Sciences, Antwerp, Belgium
| | - Haïzam Oubari
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Louise Callens
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Yanis Berkane
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes, France
- Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA
| | | | - François Saget
- Department of SAMU-SMUR-Emergencies, Rennes University Hospital Center, Rennes, France
| | - Wiebren Tjalma
- Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, B-2650, Antwerp, Belgium
| | - Gunther Steenackers
- InViLab Research Group, Department Electromechanics, Faculty of Applied Engineering, University of Antwerp, Groenenborgerlaan 171, B-2020, Antwerpen, Belgium
| | - Curtis L. Cetrulo Jr
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA
| | - Alexandre G. Lellouch
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA
| | - Filip Thiessen EF
- Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, B-2650, Antwerp, Belgium
- Department of Plastic, Reconstructive and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, Antwerp, Belgium
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium
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Gandolfi S, Chaput B, Berkane Y, Lupon E, Karra A. The accessory vascularization of the tensor fasciae latae muscle: towards a new classification? Surg Radiol Anat 2024:10.1007/s00276-024-03343-8. [PMID: 38530383 DOI: 10.1007/s00276-024-03343-8] [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] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE The tensor fasciae latae (TFL) muscle is supplied by the lateral femoral circumflex artery (LCFA), arising from the deep femoral artery. However, it has been noted that there is also a consistent vascular anastomotic network. The aim of this study was to describe the accessory vascularization of the TFL muscle through a descriptive anatomical study, in order to hypothesize the feasibility of harvesting a TFL flap in the event of an injury to the main pedicle. In addition, we illustrate this hypothesis with a successful clinical case of Scarpa freconstruction following ligature of the deep femoral artery. METHODS The description of the accessory vascularization was obtained by injecting dye into seven lateral femoral circumflex arteries (LCFA), six superficial circumflex iliac arteries (SCIA), and three inferior gluteal arteries (IGA). RESULTS The TFL muscle was vascularized primarily by the LCFA. A vascular anastomotic network with the SCIA and the IGA was observed. After selective injection to the SCIAs and IGAs, the subsequent injection to the LCFA showed a diffusion of the TFL skin paddle with a perforasome overlapping between the different vascular territories. CONCLUSION The ascending branch of the lateral femoral circumflex plays a dominant role in the vascularization of the TFL muscle. As a result of a periarticular anastomotic network of the hip, this artery establishes several connections with the proximal arteries. Consequently, in cases where blood flow through the LCFA is interrupted, it should be equally possible to harvest the TFL flap through its accessory vascularization.
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Affiliation(s)
- Silvia Gandolfi
- Plastic and Reconstructive Surgery Department, Rangueil University Hospital Center of Toulouse, 1 Avenue du Professeur Jean Poulhès, Toulouse, 31400, France.
| | - B Chaput
- Plastic and Reconstructive Surgery Department, Rangueil University Hospital Center of Toulouse, 1 Avenue du Professeur Jean Poulhès, Toulouse, 31400, France
| | - Y Berkane
- Plastic and Reconstructive Surgery Department, Pontchaillou University Hospital Center of Rennes, 2 Rue Henri le Guilloux, Rennes, 35000, France
| | - E Lupon
- Plastic and Reconstructive Surgery Department, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, Nice, France
| | - A Karra
- Plastic Surgery Department, Habib Bourguiba University Hospital Sfax, Sfax, Tunisia
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Gherle B, Pozner VL, Berkane Y, Watier E, Bertheuil N, Qassemyar Q. Pre-expanded thin DIEP free flap in pediatric upper extremity reconstruction for burn sequelae: A case report. ANN CHIR PLAST ESTH 2024; 69:173-177. [PMID: 38216362 DOI: 10.1016/j.anplas.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 01/14/2024]
Abstract
Deep burns sequelae involving the upper limb are challenging even for experienced surgeons, mainly because local reconstructive options and donor sites are often compromised. The use of free flaps for this type of reconstruction remains difficult due to the small recipient vessel diameter and tendency to vasospasm. Moreover, pediatric cases bring the challenge to another level. We present the case of a 13-year-old girl presenting major retractile sequelae of the upper left limb, including complete wrist immobilization combining wrist hyper-extension, ulnar deviation deformity, and a ulno-carpal dislocation. She was referred to our department where a two-stage reconstruction was performed using a pre-expanded free deep inferior epigastric artery perforator (DIEP) flap. The first surgery consisted of placing two kidney-shaped expanders in a subfascial plane in the hypogastric region. Four months later, after a bi-weekly expansion, an excision of the scar tissue, and the DIEP flap transfer were completed. At the 12-month follow-up evaluation, both aesthetic and functional results were satisfactory, with a good contour and regained mobility of the wrist.
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Affiliation(s)
- B Gherle
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Université de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; Doctoral School of Biological and Biomedical Sciences, University of Oradea, Oradea, Romania.
| | - V L Pozner
- Private Practice, 66, rue de Lisbone, 75008 Paris, France
| | - Y Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Université de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; MOBIDIC, UMR INSERM 1236, Rennes University Hospital, Rennes, France; Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children's Boston, Harvard Medical School, Boston MA
| | - E Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Université de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - N Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Université de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; MOBIDIC, UMR INSERM 1236, Rennes University Hospital, Rennes, France.
| | - Q Qassemyar
- Private Practice, 66, rue de Lisbone, 75008 Paris, France
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Berkane Y, Chaput B, Bertheuil N. A Two-Step Approach for Breast Augmentation with Chest Wall Deformity? Aesthetic Plast Surg 2024:10.1007/s00266-024-03883-9. [PMID: 38413444 DOI: 10.1007/s00266-024-03883-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
Breast augmentation in the case of chest wall deformity can be challenging. It is essential to treat the two problematics separately, and not to attempt compensation for asymmetry with vastly different breast implants. With this work, we wish to highlight the approach based on the use of custom-made 3D implants, enabling optimal correction of thoracic deformity. A first case study illustrates a one-step approach to correcting deformity and augmenting the breast. The importance of separate management of these issues lies in the fact that possible normalization of thoracic dysmorphia alone can sometimes lead to withdrawal of the request for breast augmentation. We illustrate this with a second case report with optimal patient satisfaction after isolated correction of a pectus excavatum.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, Rennes University Hospital Center, University of Rennes, 16 Boulevard de Bulgarie, 35000, Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- SITI Laboratory, INSERM UMR1236, University of Rennes, Rennes, France
| | - Benoit Chaput
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toulouse University Hospital Center, Rouen, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, Rennes University Hospital Center, University of Rennes, 16 Boulevard de Bulgarie, 35000, Rennes, France.
- SITI Laboratory, INSERM UMR1236, University of Rennes, Rennes, France.
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Lupon E, Berkane Y, Bertheuil N, Cetrulo CL, Vaillant C, Chaput B, Camuzard O, Lellouch AG. Non-surgical treatment of post-burn hypopigmentation: a literature review. J Burn Care Res 2024:irae030. [PMID: 38401148 DOI: 10.1093/jbcr/irae030] [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: 05/25/2023] [Indexed: 02/26/2024]
Abstract
The treatment of post-burn hypopigmentation was primarily surgical before the advent of new technologies. Medical devices and therapies are emerging to manage scar sequelae that can be disfiguring and associated with severe psychosocial impact. These innovations have been poorly investigated for hypopigmentation, but they represent a real hope. We reviewed all articles published on Pubmed up to June 2022. Included studies had to specifically focus on treating post-burn hypopigmented scars. All articles evaluating transient solutions such as make-up, and articles describing inflammation-linked hypopigmentation with no etiological details or no burn injury history were excluded. Through this review, we have highlighted six different types of non-surgical treatments reported in post-burn leukoderma potentially allowing definitive results. Electrophoto-Biomodulation or E light (combining intensive pulsed light, radiofrequency, and cooling), topical daylight psoralen UVA therapy, and lasers (Fractional lasers using pulse energies or CO2FL devices, lasers-assisted drug delivery as local bimatoprost and tretinoin or pimecrolimus) have been explored with encouraging results in hypopigmented burns. Finally, other promising medical strategies include using FK506, a nonsteroidal anti-inflammatory drug, to induce melanogenesis or using melanocyte-stimulating hormones with fractional laser-assisted drug deliveries, which are expected to emerge soon.
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Affiliation(s)
- Elise Lupon
- Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, Nice, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Camille Vaillant
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Benoît Chaput
- Department of Plastic surgery, University Toulouse III Paul Sabatier, Toulouse, France
| | - Olivier Camuzard
- Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, Nice, France
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA, USA
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10
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Berkane Y, Jain R, Ajenu EO, Shamlou AA, Nguyen K, McCarthy M, Uygun BE, Lellouch AG, Cetrulo CL, Uygun K, Randolph MA, Tessier SN. A Swine Burn Model for Investigating the Healing Process in Multiple Depth Burn Wounds. J Vis Exp 2024. [PMID: 38465950 DOI: 10.3791/66362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Burn wound healing is a complex and long process. Despite extensive experience, plastic surgeons and specialized teams in burn centers still face significant challenges. Among these challenges, the extent of the burned soft tissue can evolve in the early phase, creating a delicate balance between conservative treatments and necrosing tissue removal. Thermal burns are the most common type, and burn depth varies depending on multiple parameters, such as temperature and exposure time. Burn depth also varies in time, and the secondary aggravation of the "shadow zone" remains a poorly understood phenomenon. In response to these challenges, several innovative treatments have been studied, and more are in the early development phase. Nanoparticles in modern wound dressings and artificial skin are examples of these modern therapies still under evaluation. Taken together, both burn diagnosis and burn treatments need substantial advancements, and research teams need a reliable and relevant model to test new tools and therapies. Among animal models, swine are the most relevant because of their strong similarities in skin structure with humans. More specifically, Yucatan minipigs show interesting features such as melanin pigmentation and slow growth, allowing for studying high phototypes and long-term healing. This article aims to describe a reliable and reproducible protocol to study multi-depth burn wounds in Yucatan minipigs, enabling long-term follow-up and providing a relevant model for diagnosis and therapeutic studies.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University; SITI Laboratory, UMR, INSERM, Université de Rennes
| | - Rohil Jain
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Emmanuella O Ajenu
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Austin A Shamlou
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Khanh Nguyen
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Michelle McCarthy
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Basak E Uygun
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Innovative Therapies in Haemostasis, INSERM UMR-S, University of Paris
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Korkut Uygun
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston
| | - Shannon N Tessier
- Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School;
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11
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Berkane Y, Oubari H, van Dieren L, Charlès L, Lupon E, McCarthy M, Cetrulo CL, Bertheuil N, Uygun BE, Smadja DM, Lellouch AG. Tissue engineering strategies for breast reconstruction: a literature review of current advances and future directions. Ann Transl Med 2024; 12:15. [PMID: 38304901 PMCID: PMC10777243 DOI: 10.21037/atm-23-1724] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/15/2023] [Indexed: 02/03/2024]
Abstract
Background and Objective Mastectomy is a primary treatment for breast cancer patients, and both autologous and implant-based reconstructive techniques have shown excellent results. In recent years, advancements in bioengineering have led to a proliferation of innovative approaches to breast reconstruction. This article comprehensively explores the promising perspectives offered by bioengineering and tissue engineering in the field of breast reconstruction. Methods A literature review was conducted between April and June 2023 on PubMed and Google Scholar Databases. All English and French articles related to bioengineering applied to the field of breast reconstruction were included. We used the Evidence-Based Veterinary Medicine Association (EBVM) Toolkit 14 checklist for narrative reviews as a quality assurance measure and the Scale for the Assessment of Narrative Review Articles (SANRA) tool to self-assess our methodology. Key Content and Findings Over 130 references related to breast bioengineering were included. The analysis revealed four key applications: enhancing the quality of the skin envelope, improving the viability of fat grafting, creating breast shape and volume via bio-printing, and optimizing nipple reconstruction through engineering techniques. The primary identified approaches revolved around establishing structural support and enhancing cellular viability. Structural techniques predominantly involved the implementation of 3D printed, decellularized, or biocompatible material scaffolds. Meanwhile, promoting cellular content trophicity primarily focused on harnessing the regenerative potential of adipose-derived stem cells (ADSCs) and increasing the tissue's survivability and cell trophicity. Conclusions Tissue and bioengineering hold immense promise in the field of breast reconstruction, offering a diverse array of approaches. By combining existing techniques with novel advancements, they have the potential to significantly enhance the therapeutic options available to plastic and reconstructive surgeons.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes, Rennes, France
- Unité Mixte de Recherche UMR 1236 Suivi Immunologique des Thérapeutiques Innovantes, INSERM and University of Rennes, Rennes, France
| | - Haizam Oubari
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Grenoble University Hospital Center, Grenoble, France
| | - Loïc van Dieren
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic Surgery, University of Antwerp, Wilrijk, Belgium
| | - Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
| | - Elise Lupon
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Reconstructive Surgery, Pasteur 2 Hospital, University Côte d’Azur, Sophia Antipolis, Nice, France
| | - Michelle McCarthy
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes, Rennes, France
- Unité Mixte de Recherche UMR 1236 Suivi Immunologique des Thérapeutiques Innovantes, INSERM and University of Rennes, Rennes, France
| | - Basak E. Uygun
- Shriners Children’s Boston, Boston, MA, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David M. Smadja
- Unité Mixte de Recherche UMR-S 1140 Innovative Therapies in Haemostasis, INSERM and University of Paris, Paris, France
- Department of Hematology, European Georges Pompidou Hospital, Paris, France
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Unité Mixte de Recherche UMR-S 1140 Innovative Therapies in Haemostasis, INSERM and University of Paris, Paris, France
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12
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von Reiterdank IF, Tawa P, Berkane Y, de Clermont-Tonnerre E, Dinicu A, Pendexter C, Goutard M, Lellouch AG, van der Molen ABM, Coert JH, Cetrulo CL, Uygun K. Sub-Zero Non-Freezing of Vascularized Composite Allografts Preservation in Rodents. Res Sq 2023:rs.3.rs-3750450. [PMID: 38234765 PMCID: PMC10793490 DOI: 10.21203/rs.3.rs-3750450/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Ischemia is a major limiting factor in Vascularized Composite Allotransplantation (VCA) as irreversible muscular injury can occur after as early as 4-6 hours of static cold storage (SCS). Organ preservation technologies have led to the development of storage protocols extending rat liver ex vivo preservation up to 4 days. Development of such a protocol for VCAs has the added challenge of inherent ice nucleating factors of the graft, therefore this study focused on developing a robust protocol for VCA supercooling. Rodent partial hindlimbs underwent subnormothermic machine perfusion (SNMP) with several loading solutions, followed by cryoprotective agent (CPA) cocktail developed for VCAs. Storage occurred in suspended animation for 24h and VCAs were recovered using SNMP with modified Steen. This study shows a robust VCA supercooling preservation protocol in a rodent model. Further optimization is expected to allow for its application in a transplantation model, which would be a breakthrough in the field of VCA preservation.
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Affiliation(s)
- Irina Filz von Reiterdank
- Center for Engineering in Medicine and Surgery, Derpartment of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Pierre Tawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Paris Saint-Joseph
| | - Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, CHU Rennes, University of Rennes
| | | | - Antonia Dinicu
- Center for Engineering in Medicine and Surgery, Derpartment of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Casie Pendexter
- Center for Engineering in Medicine and Surgery, Derpartment of Surgery, Massachusetts General Hospital, Harvard Medical School
| | - Marion Goutard
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Paris Saint-Joseph
| | - Alexandre G Lellouch
- Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006
| | - Aebele B Mink van der Molen
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht University
| | - J Henk Coert
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht University
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School
| | - Korkut Uygun
- Center for Engineering in Medicine and Surgery, Derpartment of Surgery, Massachusetts General Hospital, Harvard Medical School
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13
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Berkane Y, Kostyra DM, Chrelias T, Randolph MA, Lellouch AG, Cetrulo CL, Uygun K, Uygun BE, Bertheuil N, Duisit J. The Autonomization Principle in Vascularized Flaps: An Alternative Strategy for Composite Tissue Scaffold In Vivo Revascularization. Bioengineering (Basel) 2023; 10:1440. [PMID: 38136031 PMCID: PMC10740989 DOI: 10.3390/bioengineering10121440] [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: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Autonomization is a physiological process allowing a flap to develop neo-vascularization from the reconstructed wound bed. This phenomenon has been used since the early application of flap surgeries but still remains poorly understood. Reconstructive strategies have greatly evolved since, and fasciocutaneous flaps have progressively replaced muscle-based reconstructions, ensuring better functional outcomes with great reliability. However, plastic surgeons still encounter challenges in complex cases where conventional flap reconstruction reaches its limitations. Furthermore, emerging bioengineering applications, such as decellularized scaffolds allowing a complex extracellular matrix to be repopulated with autologous cells, also face the complexity of revascularization. The objective of this article is to gather evidence of autonomization phenomena. A systematic review of flap autonomization is then performed to document the minimum delay allowing this process. Finally, past and potential applications in bio- and tissue-engineering approaches are discussed, highlighting the potential for in vivo revascularization of acellular scaffolds.
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Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- SITI Laboratory, UMR1236, INSERM, Rennes University, 2 Rue Henri le Guillou, 35000 Rennes, France
| | - David M. Kostyra
- Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA;
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Theodoros Chrelias
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
| | - Mark A. Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA;
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; (M.A.R.); (A.G.L.); (C.L.C.J.)
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
| | - Korkut Uygun
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Basak E. Uygun
- Shriners Children’s Boston, 51 Blossom Street, Boston, MA 02114, USA; (K.U.); basa (B.E.U.)
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- SITI Laboratory, UMR1236, INSERM, Rennes University, 2 Rue Henri le Guillou, 35000 Rennes, France
| | - Jérôme Duisit
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France (T.C.); (N.B.)
- IRIS Sud Hospitals, Rue Baron Lambert 38, 1040 Etterbeek, Belgium
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14
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Berkane Y, Lellouch AG, Goudot G, Shamlou A, Filz von Reiterdank I, Goutard M, Tawa P, Girard P, Bertheuil N, Uygun BE, Randolph MA, Duisit J, Cetrulo CL, Uygun K. Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study. Bioengineering (Basel) 2023; 10:1415. [PMID: 38136006 PMCID: PMC10740951 DOI: 10.3390/bioengineering10121415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/25/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Machine perfusion has developed rapidly since its first use in solid organ transplantation. Likewise, reconstructive surgery has kept pace, and ex vivo perfusion appears as a new trend in vascularized composite allotransplants preservation. In autologous reconstruction, fasciocutaneous flaps are now the gold standard due to their low morbidity (muscle sparing) and favorable functional and cosmetic results. However, failures still occasionally arise due to difficulties encountered with the vessels during free flap transfer. The development of machine perfusion procedures would make it possible to temporarily substitute or even avoid microsurgical anastomoses in certain complex cases. We performed oxygenated acellular sub-normothermic perfusions of fasciocutaneous flaps for 24 and 48 h in a porcine model and compared continuous and intermittent perfusion regimens. The monitored metrics included vascular resistance, edema, arteriovenous oxygen gas differentials, and metabolic parameters. A final histological assessment was performed. Porcine flaps which underwent successful oxygenated perfusion showed minimal or no signs of cell necrosis at the end of the perfusion. Intermittent perfusion allowed overall better results to be obtained at 24 h and extended perfusion duration. This work provides a strong foundation for further research and could lead to new and reliable reconstructive techniques.
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Affiliation(s)
- Yanis Berkane
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Alexandre G. Lellouch
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, 75006 Paris, France
| | - Guillaume Goudot
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA;
- INSERM U970 PARCC, Université Paris Cité, 75000 Paris, France
| | - Austin Shamlou
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Irina Filz von Reiterdank
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
- University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Marion Goutard
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Pierre Tawa
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Paul Girard
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Basak E. Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Mark A. Randolph
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Jérôme Duisit
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Iris South Hospitals, 1040 Brussels, Belgium
| | - Curtis L. Cetrulo
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Korkut Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
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15
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Beaufils T, Berkane Y, Freton L, Richard C, Watier É, Qassemyar Q, Bertheuil N. A New Surgical Technique for Female-to-Male Top Surgery: The Posterioinferior Pedicle (PIPe) Approach. Aesthetic Plast Surg 2023; 47:2283-2294. [PMID: 37684416 DOI: 10.1007/s00266-023-03552-3] [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: 05/12/2023] [Accepted: 07/23/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Most of the time, female-to-male (FtoM) chest surgery involves mastectomy techniques and free transplantation of the nipple-areola complex. With the increasing prevalence of gender dysphoria and the demand for female-to-male gender reassignment surgery, the need for FtM top surgery is also rising. To meet this demand, we present a new approach: the PIPe technique, based on a fasciocutaneous flap with a posteroinferior pedicle. MATERIALS AND METHODS All patients with FtoM gender dysphoria undergoing surgery using the posteroinferior pedicle flap technique in the Plastic Surgery Department at Rennes University Hospital Center were included. The procedure involved extensive liposuction of the lower internal and external mammary quadrants, followed by liposuction of deep tissues in the upper quadrants, except in the pedicle area. After removing skin from the lower quadrants down to the dermis and de-epithelializing the posteroinferior pedicle flap, the thoracic flap was lowered and the areola transposed. RESULTS From July 2022 to March 2023, fifteen patients underwent surgery, and their results were collected prospectively. The average age was 25 years, the mean weight was 76.6 kg, and the average BMI was 28.1 kg/m2. The average operating time was 102 min, and the mean weight excised was 459.5 g. The average length of hospital stay was 3.3 days, and the drainage duration was 2.4 days. No major complications were reported, and there were no cases of reintervention or recurrence. CONCLUSIONS Our study presents a novel surgical approach utilizing the posteroinferior pedicle technique. Its key benefit lies in the preservation of neurovascular function, which makes it an attractive option for patients seeking to retain nipple sensitivity. This procedure is reliable, reproducible, and recommended as a first-line treatment for grade II and III gynecomastia due to its low rate of major complications and favorable functional and aesthetic outcomes. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Tristan Beaufils
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | - Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- INSERM U1236, University of Rennes 1, Rennes, France
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France
| | - Lucas Freton
- Department of Urology, Rennes University Hospital Center, Rennes, France
| | - Claire Richard
- Department of Urology, Rennes University Hospital Center, Rennes, France
| | - Éric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | | | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France.
- INSERM U1236, University of Rennes 1, Rennes, France.
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France.
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16
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Berkane Y, Hayau J, von Reiterdank IF, Kharga A, Charlès L, van der Molen AM, Coert JH, Bertheuil N, Randolph M, Cetrulo CL, Longchamp A, Lellouch AG, Uygun K. Supercooling: A Promising Technique for Prolonged Organ Preservation in Solid Organ Transplantation, and Early Perspectives in Vascularized Composite Allografts. Front Transplant 2023; 2:1269706. [PMID: 38682043 PMCID: PMC11052586 DOI: 10.3389/frtra.2023.1269706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Ex-vivo preservation of transplanted organs is undergoing spectacular advances. Machine perfusion is now used in common practice for abdominal and thoracic organ transportation and preservation, and early results are in favor of substantially improved outcomes. It is based on decreasing ischemia-reperfusion phenomena by providing physiological or sub-physiological conditions until transplantation. Alternatively, supercooling techniques involving static preservation at negative temperatures while avoiding ice formation have shown encouraging results in solid organs. Here, the rationale is to decrease the organ's metabolism and need for oxygen and nutrients, allowing for extended preservation durations. The aim of this work is to review all advances of supercooling in transplantation, browsing the literature for each organ. A specific objective was also to study the initial evidence, the prospects, and potential applications of supercooling preservation in Vascularized Composite Allotransplantation (VCA). This complex entity needs a substantial effort to improve long-term outcomes, marked by chronic rejection. Improving preservation techniques is critical to ensure the favorable evolution of VCAs, and supercooling techniques could greatly participate in these advances.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, CHU Rennes, University of Rennes, Rennes, France
- MOBIDIC, UMR INSERM 1236, Rennes University Hospital, Rennes, France
| | - Justine Hayau
- Division of Plastic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Engineering for Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anil Kharga
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
- Center for Engineering for Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
| | - A Mink van der Molen
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J Henk Coert
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, CHU Rennes, University of Rennes, Rennes, France
- MOBIDIC, UMR INSERM 1236, Rennes University Hospital, Rennes, France
| | - Mark Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
| | - Alban Longchamp
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
- Center for Engineering for Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Center for Transplant Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
| | - Korkut Uygun
- Shriners Children’s Boston, Harvard Medical School, Boston, MA, USA
- Center for Engineering for Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Transplant Sciences, Massachusetts General Hospital, Boston, MA, USA
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17
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Alabdulkareem M, Berkane Y, Le Bras E, Rousson E, Chrelias T, Beaufils T, Leclere FM, Watier E, Bertheuil N. Axillary Hidradenitis Suppurativa: A Comparison between Two Perforator Flap Reconstructive Approaches after Radical Surgical Management. Plast Reconstr Surg Glob Open 2023; 11:e5301. [PMID: 37811354 PMCID: PMC10558224 DOI: 10.1097/gox.0000000000005301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/11/2023] [Indexed: 10/10/2023]
Abstract
Background Axillary hidradenitis suppurativa (HS) can result in significant functional impairment in both personal and professional lives. Stage 3 HS requires radical surgical treatment. Flap reconstruction allows for faster healing and better functional and aesthetic outcomes. We compared the results of thoracodorsal artery perforator (TDAP) and propeller inner arm artery perforator (IAAP) flap reconstructions after radical surgical treatment of axillary HS. Methods We conducted a retrospective study that included 13 consecutive patients who underwent stage 3 axillary HS treatment between August 2015 and January 2023. Seven patients underwent reconstruction by islanded TDAP flaps, whereas six patients underwent reconstruction by propeller IAAP flaps, with one patient undergoing bilateral reconstruction. The data collected from the patient records included age, gender, smoking status, body mass index, comorbidities, operative time, defect size, flap size, hospital stay, and complications. Results Although not statistically significant (P = 0.1923), a higher rate of flap complications is reported here with propeller IAAP flaps (42.86 %), whereas islanded TDAP flaps had no flap complications (0%). We found a statistically significant difference in operative time (P = 0.0006), defect size (P = 0.0064), and flap size (P = 0.0012) between the two groups. All patients exhibited satisfactory functional and aesthetic outcomes. Fourteen flaps were performed in total; only one case exhibited recurrence (7.14%). Conclusion After radical surgical management, both islanded TDAP and propeller IAAP flap reconstructions offer excellent outcomes for stage 3 axillary HS. We strongly encourage our peers to consider performing perforator flaps over secondary healing for these patients with a major functional impairment.
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Affiliation(s)
- Mohammad Alabdulkareem
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Yanis Berkane
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
- UMR U1236-MICMAC, Immunology and Therapy Lab, Rennes University Hospital, Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
- Shriners Children’s Boston, Harvard Medical School, Boston, Mass
| | - Enna Le Bras
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Etienne Rousson
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Theodoros Chrelias
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Tristan Beaufils
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Franck-Marie Leclere
- Department of Plastic, Reconstructive and Hand Surgery, Poitiers University Hospital, CHU de la Miletrie de Poitiers, Poitiers, France
- Laboratoire d’anatomie et de Simulation, Université de Poitiers, Poitiers, France
| | - Eric Watier
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, Rennes University, Rennes, France
- UMR U1236-MICMAC, Immunology and Therapy Lab, Rennes University Hospital, Rennes, France
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18
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Berkane Y, Herlin C, Bertheuil N. Comment on "Surgical management of slightly or non-displaced corporal scaphoid fractures by retrograde percutaneous screw fixation through the anterior trapezium horn: A single-center retrospective French study of 33 patients between January 2015 and January 2019". ANN CHIR PLAST ESTH 2023; 68:385-386. [PMID: 37121848 DOI: 10.1016/j.anplas.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Y Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud (CHU de Rennes), University of Rennes 1, Rennes, France; Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - C Herlin
- Department of Plastic and Reconstructive Surgery, Wound Healing and Burns Units, Lapeyronie University Hospital, Montpellier-Nîmes University, Montpellier, France
| | - N Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud (CHU de Rennes), University of Rennes 1, Rennes, France; SITI Laboratory, Rennes University Hospital, Rennes, France; Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rouen, Rouen, France
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19
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Charlès L, Agius T, Filz von Reiterdank I, Hagedorn J, Berkane Y, Lancia HH, Uygun BE, Uygun K, Cetrulo CL, Randolph MA, Lellouch AG. Modified Tail Vein and Penile Vein Puncture for Blood Sampling in the Rat Model. J Vis Exp 2023:10.3791/65513. [PMID: 37458471 PMCID: PMC10910861 DOI: 10.3791/65513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Blood samples are required in most experimental animal designs to assess various hematological parameters. This paper presents two procedures for blood collection in rats: the lateral tail vein puncture and the dorsal penile vein puncture, which offer significant advantages over other previously described techniques. This study shows that these two procedures allow for fast sampling (under 10 min) and yield sufficient blood volumes for most assays (202 μL ± 67.7 μL). The dorsal penile vein puncture must be done under anesthesia, whereas the lateral tail vein puncture can be done on a conscious, restrained animal. Alternating these two techniques, therefore, enables blood draw in any situation. While it is always recommended for an operator to be assisted during a procedure to ensure animal welfare, these techniques require only a single operator, unlike most blood sampling methods that require two. Moreover, whereas these previously described methods (e.g., jugular stick, subclavian vein blood draw) require extensive prior training to avoid harm to or death of the animal, tail vein and dorsal penile vein puncture are rarely fatal. For all these reasons, and according to the context (e.g., for studies including male rats, during the perioperative or immediate postoperative period, for animals with thin tail veins), both techniques can be used alternately to enable repeated blood draws.
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Affiliation(s)
- Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Thomas Agius
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois and University of Lausanne
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht
| | - Janna Hagedorn
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), Rennes 1 University
| | - Hyshem H Lancia
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Basak E Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Korkut Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital;
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20
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Chrelias T, Berkane Y, Rousson E, Uygun K, Meunier B, Kartheuser A, Watier E, Duisit J, Bertheuil N. Gluteal Propeller Perforator Flaps: A Paradigm Shift in Abdominoperineal Amputation Reconstruction. J Clin Med 2023; 12:4014. [PMID: 37373707 DOI: 10.3390/jcm12124014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/18/2023] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Abdominoperineal amputation (AAP) is a gold standard procedure treating advanced abdominal and pelvic cancers. The defect resulting from this extensive surgery must be reconstructed to avoid complications, such as infection, dehiscence, delayed healing, or even death. Several approaches can be chosen depending on the patient. Muscle-based reconstructions are a reliable solution but are responsible for additional morbidity for these fragile patients. We present and discuss our experience in AAP reconstruction using gluteal-artery-based propeller perforator flaps (G-PPF) in a case series. Between January 2017 and March 2021, 20 patients received G-PPF reconstruction in two centers. Either superior gluteal artery (SGAP)- or inferior artery (IGAP)-based perforator flaps were performed depending on the best configuration. Preoperative, intraoperative, and postoperative data were collected. A total of 23 G-PPF were performed-12 SGAP and 11 IGAP flaps. Final defect coverage was achieved in 100% of cases. Eleven patients experienced at least one complication (55%), amongst whom six patients (30%) had delayed healing, and three patients (15%) had at least one flap complication. One patient underwent a new surgery at 4 months for a perineal abscess under the flap, and three patients died from disease recurrence. Gluteal-artery-based propeller perforator flaps are an effective and modern surgical procedure for AAP reconstruction. Their mechanic properties, in addition to their low morbidity, make them an optimal technique for this purpose; however, technical skills are needed, and closer surveillance with patient compliance is critical to ensure success. G-PPF should be widely used in specialized centers and considered a modern alternative to muscle-based reconstructions.
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Affiliation(s)
- Theodoros Chrelias
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
| | - Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children's Boston, Harvard Medical School, Boston, MA 02115, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
- MICMAC, UMR INSERM U1236, Rennes University Hospital, 35033 Rennes, France
| | - Etienne Rousson
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
| | - Korkut Uygun
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children's Boston, Harvard Medical School, Boston, MA 02115, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Bernard Meunier
- Department of Hepatobiliary and Digestive Surgery, CHU Rennes, University of Rennes 1, 35700 Rennes, France
| | - Alex Kartheuser
- Colorectal Surgery Unit, Department of Surgery, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Eric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
| | - Jérôme Duisit
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
- Department of Plastic and Reconstructive Surgery, Hôpitaux IRIS Sud, 1050 Brussels, Belgium
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children's Boston, Harvard Medical School, Boston, MA 02115, USA
- MICMAC, UMR INSERM U1236, Rennes University Hospital, 35033 Rennes, France
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21
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Meresse T, Lupon E, Berkane Y, Classe JM, Camuzard O, Gangloff D. [Oncologic plastic surgery: An essential activity to develop in France]. ANN CHIR PLAST ESTH 2023; 68:286-287. [PMID: 36967308 DOI: 10.1016/j.anplas.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 06/14/2023]
Affiliation(s)
- T Meresse
- Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital and Department of Plastic surgery, University Toulouse III Paul Sabatier, Toulouse, France
| | - E Lupon
- Department of Plastic and Reconstructive Surgery, institut universitaire locomoteur et du sport, Pasteur 2 Hospital, University Côte d'Azur, 30, voie Romaine, 06001 Nice, France.
| | - Y Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - J M Classe
- Department of Surgical Oncology, institut de cancerologie de l'ouest, Saint-Herblain, France
| | - O Camuzard
- Department of Plastic and Reconstructive Surgery, institut universitaire locomoteur et du sport, Pasteur 2 Hospital, University Côte d'Azur, 30, voie Romaine, 06001 Nice, France
| | - D Gangloff
- Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital and Department of Plastic surgery, University Toulouse III Paul Sabatier, Toulouse, France
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22
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Berkane Y, Saget F, Lupon E, Mocquard C, Pluvy I, Watier E, Lellouch AG, Duisit J, Chaput B, Bertheuil N. Abdominoplasty and lower body lift surgery improves the quality of life after massive weight loss: a prospective multicenter study. Plast Reconstr Surg 2023:00006534-990000000-01871. [PMID: 37189244 DOI: 10.1097/prs.0000000000010683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS We performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with pre and post-operative evaluation were included. RESULTS The mean age of the patients was 43.2 ± 13.2 years. All categories of the SF36 questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months post-operative. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03, at 6 and 12 months respectively) and in all domains (self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (desire, arousal, lubrication, satisfaction), but only the desire stayed improved at 12 months. CONCLUSION Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss as well as the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients.
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Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - François Saget
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
| | - Elise Lupon
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Nice, Côte d'Azur University, Nice, France
| | - Camille Mocquard
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
- INSERM U1236, University of Rennes 1, Rennes, France
- SITI Laboratory, Rennes University Hospital, Rennes, France
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Besancon, Franche-Comté University, Besancon, France
| | - Eric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jérôme Duisit
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
| | - Benoit Chaput
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Sud, University of Rennes 1, Rennes, France
- INSERM U1236, University of Rennes 1, Rennes, France
- SITI Laboratory, Rennes University Hospital, Rennes, France
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23
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Berkane Y, Alana Shamlou A, Reyes J, Lancia HH, Filz von Reiterdank I, Bertheuil N, Uygun BE, Uygun K, Austen WG, Cetrulo CL, Randolph MA, Lellouch AG. The Superficial Inferior Epigastric Artery Axial Flap to Study Ischemic Preconditioning Effects in a Rat Model. J Vis Exp 2023:10.3791/64980. [PMID: 36779623 PMCID: PMC10910865 DOI: 10.3791/64980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Fasciocutaneous flaps (FCF) have become the gold standard for complex defect reconstruction in plastic and reconstructive surgery. This muscle-sparing technique allows transferring vascularized tissues to cover any large defect. FCF can be used as pedicled flaps or as free flaps; however, in the literature, failure rates for pedicled FCF and free FCF are above 5%, leaving room for improvement for these techniques and further knowledge expansion in this area. Ischemic preconditioning (I.P.) has been widely studied, but the mechanisms and the optimization of the I.P. regimen are yet to be determined. This phenomenon is indeed poorly explored in plastic and reconstructive surgery. Here, a surgical model is presented to study the I.P. regimen in a rat axial fasciocutaneous flap model, describing how to safely and reliably assess the effects of I.P. on flap survival. This article describes the complete surgical procedure, including suggestions to improve the reliability of this model. The objective is to provide researchers with a reproducible and reliable model to test various ischemic preconditioning regimens and assess their effects on flap survivability.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), University of Rennes 1; Shriners Children's Boston
| | - Austin Alana Shamlou
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Jose Reyes
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School
| | - Hyshem H Lancia
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Plastic Surgery and Hand Surgery, University Medical Center Utrecht
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), University of Rennes 1
| | - Basak E Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Korkut Uygun
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - William G Austen
- Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Plastic Surgery Research Laboratory, Massachusetts General Hospital; Shriners Children's Boston
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Plastic, Reconstructive, and Aesthetic Surgery, Groupe Almaviva Santé, Clinique de l'Alma;
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24
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Berkane Y, Beaufils T, Saget F, Girard P, Lellouch AG, Duisit J, Bertheuil N. Parasacral Perforator Flaps for Buttock Enhancement. Aesthet Surg J 2023; 43:NP64-NP65. [PMID: 36039577 DOI: 10.1093/asj/sjac241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 01/18/2023] Open
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25
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Goudot G, Berkane Y, de Clermont-Tonnerre E, Guinier C, Filz von Reiterdank I, van Kampen A, Uygun K, Cetrulo CL, Uygun BE, Dua A, Lellouch AG. Microvascular assessment of fascio-cutaneous flaps by ultrasound: A large animal study. Front Physiol 2022; 13:1063240. [PMID: 36589429 PMCID: PMC9797596 DOI: 10.3389/fphys.2022.1063240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives: Blood perfusion quality of a flap is the main prognostic factor for success. Microvascular evaluation remains mostly inaccessible. We aimed to evaluate the microflow imaging mode, MV-Flow, in assessing flap microvascularization in a pig model of the fascio-cutaneous flap. Methods: On five pigs, bilateral saphenous fascio-cutaneous flaps were procured on the superficial femoral vessels. A conventional ultrasound evaluation in pulsed Doppler and color Doppler was conducted on the ten flaps allowing for the calculation of the saphenous artery flow rate. The MV-Flow mode was then applied: for qualitative analysis, with identification of saphenous artery collaterals; then quantitative, with repeated measurements of the Vascularity Index (VI), percentage of pixels where flow is detected relative to the total ultrasound view area. The measurements were then repeated after increasing arterial flow by clamping the distal femoral artery. Results: The MV-Flow mode allowed a better follow-up of the saphenous artery's collaterals and detected microflows not seen with the color Doppler. The VI was correlated to the saphenous artery flow rate (Spearman rho of 0.64; p = 0.002) and allowed to monitor the flap perfusion variations. Conclusion: Ultrasound imaging of microvascularization by MV-Flow mode and its quantification by VI provides valuable information in evaluating the microvascularization of flaps.
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Affiliation(s)
- Guillaume Goudot
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Hôpital Européen Georges-Pompidou, Assistance Publique—Hôpitaux de Paris (APHP), Université Paris-Cité, Paris, France,*Correspondence: Guillaume Goudot,
| | - Yanis Berkane
- Hôpital Européen Georges-Pompidou, Assistance Publique—Hôpitaux de Paris (APHP), Université Paris-Cité, Paris, France,Shriners Children’s Boston, Boston, MA, United States,Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Eloi de Clermont-Tonnerre
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Claire Guinier
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Irina Filz von Reiterdank
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States,Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Antonia van Kampen
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,University Clinic of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
| | - Korkut Uygun
- Shriners Children’s Boston, Boston, MA, United States,Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Curtis L. Cetrulo
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States
| | - Basak E. Uygun
- Shriners Children’s Boston, Boston, MA, United States,Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Anahita Dua
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandre G. Lellouch
- Shriners Children’s Boston, Boston, MA, United States,Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory Center for Transplantation Sciences, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States,Department of Plastic, Reconstructive and Aesthetic Surgery, Groupe Almaviva Santé, Clinique de l’Alma, IAOPC, Paris, France
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Berkane Y, Bertheuil N. Comment on "Augmentation mammaplasty by superolateral thoracic flap: a case report". J Med Case Rep 2022; 16:377. [PMID: 36253835 PMCID: PMC9578227 DOI: 10.1186/s13256-022-03602-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/18/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Hospital Sud, University of Rennes 1, Rennes, France. .,Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Hospital Sud, University of Rennes 1, Rennes, France.,INSERM U1236, University of Rennes 1, Rennes, France.,SITI Laboratory, Rennes University Hospital, Rennes, France
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Vaillant C, Berkane Y, Lupon E, Atlan M, Rousseau P, Lellouch AG, Duisit J, Bertheuil N. Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11195813. [PMID: 36233681 PMCID: PMC9572569 DOI: 10.3390/jcm11195813] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new therapeutic alternative by ensuring reconstructions of large defects, reducing donor site morbidity, and enhancing functional recovery. The aim of this study was to achieve a systematic review of perforator flaps use in HS. PATIENTS AND METHODS PubMed and Cochrane databases were searched from 1989 to 2021. The PRISMA statement was used in the study selection process and the review was registered on PROSPERO. Furthermore, patient characteristics, operative technique, complications, and recurrences were searched. RESULTS Thirty-six articles were selected including 286 patients and 387 flaps. Axillary localization was mostly represented (83.2%). Direct donor site closure was achieved in 99.1% of cases. In total, 15.1% of the flaps presented at least one of the following complications: wound dehiscence (5.5%), partial necrosis (2.9%), hematoma or seroma (2.1%), infection (2.1%), venous congestion (1.8%), and nerve injury (0.3%). Two cases of total necrosis were recorded. Recurrence of the disease was observed in 2.7% of the defects. CONCLUSIONS Pedicled perforator flaps are a reliable and reproducible technique in the reconstruction of HS defects. They are associated with a low recurrence rate while ensuring an effective reconstruction with reduced morbidity and faster recovery compared to the techniques classically used in this indication.
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Affiliation(s)
- Camille Vaillant
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, France
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Angers, 49933 Angers, France
| | - Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital and Shriners Children’s Boston, Harvard Medical School, Boston, MA 02115, USA
| | - Elise Lupon
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital, CHU Toulouse, 31013 Toulouse, France
| | - Michael Atlan
- Department of Plastic, Reconstructive and Aesthetic Surgery, Tenon Hospital, AP-HP, 75020 Paris, France
| | - Pascal Rousseau
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Angers, 49933 Angers, France
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital and Shriners Children’s Boston, Harvard Medical School, Boston, MA 02115, USA
| | - Jérôme Duisit
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, France
- INSERM U1236, University of Rennes 1, 35000 Rennes, France
- SITI Laboratory, Rennes University Hospital, 35203 Rennes, France
- Correspondence: ; Tel.: +33-2-99-26-71-68
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Berkane Y, Arnaud AP, Gandolfi S, Bertheuil N. Invited Response on: Comment on "Lipo-Body Lift Reconstruction Following Massive Weight Loss-Our Experience with 100 Consecutive Cases". Aesthetic Plast Surg 2022; 46:579-580. [PMID: 34041555 DOI: 10.1007/s00266-021-02316-1] [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: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
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Berkane Y, Saget F, Gandolfi S, Chrelias T, Watier E, Bertheuil N. Fleur-de-lys abdominal body contouring surgery following massive weight loss. J Plast Reconstr Aesthet Surg 2021; 74:1931-1971. [PMID: 34148835 DOI: 10.1016/j.bjps.2021.05.032] [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: 03/08/2021] [Revised: 04/03/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France.
| | - François Saget
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Silvia Gandolfi
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rouen, Rouen, France
| | - Théodoros Chrelias
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Eric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; INSERM U1236, University of Rennes 1, Rennes, France; SITI Laboratory, Rennes University Hospital, Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; INSERM U1236, University of Rennes 1, Rennes, France; SITI Laboratory, Rennes University Hospital, Rennes, France
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