Preoperative evaluation of ALT perforators and the subcutaneous fat tissue layer is feasible with an MDCT scan and provides precise data to make an adequate patient and perforator selection and determine the exact flap size.
Background: As reduction mammaplasty has become one of the most popular reconstructive procedures, there is an increasing number of reports regarding histopathologic findings in breast tissue yielded by the procedure. Patients and Methods: This study evaluates histopathologic findings in breast tissue removed during reduction mammaplasty procedures performed during a 40-month period (2008–2011), and includes 300 patients of which 258 underwent bilateral breast reduction (group B) and 42 unilateral reduction for symmetry to the contralateral reconstructed breast (group U). Results: Occult carcinomas were detected in 4 (1.55%) group B patients and 1 (2.38%) group U patient. Atypical hyperplasia and intraductal papillomas were identified in 22 (8.6%) and 5 (11.9%) patients, respectively. Benign pathologic changes including typical mild ductal hyperplasia, fibrocystic disease, adenosis, fibroadenoma, and lobular atrophy were identified in 174 (67.44%) group B and 26 (61.9%) group U patients. Conclusion: Breast carcinomas are rarely detected in breast tissue yielded by reduction mammaplasty procedures due to routinely performed preoperative assessment including clinical examination and mammograms. Pathologic examination of specimens provides the clinician with a conclusive diagnosis allowing for possible prompt further management.
Extensive postburn scars of the trunk may cause breathing difficulty and, in female patients of reproductive age, render future pregnancy a serious reconstructive goal. Scar excision and skin grafting with or without artificial dermal templates is the current preferred management. A patient who underwent staged extensive grafting of the abdominal wall by dermal regeneration template and completed a full-term successful pregnancy is presented here. Although tissue expanders have been used to expand artificial dermal templates, natural expansion by pregnancy has not been previously documented. A 30-year-old woman with extensive chest and abdominal wall, bilateral gluteal and breast scars after burns sustained at childhood presented with difficulty in deep breathing. Abdominal scar tissue was excised and the abdominal wall was reconstructed by dermal regeneration template and autologous thin split-thickness skin graft in two stages. Six months postoperatively, spirometric values were improved by 15%, while 1 year later the patient completed successfully a full-term pregnancy. Reconstruction of extensive abdominal postburn scars by dermal regeneration template improves breathing by increasing elasticity and compliance of the reconstructed area. In female patients, the template can be extensively and naturally expanded by the gradually growing uterus, allowing for full-term pregnancy.
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