Background According to current literature, the estimated average survival rate for Remotion, the total wrist implants, is above 90% on an 8-year follow-up. We examined our series of Remotion to calculate its survival rate on a 10-year follow-up.
Case Description A total of 23 cases of total wrist implants were reviewed. The case series included 22 patients, 18 females and 4 males, of an average age of 55 years. The case series included 19 inflammatory rheumatic diseases, 3 Kienböck disease, and 1 posttraumatic arthrosis.
Conclusion The average survival rate of our case series was 95.7% on a 4-year follow-up, 91.3% on a 6-year follow-up, and 69% on a 10-year follow-up. On our review, the QuickDASH score, pain, wrist extension range of motion, and grip strength were improved postoperatively. No difference was shown between preoperative and postoperative values for wrist flexion, pronation, and supination. The case series included a septic case, treated by arthrodesis, and three total wrist implants displacements, two of which were treated by carpal implant, and the remaining one was treated by arthrodesis.
Clinical Relevance The survival rate of the total wrist replacement implant Remotion was estimated to be 69%.
Background: The addition of face allotransplantation (FT) to the head and neck reconstructive surgery arsenal has started a true revolution. This study is aimed at providing an extensive analysis of the current practice of composite tissue allotransplantation. Moreover, a thorough description of pre-procedural, intra-operative, and post-procedural settings, indications, contraindications, outcomes, ethical considerations, and future perspectives is provided. Methods: The authors’ experience was supplemented with a literature review performed by using the PubMed, MEDLINE, and Embase databases on February 21, 2022. The search terms used were “face transplantation indications”, “face transplantation complications”, and “face transplantation ethical issues”. Results: The most recent achievements and long-term clinical sequelae of FT are classified and summarized. A large number of records (4435) were identified. Seventy-five articles were assessed for eligibility. Publications without new data and reports with a patient follow-up < 5 years were excluded. Nineteen articles met the criteria for inclusion. Conclusions: The most recent achievements in the field of FT may be combined with cutting-edge regenerative medicine procedures and innovative immunological processing. It is paramount to build strong international networks between the world FT experts in order to achieve higher-level outcomes and reduce the complication rate. Nevertheless, the utmost caution is required in patient selection, clinical assessment, strict follow-up, and rejection management.
Background:
Hidradenitis suppurativa (HS) is a common chronic condition that is often resistant to conservative treatment and requires a wide and aggressive surgical approach to prevent recurrence. A prospective study was performed comparing the outcomes of thoracodorsal artery perforator (TDAP) flap-based reconstruction and secondary intention closure (SIC) after wide local excision (WLE) of axillary HS.
Methods:
A prospective study was conducted on 68 patients with stage 3 axillary HS. Thirty-three patients underwent a WLE procedure and were left to heal by secondary intention (SIC group), and 35 patients underwent immediate reconstruction with a homolateral TDAP flap (TDAP group). Inpatient stay, healing time, postoperative complications rate, and pain were analyzed in both groups, comparing preoperative shoulder function (using Constant-Murley shoulder outcome score) and quality of life (using a dermatology life quality index) with postoperative shoulder function and quality of life.
Results:
Patients receiving TDAP flaps had significantly faster recovery, fewer complications, and fewer overall number of procedures than those who underwent SIC. All patients reported an improved quality of life after their operation. The TDAP group showed significantly more improvement than the SIC group (P < 0.001). Patients receiving TDAP flaps reported a significant reduction in pain and discomfort and better shoulder function compared with patients in the SIC group (P < 0.001).
Conclusions:
WLE and TDAP flap-based reconstruction for axillary stage 3 HS provide optimal postprocedural functional results with a low complication rate. Complete remission of the disease was observed after the procedure. Despite the relatively slow learning curve of this procedure, the authors strongly recommend this technique as a very good option for the management of stage 3 axillary HS.
CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
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