The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Richard G. Bennett - One of the best experts on this subject based on the ideXlab platform.
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Success of delayed full-thickness skin Grafts after Mohs micrographic surgery
Journal of The American Academy of Dermatology, 1995Co-Authors: Marie-josee Thibault, Richard G. BennettAbstract:Abstract Background: Specific factors affect the outcome of full-thickness skin Grafts after Mohs micrographic surgery. No recent clinical studies have systematically investigated the clinical factors that may affect the success of full-thickness skin Grafts. Objective: Our objective was to analyze patient data to define factors that may influence the success of full-thickness skin Grafts. Methods: We reviewed the clinical course of 117 patients who had full-thickness skin Grafts after Mohs micrographic surgery. We analyzed these cases using patient variables, tumor variables, and skin Graft variables and then correlated these variables to skin Graft success. Results: Delay of skin Graft placement (>1 day) was significantly correlated with subsequent skin Graft success ( p = 0.015). Skin Graft Necrosis was more likely to develop in men than in women ( p = 0.021). Conclusion: A delay of 2 to 8 days between Mohs micrographic surgery and full-thickness skin Graft placement resulted in a lower incidence of skin Graft Necrosis than no delay or a delay of 1 day.
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Cigarette Smoking and Flap and Full-Thickness Graft Necrosis
Archives of dermatology, 1991Co-Authors: David Goldminz, Richard G. BennettAbstract:The association between cigarette smoking and Necrosis of flaps and full-thickness Grafts was analyzed in 220 patients. Review of a series of 916 flaps and full-thickness Grafts revealed 44 patients in whom some degree of tissue Necrosis occurred. These patients with Necrosis were age and gender matched with 176 controls randomly selected from the remaining 872 patients. Current high-level smokers, that is those smoking one or more packs per day, had Necrosis develop approximately three times more frequently than never smokers, low-level smokers (less than one pack per day), or former smokers (95% confidence interval, 1.2 to 8.2). Former smokers (relative risk, 1.4; 95% confidence interval, 0.6 to 3.2) and low-level smokers (relative risk, 1.1; 95% confidence interval, 0.2 to 6.1) were at a negligible increased risk for Necrosis that was not significantly different from never smokers. Once tissue Necrosis developed, the median percent of the visible flap or Graft tissue that necrosed was approximately threefold greater among current smokers (regardless of the number of packs per day smoked) than never smokers.
Luo Dong-bi - One of the best experts on this subject based on the ideXlab platform.
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Application of vacuum sealing drainage in the treatment of large skin avulsion of lower extremities
Hainan Medical Journal, 2014Co-Authors: Luo Dong-biAbstract:Objective To investigate the efficacy of vacuum sealing drainage in the treatment of large skin avulsion of lower extremities. Methods The anti-take the skin thickness in the skin Graft and subdermal vascular network flap in situ Graft joint vacuum sealing drainage were performed in the treatment of 24 patients with skin of lower limbs avulsion. Results Sixteen patients suffered a closed wound; 6 suffered small skin Graft Necrosis and were cured after changing dressing; 2 suffered skin flap Necrosis and were healed completely after the second stamp skin Graft. All patients were followed up for 6 to 36 months, with an average of 24 months. The subdermal vascular network flap in situ Graft limb had appearance and color close to normal, with good flexibility and joint function; situ skin Grafting of full-thickness skin Graft had a small amount of scar, and functional recovery was satisfactory. No bones, joints and soft tissue infections and other complications occured. Conclusion Vacuum sealing drainage can effectively control the infection, and promote skin Grafts and wound attached in the treatment of the skin of lower limbs avulsion, which is good for the survival of skin Grafts.
Ju Won Yi - One of the best experts on this subject based on the ideXlab platform.
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prospective randomized comparison of scar appearances between coGraft of acellular dermal matrix with autologous split thickness skin and autologous split thickness skin Graft alone for full thickness skin defects of the extremities
Plastic and Reconstructive Surgery, 2016Co-Authors: Ju Won YiAbstract:BACKGROUND: The purpose of this study was to evaluate the clinical outcomes of coGrafting of acellular dermal matrix with autologous split-thickness skin and autologous split-thickness skin Graft alone for full-thickness skin defects on the extremities. METHODS: In this prospective randomized study, 19 consecutive patients with full-thickness skin defects on the extremities following trauma underwent Grafting using either coGraft of acellular dermal matrix with autologous split-thickness skin Graft (nine patients, group A) or autologous split-thickness skin Graft alone (10 patients, group B) from June of 2011 to December of 2012. The postoperative evaluations included observation of complications (including Graft Necrosis, Graft detachment, or seroma formation) and Vancouver Scar Scale score. RESULTS: No statistically significant difference was found regarding complications, including Graft Necrosis, Graft detachment, or seroma formation. At week 8, significantly lower Vancouver Scar Scale scores for vascularity, pliability, height, and total score were found in group A compared with group B. At week 12, lower scores for pliability and height and total scores were identified in group A compared with group B. CONCLUSIONS: For cases with traumatic full-thickness skin defects on the extremities, a statistically significant better result was achieved with coGraft of acellular dermal matrix with autologous split-thickness skin Graft than with autologous split-thickness skin Graft alone in terms of Vancouver Scar Scale score. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Radha Ram - One of the best experts on this subject based on the ideXlab platform.
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Tectonic corneal lamellar Grafting for surgically-induced necrotizing scleritis after strabismus surgery: Case report & literature review.
American journal of ophthalmology case reports, 2018Co-Authors: Radha RamAbstract:Abstract Purpose To report the first case of infectious surgically-induced necrotizing scleritis following strabismus surgery which was treated successfully with a tectonic corneal Graft. Observations We report a case of surgically-induced necrotizing scleritis after strabismus surgery in a 61-year-old gentleman with gout and a subconjunctival abscess. Surgical drainage of the subconjunctival abscess led to a diagnosis of scleral melt which was subsequently treated with a tectonic corneal Graft along with aggressive medical management. Over the following eight months, the patient showed no signs of endophthalmitis, Graft Necrosis, nor Graft dehiscence, and serial anterior segment optical coherence tomography imaging demonstrated anatomic stability. Conclusions and importance This case offers further insights into a rare but vision-threatening and potentially life-threatening diagnosis. In conjunction with aggressive local and systemic treatment, tectonic lamellar keratoplasty provides good therapeutic and tectonic results for scleral Necrosis after strabismus surgery. This case also demonstrates the importance of screening for associated systemic risk factors in any patient with scleritis for appropriate, targeted therapy.
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Tectonic corneal lamellar Grafting for surgically-induced necrotizing scleritis after strabismus surgery: Case report & literature review
Elsevier, 2018Co-Authors: Radha RamAbstract:Purpose: To report the first case of infectious surgically-induced necrotizing scleritis following strabismus surgery which was treated successfully with a tectonic corneal Graft. Observations: We report a case of surgically-induced necrotizing scleritis after strabismus surgery in a 61-year-old gentleman with gout and a subconjunctival abscess. Surgical drainage of the subconjunctival abscess led to a diagnosis of scleral melt which was subsequently treated with a tectonic corneal Graft along with aggressive medical management. Over the following eight months, the patient showed no signs of endophthalmitis, Graft Necrosis, nor Graft dehiscence, and serial anterior segment optical coherence tomography imaging demonstrated anatomic stability. Conclusions and importance: This case offers further insights into a rare but vision-threatening and potentially life-threatening diagnosis. In conjunction with aggressive local and systemic treatment, tectonic lamellar keratoplasty provides good therapeutic and tectonic results for scleral Necrosis after strabismus surgery. This case also demonstrates the importance of screening for associated systemic risk factors in any patient with scleritis for appropriate, targeted therapy. Keywords: Surgically induced necrotizing scleritis, Corneal Graft, Strabismus, Gout, Subconjunctival abscess, Optical coherence tomograph
Robert L Fairchild - One of the best experts on this subject based on the ideXlab platform.
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early t cell response to alloGrafts occuring prior to alloantigen priming up regulates innate mediated inflammation and Graft Necrosis
American Journal of Pathology, 2004Co-Authors: Tarek Elsawy, Masayoshi Miura, Robert L FairchildAbstract:The early inflammatory response within organ alloGrafts is initiated by ischemia/reperfusion (I/R) and promotes subsequent alloantigen-primed T cell recruitment into and rejection of the Graft. Polymorphonuclear leukocyte (PMN)-mediated tissue damage is a primary component of the early inflammation in alloGraft rejection. We sought to compare and elucidate the mechanism of early PMN infiltration into cardiac isoGrafts and alloGrafts. Despite identical production of PMN attractant chemokines, PMN infiltration following reperfusion into syngeneic and allogeneic Grafts was not equivalent. PMN infiltration into isoGrafts peaked at 9 to 12 hours post-transplant and quickly resolved. In contrast, PMN infiltration into alloGrafts continued to elevated levels, peaking at 24 hours post-reperfusion. This amplified PMN infiltration into alloGrafts did not resolve until 72 hours post-reperfusion and was accompanied by marked parenchymal Necrosis. This early innate inflammatory response was regulated by IFN-γ-producing CD8 + T cells present in the recipient before detectable alloantigen T cell priming. Co-culture with CD62L low CD8 + T cells, but not CD62L high CD8 + or CD62L low CD4 + T cells, harvested from naive animals induced allogeneic endothelial cells to express IFN-γ-dependent chemokines. These data demonstrate CD8 + T cell-mediated attack on the vascular endothelium of alloGrafts within hours following organ reperfusion that amplifies innate immune-mediated intra-Graft inflammation and Necrosis.
