Delayed closure of complex defects with serial tightening of loop sutures – clinical outcome in 64 consecutive patients

Felcht, Moritz; Koenen, Wolfgang; Weiß, Christel; Weina, Kasia; Géraud, Cyrill; Faulhaber, Jörg

doi:10.1111/jdv.12122

Cited by 9 publications

(10 citation statements)

References 22 publications

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“…Because of this, local radiotherapy and single-agent rituximab are recommended for patients who are not eligible for such an aggressive treatment (4). Yet, the malignant skin clone can be detected in the lymph nodes, blood and bone marrow at early stages of PCLBCL/ LT disease where local skin treatments will most likely be not effective (36). Furthermore, rituximab monotherapy often shows relapses in the long-term follow-up (37).…”

Section: Discussionmentioning

confidence: 99%

Aggressive primary cutaneous B‐cell lymphomas show increased Angiopoietin‐2‐induced angiogenesis

Teichert

Stumpf

Booken

et al. 2015

Experimental Dermatology

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Primary cutaneous large B-cell lymphomas, leg type (PCLBCL/LT) are primary cutaneous B-cell lymphoma (PCBCL) with an intermediate prognosis. Therefore, antracycline-based polychemotherapy combined with rituximab has been recommended as first-line treatment. Yet, despite this regimen, the 5-year survival rate remains 50-66% only. Angiogenesis, the formation of a vascular network, is essential for the pathogenesis of nodal lymphomas. So far, no study has analysed angiogenesis and its key factors in PCLBCL/LT. The present study was aimed at characterizing angiogenesis in PCLBCL/LT to identify the angiogenic molecules as potential therapeutic targets. The intra-tumoral microvessel density (MVD) was assessed by immunohistochemical studies of CD20 and CD31. The MVD was higher in PCLBCL/LT compared with indolent PCBCL. Analyses of open-source microarray data showed correlation between the angiogenic molecule angiopoietin-2 (Ang-2) and pan-endothelial cell markers. ELISA studies determined a shift between Ang-2 and Ang-1 towards Ang-2 in the peripheral blood of PCLBCL/LT patients. Immunofluorescence costainings against the Ang receptor Tie2/angiogenic integrins/CD34 revealed that the vasculature in both aggressive and indolent PCBCL tumors harbours an endothelial cell subpopulation with reduced expression of Tie2. In contrast, the alternative Ang-2 binding partners, angiogenic integrins, are strongly expressed in PCBCL. In line with these findings, downstream targets of Ang-2-integrin signalling, that is phosphorylation of focal adhesion kinase at Tyr397, and sprouting angiogenesis are enhanced in PCLBCL/LT. Our data present Ang-2 as a promising therapeutic target and anti-angiogenic therapy as a new line in treatment of PCLBCL/LT as a hitherto intractable disease.

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Section: Discussionmentioning

confidence: 99%

Aggressive primary cutaneous B‐cell lymphomas show increased Angiopoietin‐2‐induced angiogenesis

Teichert

Stumpf

Booken

et al. 2015

Experimental Dermatology

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“…Several techniques have been established to reconstruct partial-thickness defects of the nasal ala. For smaller defects, these include second intention healing, side-to-side closure, delayed closure with serial tightening, full-thickness skin grafts, the myocutaneous island pedicle fl ap, the rhombic transposition fl ap, the Z-advancement fl ap, the keystone perforator island fl ap, or the bilobed fl ap. Larger defects may be closed using the cranially inserted nasolabial transposition fl ap (melolabial fl ap), the subcutaneous island pedicle fl ap, the shark island fl ap, the nasal dorsum transposition fl ap, the two-stage nasolabial interpolation fl ap or dermal regeneration templates as one-stage or two-stage procedures [ 1,[3][4][5][6][7][8][9][10][11][12] . Unfortunately, complication rates associated with an undesirable cosmetic outcome are highest for defects of the nasal ala and tip [ 13 ] .…”

Section: Introductionmentioning

confidence: 99%

The caudolaterally inserted transposition flap and its variations for reconstruction of defects of the nasal ala

Felcht¹

2017

J Deutsche Derma Gesell

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SummaryClosure of non-full-thickness defects of the nasal ala can be a surgical challenge. While there is a plethora of various reconstructive techniques, not all of them are easy to learn and carry out. Recently, the dermatosurgeon Andreas Lösler from the Department of Dermatology at the Hornheide Medical Center, Germany, developed and published the caudolaterally inserted transposition flap for the reconstruction of alar defects. Given its relative novelty, this technique, which is characterized by a very low complication rate, is still unknown to most dermatosurgeons and has not yet found its way into standard dermatosurgery textbooks. The present review describes the caudolaterally inserted transposition flap and two modifications thereof, which allow for the closure of large alar defects as well as defects of the alar crease. Comparisons are made to the two flaps most commonly employed for alar reconstruction, the bilobed flap and the cranially inserted nasolabial transposition flap (melolabial flap).

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“…Bei kleineren Defekten gehören dazu die Sekundärheilung, der direkte Verschluss, der zeitversetzte Verschluss mit serieller Raffnaht, die Vollhauttransplantation, die gestielte myokutane Insellappenplastik, die rautenförmige Transpositionslappenplastik, der Verschiebelappen (Z‐Plastik), die trapezförmige perforatorbasierte Insellappenplastik oder die zweifach gestielte Lappenplastik. Für die Deckung größerer Defekte können die melolabiale Transpositionslappenplastik von nasolabial, die gestielte subkutane Insellappenplastik und ihre Variante der „Shark‐Island‐Flap“ mit cranial ausgedünnter Spitze, die Transpositionslappenplastik vom Nasenrücken, die Deckung mittels gestielter Lappenplastik von nasolabial oder der Einsatz von Hauteratzpäraraten angewendet werden . Bedauerlicherweise sind Komplikationen, die mit einem unerwünschten kosmetischen Ergebnis assoziiert sind, bei Defekten an Nasenflügel und Nasenspitze am häufigsten .…”

Section: Introductionunclassified

Defektdeckung am Nasenflügel durch die kaudolateral gedrehte Transpositionslappenplastik und ihre Varianten

Felcht¹

2017

J Deutsche Derma Gesell

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Defekte am Nasenflügel können für den Dermatochirurgen eine Herausforderung darstellen. Unterschiedliche Methoden der Defektdeckung wurden in der Vergangenheit entwickelt, allerdings sind diese teilweise kompliziert zu erlernen und durchzuführen. Der Dermatochirurg Andreas Lösler aus der Fachklinik für Dermatologie Hornheide, hat kürzlich die kaudolateral gedrehte Transpositionslappenplastik zur Deckung von Defekten am Nasenflügel entwickelt und publiziert. Diese zeigt eine sehr geringe Komplikationsrate. Da sie noch relativ neu ist, ist diese Technik den meisten Dermatochirurgen noch nicht bekannt und bisher auch nicht in den Standardwerken der Dermatochirurgie erwähnt. In dieser Übersichtsarbeit wird die Technik der kaudolateral gedrehten Transpositionslappenplastik beschrieben und zwei Varianten vorgestellt, die es erlauben, auch große Defekte und lateral gelegene Defekte im Bereich des Nasenflügels zu decken. Der kaudolateral gedrehte Transpositionslappen wird mit den beiden häufigsten Lappenplastiken zur Defektdeckung im Bereich des Nasenflügels, dem zweifach gestielten Lappen (bilobed flap) und der melolabialen Transpositionslappenplastik verglichen. SummaryClosure of non-full-thickness defects of the nasal ala can be a surgical challenge. While there is a plethora of various reconstructive techniques, not all of them are easy to learn and carry out. Recently, the dermatosurgeon Andreas Lösler from the Department of Dermatology at the Hornheide Medical Center, Germany, developed and published the caudolaterally inserted transposition flap for the reconstruction of alar defects. Given its relative novelty, this technique, which is characterized by a very low complication rate, is still unknown to most dermatosurgeons and has not yet found its way into standard dermatosurgery textbooks. The present review describes the caudolaterally inserted transposition flap and two modifications thereof, which allow for the closure of large alar defects as well as defects of the alar crease. Comparisons are made to the two flaps most commonly employed for alar reconstruction, the bilobed flap and the cranially inserted nasolabial transposition flap (melolabial flap).

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Delayed closure of complex defects with serial tightening of loop sutures – clinical outcome in 64 consecutive patients

Abstract: The use of loop sutures allows the delayed closure of large defects avoiding the need for skin flaps or grafts in most cases.

Cited by 9 publications

References 22 publications

Aggressive primary cutaneous B‐cell lymphomas show increased Angiopoietin‐2‐induced angiogenesis

Aggressive primary cutaneous B‐cell lymphomas show increased Angiopoietin‐2‐induced angiogenesis

The caudolaterally inserted transposition flap and its variations for reconstruction of defects of the nasal ala

Defektdeckung am Nasenflügel durch die kaudolateral gedrehte Transpositionslappenplastik und ihre Varianten

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