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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, Markbram Bouman, Max De Vries, Birgit I Witte, 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, Markbram Bouman, Marlon E Buncamper, Margriet G Mullender, 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.
Wouter B Van Der Sluis - 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, Markbram Bouman, Max De Vries, Birgit I Witte, 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, Markbram Bouman, Marlon E Buncamper, Margriet G Mullender, 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.
Debby K A Saputra - One of the best experts on this subject based on the ideXlab platform.
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the use of split Thickness versus full Thickness Skin Graft to resurface volar aspect of pediatric burned hands a systematic review
Burns, 2015Co-Authors: Theddeus O H Prasetyono, Patricia Marcellina Sadikin, Debby K A SaputraAbstract:Abstract Objective The aim of this systematic review was to discuss the comparison of split-Thickness Skin Graft (STSG) and full-Thickness Skin Graft (FTSG) use as the treatment for volar digital and palmar burns in children. Methods We conducted PubMed and Cochrane Library searches using keywords “hand injuries”, “contracture” and “Skin transplantation”. The search was limited to studies published from 1st January 1980 until 31st December 2013 and used English language. We selected the studies based on specific inclusion and exclusion criteria. We assessed the quality of the studies by using Newcastle–Ottawa Scale (NOS) for cohort studies. Results We included eight articles in our systematic review. One of those studies is a prospective cohort study and the others are retrospective cohort studies. Based on combined range of motion (ROM) evaluation in three studies, STSG group yielded poorer functional outcomes than FTSG group. However, there is no study which can fairly show that FTSG was significantly superior to STSG to achieve good functional outcomes. Conclusion Currently, there is no strong, high-quality evidence to prove that FTSG is superior to STSG to cover pediatric palmar burns. Either FTSG or STSG can be utilized with consideration of several influential factors especially splinting and physiotherapy. Type of study/level of evidence Therapeutic, II.
Marlon E Buncamper - 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, Markbram Bouman, Max De Vries, Birgit I Witte, 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, Markbram Bouman, Marlon E Buncamper, Margriet G Mullender, 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.
W J H J Meijerink - One of the best experts on this subject based on the ideXlab platform.
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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, Markbram Bouman, Marlon E Buncamper, Margriet G Mullender, 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.
