The Experts below are selected from a list of 67584 Experts worldwide ranked by ideXlab platform
Geoffrey G Hallock - One of the best experts on this subject based on the ideXlab platform.
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immediate reGrafting of the split thickness Skin Graft donor site assists healing
Plastic and reconstructive surgery. Global open, 2017Co-Authors: Brian P Bradow, Geoffrey G Hallock, Samuel P WilcockAbstract:BACKGROUND: Delayed or even lack of healing of a split-thickness Skin Graft (STSG) donor site is a potential problem with elderly patients or those with poor wound healing capabilities. A proactive solution that may minimize this risk is to reGraft that donor site using otherwise discarded Skin Graft remnants. METHODS: A prospective, nonrandomized, consecutive study was designed to compare the time to healing of the commonly used anterior thigh STSG donor site in patients who had routine dressings (n = 113) versus those with comorbidities known to adversely affect wound healing and had planned reGrafting (n = 204). Those comorbidities included age (≥65 years), diabetes mellitus, peripheral vascular disease, chronic renal disease, and chronic steroid use. RESULTS: The average number of comorbidities in the reGrafted subgroup versus those not reGrafted was 1.41 and 0.31, respectively. This was considered to be a significant difference (P < 0.0001) confirming the validity in predicting patients at risk for adverse donor-site healing that would benefit by reGrafting. The mean time required for donor-site reepithelialization of those reGrafted was 17.2 days compared with 17.8 days for those not reGrafted (P = 0.2395), which was not significantly different. CONCLUSIONS: ReGrafting the STSG donor site of patients with known comorbidities, that is, those expected to have delayed healing in general, had a mean time to reepithelialization comparable with conventionally treated individuals. This was considered a direct consequence of recycling rather than discarding any excess Skin Graft materials when so indicated and can be a proactive solution to a potentially cumbersome dilemma.
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The cosmetic split-thickness Skin Graft donor site.
Plastic and Reconstructive Surgery, 1999Co-Authors: Geoffrey G HallockAbstract:: Any split-thickness Skin Graft donor site is obvious to some degree because of pigment alterations and, at the worst, it can develop hypertrophic scarring. A predictably superior aesthetic result is possible if this site is converted to a full-thickness defect followed by primary closure, because a linear scar is the only residuum. Using a modified tumescent technique, the groin can also be readily used as a split-thickness donor site if a thin Graft is preferred; it captures the attributes of an ideal donor site in which pain is diminished, healing rapid, and the scar inconspicuous, just as when it is used as a full-thickness Skin Graft donor site.
Nivaldo Antonio Parizotto - One of the best experts on this subject based on the ideXlab platform.
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Effects of photobiomodulation therapy in the integration of Skin Graft in rats
Lasers in Medical Science, 2019Co-Authors: Tatiane Neiva Santos Castro, Cintia Cristina Santi Martignago, Lívia Assis, Francisco Eugênio Deusdará Alexandria, José Carlos Tatmatsu Rocha, Nivaldo Antonio ParizottoAbstract:Skin Graft is one of the most common techniques used in plastic surgery and repair. However, there are some complications that can lead to loss of the Skin Graft. Thus, several features have been studied with the aim of promoting the integration of Skin Grafts. Among these resources, the use of laser photobiomodulation (laser PBM) has been highlighted. The present study aimed to investigate the effects of laser PBM on the viability and integration of Skin Grafts in rats. Twenty male Wistar rats (± 250 g) were randomly assigned into two experimental groups with 10 animals each: control group, animals submitted to Skin Graft and simulation of laser PBM; laser PBM group, submitted to the Skin Graft and submitted to laser PBM at 660 nm, 40 mW, 60 s, 2.4 J. The animals were submitted to laser photobiomodulation immediately after the surgical procedure and each 24 h. Animal euthanasia occurred on the 7th day after surgery, 24 h after the last treatment session. The histopathological analysis revealed that the laser PBM showed better adhesion of the Graft when compared to the control group. Likewise, the morphometric analysis of mast cells, blood vessels, and collagen showed a statistically significant increase in the animals irradiated with the laser PBM when compared to the control group. In addition, immunohistochemical analysis demonstrated that the laser PBM showed statistically higher immunoexpression of FGF when compared to the CG. However, IL-4 immunoexpression did not show statistical difference between the experimental groups. From the results obtained in the present study, it can be suggested that laser photobiomodulation was effective in promoting the integration and viability of total Skin Grafts in rats.
Serkan Yıldırım - One of the best experts on this subject based on the ideXlab platform.
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use of honey as an adjunct in the healing of split thickness Skin Graft donor site
Dermatologic Surgery, 2003Co-Authors: Aykut Misirlioglu, Sinem Eroglu, Naci Karacaoglan, Mithat Akan, Tayfun Aköz, Serkan YıldırımAbstract:BACKGROUND Different techniques are being used in treatment of split-thickness Skin Graft donor sites; however, there is not a widely accepted method established for these partial-thickness wounds. It is well known that honey has been very effective in the treatment of various types of wounds, but there is not any information about the usage of honey as split-thickness Skin Graft donor site dressing in the literature. OBJECTIVE To evaluate and compare the effectiveness of honey-impregnated gauzes, hydrocolloid dressings, and as a conventional dressing, saline-soaked gauzes for Skin Graft donor sites. METHODS This is a nonrandomized, prospective, open-label (noncontrolled), side-by-side comparison trial of various options that are available for second-intention healing of donor site for split-thickness Skin Grafts. Eighty-eight patients who underwent Skin Grafting were observed using two different groups. In the first group, the donor site was divided into two equal halves, with each half being treated with honey-soaked gauzes and the other half with paraffin gauzes (group 1A), hydrocolloid dressings (group 1B), and saline-soaked gauzes (group 1C) alternatively. In the second group, two separate donor sites were formed, with one of them being treated with honey-impregnated gauzes (groups 2A–C) and the other one treated with either paraffin gauzes (group 2A), hydrocolloid dressings (group 2B), or saline-soaked gauzes (group 2C). The healing time, rate of infection, and sense of pain were evaluated. RESULTS In the treatment of split-thickness Skin Graft donor sites, honey-impregnated gauzes showed faster epithelization time and a low sense of pain than paraffin gauzes and saline-soaked gauzes. There was no significant difference between honey-impregnated gauzes and hydrocolloid dressings with regard to epithelization time and sense of pain. CONCLUSION The use of honey-impregnated gauzes is effective, safe, and practical. Honey can be an alternative material for the split-thickness Skin Graft donor site treatment.
Margriet G. Mullender - One of the best experts on this subject based on the ideXlab platform.
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penile inversion vaginoplasty with or without additional full thickness Skin Graft to Graft or not to Graft
Plastic and Reconstructive Surgery, 2017Co-Authors: Marlon E Buncamper, Wouter B Van Der Sluis, Max De Vries, Birgit I Witte, Mark-bram Bouman, Margriet G. MullenderAbstract:BACKGROUND: Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness Skin Graft as neovaginal lining is controversial. Some believe that having extra penile Skin for the vulva gives better aesthetic results. Others believe that it gives inferior functional results because of insensitivity and Skin Graft contraction. METHODS: Transgender women undergoing penile inversion vaginoplasty were studied prospectively. The option to add full-thickness Skin Graft is offered in patients where the penile Skin length lies between 7 and 12 cm. Neovaginal depth was measured at surgery and during follow-up (3, 13, 26, and 52 weeks postoperatively). Satisfaction with the aesthetic result, neovaginal depth, and dilation regimen during follow-up were recorded. Satisfaction, sexual function, and genital self-image were assessed using questionnaires. RESULTS: A total of 100 patients were included (32 with and 68 without additional full-thickness Skin Graft). Patient-reported aesthetic outcome, overall satisfaction with the neovagina, sexual function, and genital self-image were not significantly associated with surgical technique. The mean intraoperative neovaginal depth was 13.8 ± 1.4 cm. After 1 year, this was 11.5 ± 2.5 cm. The largest decline (-15 percent) in depth is observed in the first 3 postoperative weeks (p < 0.01). CONCLUSIONS: The authors can confirm neither of the suggested arguments, for or against full-thickness Skin Graft use, in penile inversion vaginoplasty. The additional use of full-thickness Skin Graft does not influence neovaginal shrinkage, nor does it affect the patient- and physician-reported aesthetic or functional outcome. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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revision vaginoplasty a comparison of surgical outcomes of laparoscopic intestinal versus perineal full thickness Skin Graft vaginoplasty
Plastic and Reconstructive Surgery, 2016Co-Authors: Wouter B Van Der Sluis, Marlon E Buncamper, Margriet G. Mullender, Mark-bram Bouman, W J H J MeijerinkAbstract:BACKGROUND: Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness Skin Graft revision vaginoplasty. METHODS: A retrospective chart review of patients who underwent revision vaginoplasty at the authors' institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared. RESULTS: The authors studied a consecutive series of 50 transgender and three biological women who underwent revision vaginoplasty, of which 21 were laparoscopic intestinal and 32 were perineal full-thickness Skin Graft vaginoplasties, with a median clinical follow-up of 3.2 years (range, 0.5 to 19.7 years). Patient demographics did not differ significantly. There was no mortality. Two intraoperative rectal perforations (10 percent) occurred in the intestinal group versus six (19 percent) in the full-thickness Skin Graft group. Operative time was shorter for the full-thickness Skin Graft vaginoplasty group (131 +/- 35 minutes versus 191 +/- 45 minutes; p < 0.01). Hospitalization length did not differ significantly. Successful vaginal (re)construction was achieved in 19 intestinal (91 percent) and 26 full-thickness Skin Graft (81 percent) vaginoplasty procedures. A deeper neovagina was achieved with intestinal vaginoplasty (15.9 +/- 1.4 cm versus 12.5 +/- 2.8 cm; p < 0.01). CONCLUSIONS: Both laparoscopic intestinal and full-thickness Skin Graft vaginoplasty can be used as secondary vaginal reconstruction. Intraoperative and postoperative complications do not differ significantly, but rectal perforation was more prevalent in the full-thickness Skin Graft vaginoplasty group. Although the operative time of laparoscopic intestinal vaginoplasty is longer, adequate neovaginal depth was more frequently achieved than in secondary perineal full-thickness Skin Graft vaginoplasty. CLINCAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Achilleas Thoma - One of the best experts on this subject based on the ideXlab platform.
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systematic review of Skin Graft donor site dressings
Plastic and Reconstructive Surgery, 2009Co-Authors: Sophocles H Voineskos, Olubimpe Ayeni, Leslie Mcknight, Achilleas ThomaAbstract:Background: Debate continues about what split-thickness Skin Graft donor-site dressing provides the best outcomes for patients at the lowest cost. The goal of this systematic review was to determine which donor-site dressings are associated with the best outcomes for the following: pain, infection rate, healing quality, healing rate, quality of life, and cost. Methods: A comprehensive literature review and assessment was undertaken by two independent reviewers. Articles were selected using specific inclusion criteria. Split-thickness Skin Graft donor-site dressings were classified as either moist or nonmoist based on the state of the dressing upon initial application. Methodological quality of randomized controlled trials was assessed using the Jadad scale. Results: Seventy-five relevant articles were included in the final analysis, three of which were review articles. The most commonly measured outcome was healing rate (64 of 72), followed by pain (58 of 72), infection rate (40 of 72), healing quality (40 of 72), and cost (15 of 72). No studies measured quality of life. The majority of articles were randomized controlled trials (35 of 75), followed by observational studies (22 of 75), unsystematic clinical observations (15 of 75), and review articles (three of 75). It was difficult to compare moist and nonmoist dressings in this review because of the methodological heterogeneity of the included articles. The available evidence suggests, however, that moist dressings are superior in terms of pain. Conclusions: Some weak evidence exists that supports "wet dressings." To determine the best split-thickness Skin Graft donor-site dressing, more methodologically sound randomized controlled trials are needed. Trials with parallel economic evaluations should be undertaken to answer this question.
