Overall complication rates of DIEP flap breast reconstructions in Germany – a multi-center analysis based on the DGPRÄC prospective national online registry for microsurgical breast reconstructions

While autologous breast reconstruction has gained momentum over recent years, there is limited data on the structure and quality of care of microsurgical breast reconstruction in Germany. Using the breast reconstruction database established by the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC), the presented study investigated the overall outcomes of deep inferior epigastric perforator (DIEP) flap reconstructions in Germany. Data of 3926 patients and 4577 DIEP flaps performed by 22 centers were included in this study. Demographics, patient characteristics, perioperative details and postoperative outcomes were accounted for. Centers performing < Ø 40 (low-volume (LV)) vs. ≥ Ø 40 (high-volume (HV)) annual DIEP flaps were analyzed separately. Overall, total and partial flap loss rates were as low as 2.0% and 1.1% respectively, and emergent vascular revision surgery was performed in 4.3% of cases. Revision surgery due to wound complications was conducted in 8.3% of all cases. Mean operative time and length of hospital stay was significantly shorter in the HV group (LV: 385.82 min vs. HV: 287.14 min; LV: 9.04 (18.87) days vs. HV: 8.21 (5.04) days; both p < 0.05). The outcome and complication rates deduced from the national registry underline the high standard of microsurgical breast reconstruction on a national level in Germany

Complex reconstructions in head and neck cancer surgery: decision making

Defects in head and neck after tumor resection often provide significant functional and cosmetic deformity. The challenge for reconstruction is not only the aesthetic result, but the functional repair. Cancer may involve composite elements and the in sano resection may lead to an extensive tissue defect. No prospective randomized controlled studies for comparison of different free flaps are available. There are many options to cover defects and restore function in the head and neck area, however we conclude from experience that nearly all defects in head and neck can be closed by 5 different free flaps: radial forearm flap, free fibula flap, anterior lateral thigh flap, lateral arm flap and parascapular flap

The relationship between acute coronary artery diseases with c-reactive protein +1059 G/C and angiotensin-converting enzyme I/D gene polymorphisms

Objective: The purpose of this study was to evaluate the presence of an association between the CRP +1059 G/C and ACE I/D gene polymorphisms and patients who were diagnosed to have acute coronary syndrome and underwent coronary angiography. Methods: A total of 126 patients (mean age: 60.0±12.9) and 144 healthy individuals (mean age: 52.1±13.0) were included to this study. The presence of CRP +1059 G/C and ACE I/D gene polymorphisms were analyzed using the RFLP method. Results: When the patient and control groups were evaluated in terms of ACE I/D gene polymorphism, no statistically significant difference was found in the frequency of ACE DD and ACE ID between the two groups (P>0.05), while the percentage of ACE II genotype was statistically significantly higher in the patient group compared with the control group (P0.05). When the presence of the ACE I/D genotype and CRP G/C genotype was compared in patients with vessel disease (one vessel, two vessels and three vessels) among the patients with coronary artery diseases with the control group, statistically significant differences were found between the two groups (P<0.05). In addition, the frequency of the ACE I/D genotype in hypertensive patients with coronary artery disease was statistically significantly higher (P<0.033). Also, the frequency of the CRP +1059 G/C genotype was found to be statistically significantly higher in the patient group (P<0.026). Conclusion: This study demonstrated that CRP +1059 G/C and ACE I/D gene polymorphisms may be a genetic marker associated with coronary artery disease in patients diagnosed with ACS. © 2016, E-Century Publishing Corporation. All rights reserved

Dancing: More than a therapy for patients with venous insufficiency

Objective This study aims to figure out the effects of dance therapy on patients with chronic venous insufficiency disease. Methods Forty subjects with chronic venous insufficiency were recruited to either the control group or the dance therapy group. As the severity of chronic venous insufficiency was defined with the Venous Clinical Severity Scores (VCSS), patients in control group received only medical treatment. Twenty patients with chronic venous insufficiency in dance therapy group received three times a week, for five weeks, totally 15 sessions of dance therapy in addition to medical treatment. Results There was no significant difference in pre- and post-treatment results of Rivermead Index, VCSS parameters constipation complaint, assistive breath muscle activity, lower limb circumference, strength and range of motion between groups (p > 0.05). The remarkable result of this study was obtaining that the post-treatment quality of life scale's bodily pain score was significantly higher in the dance therapy group than the control group (p < 0.05). Conclusions It was concluded that dance therapy has positive effects on quality of life. There were no barriers to chronic venous insufficiency patients in this form of gentle exercise, showing that it is to meliorate the cardiovascular, physical and psychological benefits of an activity that is enhancing of the self-esteem in addition to the quality of life. Treatment of chronic venous insufficiency should consist of methods that support the patient mentally, physically and psychologically, in addition to the medical treatment. Dance therapy might be a potential exercise intervention for improvements in chronic venous insufficiency patients, so clinicians focusing on them could recommend this form of gentle exercise in addition to the medical treatment.C1 [Dogru-Huzmeli, Esra; Gokcek, Ozden; Cam, Yagmur] Hatay Mustafa Kemal Univ, Hlth Sci Fac, Physiotherapy & Rehabil Dept, Antakya, Turkey.[Fansa, Iyad; Lale, Cem] Hatay Mustafa Kemal Univ, Tayfur Ata Sokmen Med Fac, Dept Cardiovasc Surg, Antakya, Turkey.[Oznur-Karabicak, Gul] Adnan Menderes Univ, Hlth Sci Fac, Dept Physiotherapy & Rehabil, Aydin, Turkey.[Cetisli-Korkmaz, Nilufer] Pamukkale Univ, Sch Phys Therapy & Rehabil, Antakya, Turkey