Wyniki wyszukiwania - Biblioteka Nauki

1

Surgical Treatment of Patients with Poland's Syndrome - Own Experience

100%

Fijałkowska M. , Antoszewski B.

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2011

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tom 83

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nr 12

662-667

EN

Poland's syndrome is characterized by variable clinical picture. Classic deformity consists of unilateral hypoplasia or aplasia of the sternocostal head of the pectoralis major muscle and ipsilateral hand malformations. Additionally on the affected side hypoplasia or aplasia of the breast in women is observed. Variable malformations in Poland's syndrome cause that there is no uniform treatment schedule.The aim of the study was to analyze surgical treatment conducted in patients with Poland's syndrome in Plastic, Reconstructive and Aesthetic Surgery Clinic.Material and methods. A retrospective analysis of surgical treatment was carried out in the group of 66 patients with Poland's syndrome on the basis of their medical documentation.Results. The most common operation performed in women was breast reconstruction with silicone implant. Two men had their chest symmetrized by fat grafting. Syndactyly observed in patients with complete Poland's syndrome was surgically removed in early childhood.Conclusions. Treatment of patients with Poland's syndrome, mainly due to variable clinical picture, is individual and depends on age, sex and degree of deformity. In children with complete Poland's syndrome operations include surgical removing of syndactyly. Breast reconstruction in women with Poland's syndrome with silicone implants is known and safe method. Such procedures are performed after 18 years of age.

2

Body Contouring after Massive Weight Loss – Case Report

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Zieliński T. , Antoszewski B.

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2012

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tom 84

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nr 11

585-589

EN

The paper presents a 25-year-old woman who is using a strict diet of 1000 kcal lost 83 kg in 18 months. Despite her young age, weight loss caused numerous cutaneous fatty folds, because her skin was not elastic or resilient enough. The patient undergo a multi-stage surgical treatment aiming to rectify the deformations. This example illustrates the problems of patients having undergone intensive slimming procedures and presents surgical treatment methods that rectify typical deformations in these patients.

3

Dermatoscopy as a Helpful Tool in Plastic Surgeon’s Practice – A Preliminary Study

80%

Antoszewski B. , Fijałkowska M. , Stabryła P. , Kasielska-Trojan A.

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nr 12

609-613

EN

The aim of the study was to examine the utility of dermatoscopy in plastic surgeons’ practice in pigmented and non-pigmented skin lesions management. Material and methods. The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned. Results. The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation. Conclusions. Dermatoscopy seems to be helpful in surgeons’ dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions’ removal (electro resection), which gives better aesthetic results.

4

Long-Term Results of Partial Nasal Reconstructions with Indian Flap

80%

Iljin A. , Lewandowicz E. , Starska K. , Antoszewski B.

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nr 12

626-633

EN

The aim of the study was clinical evaluation of the results following reconstruction with the Indian flap in patients with partial nasal defects, and estimation of their postoperative life quality in functional and aesthetic aspects. Material and methods. We analyzed results in 38 patients who underwent reconstructions with the Indian flap in the Department of Plastic, Reconstructive and Aesthetic Surgery between years 2000‑2013. The patients were followed-up for at least 2 years. We estimated their life quality in aesthetic and functional aspects after surgery. Results. Observed complications of nasal reconstruction were alar asymmetry in 6 patients (15.8%), nasal obstruction in 6 persons (15.8%), wide postoperative scar in 4 (10.5%), and non-aesthetic appearance of the donor site in two cases (5.3%). Estimation of life quality post surgery in the examined group of patients revealed significant postoperative improvement in both functional and aesthetic aspects. Conclusions. 1. Reconstructions of nasal defects with the Indian flap resulted in satisfactory longterm postoperative results, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with Indian flap of individuals with partial nasal defects contributed to significant postoperative improvement in both functional and aesthetic aspects and their life quality.

5

Prace Oryginalne Original Papers Why Women Who Have Mastectomy Decide Not to Have Breast Reconstruction?

80%

Zieliński T. , Lorenc-Podgórska K. , Antoszewski B.

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nr 10

451-455

EN

Breast cancer is the most common malignancy occurring in women. The treatment of breast cancer is a complex, multistep process involving surgical treatment, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and very often rehabilitation. After the treatment of the underlying disease, or still in its course, there remains a problem of deformation of the chest. Although the number of women opting for breast reconstructive surgery increases every year, the number of such procedures in Poland is low. The aim of the study was to investigate the reasons why women after amputation of the breast due to cancer are not likely to undergo breast reconstructive surgery. Material and methods. The study comprised 73 women, residents of the province of Silesia, aged between 37 and 79 years, who had undergone mastectomy for malignancy in the years 1987-2013. Results. From all of the reasons given by women for refraining from breast reconstruction, the most frequently pointed was the fear of being subjected to further surgery (38.3%). 23 women (31.5%) admitted that they were also afraid of postoperative pain. Similarly, a common response (35.6%) was that it is not essential for their mental state, and 30% of respondents fully accepted their appearance after mastectomy. Concern about the effect of failed reconstruction was reported by 24.6% of the women, and the fear that the surgery could negatively affect the process of cancer treatment by 27.4% of respondents. Lack of information about the capabilities and knowledge of breast reconstruction methods was not an important factor in decision-making. Conclusions. Most of the surveyed women who abandon breast reconstruction surgery, make this decision on the basis of more than one reasons. Fear of undergoing a second surgical procedure and pain related to it were the most important reasons for the refusal of breast reconstruction. An important factor in the decision to desist from breast reconstruction is the age of the patients.

6

Surgical Correction of a Webbed-Neck Deformity in Turner’S Syndrome

80%

Zieliński T. , Lorenc-Podgórska K. , Antoszewski B.

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2015

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tom 87

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nr 3

134-138

EN

Turner’s syndrome occurs in approximately 1 out of every 2,000 to 2,500 live-born girls. This genetically determined pathology is characterised by multiple congenital anomalies. A typical form of this syndrome is associated with a lack of one of the sex chromosomes (karyotype 45, X). From the point of view of plastic surgery, one of the most important elements of the therapy is correction of the webbed neck deformity. The aim of the study was to present the possibilities of surgical treatment of a webbed neck of patients with Turner’s syndrome and the evaluation of treatment results. In the years 2000-2012, six children with Turner’s syndrome were treated because of the webbed neck deformity. The age of patients ranged from 9 to 17 years. In the case of all patients, the aim was to distribute the neck skin folds by using Z-plasty in conjunction with a shift to the back of glabrous skin flaps mobilised from the anterolateral surface of the neck. In the case of four operated patients, the folds were completely removed and a correct symmetrical outline of the neck was obtained. One patient was found to have unilateral moderate webbed neck recurrence after about 2 years of treatment. In one case, the correction was insufficient. The performed surgical procedures enabled correction of low hairline only in the lateral parts of the neck. The lower line of the scalp in the central part of the neck has remained unchanged. The lateral approach with a shift of glabrous skin flap to the back, which we performed, allows for effective reduction of the webbed neck, excision of bands of the connective tissue and correction of the low hairline on the side of the neck. Z-plasty enables an adequate extension of scars and improves the contour of the neck.

7

Long-term Results of Breast Reduction in Female-to-Male Transsexuals

80%

Antoszewski B. , Bratoś R. , Sitek A. , Fijałkowska M.

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2012

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tom 84

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nr 3

144-151

EN

Transsexualism is considered to be an extreme end in a large group of gender identity disorders. Two main types of transsexualism are identified: male-to-female (MtF) and female-to-male (FtM). Transsexual persons have a feeling of being incarcerated in a foreign body and therefore they wish to change their sex by hormone therapy and surgical treatment. Breast reduction usually is the first procedure in the process of surgical reassignment in FtM transsexual persons.The aim of this study was to evaluate the long-term results of breast reduction in FtM transsexual persons, taking into account breast size and surgical technique. The doctors' and patients' opinions about the results were also compared.Material and methods. The study was carried out in a group of 98 FtM transsexual persons treated at the Department of Plastic, Reconstructive and Aesthetic Surgery. Evaluation of the long-term results of breast reduction was performed based on clinical examination done by the doctors and a questionnaire filled in by the patients and the surgeons.Results. Good results of breast reduction were achieved in more than 60% of the examined patients operated on mainly by Webster technique.Conclusions. Clinical examination of the long-term results of breast reduction in FtM transsexual persons revealed good aesthetic effects. The doctors' and the patients' opinions were similar.

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Rekonstrukcja przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej wyspowym płatem zamałżowinowym u chorych z rakiem podstawnokomórkowym lub kolczystokomórkowym

70%

Iljin A. , Antoszewski B. , Durko M. , Zieliński T. , Pietruszewska W.

Polish Journal of Otolaryngology

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2018

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tom 72

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nr 3

4-10

PL

Cel: Przedstawienie klinicznego doświadczenia z zastosowania wyspowego płata zamałżowinowego (Postauricular Island Flap; PIF) oraz ocena wyników rekonstrukcji przewodu słuchowego zewnętrznego (External Auditory Canal; EAC) i/lub muszli małżowiny usznej tą metodą u pacjentów po wycięciu złośliwej zmiany nowotworowej tej okolicy. Materiał i metody: Analizie poddano łącznie 19 chorych po wycięciu raka z zastosowaniem PIF (2000–2015) – 11 pacjentów po rekonstrukcji muszli małżowiny usznej, 8 pacjentów po rekonstrukcji muszli wraz z EAC. Oceniono wczesne i odległe wyniki leczenia operacyjnego. Porównano opinie chirurga i pacjenta. Wyniki: U wszystkich badanych zmiany wycięto w całości, nie stwierdzając wznowy w ciągu min. 2 lat obserwacji. Przekrwienie bierne wystąpiło u 5 chorych (26,3%), nadmierne przyleganie małżowiny usznej u 4 pacjentów (21%), u 3 chorych (15,8 %) zauważono odstawanie płatka, a u 3 osób (15,8%) zwężenie EAC. Wyniki pooperacyjne były bardzo dobre u wszystkich pacjentów (tak w ocenie chirurga, jak i chorych), za wyjątkiem pacjentów z nadmiernym przyleganiem małżowiny usznej i z odstawaniem płatka, u których oceny były satysfakcjonujące. Wnioski: 1) Operacje po wycięciu guza przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej połączone z rekonstrukcją wyspowym płatem zza małżowiny usznej pozwoliły na doszczętne wycięcie zmian (bez oznak wznów) oraz zachowanie właściwego konturu muszli operowanej małżowiny usznej. 2) Zastosowanie dostępu w okolicy zamałżowinowej u chorych z rakiem umiejscowionym w obrębie przewodu słuchowego zewnętrznego pozwoliło nie tylko na właściwą wizualizację i ocenę rozległości tych zmian, ale także stworzyło dobre dojście do pola operacyjnego.

9

Selected Methods of the Chest Wall Reconstruction for Sternal Dehiscence after Median Sternotomy

70%

Lewandowicz E. , Iljin A. , Kasielska-Trojan A. , Fijałkowska M. , Antoszewski B.

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2015

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tom 86

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nr 5

230-234

EN

Dehiscence of a median sternotomy wound is a potentially devastating and life-threatening complication of cardiac procedures.Depending on the localization, extensiveness, and profoundness of the defect a variety of muscle flaps may be used to cover the frontal mediastinum, in particular: pectoralis major, rectus abdominisor latissimus dorsi. In spite of several options for restoration of sternal integrity we cannot avoid following serious local complications increasing patients morbidity. The aim of this paper is to report a method of sternal dehiscence management. Surgical technique and its results are presented on the example of two patients treated in Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University in Łódź because of sternal dehiscence after cardiovascular procedure with sternotomy. Our experience indicates that modified bilateral pectoralis major flap seems to be effective surgical method of sternal dehiscence treatment. Also it is worth to remember that surgical procedure in this complication should be performed as soon as possible to decrease patient’s disability and to avoid following complications

10

External auditory meatus and/or conchal bowl reconstruction with postauricular island flap in patients with Basal Cell Carcinoma or Squamous Cell Carcinoma

70%

Iljin A. , Antoszewski B. , Durko M. , Zieliński T. , Pietruszewska W.

Polish Journal of Otolaryngology

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2018

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tom 72

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nr 3

4-10

EN

Aims. Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with pif in patients after carcinoma resections. Methods. We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were reexamined and evaluated in respect of early and long-term results after surgical treatment considering both the plastic surgeon’s and the patient’s opinion. Results. The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3%), pinning of the operated ear in four patients (21%), prominent earlobe in three (15.8%), and eac constriction in three cases (15.8%). The postoperative result was very good in all cases (both in the opinion of the plastic surgeon and the patients), except for patients with pinning of the operated ear, with a prominent earlobe (moderately satisfied). Conclusions. 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and for the preservation of a proper conchal shape in the reconstructed ear. 2. A retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access.