1.Vascularized bone grafts for post-traumatic defects in the upper extremity
Giovanna PETRELLA ; Daniele TOSI ; Filippo PANTALEONI ; Roberto ADANI
Archives of Plastic Surgery 2021;48(1):84-90
Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5–6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.
2.Nicolau's Syndrome Complicated by Atypical Necrotizing Fasciitis.
Francesco SEGRETO ; Daniele TOSI ; Giovanni Francesco MARANGI ; Pierluigi GIGLIOFIORITO ; Alfonso Luca PENDOLINO ; Paolo PERSICHETTI
Archives of Plastic Surgery 2013;40(3):267-268
No abstract available.
Fasciitis, Necrotizing
4.Hidden Sentinel Node in Cutaneous Melanoma.
Francesco SEGRETO ; Daniele TOSI ; Giovanni Francesco MARANGI ; Alfonso Luca PENDOLINO ; Stefano SANTORO ; Pierluigi GIGLIOFIORITO ; Paolo PERSICHETTI
Archives of Plastic Surgery 2013;40(5):642-644
No abstract available.
Melanoma
;
Nitriles
;
Pyrethrins
5.Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol.
Giovanni Francesco MARANGI ; Francesco SEGRETO ; Igor POCCIA ; Stefano CAMPA ; Daniele TOSI ; Daniela LAMBERTI ; Paolo PERSICHETTI
Archives of Plastic Surgery 2016;43(4):360-364
BACKGROUND: Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. METHODS: A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. RESULTS: Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). CONCLUSIONS: The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.
Abdominoplasty*
;
Body Mass Index
;
Chemoprevention
;
Drainage
;
Enoxaparin
;
Hematoma
;
Hemostasis
;
Humans
;
Mortality
;
Pulmonary Embolism
;
Risk Assessment
;
Risk Factors
;
Surgery, Plastic
;
Thromboembolism
;
Thrombosis
;
Venous Thromboembolism
;
Venous Thrombosis
6.Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol.
Giovanni Francesco MARANGI ; Francesco SEGRETO ; Igor POCCIA ; Stefano CAMPA ; Daniele TOSI ; Daniela LAMBERTI ; Paolo PERSICHETTI
Archives of Plastic Surgery 2016;43(4):360-364
BACKGROUND: Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. METHODS: A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. RESULTS: Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). CONCLUSIONS: The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.
Abdominoplasty*
;
Body Mass Index
;
Chemoprevention
;
Drainage
;
Enoxaparin
;
Hematoma
;
Hemostasis
;
Humans
;
Mortality
;
Pulmonary Embolism
;
Risk Assessment
;
Risk Factors
;
Surgery, Plastic
;
Thromboembolism
;
Thrombosis
;
Venous Thromboembolism
;
Venous Thrombosis