The Impact of Post-Mastectomy Radiotherapy on Delayed Alloplastic Breast Reconstruction - Experience of One Center

Porosnicu, Andrei Ludovic; Ghiurco, Ioana; Atanasescu, Vlad Petre; Riza, Stefania-Mihaela; Hariga, Cristian Sorin; Lascar, Ioan; Sinescu, Ruxandra Diana

doi:10.21614/chirurgia.116.2.224

Cited by 4 publications

(1 citation statement)

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“…(2) documented history of miscarriage(s) within the study timeframe; (3) consent to participate in the study and for the use of their medical records for research purposes; (4) a documented thrombophilia genetic panel. Exclusion criteria included (1) known chromosomal or anatomical abnormalities of the fetus; (2) history of induced abortion; (3) presence of autoimmune diseases and antiphospholipid syndrome; (4) incomplete medical records; (5) lack of consent to provide access to personal and medical records; (6) presence of comorbid factors that are known to influence the coagulation balance, such as malignancies [29][30][31], recent surgical procedures [32][33][34][35], and different hematologic disturbances and medication regimens [36,37].…”

Section: Participantsmentioning

confidence: 99%

Risk Factors of Thrombophilia-Related Mutations for Early and Late Pregnancy Loss

Borsi,

Potre,

Ionita

et al. 2024

Medicina

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Background and Objectives: This retrospective cohort study investigates the role of genetic thrombophilia in pregnant women experiencing early pregnancy loss compared to those with late pregnancy loss. Materials and Methods: Participants were categorized into early and late pregnancy loss groups based on gestational age. A total of 156 patients were included, out of which 103 had early-trimester pregnancy losses and 96 had multiple miscarriages. Results: The study revealed a synergistic effect of Factor V Leiden (FVL G1691A) and Methylenetetrahydrofolate Reductase (MTHFR C677T) mutations (coefficient 3.42). Prothrombin (PT) G20210A and β-Fibrinogen 455 G>A mutations exhibited a significant interaction (coefficient 1.98). Additionally, MTHFR A1298C and Plasminogen Activator Inhibitor-1 (PAI-1 4G/5G) mutations showed a significant interaction (coefficient 1.65). FVL G1691A and Endothelial Protein C Receptor (EPCR) allele A1/A2 mutations also demonstrated a significant association (coefficient 2.10). Lastly, MTHFR C677T and Glycoprotein IIb/IIIa T1565C mutations interacted significantly (coefficient 1.77). Risk factor analysis identified several mutations associated with early pregnancy loss, including PAI-1 4G/5G homozygous (OR 3.01), FVL G1691A heterozygous (OR 1.85), and MTHFR A1298C heterozygous (OR 1.55). Both homozygous and heterozygous MTHFR C677T mutations were significant risk factors (OR 2.38; OR 2.06), as was PT G20210A homozygous mutation (OR 1.92). The PAI-1 4G/4G homozygous variant posed a risk (OR 1.36). Late pregnancy loss was associated with MTHFR A1298C homozygous mutation (OR 3.79), β-Fibrinogen 455 G>A heterozygous mutation (OR 2.20), and MTHFR A1298C heterozygous mutation (OR 2.65). Factor XIII G1002T heterozygous mutation (OR 1.18) and PAI-1 4G/5G homozygous mutation (OR 2.85) were also significant risk factors. EPCR allele A1/A2 (OR 1.60) and A2/A3 (OR 1.73) mutations were identified as significant risk factors for late pregnancy loss. Furthermore, FVL G1691A homozygous mutation, PT G20210A homozygous mutation, MTHFR C677T heterozygous mutation, MTHFR A1298C heterozygous mutation, and EPCR allele A1/A2 were identified as significant risk factors for multiple miscarriage. Conclusions: This study highlights significant interactions and risk factors related to genetic thrombophilia mutations in different types of pregnancy loss, contributing valuable insights for miscarriage management guidelines.

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Section: Participantsmentioning

confidence: 99%

Risk Factors of Thrombophilia-Related Mutations for Early and Late Pregnancy Loss

Borsi,

Potre,

Ionita

et al. 2024

Medicina

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The clinical application of lateral chest flap transfer combined with relay skin flap transfer to repair soft tissue defects of the chest wall after tumor resection

Guo¹,

Wang²,

Wang³

et al. 2022

J Thorac Dis

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Background: After thoracic tumor resection, there is often a large area of soft tissue defect left, even with exposed ribs and sternum, which needs to be repaired by skin flap transplantation. This study aims to introduce lateral thoracic flaps combined with local flaps to repair the soft tissue defect of the chest wall after the repair of malignant tumors, and try to retain the latissimus dorsi myocutaneous flap as a spare repair myocutaneous flap to avoid subsequent tumor recurrence and lack of local flaps for supply body source.Methods: A total of 26 patients with chest wall soft tissue defect with or without exposed rib and sternum after tumor resection at presentation from January 2017 to October 2021 were included in this study. None of the patients required breast reconstruction. Patients ranged in age from 34 to 56 years old. The above patients were treated with lateral thoracic flaps combined with local rotational advancement flaps to repair chest wall soft tissue defects. The postoperative wound healing, scar hyperplasia and recurrence of the patients were followed up.Results: Among the patients in this study, 25 incisions healed by primary incision, 1 incision was delayed, and healed after 10 days of dressing change. Postoperatively, the incisions of the patients were all intact, and there were no complications such as skin necrosis and infection. All patients were followed up for 6-18 months, and the incision healed well without complications such as skin necrosis and infection. Of the patients, 2 males developed dermatofibrosarcoma carina recurrence 6 and 10 months after surgery, respectively. After extensive excision, an ipsilateral latissimus dorsi myocutaneous flap was used to repair the defect. The Vancouver scar scale was used to evaluate the hyperplasia of all incisions at 6 months postoperatively. The mean score was 5.92±1.6. Conclusions:The lateral thoracic flap combined with the local flap to repair the chest wall soft tissue defect after tumor surgery is a strategic decision for surgical treatment, which is beneficial to the sequential surgical treatment of tumor patients.

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Navigating the Complexities of Radiation Injuries: Therapeutic Principles and Reconstructive Strategies

Grosu-Bularda,

Lita,

Hodea

et al. 2024

JPM

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Radiation injuries, particularly those resulting from therapeutic or accidental exposure, present complex challenges for medical management. These injuries can manifest localized skin damage or extend to deeper tissues, presenting as various clinical entities that require treatment strategies, ranging from conservative management to complex surgical interventions. Radiation treatment constitutes a fundamental component of neoplastic management, with nearly two out of three oncological instances undergoing it as an element of their therapeutic strategy. The therapeutic approach to radiation injury consists of expanding prophylactic measures while maintaining the efficacy of treatment, such as conservative treatment or local debridement followed by reconstruction. The armamentarium of reconstructive methods available for plastic surgeons, from secondary healing to free tissue transfer, can be successfully applied to radiation injuries. However, the unique pathophysiological changes induced by radiation necessitate a careful and specialized approach for their application, considering the altered tissue characteristics and healing dynamics. The therapeutic strategy is guided by both the severity and progression of the injury, with the primary aim of restoring functionality and aesthetic aspects while simultaneously minimizing the risk of complications. This paper explores the various conditions encompassed by the term “radiation injury,” reviews both non-surgical and surgical therapeutic strategies for managing these injuries, and highlights the unique challenges associated with treating irradiated tissues within specific oncological contexts.

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The Impact of Post-Mastectomy Radiotherapy on Delayed Alloplastic Breast Reconstruction - Experience of One Center

Cited by 4 publications

References 0 publications

Risk Factors of Thrombophilia-Related Mutations for Early and Late Pregnancy Loss

Risk Factors of Thrombophilia-Related Mutations for Early and Late Pregnancy Loss

The clinical application of lateral chest flap transfer combined with relay skin flap transfer to repair soft tissue defects of the chest wall after tumor resection

Navigating the Complexities of Radiation Injuries: Therapeutic Principles and Reconstructive Strategies

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