The angiosomal theory and its clinical application is not the latest science discovery. Nevertheless, its importance in plastic reconstructive surgery is still often underestimated when planning surgical procedures. Knowing and understanding the main problem can be useful not only for planning the flap design but also for survival of large flaps and also the wound healing process. Learning more about the complexity of skin and soft tissue anatomy and the vasculatory system can be beneficial for a variety of medical subspecialities. The article is divided into two parts. Part one is an introduction to the history, anatomy and physiology of angiosomes and perforator flaps. The second part describes practical applications in 3 various cases treated at the Department of Plastic and Esthetic Surgery, University Hospital Olomouc.
- Klíčová slova
- angiosome,
- MeSH
- anastomóza chirurgická MeSH
- anatomické modely * MeSH
- chirurgické laloky klasifikace krevní zásobení transplantace MeSH
- chirurgicky vytvořené struktury * dějiny krevní zásobení MeSH
- lidé MeSH
- mladý dospělý MeSH
- modely kardiovaskulární * MeSH
- perforátorový lalok krevní zásobení transplantace MeSH
- plastická chirurgie metody MeSH
- poranění dolní končetiny rehabilitace terapie MeSH
- poranění prstů ruky rehabilitace terapie MeSH
- prsy chirurgie transplantace MeSH
- senioři MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Microvascular free flap reconstruction is a routine option for coverage of a variety of tissue defects. Accurate monitoring in the postoperative period is a crucial part of successful flap surgery allowing early detection of vascular compromise and prompt intervention in flap salvaging. Despite that many safety procedures to assess flap viability have been developed, flap failure is consistently seen in 2-5% of free tissue transfers. In addition, great progress is being made in relation to various state-of-the-art technologies for flap monitoring. However, the gold standard still remains clinical monitoring at most institutions even though there is no standardized management protocol. The review should present a prospective optimal monitoring protocol and introduce some of the latest monitoring devices based on the recent literature and personal experience.
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare peripheral T cell lymphoma. BIA-ALCL is a disease of the fibrous capsule surrounding the implant and occurs in patients after both breast reconstruction and augmentation. More than 300 cases have been reported so far, including two in a transgender patient. Here we describe BIA-ALCL presented with a mass in a transgender patient and the first case of BIA-ALCL in the Czech Republic. In 2007, a 33-year-old transgender male to female underwent bilateral breast augmentation as a part of his transformation to female. In June 2014, the patient developed a 5-cm tumorous mass in her left breast. Magnetic resonance imaging of the chest revealed a ruptured implant and a tumorous mass penetrating into the capsule and infiltrating the pectoral muscle. An R0 surgery was indicated-the implant, silicone gel and capsule were removed, and the tumorous mass was resected together with a part of the pectoral muscle. Histology revealed anaplastic large-cell lymphoma. The patient underwent standard staging procedures for lymphoma including a bone marrow trephine biopsy, which confirmed stage IE. The patient was treated with the standard chemotherapy for systemic ALCL-6 cycles of CHOP-21. The patient was tumor-free at the 2-year follow-up. BIA-ALCL has been reported mostly in women who received implants for either reconstructive or aesthetic augmentation. This is the third report of BIA-ALCL in a transgender person, the first in the Czech Republic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
- MeSH
- anaplastický velkobuněčný lymfom diagnostické zobrazování etiologie terapie MeSH
- cyklofosfamid MeSH
- doxorubicin MeSH
- implantace prsní náhrady škodlivé účinky metody MeSH
- imunohistochemie MeSH
- jehlová biopsie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- nádory prsu diagnostické zobrazování etiologie terapie MeSH
- následné studie MeSH
- odstranění implantátu MeSH
- PET/CT MeSH
- prednison MeSH
- protokoly protinádorové kombinované chemoterapie MeSH
- prsní implantáty škodlivé účinky MeSH
- silikonové gely škodlivé účinky MeSH
- transgender osoby MeSH
- vinkristin MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
