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Loreti A, Bruno E, Abate O, Arelli F, Spallone D, La Pinta M, Matropietro T, Ponti E, Broglia L, Costarelli L, Scavina P, Ribuffo D, Fortunato L. Breast Reconstruction using the Anterior Approach Scarless Latissimus Dorsi Muscular flap: A Single Center Retrospective Study. JPRAS Open 2024; 40:194-205. [PMID: 38601882 PMCID: PMC11004073 DOI: 10.1016/j.jpra.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/03/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Scarless latissimus dorsi (LD) flap is a breast reconstruction technique, which allow to cover the lower pole of implant with a large portion of the LD muscle without skin paddle; it represents a surgical solution that transpose vascularized tissue avoiding the failure of breast reconstruction, following necrosis of mastectomy skin flaps. Material and Method A retrospective review of patients undergoing immediate or delayed breast reconstruction using scarless LD flap reconstructions was performed. Clinical data obtained from follow-up visits were recorded. To evaluate breast shape contentment and patient satisfaction, the patients were requested to answer the Breast-Q, version 2.0 reduction module postoperative scales questionnaire at the 12-month follow-up. Results We performed 19 scarless LD flap reconstructions between September 2019 and June 2022. The surgical time in average (considering minutes ± SD) was 130 (±15) minutes. The aesthetic assessment was good/excellent in 83% of patients. This was statistically significant (P=0.0). Conclusions The scarless LD flap reconstruction is a valid and reliable solution, which has the advantage to reduce the risk of exposed prosthesis if native skin necrosis occurs.
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Affiliation(s)
- Andrea Loreti
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Edoardo Bruno
- Department of Surgery “P.Valdoni,” Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via dei Latini 33, 00185 Rome, Italy
| | - Ornella Abate
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Floriana Arelli
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Diana Spallone
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Massimo La Pinta
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Tiziana Matropietro
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Elisabetta Ponti
- Radiation Oncology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Laura Broglia
- Breast Radiology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Leopoldo Costarelli
- Pathology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Paola Scavina
- Oncology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Diego Ribuffo
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Lucio Fortunato
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
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Loreti A, Arelli F, Spallone D, Bruno E, Abate O. The use of the internal pudendal artery perforator flap after abdominoperineal reconstruction: A single center study. J Plast Reconstr Aesthet Surg 2023; 84:87-92. [PMID: 37327737 DOI: 10.1016/j.bjps.2023.05.015] [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: 08/09/2022] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 06/18/2023]
Abstract
Abdominoperineal resection (APR) is still a valuable option in the presence of cancer recurrences or salvage surgery. Primary perineal closure after conventional APR curries a high rate of wound complications. A multidisciplinary approach with perineal soft tissue reconstruction surgical time improves the immediate and long-term prognosis of these patients. The aim of the study is to report our experience with the use of the internal pudendal artery perforator flap in perineal region reconstruction after APR. We performed 11 perineal region reconstructions after conventional APR between September 2016 and December 2020. In 8 cases the reconstruction was performed on previously irradiated tissues while in 2 cases the radiotherapy was carried out on the perineal tissues solely for adjuvant therapy. A rotation perforating flap was harvested in 8 cases, an advance island flap in 2 cases, and a propeller type in one case. All 11 flaps survived with no immediate postoperative major complications. Only one case showed dehiscence of the donor site wound healed with conservative treatment. Average hospitalization time was 11 days internal pudendal artery perforator flap represents a valid and reliable reconstructive solution after APR showing low complication rates and minimal donor site morbidity even in patients with previous radiotherapy.
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Affiliation(s)
- Andrea Loreti
- Plastic Reconstructive Surgery Division, San Giovanni-Addolorata, Via dell'Amba Aradam, 9, 00184 Rome, Italy
| | - Floriana Arelli
- Plastic Reconstructive Surgery Division, San Giovanni-Addolorata, Via dell'Amba Aradam, 9, 00184 Rome, Italy
| | - Diana Spallone
- Plastic Reconstructive Surgery Division, San Giovanni-Addolorata, Via dell'Amba Aradam, 9, 00184 Rome, Italy
| | - Edoardo Bruno
- Department of Surgery ''P.Valdoni'', Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Via Giovanni Maria Lancisi, 2, 00161 Roma, Italy.
| | - Ornella Abate
- Plastic Reconstructive Surgery Division, San Giovanni-Addolorata, Via dell'Amba Aradam, 9, 00184 Rome, Italy
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Loreti A, Fanelli B, Abate O, Spallone D, Arelli F, Bruno E, Marcasciano M, La Pinta M, Meli EZ, Fortunato L. Surgical Delay of Nipple Areola Complex: A Powerful Technique to Extend the Indication of Nipple-Sparing Mastectomy. Clin Breast Cancer 2023; 23:255-264. [PMID: 36681577 DOI: 10.1016/j.clbc.2023.01.003] [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: 07/01/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Surgical delay (SD) techniques, performed before the nipple sparing mastectomy (NSM), are procedures conceived to improve the blood supply to the nipple-areola complex (NAC) in order to overcome the ischemic risk. The aim of the study is reporting our experience with SD of the NAC in the setting of NSM, identify the rate of nipple and skin necrosis and other complications and to evaluate patient satisfaction with cosmetic outcome. PATIENTS AND METHODS A retrospective review of female patients, who underwent NSM and breast reconstruction between the July 2014 and the July 2019, was performed at the Breast Unit of San Giovanni-Addolorata Hospital in Rome. Eighty-nine NSM after SD procedure were performed in 66 patients. In all cases immediate breast reconstruction was performed with a direct to implant technique and polyurethane implants in prepectoral plan were used in all reconstructions. RESULTS We registered only 1 case of total NAC necrosis and 3 skin flap necrosis. Furthermore, patient satisfaction with breast reconstruction resulted excellent or good in 23 cases and good in 36 cases; the external plastic surgeon considered the breast reconstruction excellent or good in 63 cases. CONCLUSION We support the thesis that SD techniques may expand indications for NAC sparing mastectomy and immediate breast reconstruction in women with known risk factors for local complications. Microabstract This is the largest single center series on surgical delay of nipple areola complex providing interesting data on follow-up and complication rates and we support the thesis that surgical delay techniques may expand indications for nipple-areola complex sparing mastectomy and immediate breast reconstruction in women with known risk factors for local complications.
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Affiliation(s)
- Andrea Loreti
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy.
| | - Benedetta Fanelli
- Department of Surgery ''P.Valdoni'', Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ornella Abate
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy
| | - Diana Spallone
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy
| | - Floriana Arelli
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy
| | - Edoardo Bruno
- Department of Surgery ''P.Valdoni'', Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Marco Marcasciano
- Division of Plastic and Reconstructive Surgery, Magna Grecia University of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Massimo La Pinta
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy
| | | | - Lucio Fortunato
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy
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Loreti A, Ornella A, Arelli F, Spallone D, Bruno E, De Luca P, Costarelli L, Camaioni A. Central mucoepidermoid carcinoma of the mandible deriving from odontogenic cyst: A case report and review of the literature. Clin Case Rep 2022; 10:e6040. [PMID: 35937015 PMCID: PMC9347325 DOI: 10.1002/ccr3.6040] [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: 03/22/2022] [Revised: 05/11/2022] [Accepted: 06/03/2022] [Indexed: 11/08/2022] Open
Abstract
Mucoepidermoid Carcinoma (MEC) it can origin from a mandibular odontogenic cyst. We report the case of a 63‐year‐old man with MEC of the right retromolar trigonum of the mandibula. We performed a wide mandibular excision and immediate reconstruction with a fibula bone free flap. Treatment of mandibular mucoepidermoid carcinoma central type can be carried out safely and aesthetical valid through a wide segmental mandibular excision with an immediate reconstruction with fibula bone‐free flap and a postoperative RT.
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Affiliation(s)
- Andrea Loreti
- Plastic Reconstructive Surgery Division San Giovanni‐Addolorata Rome Italy
| | - Abate Ornella
- Plastic Reconstructive Surgery Division San Giovanni‐Addolorata Rome Italy
| | - Floriana Arelli
- Plastic Reconstructive Surgery Division San Giovanni‐Addolorata Rome Italy
| | - Diana Spallone
- Plastic Reconstructive Surgery Division San Giovanni‐Addolorata Rome Italy
| | - Edoardo Bruno
- Department of Surgery “P.Valdoni”, Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I Sapienza University of Rome Rome Italy
| | - Pietro De Luca
- Department of Head and Neck – Otorhinolaryngology San Giovanni‐Addolorata Rome Italy
| | | | - Angelo Camaioni
- Department of Head and Neck – Otorhinolaryngology San Giovanni‐Addolorata Rome Italy
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Loreti A, Abate O, Arelli F, Spallone D, Bruno E, De Luca P, Tassone D, Camaioni A. Reconstruction of hypopharyngeal defects with anterolateral thigh free flap: A single-center retrospective analysis. Am J Otolaryngol 2022; 43:103542. [PMID: 35905665 DOI: 10.1016/j.amjoto.2022.103542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/19/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Reconstruction of expanded hypopharyngeal defects following laryngo-hypopharyngectomy for surgical treatment of primary is still a challenge for head and neck surgeons. Tradiotionally, jejunal or radial forearm flaps are the common reconstructive choice. Recently, the anterolateral thigh (ALT) free flap has served for pharyngoesophageal reconstruction. The goal of this work is to describe a retrospective analysis about a five-year single-center experience in the reconstruction of post-operative hypopharyngeal defects with ALT free flap. METHODS A single-center retrospective study was performed, including patients treated for patients who underwent tumor surgery involving hypopharynx with ALT free flap reconstruction from 2015 to 2020. Exclusion criteria were paediatric (0-18 years) patients, and the absence of follow-up. RESULTS The study included 23 adult patients. The mean size of the flap was 90 cm2 (range 60-130 cm2). The mean time required to harvest the antero-lateral tight flap was 70 min (range 35-120 min). The median age was 46.3 years (SD 15.81, range: 19-84 years), with a gender female prevalence (F = 48, M = 33). Mean follow-up was 77.7 months (min 4-max 361, SD 72.46). One patient (4.4 %) showed a hypopharyngeal stenosis. CONCLUSION ALT free flap represents a successful and versatile reconstructive option for hypopharyngeal defects extended to oropharynx and/or larynx following total laryngectomy with circumferential or partial hypopharyngectomy, regardless of the functional and aesthetic results, with minimal donor-site complication.
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Affiliation(s)
- Andrea Loreti
- Plastic and Reconstructive Surgery Division, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Ornella Abate
- Plastic and Reconstructive Surgery Division, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Floriana Arelli
- Plastic and Reconstructive Surgery Division, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Diana Spallone
- Plastic and Reconstructive Surgery Division, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Edoardo Bruno
- Department of Plastic Reconstructive and Aesthetic Surgery, Sapienza Università of Rome, Rome, Italy
| | - Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy; Department of Otolaryngology, San Giovanni-Addolorata Hospital, Rome, Italy.
| | - Domenico Tassone
- Department of Otolaryngology, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Angelo Camaioni
- Department of Otolaryngology, San Giovanni-Addolorata Hospital, Rome, Italy
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Di Raimondo C, Caposiena Caro RD, Spallone D, Silvaggio D, Lombardo P, Del Duca E, Campione E, Spallone G, Bianchi L. Baseline neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) correlate with advanced stages in cutaneous squamous cell carcinoma. Int J Dermatol 2021; 61:175-179. [PMID: 34212366 DOI: 10.1111/ijd.15755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) at diagnosis have been shown to correlate with advanced disease and to be prognostic factors in many tumors. However, their role as a prognostic factor for cutaneous squamous cell carcinoma (cSCC) has not yet been studied. OBJECTIVE Therefore, the aim of our study was to evaluate the correlation of NLR and RDW with stages of disease in patients with cSCC in order to define whether or not higher values of these two markers correlate with a more aggressive disease. METHODS We retrospectively analyzed the NLR and RDW in a total of 51 newly diagnosed cSCC patients. NLR and RDW were calculated using data obtained from the complete blood count (CBC). RESULTS Median NLR among patients with the non-advanced disease (in situ and stage I) was 2.2, whereas median NLR for patients with advanced disease was 4.87. Median RDW among patients with early stage disease was 13.7%, while median RDW in patients with advanced disease was 15.81%. Statistical analysis showed positive associations of advanced cSCC stages with NLR or RDW higher than 3.07 or 14.5%, respectively. CONCLUSIONS Therefore, our analysis demonstrated how both NLR and RDW represent cheap and easily available factors that could be used as markers for advanced cSCC. They could help to identify patients with advanced stages disease that requires a strict follow-up.
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Affiliation(s)
| | | | - Diana Spallone
- Department of Plastic Surgery, San Giovanni Hospital, Rome, Italy
| | | | - Paolo Lombardo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Ester Del Duca
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Elena Campione
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Spallone
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
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Loreti A, Siri G, De Carli M, Fanelli B, Arelli F, Spallone D, Abate O, La Pinta M, Manna E, Meli EZ, Costarelli L, Andrulli D, Broglia L, Scavina P, Fortunato L. Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture. Breast 2020; 54:127-132. [PMID: 33010626 PMCID: PMC7529839 DOI: 10.1016/j.breast.2020.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/06/2020] [Accepted: 09/22/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants. METHODS A retrospective review of consecutive patients treated at our Institution with mastectomy and one-stage IBR and implant reconstruction between 2013 and 2018, with or without post mastectomy radiation therapy (PMRT), was conducted. Immediate breast reconstruction was performed by implanting 186 PU covered implants and 172 TE implants. RESULTS Three-hundred-twelve women underwent 358 DTI IBR with PU or TE implants, were analyzed with a median follow-up time of 2.3 years (range 1.0-3.0). The overall rate of CC Baker grade III and IV was 11.8% (95%CI: 8.4-16.3), while, after PU and TE implant placement it was 8.1% (95% CI: 4.1-15.7) and 15.8% (95% CI: 4.1-15.7) [p = 0.009]), respectively. Irradiated breasts developed CC more frequently rather than non-irradiated breasts (HR = 12.5, p < 0.001), and the relative risk was higher in the TE group compared with the PU group (HR = 0.3, p = 0.003). CONCLUSIONS After mastectomy and one-stage IBR, the use of PU covered implants is associated with a lower incidence of CC compared to TE implants. This advantage is amplified several folds for patients who necessitate PMRT. Footnote: Capsular contracture (CC); Immediate Breast Reconstruction (IBR); Directto- Implant (DTI); Textured (TE); Polyurethane (PU); Post mastectomy radiation therapy (PMRT); Nipple Sparing mastectomy (NSM).
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Affiliation(s)
- Andrea Loreti
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy.
| | - Giacomo Siri
- Department of Mathematics, University of Genoa, Genoa, Italy
| | - Matteo De Carli
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Benedetta Fanelli
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Floriana Arelli
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Diana Spallone
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Ornella Abate
- Plastic and Reconstructive Surgery Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Massimo La Pinta
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Elena Manna
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Emanuele Zarba Meli
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Leopoldo Costarelli
- Pathology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Damiana Andrulli
- Radiation Oncology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Laura Broglia
- Breast Radiology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Paola Scavina
- Oncology Division, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
| | - Lucio Fortunato
- Breast Unit, Azienda Ospedaliera San Giovanni-Addolorata, Via Dell'Amba Aradam 8, Rome, Italy
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Loreti A, Fanelli B, Spallone D, Arelli F, Marcasciano M, Abate O, Latini C, De Carli M, La Pinta M, Manna E, Meli E, Fortunato L. Nipple sparing mastectomy (NSM) after surgical delay (SD) and prepectoral direct to implant (DTI) reconstruction with polyurethane prostheses: Preliminary results. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30658-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ventura A, Pitocco R, Di Stefani A, Cota C, Spallone D, Bianchi L, Spallone G. Image Gallery: Peculiar subungual localization of a second primary melanoma during BRAF inhibitors treatment for metastatic melanoma: case report. Br J Dermatol 2019; 180:e142. [PMID: 31025747 DOI: 10.1111/bjd.17539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Ventura
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - R Pitocco
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Di Stefani
- Division of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - C Cota
- Department of Dermatopathology, San Gallicano Dermatological Institute, Via Elio Chianesi 53, Rome, 00144, Italy
| | - D Spallone
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy.,Department of Plastic Surgery, San Giovanni Hospital
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - G Spallone
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
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Cervelli V, Nicoli F, Spallone D, Verardi S, Sorge R, Nicoli M, Balzani A. Treatment of traumatic scars using fat grafts mixed with platelet-rich plasma, and resurfacing of skin with the 1540 nm nonablative laser. Clin Exp Dermatol 2011; 37:55-61. [DOI: 10.1111/j.1365-2230.2011.04199.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Cervelli V, Brinci L, Palla L, Spallone D, Izzo V, Curcio CB, Lucarini L, De Angelis B. Skin necrosis of scrotum due to endovascular embolisation: a case report. Int Wound J 2011; 9:70-5. [PMID: 21883935 DOI: 10.1111/j.1742-481x.2011.00847.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of our case report was to analyse the results obtained with the Matriderm® system and autologous skin grafting for the surgical treatment of skin necrosis of scrotum as a result of endovascular embolisation. We recruited one patient with scrotum skin necrosis as a result of endovascular embolisation admitted at the department of Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata'. The patient underwent Matriderm® system and autologous skin grafting for skin necrosis treatment. After a single treatment, reduction of the skin necrosis was obtained, after 30 days from the surgical treatment. Patient experienced a reduction in pain and a complete restoration of the loss in volume and quality of skin was noticed. Matriderm® system and autologous skin grafting is a simple, safe and feasible technique. When comparing this treatment with others, Matriderm® is a simpler, more economic and less time-consuming method, and does not require sophisticated laboratory facilities.
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Affiliation(s)
- Valerio Cervelli
- Department of Plastic and Reconstructive Surgery at the University of Rome 'Tor Vergata', Rome, Italy
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Abstract
The aim of this study was to prove the effectiveness of MatriDerm(®) combined with skin grafting versus skin grafting alone in post-traumatic wounds treatment. At the Department of Plastic and Reconstructive Surgery of the University of Rome Tor Vergata, we treated 60 patients: 30 patients with dermal substitutes (MatriDerm(®)) combined with autologous skin graft and 30 with skin graft alone. Two weeks after the first treatment, 95% of wounds treated with MatriDerm(®) and skin graft showed a re-epithelisation, whereas it was 75-80% in the control group. We used the Manchester Scar Scale (MSS) and patient's self-estimation scale to assess the outcomes. Mann-Whitney U test was performed for the five items of the MSS and the results were combined to those of patient's self-estimation scale and the re-epithelialisation percentage to test the significance between the two groups. These data confirm the evidence of the clinical use of MatriDerm(®) technology in the healing of soft tissue wounds and prove the effectiveness of combining MatriDerm(®) and skin grafting for the first time. Furthermore, we observed a percentage reduction of wound contraction and in the same time an improvement of elasticity, quality of scars tissue and dermal architecture.
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Affiliation(s)
- Valerio Cervelli
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy
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Cervelli V, Gentile P, Spallone D, Nicoli F, Verardi S, Petrocelli M, Balzani A. Ultrapulsed fractional CO2 laser for the treatment of post-traumatic and pathological scars. J Drugs Dermatol 2010; 9:1328-1331. [PMID: 21061753] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Scar management is a long-term process. A variety of modalities have been employed and, depending on scar type, treatment may be invasive and/or conservative. The purpose of this study was to evaluate a new CO2 laser resurfacing for post-traumatic and pathological scars and to compare this device with classic dermabrasion. The new fractionated ultrapulsed CO2 laser (Ultrapulse Encore, Lumenis Ltd., Santa Clara, CA) is equipped with two types of scanners: the first, ActiveFX, is non-sequential while the second, DeepFX, is sequential and produces microspot. MATERIALS AND METHODS From September 2008 to November 2008, a study on 60 patients was performed. The patients (average age 47.3 years) enrolled in this study had severely scarred skin and were divided into two groups of 30 people. All patients were Caucasian with skin type II or III. Each scar was photographed and scored by the authors using the Manchester Scar Scale (MSS). Follow-up ranged from 12-15 months. RESULTS Sixty patients were analyzed in two homogeneous groups. Significant improvement in skin tone, texture and appearance of skin was noted in all patients treated with CO2 laser, lower improvement resulted with dermabrasion. Both subjects and investigators noted similar aesthetic improvement. No major complications were found for both groups and minor complications included transient erythema and edema. CONCLUSION Fractional ultrapulsed CO2 laser resurfacing has proven to be both safe and effective. The efficacy and favorable side effects profile for this technology, with low incidence of pigmentary changes, make it a viable alternative for the treatment of moderate-to-severe scars.
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Affiliation(s)
- Valerio Cervelli
- Plastic and Reconstructive Surgery Department, University of Tor Vergata, Rome, Italy
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Cervelli V, De Angelis B, Spallone D, Lucarini L, Arpino A, Balzani A. Use of a novel autologous cell-harvesting device to promote epithelialization and enhance appropriate pigmentation in scar reconstruction. Clin Exp Dermatol 2010; 35:776-80. [DOI: 10.1111/j.1365-2230.2009.03728.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cervelli V, Lucarini L, Spallone D, Brinci L, de Angelis B. Use of platelet rich plasma and hyaluronic acid on exposed tendons of the foot and ankle. J Wound Care 2010; 19:186, 188-90. [PMID: 20505591 DOI: 10.12968/jowc.2010.19.5.48045] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Platelet rich plasma was used as an autologous scaffold for cellular growth, in combination with hyaluronic acid as a temporary dermal substitute. This aided healing of acute and chronic open wounds of the foot and ankle.
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Affiliation(s)
- V Cervelli
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy
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Cervelli V, Lucarini L, Cerretani C, Spallone D, Palla L, Brinci L, De Angelis B. The use of Matriderm and autologous skin grafting in the treatment of diabetic ulcers: a case report. Int Wound J 2010; 7:291-6. [PMID: 20529143 PMCID: PMC7951783 DOI: 10.1111/j.1742-481x.2010.00687.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of our case report was to analyse the results obtained with the Matriderm system and autologous skin grafting for the surgical treatment of diabetic ulcers. We recruited one patient with diabetic ulcers admitted at the Department of Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata'. The patient underwent Matriderm system and autologous skin grafting for diabetic ulcer treatment. After just a single treatment, we obtained reduction in ulcer after 15 days from the surgical treatment. We achieved a reduction in pain and exudate secretion of the ulcer. We noticed an almost complete restoration of the missing volume and good quality of skin. Matriderm system and autologous skin grafting is a simple, safe and feasible technique. This method, when compared with other methods of treatment, is simple, cheap, less time consuming and does not require sophisticated laboratory facilities.
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Affiliation(s)
- Valerio Cervelli
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Via l'Aquila 7, 00176 Roma
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Cervelli V, Spallone D, Lucarini L, Palla L, Brinci L, De Angelis B. Treatment of stable vitiligo hands by ReCell system: a preliminary report. Eur Rev Med Pharmacol Sci 2010; 14:691-694. [PMID: 20707289] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND The aim of this report was to analyze the results obtained with the ReCell system for the surgical treatment of stable vitiligo hands. MATERIALS AND METHODS One patient with stable vitiligo of the hands was admitted at the Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata. The patient underwent to ReCell system for the treatment of stable vitiligo hands. RESULTS The repigmentation was assessed using the Vitiligo Area Scoring index (VASI). The extent of pigmentation was scored as excellent, good, fair, and poor depending on the percentage of the repigmentation in the previously depigmented site. The color of the repigmented area was compared with the adjacent normally pigmented area. The patient had an excellent repigmentation. CONCLUSIONS ReCell system is a simple, safe and feasible technique. The method that uses noncultured autologous epidermal suspension is simpler, cheaper, less time consuming and does not require sophisticated laboratory facilities, when compared with methods employing cultured melanocytes.
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Affiliation(s)
- V Cervelli
- Department of Plastic and Reconstructive Surgery at the University of Rome Tor Vergata, Rome, Italy
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Palla L, De Angelis B, Lucarini L, Spallone D, Palla G, Cervelli V. A case of labial fusion and urinary pseudo-incontinence in an elderly woman. A surgical treatment and a review. Eur Rev Med Pharmacol Sci 2010; 14:491-493. [PMID: 20556931] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Labial fusion is defined as either partial or complete adherence of the labia minora (1), and also called vulvar fusion, adhesions of the labia minor or conglutination of the labia minora and sinechia of the vulva. The complete and severe labial fusion is a rare pathology with a small number of cases reported in the literature in adults. We present a case report of a postmenopausal woman who presented with voiding difficulty and incontinence and was treated by surgical division of the adhesions and immediate resolution of the urinary incontinence confirmed by multichannel urodynamic test postoperatively.
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Affiliation(s)
- L Palla
- Plastic Surgery Department, University of Tor Vergata, Rome, Italy.
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Cervelli V, Spallone D, Bottini JD, Silvi E, Gentile P, Curcio B, Pascali M. Alar batten cartilage graft: treatment of internal and external nasal valve collapse. Aesthetic Plast Surg 2009; 33:625-34. [PMID: 19421808 DOI: 10.1007/s00266-009-9349-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Accepted: 03/27/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to describe the efficacy of alar batten graft in correcting internal and external nasal valve collapse (i.n.v. and e.n.v.) and evaluate the functional and aesthetic results. METHODS From July 2006 to September 2008, 80 patients (54 females and 26 males) underwent alar batten cartilage grafting. The patients were divided into three groups: (1) 55 patients with iatrogenic nasal valve collapse (80% i.n.v., 20% e.n.v.), (2) 15 patients with posttraumatic nasal valve collapse (45% i.n.v., 55% e.n.v.), and (3) 10 patients with congenital nasal valve collapse (100% e.n.v.). Patients were evaluated at 6, 12, 24, and some at 36 months after surgery. The final follow-up was at least 24 months. RESULTS The results of this study revealed a significant increase in the size of the aperture at the internal or external nasal valve after the application of alar batten grafts. All the patients noted improvement in their nasal airway breathing and in their cosmetic appearance. No major complication was observed. CONCLUSION The alar batten graft is a simple, versatile technique for long-term reshaping, repositioning, and reconstruction of the nasal valve collapse.
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Affiliation(s)
- Valerio Cervelli
- Department of Plastic and Reconstructive Surgery, University of Rome Tor vergata, Viale Oxford, V. U.Saba n 71, 00100, Rome, Italy
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Cervelli V, De Angelis B, Balzani A, Colicchia G, Spallone D, Grimaldi M. Treatment of stable vitiligo by ReCell system. Acta Dermatovenerol Croat 2009; 17:273-278. [PMID: 20021980] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of our study was to analyze the results obtained with the ReCell system for surgical treatment of stable vitiligo. At Department of Plastic and Reconstructive surgery, University of Tor Vergata in Rome, we treated 15 patients with stable vitiligo during a 2-year period. The stability of vitiligo lesions varied between 1 and 4 years. The mean stability was 2.25. The disease activity according to Vitiligo Disease Activity Score (VIDA) was 0 in all cases, which means that all patients had a stability of greater than or equal to 1 year. Three (20%) patients had vitiligo vulgaris, seven (46.6%) segmental vitiligo and five (33.3%) focal vitiligo. Repigmentation was assessed using the Vitiligo Area Scoring Index (VASI). The extent of pigmentation was scored as excellent, good, fair, and poor depending on the percentage of repigmentation in the previously depigmented site. The color of the repigmented area was compared with the adjacent normally pigmented area: excellent color match was present in ten (66.6%) and good in five (33.3%) cases. There was no fair or poor outcome. Repigmentation greater than 75% was recorded in 12 (80%) and 25% to 50% repigmentation in three (20%) of 15 patients treated. ReCell is a feasible, simple and safe technique. The method that uses noncultured autologous epidermal suspension is simpler, less expensive, less time consuming, and does not require sophisticated laboratory facilities as compared with the methods employing cultured melanocytes.
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Affiliation(s)
- Valerio Cervelli
- Department of Plastic and Reconstructive Surgery, Policlinico Casilino, University of Tor Vergata, Rome, Italy
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