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GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW

Yasir Ali AlShehri, Hiba AlBurshaid, Layan AlBassam, Khalid AlMutairi
Aim: To share our experience with the management of Fournier gangrene (FG) using the bagging technique of the testes, and to highlight the importance of implementing a multidisciplinary approach in managing FG. Case presentation: A 58-year-old male with type 2 diabetes mellitus (DM) was brought to the emergency department (ED) with necrotizing fasciitis involving the genitalia; he was managed in the ED with Intravenous (IV) fluid resuscitation and IV antibiotics. The surgical team was consulted and multiple debridement procedures were done...
2019: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Kamal Chtira, Yassine Elallouchi, Farid Zahrou, Mouhssine Assamadi, Abdelaziz Ait El Qadi, Houssaine Ghannane, Mehdi Laghmari
Nasofrontal fistulas correspond to the persistence of an abnormal communication of embryological origin between the deep layer of the skin and the central nervous system (CNS). They can rarely be associated with a dermoid cyst and be revealed by a locoregional infection, and especially neuromeningeal infections can be serious. The treatment is mainly surgical by performing a total excision of the cyst and the repair of defects. The authors report the case of an 18-month-old infant operated for a dermoid cyst revealed by a nasofrontal fistula...
2019: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Joerg Schnoor, Christoph E Heyde, Mary Niese-Anke, Steffen Friese, Thilo Busch, Jan-S Jarvers
Objective: Cervical bone fractures describe a predominant trauma in the elderly. With demographic change, prone patient positions might create further stress on personnel resources. Therefore, the aim of this study was to conduct an age-related analysis of pre- and intraoperative process times in patients with cervical fractures. Methods: We reviewed all schedules with cervical spine surgery performed at a tertiary hospital. Two different operative patient positions were specified: prone and supine. We retrospectively analysed three study groups: comparison group (group 1: ≤59 years of age), old patients (group 2: 60-79 years), and very old patients (group 3: ≥80 years)...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Jurek Schultz, Percy Schröttner, Susann Leupold, Adrian Dragu, Silvana Sußmann, Michael Haase, Guido Fitze
Introduction: Human fingertips are able to regenerate soft tissue and skin after amputation injuries with excellent cosmetic and functional results when treated with semiocclusive dressings. Despite bacterial colonizations, proceeding infections are not reported with this management. The underlying mechanisms for this form of regenerative healing as well as for the resilience to infections are not known. Due to the lack of mechanical protection, the leakage of maloderous woundfluid and the sometimes challenging application, conventional film dressings have their problems, especially in treating young children...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Reinhard E Friedrich, Christian Hagel
Neurofibromatosis type 1 (NF1) is a tumor predisposition disease. Multiple neurofibromas are among the characteristic tumors of NF1. The report describes the diagnosis and treatment of a large spinal neurofibroma in a NF1 patient. The tumor showed a striking pigmentation and was diagnosed as pigmented (melanotic) neurofibroma. The distinction between this rare tumor variant and other pigmented tumors, especially malignant melanoma, is of primary importance.
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Anas Aljasir, Thomas Pierson, Gerd Hoffmann, Henrik Menke
Infection of donor sites in split-thickness skin grafts is one of the complications of skin transplantation. Nutrition status and associated diseases play important roles in healing of donor sites. There are different ways used to treat infected donor sites. Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Mohamed Ghanem, Christina Pempe, Dirk Zajonz, Andreas Roth, Christoph-Eckhard Heyde, Christoph Josten
Introduction: Infection of the knee joint after primary total knee arthroplasty is a serious complication. In this work, we would like to evaluate the mid-term results after two-stage revision of total knee replacement in periprosthetic infection using dynamic spacer, in particular with regard to the function of the knee joint after reimplantation. Patients and methods: In this retrospective study, we included patients who were treated in our clinic between 2005 and 2013 due to infection of the knee after total knee arthroplasty...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Ahmed Hassan El-Sabbagh
Background: Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Waldemar Reich, Anika Exner, Eileen Winter, Bilal Al-Nawas, Alexander Walter Eckert
The reconstruction of extended defects of the concha poses a complex challenge for plastic surgeons. In cases of subtotal ablation, an alternative method designed especially for elderly oncological patients consists of epithetic rehabilitation. However, inserting an implant-retained concha epithesis proves challenging in patients with antecedents of deep resections involving the mastoid process. In the present case study, we report on the long-term treatment course (2009-2017) of a 79-year-old male patient suffering from a recurrent basal cell carcinoma of the retroauricular region...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Christoph Wölfl, Laura Schuster, Bernd Höner, Sarah Englert, Roman Klein, Christoph Hirche, Matthias Münzberg, Paul Alfred Grützner, Ulrich Kneser, Leila Harhaus
Background: Low bone mineral density (BMD) leads to metaphyseal fractures, which are considered of delayed, qualitatively reduced healing resulting in prolonged care phases and increased socioeconomic costs. Extracorporeal shockwave therapy (ESWT) is already approved to support bone healing of pseudarthrosis and delayed unions. With this study, we examined its influence on bone turnover markers (BTM) during fracture healing in patients with low and normal BMD. Methods: Within a period of 2 years, patients with a metaphyseal fracture of the distal radius or the proximal humerus, requiring surgical osteosynthesis were included into the study...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Roman Klein, Wolfgang Armbruster, Martin Grotz, Bernd Höner, Matthias Münzberg, Paul Alfred Grützner, Christoph Georg Wölfl
Objective: To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli). Design: We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding)...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Reinhard E Friedrich, Caroline Diekmeier
Objective: Neurofibromatosis type 1 (NF1) is an autosomal dominant tumor predisposition syndrome with a tendency to develop peripheral nerve sheath tumors (PNST). Plexiform neurofibromas (PNF) are detected in a high proportion of affected patients. The tumors can lead to severe disfigurement and are classified as precancerous. This study examines the surgical procedures that have been performed on large PNST of the upper limb and hand, and investigates whether a specific distribution pattern of the tumors can be detected in surgically treated cases...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Holger Rupprecht, Katharina Gaab
Shotgun injuries from a short distance (<3 m) may cause massive bleeding and tissue destruction. Only immediate aggressive (surgical) therapy prevents lethal outcome. We report about a 27-year-old patient, who was wounded on the left chest wall by a straight-cut shotgun from a short distance. In cases of this special traumatic pattern damage control measures are necessary. The measures should take place in preclinical emergency management (by the on-site emergency physician). We report about the emergency management from admission to our hospital and the following surgical treatment until discharge from the hospital...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Holger Rupprecht, Julia Reinfelder, Alp Turkoglu
Lethal necrotizing pancreatitis postpartum due to primary hyperparathyroidism caused by a parathyroid adenoma can be considered as a rarity. Due to the unspecific clinical signs and uncommonness this disorder may be overseen very easily. The reported case illustrates the very importance of early diagnosis of this endocrine disorder in pregnancy in order to avoid a lethal course.
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Katrin Bauer, Christof Keller
We report a case of recurrent gastritis with pyloric stenosis and cholangitis due to a rare variation in bile duct anatomy. A 72-year-old female patient showed recurrent gastral ulcers and biliary colic with cholangitis caused by gallstones in the main bile duct with an ectopic orifice in the prepyloric region and concurrent inflammatory pyloric stenosis. After temporarily successful endoscopic treatment with stenting and pyloric dilatation, the patient suffered from recurrent cholangitis. Finally, the abnormal biliary anatomy required surgical treatment with biliodigestive anastomosis...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Matthias Spalteholz, Jens Gulow
Rhabdomyosarcoma (RMS) represents a malignant tumor of skeletal muscle cells arising from rhabdomyoblasts. RMS represents the most common soft tissue sarcoma in children. In adults it is uncommon and accounts for less than 1% of all malignant solid tumors. While treatment protocols are well known for children, there is no standardized regimen in adults. This is one reason, why the outcome in adults is worse than in children. We present the case of a 59-year-old female patient with pleomorphic rhabdomyosarcoma (PRMS) infiltrating the thoracic spine...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Jeannine Schreiter, Sophia Meyer, Christian Schmidt, Ronny M Schulz, Stefan Langer
Background/purpose: The use of dorsal skinfold chamber models has substantially improved the understanding of micro-vascularisation in pathophysiology over the last eight decades. It allows in vivo pathophysiological studies of vascularisation over a continuous period of time. The dorsal skinfold chamber is an attractive technique for monitoring the vascularisation of autologous or allogenic transplants, wound healing, tumorigenesis and compatibility of biomaterial implants. To further reduce the animals' discomfort while carrying the dorsal skinfold chamber, we developed a smaller chamber (the Leipzig Dorsal Skinfold Chamber) and summarized the commercial available chamber models...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Nick Spindler, Florian Kaatz, Christine Feja, Christian Etz, Friedrich-Wilhelm Mohr, Ingo Bechmann, Christoph Josten, Stefan Langer, Sabine Loeffler
Introduction: Deep sternal wound infections (DSWI) are a rare but devastating complication after median sternotomy. Minor perfusion in bone and soft tissue, especially after recruiting the internal mammary artery for bypass supports the development of wound infection and nonunion of the sternal bone. The aim of the study was the macroscopic and radiological presentation of the vascular system supplying the sternum, in particular the compensating blood supply routes in the event that the internal mammary artery is no longer available after use as a bypass vessel...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Florian Wichlas, Serafim Tsitsilonis, Sebastian Kopf, Björn Dirk Krapohl, Sebastian Manegold
Introduction: The aim of the present study is to develop a heuristic that could replace the surgeon's analysis for the decision on the operative approach of distal radius fractures based on simple fracture characteristics. Patients and methods: Five hundred distal radius fractures operated between 2011 and 2014 were analyzed for the surgeon's decision on the approach used. The 500 distal radius fractures were treated with open reduction and internal fixation through palmar, dorsal, and dorsopalmar approaches with 2...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Reinhard E Friedrich, Meike Fraederich, Gerhard Schoen
Objective: The aim of this study was to determine the frequency and morphology of Haller cells using a new radiological technique that allows examination of the facial skull. Material and methods: In a single center retrospective cohort study the cone-beam computed tomography (CBCT) volume data of the maxillary sinus of 199 patients were analysed (398 paranasal sinuses). If Haller cells were found, their capacity was determined. If orthopantomograms (OPG) were taken in a narrow time frame around the CBCT investigation, the rate of correspondence of the radiological findings was determined...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
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