A 45-year-old woman underwent a delayed breast reconstruction with a free Deep Inferior Epigastric Perforator Flap (DIEP flap) with total flap failure on the fourth postoperative day. Hematological investigation to ex...A 45-year-old woman underwent a delayed breast reconstruction with a free Deep Inferior Epigastric Perforator Flap (DIEP flap) with total flap failure on the fourth postoperative day. Hematological investigation to exclude thrombofilia revealed a resistance to activated protein C (APC) with a factor V Leiden heterozygous mutation. The postoperative course was further complicated by delayed wound healing probably due to ascorbic acid (Vitamin C) related cytotoxic activity to fibroblasts. The surgeon must be aware of the use of preoperative nutritional supplement administration among patients. Future cost-effectiveness analyses should be made to warrant preoperative thrombophilia screening to prevent free flap failures.展开更多
Dermabond Protape (2-octyl-cyanoacrylate and pressure sensitive adhesive mesh;Prineo, Closure Medical Corporation) is a topical mesh and skin adhesive that forms a strong polymeric bond across opposed wound edges allo...Dermabond Protape (2-octyl-cyanoacrylate and pressure sensitive adhesive mesh;Prineo, Closure Medical Corporation) is a topical mesh and skin adhesive that forms a strong polymeric bond across opposed wound edges allowing the normal healing process to occur. No published studies have already compared the use of a topical mesh en skin adhesive in wound closure. This study evaluated the possible applications of a combined mesh-adhesive system in 100 plastic surgery operations (14 different surgical procedures) with a mean follow-up of 85.5 days. The rate of allergic reaction, infection, wound dehiscence and hypertrophic scar formation were recorded in relation to patient co-morbidities, medication and tobacco consumption. No technical restrictions were found during the Dermabond Protape application. The average time for the topical mesh and skin adhesive application was 2 minutes. The Dermabond protape was removed 7 through 10 days after the operation. Three patients (3/100 or 3%) reported an allergic reaction without increased scar formation. Hyper-inflammation in one or more wound areas with a micro-abscess were noted in 11 different patients probably due to polyglactin 910 (vicryl) sutures at their scheduled follow-up visit 1 week after their operation. Increased tissue inflammation and scar formation were found in these patients with hypertrophic scars in 1 patient (1/11 or 9.1%). One upper leg wound dehiscence was seen in a diabetes mellitus patient using corticosteroids. Two patients (2/100 or 2%) with a history of tobacco abuse showed a partial wound dehiscence after an abdominoplasty and a partial areola dehiscence after mamma reduction respectively (Table 2).展开更多
文摘A 45-year-old woman underwent a delayed breast reconstruction with a free Deep Inferior Epigastric Perforator Flap (DIEP flap) with total flap failure on the fourth postoperative day. Hematological investigation to exclude thrombofilia revealed a resistance to activated protein C (APC) with a factor V Leiden heterozygous mutation. The postoperative course was further complicated by delayed wound healing probably due to ascorbic acid (Vitamin C) related cytotoxic activity to fibroblasts. The surgeon must be aware of the use of preoperative nutritional supplement administration among patients. Future cost-effectiveness analyses should be made to warrant preoperative thrombophilia screening to prevent free flap failures.
文摘Dermabond Protape (2-octyl-cyanoacrylate and pressure sensitive adhesive mesh;Prineo, Closure Medical Corporation) is a topical mesh and skin adhesive that forms a strong polymeric bond across opposed wound edges allowing the normal healing process to occur. No published studies have already compared the use of a topical mesh en skin adhesive in wound closure. This study evaluated the possible applications of a combined mesh-adhesive system in 100 plastic surgery operations (14 different surgical procedures) with a mean follow-up of 85.5 days. The rate of allergic reaction, infection, wound dehiscence and hypertrophic scar formation were recorded in relation to patient co-morbidities, medication and tobacco consumption. No technical restrictions were found during the Dermabond Protape application. The average time for the topical mesh and skin adhesive application was 2 minutes. The Dermabond protape was removed 7 through 10 days after the operation. Three patients (3/100 or 3%) reported an allergic reaction without increased scar formation. Hyper-inflammation in one or more wound areas with a micro-abscess were noted in 11 different patients probably due to polyglactin 910 (vicryl) sutures at their scheduled follow-up visit 1 week after their operation. Increased tissue inflammation and scar formation were found in these patients with hypertrophic scars in 1 patient (1/11 or 9.1%). One upper leg wound dehiscence was seen in a diabetes mellitus patient using corticosteroids. Two patients (2/100 or 2%) with a history of tobacco abuse showed a partial wound dehiscence after an abdominoplasty and a partial areola dehiscence after mamma reduction respectively (Table 2).
