The Use of Six Sigma to Assess Two Prostheses for Immediate Breast Reconstruction

Ricciardi, Carlo; Gubitosi, Adelmo; Lanzano, Giuseppe; Pieretti, Gorizio; Improta, Giovanni; E, Crisci; Ferraro, Giuseppe

doi:10.1007/978-3-030-64610-3_125

Cited by 5 publications

(6 citation statements)

References 24 publications

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“… 7 – 9 The use of collagen matrix is well known in clinical practice for soft tissue restoration, and its applications range from breast reconstruction to acute and chronic wound treatment. 10 , 11 One of many possibilities is Vergenix. It maximizes contact with the wound bed and surrounding tissues, enabling scaffolds to develop across the wound bed and reducing the risk of wound bacterial colonization.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Wound Dehiscence by Innovative Type 1 Collagen Flowable Gel: A Case Report

Ferraro

Lanzano

Grella

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Summary: The growing demand for postbariatric body-contouring surgery after massive weight loss goes hand-in-hand with an increase in wound complications. Consequently, surgical reoperation or conservative management is necessary and represents a difficult challenge to healthcare professionals. Moreover, it is well known that postbariatric patients present aberrant wound healing due to multifactorial causes, such as preoperative illness, nutritional deficiencies, and vascular disease. To treat such complex wounds, several methods have been recommended, such as the use of negative pressure wound therapy, tissue-engineered skin substitutes, and collagen-based wound dressings. The case presented here is of a patient with deep wound dehiscence of the inner left thigh, 1 week after a medial thigh lift procedure, successfully managed with Vergenix Flowable Gel, a human recombinant type I collagen produced in plants. After 2 weeks of treatment, wound dehiscence was replaced with granulation tissue, and after 4 weeks, the patient was completely healed, with an acceptable aesthetic outcome of the surgical scar.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Wound Dehiscence by Innovative Type 1 Collagen Flowable Gel: A Case Report

Ferraro

Lanzano

Grella

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…The aim of the project was basically the implementation of an HTA study by using the DMAIC strategy as already performed in previous research, where the DMAIC cycle and SS have shown their feasibility [ 38 , 39 , 41 ]; in particular, the surgical procedures were compared according to the CTQs previously defined.…”

Section: Methodsmentioning

confidence: 99%

“…The processes and characteristics of HTA were combined with those of the SS, taking the DMAIC cycle from the latter, to analyse the available data and obtain ad hoc information that can help decision makers in the process evolution of the healthcare system. In particular, traditional TT was compared with TT performed through a device considering seven relevant variables as input and three outcomes: length of hospital stay (LOS) (which was already used previously in literature [ 38 , 40 ]), drain output (which was recently employed for similar scopes in literature [ 39 , 41 ]) and surgery duration. We can consider the big picture of this work as an HTA in order to evaluate the usefulness of purchasing specific devices for the surgical activity in detail in order to reduce the patient’s stay time in the surgical facility and improve the clinical conditions after surgery compared to traditional surgery methods.…”

Section: Introductionmentioning

confidence: 99%

Comparing Two Approaches for Thyroidectomy: A Health Technology Assessment through DMAIC Cycle

Ricciardi

Gubitosi

Vecchione³

et al. 2022

Healthcare

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Total thyroidectomy is very common in endocrine surgery and the haemostasis can be obtained in different ways across surgery; recently, some devices have been developed to support this surgical phase. In this paper, a health technology assessment is conducted through the define, measure, analyse, improve, and control cycle of the Six Sigma methodology to compare traditional total thyroidectomy with the surgical operation performed through a new device in an overall population of 104 patients. Length of hospital stay, drain output, and time for surgery were considered the critical to qualities in order to compare the surgical approaches which can be considered equal regarding the organizational, ethical, and security impact. Statistical tests (Kolmogorov–Smirnov, t test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests) and visual management diagrams were employed to compare the approaches, but no statistically significant difference was found between them. Considering these results, this study shows that the introduction of the device to perform total thyroidectomy does not guarantee appreciable clinical advantages. A cost analysis to quantify the economic impact of the device into the practice could be a future development. Healthy policy leaders and clinicians who are requested to make decisions regarding the supply of biomedical technologies could benefit from this research.

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“…Reconstruction of the nipple-areola complex (NAC) completes the final aesthetic step of breast reconstruction and restores the body image of breast cancer patients who have undergone mastectomy. [1][2][3][4][5][6] An ideal reconstruction should provide good symmetry as regards color and projection compared with the contralateral nipple. The nipple can be reconstructed using a local flap, a local flap with synthetic/allogeneic/autologous graft inside or a skin graft.…”

Section: Introductionmentioning

confidence: 99%

The “Five-flap” Technique for Nipple–Areola Complex Reconstruction

Ferraro

Lanzano

Gentile

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Nipple-areola complex reconstruction aims to be the last step in the postmastectomy treatment procedure. Different techniques have been developed with the purpose of achieving optimal symmetry in position, size, shape, pigmentation, and permanent projection of the reconstructed nipple, but to date, there is no gold standard technique. The five-flap technique provides an easy, simple nipple-areola complex reconstruction method, effectively maintaining longer nipple projection, with a negligible rate of complications. Methods: From November 2018 to April 2021, a total of 21 female patients with an absent unilateral nipple-areolar complex due to postoncological mastectomy were subjected to our technique consisting of a combination of local flaps and a fullthickness skin graft. Patients were observed for 6 months to estimate the percentage of the nipple projection loss. Overall satisfaction was evaluated by the patients themselves and by an external medical observer at the end of the follow-up period. Results: None of the reconstructed nipples experienced either total or partial necrosis. Two minor complications were observed. Nipple projection loss was negligible with an average reduction of 12% from the initial projection. The nippleareolar complex shape remained excellent in all cases, with minimal alteration of the immediate postoperative results. The total average satisfaction score was 8.0 for patients and 9.0 for external observers. Conclusion:The five-flap technique represents a simple, safe, and efficacious procedure in patients with implant-based reconstruction requiring moderate to very projected nipples.

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The Use of Six Sigma to Assess Two Prostheses for Immediate Breast Reconstruction

Cited by 5 publications

References 24 publications

Successful Treatment of Wound Dehiscence by Innovative Type 1 Collagen Flowable Gel: A Case Report

Successful Treatment of Wound Dehiscence by Innovative Type 1 Collagen Flowable Gel: A Case Report

Comparing Two Approaches for Thyroidectomy: A Health Technology Assessment through DMAIC Cycle

The “Five-flap” Technique for Nipple–Areola Complex Reconstruction

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