Partial flap loss(skin involved)or fat necrosis following autologous breast reconstruction remains a dreaded postoperative complication despite significant advances in microsurgical techniques.Several strategies have ...Partial flap loss(skin involved)or fat necrosis following autologous breast reconstruction remains a dreaded postoperative complication despite significant advances in microsurgical techniques.Several strategies have been proposed in the preoperative and intraoperative period to prevent this complication ranging from preoperative imaging,intra-operative tissue perfusion assessment,appropriate perforator selection(location and number),maximizing inflow and outflow with additional anastomoses and/or pedicles,and minimizing ischemia time.Postoperative management of partial flap loss(when there is skin involvement)and fat necrosis remains a challenge,with very little published data focusing on classification,timing,and techniques.Early intervention versus close observation may depend on multiple patient factors and the degree or volume of necrosis.Secondary intervention options include hyperbaric oxygen therapy,fat aeration with a needle,liposuction,fat grafting,addition of another flap or implant,depending on the nature of the defect.This review summarizes the current evidence for each of these strategies to help the current surgeon understand their options in preventing and managing patients suffering from partial flap loss.展开更多
Acute pancreatitis constitutes 3% of all admissions with abdominal pain. There are reports of osteal fat necrosis leading to periosteal reactions and osteolytic lesions following severe pancreatitis, particularly in l...Acute pancreatitis constitutes 3% of all admissions with abdominal pain. There are reports of osteal fat necrosis leading to periosteal reactions and osteolytic lesions following severe pancreatitis, particularly in long bones. A 54-year-old man was admitted to our hospital with acute pancretitis, who later developed spinal discitis secondary to necrotizing pancreatitis. He was treated conservatively with antibiotics and after a month he recovered completely without any neurological deficit. This case is reported for its unusual and unreported spinal complications after acute pancreatitis.展开更多
文摘Partial flap loss(skin involved)or fat necrosis following autologous breast reconstruction remains a dreaded postoperative complication despite significant advances in microsurgical techniques.Several strategies have been proposed in the preoperative and intraoperative period to prevent this complication ranging from preoperative imaging,intra-operative tissue perfusion assessment,appropriate perforator selection(location and number),maximizing inflow and outflow with additional anastomoses and/or pedicles,and minimizing ischemia time.Postoperative management of partial flap loss(when there is skin involvement)and fat necrosis remains a challenge,with very little published data focusing on classification,timing,and techniques.Early intervention versus close observation may depend on multiple patient factors and the degree or volume of necrosis.Secondary intervention options include hyperbaric oxygen therapy,fat aeration with a needle,liposuction,fat grafting,addition of another flap or implant,depending on the nature of the defect.This review summarizes the current evidence for each of these strategies to help the current surgeon understand their options in preventing and managing patients suffering from partial flap loss.
文摘Acute pancreatitis constitutes 3% of all admissions with abdominal pain. There are reports of osteal fat necrosis leading to periosteal reactions and osteolytic lesions following severe pancreatitis, particularly in long bones. A 54-year-old man was admitted to our hospital with acute pancretitis, who later developed spinal discitis secondary to necrotizing pancreatitis. He was treated conservatively with antibiotics and after a month he recovered completely without any neurological deficit. This case is reported for its unusual and unreported spinal complications after acute pancreatitis.
