Commentary on: Low Negative Pressure Combined With Supertumescence Microliposuction as a New Method for Repairing Facial Fat Overfilling: A Case Series of 32 Patients

International audienceNo abstract availabl

Techniques of Concomitant Abdominoplasty and Umbilical Hernia Repair: A Review

International audienceBACKGROUND: Different methods of performing full abdominoplasty and umbilical hernia (UH) repair simultaneously have been proposed. OBJECTIVES: The aim of this study was to review and compare UH repair outcomes and umbilical stalk survival. METHODS: A literature research was performed through 28 December 2019. Other hernia repairs and mini-abdominoplasty (without umbilical transposition) were excluded. The primary outcomes analyzed were rates of UH recurrence, mesh infection, and umbilical necrosis. RESULTS: Six studies were included (5 retrospectives series, 1 case report). Hernia was repaired by an open approach (3 studies, 28 patients) or a laparoscopic approach (3 studies, 67 patients). UH repair consisted of mesh placement in the intraperitoneal or retromuscular/preperitoneal plane, or suture technique in the intraperitoneal plane. No hernia recurrence, mesh infection, or umbilical necrosis was described. CONCLUSIONS: Both open and laparoscopic approaches to simultaneous abdominoplasty and UH repair seem to be safe based on the rates of umbilical stalk vascularization, hernia recurrence, and mesh infection. However, more well-designed studies are needed to prove this hypothesis

Evaluation of the risk of post-operative bleeding complications in skin cancer surgery without interruption of anticoagulant/antithrombotic medication: A prospective cohort study

International audienceBACKGROUND: Previous reports showed lack of consensus concerning interruption of anticoagulant/antithrombotic (AC/AT) treatment before skin cancer surgery. AIM: The aim of this study was to evaluate the risk of postoperative bleeding in patients on AC/AT treatment undergoing skin cancer surgery without interruption of this treatment. METHOD: This prospective cohort study included 271 consecutive patients divided into two groups - patients without and patients with AC/AT therapy. Inclusion criteria were skin cancer (basal-cell carcinoma, squamous-cell carcinoma, or malignant melanoma). Exclusion criteria were patients undergoing regional lymph node dissection or sentinel lymph node biopsy. Postoperative bleeding complications taken into consideration were those evaluated as moderate or severe and requiring some form of surgical or non-surgical hemostasis on an outpatient or inpatient basis. RESULTS: There were 47 patients in the AC/AT group and 224 in the control group (mean age = 76.6 and 68 years, respectively), with almost equal distribution of tumours in both groups. There were 34.1% of patients on AT, 55% on AC treatment, and 10.6% on mixed treatment (AC+AT or AT+AT). Postoperative bleeding complications did not show a statistically significant difference between the two groups (p = 0.063). CONCLUSION: Skin cancer surgery can be safely performed without discontinuation of AC/AT treatment, since the risk of postoperative bleeding is statistically insignificant

Abdominoplasty with simultaneous laparoscopic umbilical hernia repair: A practical approach to preserve the umbilical vascularization

Background. - Umbilical necrosis is a well-known complication of abdominoplasty, the risk of this complication can be increased when an associated umbilical hernia requires further dissection in peri-umbilical region, potentially leading to umbilical devascularisation. Multiple minimally invasive open techniques were described to avoid this problem. The combined approach of abdominoplasty with laparoscopic umbilical hernia repair is one promising solution to avoid devascularising the umbilicus. Methods. - A retrospective evaluation of patients who underwent concomitant abdominoplasty with laparoscopic umbilical hernia repair from 2007 to 2017 was carried out. All patients were followed up and evaluated for complications, including the incidence of umbilical skin necrosis. Results. - A total of 47 patients were included in this study. The average operative duration was 3.3 hours with an average hospital stay of 2.5 days. No cases of postoperative umbilical necrosis were encountered. A mean follow-up period was 2.4 years showed no cases of hernia or rectus abdominis diastasis recurrence. Minor complications included 4 cases of dehiscence, one hematoma. There was no major complications. Conclusion. - The concomitant use of laparoscopic umbilical hernia repair and abdominoplasty is a feasible approach to reduce the risks of umbilical devascularization. Especially in larger hernias and in patients with higher risk of recurrence. (C) 2018 Elsevier Masson SAS. All rights reserved

Transverse Facial Artery Perforators: Anatomical, Two- and Three-Dimensional Radiographic Study

BACKGROUND: Increased anatomical knowledge of skin vascularization, such as the recent description of angiosome and perforasome concepts, has led to important innovations in flap surgery. In this sense, few studies have been performed on face vascularization especially for facial artery perforasomes. The aim of this study was to analyze the number, size, and localization of transverse facial artery perforators and their perfusion area. METHODS: Fourteen hemifaces of fresh adult cadavers from the Department of Anatomy of Lyon University were harvested. Transverse facial artery perforators were identified, dissected, cannulated, and selectively injected with 1 ml of patent blue or contrast solution. Photography, microangiography, and computed tomography were performed. Perforator diameter and localization from the lateral canthus were measured. Exact topography and size of the perforasome were analyzed. RESULTS: Twenty-three transverse facial artery perforators were identified. Mean perforator diameter was 1.01 +/- 0.3 mm. Mean perforating site was 31.0 +/- 8.0 mm lateral to and 38.7 +/- 8.8 mm below the lateral canthus. Mean single perforasome surface area was 25.3 +/- 18.34 cm and mean transverse facial artery skin territory was 40.5 +/- 9.78 cm. CONCLUSIONS: The transverse facial artery provides at least one perforator that can be accurately localized using a Doppler probe. Clinical applications related to the improved knowledge of transverse facial artery perforators could be as follows: (1) performing a lateral facial skin flap; (2) facial composite allotransplants; (3) face-lift procedures to improve skin perfusion; and (4) prevention of vessel injury in aesthetic procedures such as dermal filler injection or thread-lift techniques