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  • Regardless of the timing of surgery the primary

    2018-11-12

    Regardless of the timing of surgery, the primary goal of surgery is to reconstruct the orbital wall to its pretrauma condition. The present study revealed that the enophthalmos incidence was not influenced by the time interval between injury and surgery. Enophthalmos treated at <2 weeks following orbital trauma exhibited a lower improvement rate compared with enophthalmos treated at 2–4 weeks and >4 weeks following trauma. Significant enophthalmos is usually not immediately apparent following initial orbital trauma. In severe orbital trauma, the edema of the periorbital tissue may even cause proptosis on the injured side. Consequently, any surgical correction of enophthalmos should be decided after the tissue edema subsides to yield favorable esthetic outcomes. Hence, it tropisetron is not necessary to repair all orbital fractures immediately, and the indications for surgical repair should be individualized. A delay in the surgery for varying periods of time is feasible and does not affect the treatment outcome.
    Conclusion
    Introduction Breast cancer is one of the most common cancers among women worldwide. Postmastectomy breast reconstruction is currently widely used for oncological safety and because of its higher psychosocial satisfaction. Breast cancer is generally treated using multimodalities, including surgical resection, hormone therapy, chemotherapy, and radiation. In addition, various postmastectomy reconstructive methods, such as implant-based, autologous tissue, or combined reconstructions, are available. Each of these reconstructive methods has its own benefits and drawbacks. An implant-based reconstruction may provide short surgical and hospitalization time but generates relatively long periods of postoperative complications. By contrast, an autologous tissue reconstruction results in a more durable appearance and a relatively short complication phase; however, it requires long surgical and hospitalization time. By contrast, a combination of the autologous tissue and implant-based reconstructions is an effective compromise because one method can complement the other. For patients, one of the key satisfaction predictors is the postoperative complication rate. Furthermore, postoperative complications are a considerable setback for patients undergoing breast reconstruction. Therefore, choosing an appropriate reconstructive modality for each individual is a critical step that involves complex considerations. Within the limited scale of sarcomeres study, the complications arising after the three most common reconstructive modalities are compared to aid preoperative counseling and discussion.
    Materials and methods All 90 patients who underwent breast reconstruction at our institution during the past 5 years were reviewed. The clinical encounters of all reconstruction modalities were assessed, which included 38, 46, and 6 patients who underwent implant-based, autologous tissue, and combined reconstructions, respectively. Implant-based reconstruction involved prosthesis and tissue expander placement. The flaps of the autologous reconstruction group included a free deep inferior epigastric perforator (DIEP), free superior gluteal artery (SGA), free transverse rectus abdominis myocutaneous (TRAM), and pedicled-TRAM flaps. The combined reconstruction group solely used the latissimus dorsi (LD) flap with an implant placement (Table 1). Several clinical variables, including patients\' type of surgery, time required for the reconstruction, and early and late complications, were reviewed in this study. We defined early and late complications as those that occurred within and after 3 weeks of the surgery, respectively. The Chi-square test was used for comparing the statistical differences among the different groups. A value of p < 0.05 was considered statistically significant, and all confidence intervals were reported within the range of 95%. All calculations were performed using SPSS for Windows, Version 21.0 (Chicago, IL, USA).