Physical properties of Scarpa's fascia Valença‐Filipe, Rita; Mendes, Joaquim; Pereira, Francisco ...
Clinical anatomy,
20/May , Volume:
37, Issue:
4
Journal Article
Peer reviewed
Open access
Preservation of Scarpa's fascia has improved clinical outcomes in abdominoplasty procedures and in other body contour surgeries. However, the physical properties of Scarpa's fascia have not yet been ...described, and grafts are still underexplored. Fresh surgical specimens from five female patients subjected to classical abdominoplasty were dissected and analyzed. A grid was drawn on the fascia surface, dividing it into equal upper and lower halves; four Scarpa's fascia samples (30 × 10 mm) were collected from each half, 40 mm apart. The thickness was measured with a caliper. A strain/stress universal testing machine was used for mechanical tests. Twenty‐five samples were obtained (nine from the upper half, 16 from the lower). The average thickness was 0.56 ± 0.11 mm. The average values for stretch, stress, strain, and Young's Modulus were, respectively, 1.436, 4.198 MPa, 43.6%, and 23.14 MPa. The upper half showed significantly greater thickness and strain values (p = 0.020 and p = 0.048; Student's t‐test). The physical and biomechanical properties of Scarpa's fascia can make it a donor area for fascial grafts as an alternative to fascia lata, as it is always available and has minimal donor‐site morbidity. Further studies are needed to validate this statement. It seems advantageous to use the lower half of the abdomen instead of the upper part as a donor site.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
When an auricular defect is caused by high‐energy trauma that causes damage to the surrounding tissues, the patient may be not a candidate for reconstruction with local flaps and free tissue transfer ...may be necessary. Here we present a case of total auricular reconstruction in a 27 year‐old man who had total loss of the left ear and traumatized temporal skin and fascia. A radial forearm flap prelaminated by a porous polyethylene implant was employed. A “printed” ear made of silicone, based on the patient's CT‐scan of the contralateral ear, was used for intraoperative molding of the future reconstruction. Prolonged prelamination time and surgical delay (three months) were performed to reduce edema, distortion and loss of definition of the framework after revascularization. After subsequent integration and neovascularization of the added tissue, the prelaminated flap was transferred. Flap reinnervation was also performed by direct coaption of the great auricular nerve to the lateral antebrachial cutaneous nerve. The flap fully survived and there were no complications in the early postoperative period. Between 3 and 6 months, the patient returned to normal ranges in terms of warmth and cold, and recovered the discriminative facial sensibility. After one year the auricular reconstruction was intact and satisfactory aesthetic results were achieved. This method may offer a satisfactory solution for a difficult problem and may be considered for acquired total ear defects.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Subcostal scars may increase the risk of healing complications in abdominoplasty. The authors evaluated the use of thermography as a potential tool for patient selection and surgery planning to avoid ...complications and improve abdominoplasty outcomes. Two candidates for abdominoplasty procedures who presented with extensive subcostal scars were submitted to an infrared thermography protocol at all phases of the procedure: preoperative, intraoperative, and postoperative at 1 and 6 months. The preoperative thermography for both patients revealed near-normal abdominal wall perfusion. The thermograms captured intraoperatively during flap elevation did not show perfusion deficits on the upper abdominal flap. At 1 month and 6 months postoperative, dynamic thermography for both patients showed normal to near-normal perfusion. The procedures had a complication-free course with a good aesthetic result. Plastic surgeons may be reluctant to perform a full abdominoplasty in patients with a previous subcostal incision. In this preliminary analysis, we raise the potential usefulness of thermography for patients with recent subcostal scars and/or important comorbidities as a strategy for adequate patient and technique selection, avoiding possible complications. Future studies, with an increased number of patients and adequate statistical analysis, may allow us to validate the utility of thermography in these cases and reassure that the presence of previous extensive subcostal scars may not be a contraindication for a full abdominoplasty, especially if they are not recent.
Abdominoplasty techniques using a more superficial plane of dissection with Scarpa fascia preservation have been shown to improve recovery and reduce complications in nonbariatric patients. Patients ...who have experienced massive weight loss frequently need body contour procedures and represent a high-risk group.
To evaluate the effect of this technique in patients with massive weight loss after bariatric surgery.
University hospital, Portugal.
This was a single-center retrospective study of 51 postbariatric patients who had been undergone either a classic full abdominoplasty (group A) or a similar procedure except for the preservation of Scarpa fascia below the umbilicus (group B). General characteristics of both groups were analyzed, and recorded outcomes were total and daily volume of drain output, time until drain removal, time until hospital discharge, and local and systemic complications.
There were no statistically significant differences between groups regarding general characteristics or complications. The Scarpa fascia preservation group had a highly significant reduction of 79% on the total drain output, 7 days until drain removal, and 5 days' hospital stay. Long drainers (7 days or more with drains) were eliminated (reduction from 52% in group A to 3% in group B) and seroma had a 65% reduction.
Preserving Scarpa fascia during a full abdominoplasty in postbariatric patients improves recovery by reducing total drain output and hospital stay, allowing earlier drain removal, eliminating long periods with suction drains, and reducing seroma incidence. Clear benefits for the patient were obtained.
•Effective immobilization of Venturello compound on positive functionalized-SBA-15 support.•Complete desulfurization of multicomponent model diesel was achieved within 2 h.•High desulfurization ...efficiency (89%) was achieved using real untreated diesel (2300 ppm S).•High recycling capacity was found for more than nine reaction cycles.
A combination of catalytic oxidation and extraction was used for the desulfurization of a model diesel containing benzothiophene, dibenzothiophene and 4,6-dimethyldibenzothiophene, or a real diesel sample with a sulfur content of 2300 ppm. The catalysts used were the soluble peroxo compound (nBu4N)3{PO4WO(O2)24} (PW4) and a supported material denoted as PW4@TMA-SBA-15 that was prepared by immobilization of PW4 in an ordered mesoporous silica (SBA-15) derivatized with propyltrimethylammonium groups (TMA). The supported catalyst was characterized by FT-IR, FT-Raman, 31P and 13C MAS NMR spectroscopies, powder X-ray diffraction and scanning electron microscopy. Under optimized conditions (H2O2/S molar ratio = 7, 70 °C, acetonitrile as extraction solvent), both catalysts led to complete desulfurization of the model diesel within a reaction time of 2 h. The desulfurization systems could be recycled 10 times with only a slight decrease in performance being observed between the 9th and 10th oxidative desulfurization cycles. Application of the PW4 system to the real diesel led to an outstanding desulfurization efficiency of 89% after a reaction time of 2 h.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The porous metal-organic framework UiO-66(Zr) obtained via non modulated synthesis, has revealed to be a notable heterogeneous catalyst, enabling extremely fast and very efficient desulfurization of ...a multicomponent model diesel and also a real diesel fuel.
The desulfurization efficiency of various hybrid zinc-substituted polyoxometalates (PW11Zn(H2O)O395−, abbreviated as PW11Zn) was here investigated for the first time and optimized using sustainable ...systems conciliating successfully the liquid–liquid extraction and the oxidative catalytic process. Initially, the desulfurization studies were performed using a model diesel containing a mixture of the most refractory sulfur compounds and later extended to an untreated real diesel. In both cases, acetonitrile was used as extraction solvent and aqueous H2O2 as oxidant. High level of desulfurization was achieved using model and untreated diesels after few hours. The quaternary ammonium catalysts (TBAPW11Zn and ODAPW11Zn) showed higher catalytic desulfurization efficiency than the ionic liquid catalyst (BMIPW11Zn). The TBAPW11Zn behaved as a homogeneous catalyst immobilized in the extraction solvent, while the ODAPW11Zn with the long carbon chain behaved as a heterogeneous catalyst capable to be recovered from the system. Both quaternary ammonium catalysts showed to be successfully reused/recycled for various consecutive desulfurization cycles.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
