365 results on '"Paolo Persichetti"'
Search Results
2. 13. Efficacy Of Renuvion Helium Plasma To Improve The Appearance Of Loose Skin In Patients Candidate To Abdominoplasty After Massive Weight Loss: Controlled Randomized Study
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Mauro Barone, MD, PhD, Rosa Salzillo, MD, Riccardo De Bernardis, MD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Published
- 2024
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3. Innovative Application of GalaFLEX Poly-4-Hydroxybutyrate Scaffold in Breast Reduction/Mastopexy with Inferiorly Based Dermo-adipose Flap
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Barbara Cagli, MD, PhD, Marco Gratteri, MD, Andrea A. Cimmino, MD, Francesco Sofo, MD, Carlo Mirra, MD, Luca Savani, MD, Iside Vignapiano, MD, Annalisa Cogliandro, MD, PhD, Giovanni F. Marangi, MD, PhD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Abstract
Summary:. Breast reduction is one of the most required plastic surgery procedures worldwide, improving significantly the quality of life for patients with macromastia and gigantomachia. Despite various proposed approaches aiming to yield more stable results postreduction, no single technique has demonstrated unequivocal superiority. Recurrence ptosis at 6–12 months postoperative remains a challenging concern. To improve this issue, the authors propose a novel application of the poly-4-hydroxybutyrate (P4HB) scaffold on the anterior surface of the Ribeiro dermo-adipose flap. The primary aim was to establish a durable and resilient biological connection between the mammary gland and the flap, thereby promoting long-lasting outcomes in breast reduction procedures. The P4HB scaffold is a monofilament, single-layer, biologically derived, fully resorbable, rapidly integrating within breast tissue; this biological process stimulates the formation of freshly vascularized connective tissue up to a thickness of 2–3 mm. Within 18–24 months, the scaffold undergoes gradual resorption through hydrolysis-based mechanism, providing enhanced strength and resistance to the native tissue, as shown in animal model. A key innovation proposed by the authors involves the division of a 15 × 20 cm rectangular sheet of the P4HB scaffold along its diagonal, resulting in two right triangles. This modification ensures increased height of the device if compared with the traditional splitting technique of the scaffold. The strategic establishment of a biological bridge between the mammary gland and flap through the implementation of the P4HB scaffold could potentially enhance the longevity and aesthetics of breast reduction outcomes.
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- 2024
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4. Lower Abdominal vs. Lateral Thigh Perforator Flaps in Microsurgical Sarcoma Reconstruction: The Aesthetics of Donor Site Matters
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Beniamino Brunetti, Rosa Salzillo, Riccardo De Bernardis, Valeria Petrucci, Matteo Pazzaglia, Chiara Camilloni, Alessandra Putti, Marco Morelli Coppola, Stefania Tenna, and Paolo Persichetti
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microsurgery ,ALT ,SCIP ,DIEP ,reconstructive ,aesthetic ,Medicine - Abstract
Introduction: Sarcoma resection often leaves patients with big defects only amenable through microsurgical reconstruction. In such cases, it is hard for the surgeon to uphold low donor-site morbidity with an aesthetic result. The purpose of this study was to investigate the clinical outcome and the patient’s perception regarding the donor site in a cohort of patients undergoing microsurgical reconstruction with lateral thigh and lower abdominal perforator flaps. Methods: A retrospective evaluation of all patients who underwent sarcoma reconstruction with flaps harvested from the lower abdominal region (deep inferior epigastric artery perforator flap, superficial circumflex iliac artery perforator flap) or lateral thigh region (anterolateral thigh perforator flap and its variations) was performed. Only patients with defects greater than 100 cm2 were included. Patient demographics and operative variables were recorded, together with complications. Patient satisfaction and quality of life with the donor site were registered using the SCAR-Q questionnaire, which was administered at least six months post-operatively. Results: Eighteen anterolateral thigh (ALT) perforator flaps and twenty-two deep inferior epigastric artery perforator (DIEP) and superficial circumflex iliac artery perforator (SCIP) flap procedures were performed. The two groups were homogeneous for major post-operative complications (p > 0.999). Patient satisfaction with the donor site measured using the SCAR-Q questionnaire showed significantly higher scores in the DIEP/SCIP group when compared with the thigh group (p < 0.001), indicating a superiority of the lower abdominal area as an aesthetic donor site. Conclusions: The DIEP and SCIP flaps are a versatile option for reconstructing large soft-tissue defects following sarcoma resection. Therefore, flaps harvested from the lower abdomen yield a higher patient satisfaction with the donor site, which is a feature worth considering when planning a reconstructive procedure.
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- 2024
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5. D4. Analysis of Long-term Outcomes and Satisfaction of Patients Undergoing Brachioplasty Following Massive Weight Loss
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Riccardo De Bernardis, MD, Mauro Barone, MD, PhD, Rosa Salzillo, MD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Published
- 2024
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6. D1. Same Versus Different Projection Implants in Asymmetric Tuberous Breasts: Analysis Long-term Outcome and Patient’s Satisfaction
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Mauro Barone, MD, PhD, Rosa Salzillo, MD, Riccardo De Bernardis, MD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Published
- 2024
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7. Melasma treatment: a systematic review
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Nicoleta Neagu, Claudio Conforti, Marina Agozzino, Giovanni Francesco Marangi, Silviu Horia Morariu, Giovanni Pellacani, Paolo Persichetti, Domenico Piccolo, Francesco Segreto, Iris Zalaudek, and Caterina Dianzani
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melasma ,tranexamic acid ,peeling ,microneedling ,laser ,intense pulsed light ,Dermatology ,RL1-803 - Abstract
Melasma is a common chronic refractory disorder of pigmentation affecting people with darker skin types. Overall prevalence varies between 8.8% and 40%, depending on the ethnicity of the population and the geographical area. Therapeutic management of melasma is challenging, with high recurrence rates which significant impacts on the quality of life. No single treatment is universally efficacious. Systemic treatments with tranexamic acid and polypodium leucotmatous had promising results, although the former was related to systemic side effects. Microneedling and peeling were also efficacious, although their superiority to topical hydroquinone, the gold standard in melasma treatment, remains to be established. Similarly, laser and light devices have been beneficial. However, recurrence rates remain high in all treatment groups. Combination therapies, either in double or triple combinations yielded the best results when compared to single terapies. Treatment choice should be made after Wood’s lamp examination, as well as dermatoscopic evaluation, in order to select the best treatment option, targeted at each melasma subtype.
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- 2022
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8. Spotlight on the treatment armamentarium of concomitant psoriasis and inflammatory bowel disease: a systematic review
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Claudio Conforti, Caterina Dianzani, Iris Zalaudek, Michele Cicala, Paolo Persichetti, Roberta Giuffrida, Silviu-Horia Morariu, and Nicoleta Neagu
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psoriasis ,inflammatory bowel disease ,treatment ,paradoxical ,Dermatology ,RL1-803 - Abstract
Background Psoriasis and inflammatory bowel diseases share common immunological pathomechanisms and therefore similar treatment options. Objective To assess already existing therapies and their efficacy versus adverse effects and paradoxical reactions in patients presenting with either disease or both. Data sources A systematic search of the PubMed and Science.gov databases was performed for the period 2018–2020. Only articles in English were selected. Search terms included a combination of keywords: adalimumab, infliximab, etanercept, golimumab, certolizumab, ustekinumab, guselkumab, vedolizumab, secukinumab, ixekizumab, brodalumab, acitretin, cyclosporine, methotrexate, apremilast, mycophenolate mofetil, sulfasalazine, hydroxyurea, azathioprine, 6-thioguanine, tacrolimus, leflunomide and fumaric acid esters in combination with each of the following: paradoxical, psoriasis, psoriatic arthritis, inflammatory bowel disease, Crohn’s disease, ulcerative colitis. Other potentially relevant articles were identified by manually checking the references of the included literature. Study selection Recent reviews and meta-analyses, pooled analyses, cohort studies, observational studies, care reports were all included. Conclusions Psoriasis and IBD can be treated concurrently as they share common inflammatory pathways. TNF-α inhibitors and IL-12/23 have been successful in treating both psoriasis and IBD. IL-17 inhibitors are recognized treatments for psoriasis but have the potential to exacerbate IBD. Newer molecules require further clinical trials and real-life studies in order to confirm their efficacy and safety.
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- 2022
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9. The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres
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Andrea Vittorio Emanuele Lisa, Marzia Salgarello, Alessandra Huscher, Fabio Corsi, Daniele Piovani, Federica Rubbino, Stefania Andreoletti, Giovanni Papa, Francesco Klinger, Corrado Tinterri, Alberto Testori, Marta Scorsetti, Paolo Veronesi, Maria Cristina Leonardi, Mario Rietjens, Umberto Cortinovis, Valeria Summo, Emanuele Rampino Cordaro, Pier Camillo Parodi, Paolo Persichetti, Mauro Barone, Giorgio De Santis, Matteo Murolo, Michele Riccio, Angelica Aquinati, Francesco Cavaliere, Nicola Vaia, Giulia Pagura, Erica Dalla Venezia, Franco Bassetto, Vincenzo Vindigni, Luigi Ciuffreda, Maria Alessandra Bocchiotti, Alberto Sciarillo, Nadia Renzi, Graziano Meneghini, Tajna Kraljic, Andrea Loreti, Lucio Fortunato, Valentina Pino, Valeriano Vinci, and Marco Klinger
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Public aspects of medicine ,RA1-1270 - Abstract
Purpose. In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods. We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results. From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33–2.24; p
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- 2023
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10. Use of platelet-rich plasma and modified nanofat grafting in infected ulcers: Technical refinements to improve regenerative and antimicrobial potential
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Francesco Segreto, Giovanni Francesco Marangi, Carolina Nobile, Mario Alessandri-Bonetti, Chiara Gregorj, Vincenzo Cerbone, Marco Gratteri, Erika Caldaria, Maria Cristina Tirindelli, and Paolo Persichetti
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platelet-rich plasma ,anti-infective agents ,tissue grafts ,ulcer ,wounds ,Surgery ,RD1-811 - Abstract
Background Surgical reconstruction of chronic wounds is often infeasible due to infection, comorbidities, or poor viability of local tissues. The aim of this study was to describe the authors’ technique for improving the regenerative and antimicrobial potential of a combination of modified nanofat and platelet-rich plasma (PRP) in nonhealing infected wounds. Methods Fourteen patients met the inclusion criteria. Fat tissue was harvested from the lower abdomen following infiltration of a solution of 1,000 mL of NaCl solution, 225 mg of ropivacaine, and 1 mg of epinephrine. Aspiration was performed using a 3-mm cannula with 1-mm holes. The obtained solution was decanted and mechanically emulsified, but was not filtered. Non-activated leukocyte-rich PRP (naLR-PRP) was added to the solution before injection. Patients underwent three sessions of injection of 8-mL naLR-PRP performed at 2-week intervals. Results Thirteen of 14 patients completed the follow-up. Complete healing was achieved in seven patients (53.8%). Four patients (30.8%) showed improvement, with a mean ulcer width reduction of 57.5%±13.8%. Clinical improvements in perilesional skin quality were reported in all patients, with reduced erythema, increased thickness, and increased pliability. An overall wound depth reduction of 76.6%±40.8% was found. Pain was fully alleviated in all patients who underwent re-epithelization. A mean pain reduction of 42%±33.3% (as indicated by visual analog scale score) was found in non-re-epithelized patients at a 3-month follow-up. Conclusions The discussed technique facilitated improvement of both the regenerative and the antimicrobial potential of fat grafting. It proved effective in surgically-untreatable infected chronic wounds unresponsive to conventional therapies.
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- 2020
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11. Innovative Technique to Improve Chest Shape following Gynecomastia Correction in Post-bariatric Surgery Patients
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Paolo Persichetti, MD, PhD, Pierfranco Simone, MD, Annalisa Cogliandro, MD, PhD, Mauro Barone, MD, PhD, and Silvia Ciarrocchi, MD
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Surgery ,RD1-811 - Published
- 2021
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12. Subtotal extended thigh flap
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Paolo Persichetti, Daniele Tosi, Pietro Francesco Delle Femmine, and Giovanni Francesco Marangi
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Surgery ,RD1-811 - Published
- 2020
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13. Nonsurgical Rhinoplasty: A Graft-based Technique
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Francesco Segreto, MD, Giovanni Francesco Marangi, MD, PhD, Vincenzo Cerbone, MD, Mario Alessandri-Bonetti, MD, Erika Caldaria, MS, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Abstract
Background:. Nonsurgical rhinoplasty with hyaluronic acid (HA) has gained popularity due to its efficacy and minimal downtime. From a structural standpoint, it is like performing a tridimensional reshaping where only enhancement by grafts is allowed. To date, indications, technique, and products are still debated. The aim of this study is to describe the author’s experience with nonsurgical nasal reshaping, focusing on the indications and maneuvers to safely achieve, by mean of HA, the grafts previously described for surgical rhinoplasty. Materials and Methods:. A total of 70 consecutive patients underwent nonsurgical rhinoplasty using the same type of HA. The rhinoplasty module of FACE-Q was administered to all patients before treatment and 15 days posttreatment. Statistical analysis was performed. Results:. No complication was experienced. Two (2.8%) patients required a retouch after 15 days for further dorsal correction. There was a statistically significant difference between preoperative and postoperative values in all domains and overall scores of the rhinoplasty module of FACE-Q. Conclusions:. The graft-based technique proved to be safe, effective, and reliable. It may allow correction of selected nasal defects with reduced cost and minimal downtime.
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- 2019
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14. The Role of Fat Grafting in Alleviating Neuropathic Pain: A Critical Review of the Literature
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Mario Alessandri-Bonetti, MD, Francesco M. Egro, MBChB, MSc, MRCS, Paolo Persichetti, MD, PhD, Sydney R. Coleman, MD, and J. Peter Rubin, MD, FACS
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Surgery ,RD1-811 - Abstract
Background:. Neuropathic pain is one of the more severe types of chronic pain and presents a great challenge as response to medical therapy remains often unpredictable. With the opioid epidemic and the search for ways to avoid narcotics, physicians are seeking other modalities to treat neuropathic pain. In recent years, surgeons have explored various surgical avenues to improve outcomes. The aim of this review was to evaluate the current clinical evidence regarding the efficacy of fat grafting for the treatment of neuropathic pain. Methods:. A critical review was conducted to examine the current clinical evidence of fat grafting as a therapy for neuropathic pain caused by neuromas, peripheral neuralgia, migraine and headaches, neuropathic scar pain, and postmastectomy pain syndrome. Results:. The precise mechanism role of fat grafting in modulating neuropathic pain remains unclear, but it appears to reduce pain levels through the anti-inflammatory effects of adipose-derived stem cells and mechanical cushioning by fat. Conclusions:. Fat grafting is an emerging therapy for chronic neuropathic pain of various etiologies. Although promising results have been reported, sample size and level of evidence of current studies are low. The encouraging results, however, are worthy of further clinical and scientific study. The minimally invasive nature of fat grafting and favorable risk profile make this an attractive therapy for neuropathic pain.
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- 2019
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15. Minimizing Breast Implant Contamination in Breast Reconstruction Procedures: Introducing the '12 Breast Reconstruction Points'
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Barbara Cagli, MD, PhD, Rosa Salzillo, MD, Adriano Santorelli, MD, Stefania Tenna, MD, PhD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Published
- 2018
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16. Cutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review
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Claudio Conforti, Caterina Dianzani, Marina Agozzino, Roberta Giuffrida, Giovanni Francesco Marangi, Nicola di Meo, Silviu-Horia Morariu, Paolo Persichetti, Francesco Segreto, Iris Zalaudek, and Nicoleta Neagu
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COVID-19 ,novel coronavirus ,skin rash ,cutaneous manifestations ,histopathology ,ocular ,Biology (General) ,QH301-705.5 - Abstract
There have been increasing reports of skin manifestations in COVID-19 patients. We conducted a systematic review and included manuscripts describing patients with positive RT-PCR coronavirus testing from nasopharyngeal swabs who also developed cutaneous manifestations. A total of 655 patients were selected, with different types of skin rashes: Erythematous maculopapular (n = 250), vascular (n = 146), vesicular (n = 99), urticarial (n = 98), erythema multiforme/generalized pustular figurate erythema/Stevens-Johnson syndrome (n = 22), ocular/periocular (n = 14), polymorphic pattern (n = 9), generalized pruritus (n = 8), Kawasaki disease (n = 5), atypical erythema nodosum (n = 3), and atypical Sweet syndrome (n = 1). Chilblain-like lesions were more frequent in the younger population and were linked to a milder disease course, while fixed livedo racemosa and retiform purpura appeared in older patients and seemed to predict a more severe prognosis. For vesicular rashes, PCR determined the presence of herpesviruses in the vesicle fluid, which raised the possibility of herpesvirus co-infections. The erythema-multiforme-like pattern, generalized pustular figurate erythema and Stevens-Johnson syndrome were most frequently linked to hydroxychloroquine intake. A positive PCR determination of SARS-COV-2 from conjunctival swabs suggest that eye discharge can also be contagious. These cutaneous manifestations may aid in identifying otherwise asymptomatic COVID-19 carriers in some cases or predict a more severe evolution in others.
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- 2020
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17. Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol
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Giovanni Francesco Marangi, Francesco Segreto, Igor Poccia, Stefano Campa, Daniele Tosi, Daniela Lamberti, and Paolo Persichetti
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abdominoplasty ,thrombosis ,venous thrombosis ,thromboembolism ,enoxaparin ,Surgery ,RD1-811 - Abstract
Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.
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- 2016
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18. Ethics and Plastic Surgery/What is Plastic Surgery?
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Mauro Barone, Annalisa Cogliandro, and Paolo Persichetti
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Surgery ,RD1-811 - Published
- 2017
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19. Foreign Body Reaction Mimicking Sarcoma
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Francesco Segreto, Giovanni Francesco Marangi, Pietro Francesco Delle Femmine, Federico Greco, and Paolo Persichetti
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Surgery ,RD1-811 - Abstract
Foreign body reaction can sometimes mimic the features of sarcoma. A 42-year-old patient was referred to our department for a rapidly growing subcutaneous mass in the posteromedial aspect of the lower leg. Ultrasonography and magnetic resonance imaging were highly suggestive for soft tissue sarcoma. The patient underwent surgical resection. The histho-pathologic diagnosis found that the supposed sarcoma was an inflammatory pseudo-tumor, also referred to as “gossypiboms”. Surgeons must be aware that, in some cases, the imaging cannot reliably distinguish between sarcoma and foreign body reaction.
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- 2017
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20. How You Become Who You Are: A New Concept of Beauty for Plastic Surgery
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Vittoradolfo Tambone, Mauro Barone, Annalisa Cogliandro, Nicola Di Stefano, and Paolo Persichetti
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Surgery ,RD1-811 - Published
- 2015
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21. Cognitive Investigation Study of Patients Admitted for Cosmetic Surgery: Information, Expectations, and Consent for Treatment
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Mauro Barone, Annalisa Cogliandro, Giuseppe La Monaca, Vittoradolfo Tambone, and Paolo Persichetti
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informed consent ,cosmetic surgery ,quality of life ,aesthetic ,Surgery ,RD1-811 - Abstract
Background In all branches of medicine, it is the surgeon's responsibility to provide the patient with accurate information before surgery. This is especially important in cosmetic surgery because the surgeon must focus on the aesthetic results desired by the patient. Methods An experimental protocol was developed based on an original questionnaire given to 72 patients. The nature of the responses, the patients' motivation and expectations, the degree of patient awareness regarding the planned operation, and the patients' perceptions of the purpose of the required consent for cosmetic surgery were all analyzed using Fisher's exact test. Results Candidates for abdominal wall surgery had significantly more preoperative psychological problems than their counterparts did (P=0.035). A significantly different percentage of patients under 40 years of age compared to those over 40 years of age searched for additional sources of information prior to the operation (P=0.046). Only 30% of patients with a lower educational background stated that the preoperative information had been adequate, whereas 92% of subjects with secondary schooling or a postsecondary degree felt that the information was sufficient (P=0.001). A statistically significant difference was also present between patients according to their educational background regarding expected improvements in their quality of life postoperatively (P=0.008). Conclusions This study suggests that patients require more attention in presurgical consultations and that clear communication should be prioritized to ensure that the surgeon understands the patient's expectations.
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- 2015
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22. Recent Developments in the Use of Intralesional Injections Keloid Treatment
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Aurelia Trisliana Perdanasari, Davide Lazzeri, Weijie Su, Wenjing Xi, Zhang Zheng, Li Ke, Peiru Min, Shaoqing Feng, Yi Xin Zhang, and Paolo Persichetti
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keloids ,injections, intralesional ,review ,treatment outcome ,cicatrix ,Surgery ,RD1-811 - Abstract
Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.
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- 2014
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23. Retinoblastoma Plus Lipomatosis: An Autosomal Dominant Syndrome
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Stefania Tenna, Mauro Barone, Pierluigi Gigliofiorito, and Paolo Persichetti
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Surgery ,RD1-811 - Published
- 2014
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24. Versatility of Capsular Flaps in the Salvage of Exposed Breast Implants
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Beniamino Brunetti, MD, Stefania Tenna, MD, PhD, Barbara Cagli, MD, PhD, Tiziano Pallara, MD, Stefano Campa, MD, and Paolo Persichetti, MD, PhD
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Surgery ,RD1-811 - Abstract
Summary: Breast implant exposure due to poor tissue coverage or previous irradiation represents a surgical challenge both in the reconstructive and aesthetic plastic surgery practice. In case of implant extrusion or incipient exposure, the commonly suggested strategies, such as targeted antibiotic therapy, drainage and lavage of the cavity, fistulectomy, and primary closure, may be ineffective leading the surgeon to an unwanted implant removal or to adopt more invasive flap coverage procedures. Breast implant capsule, in its physiological clinical behavior, can be considered as a new reliable source of tissue, which can be used in a wide range of clinical situations. In our hands, capsular flaps proved to be a versatile solution not only to treat breast contour deformities or inframammary fold malpositions but also to salvage exposed breast implants. In this scenario, the use of more invasive surgical techniques can be avoided or simply saved and delayed for future recurrences.(Plast Reconstr Surg Glob Open 2015;3:e340; doi:10.1097/GOX.0000000000000307; Published online 30 March 2015.)
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- 2015
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25. Hidden Sentinel Node in Cutaneous Melanoma
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Francesco Segreto, Daniele Tosi, Giovanni Francesco Marangi, Alfonso Luca Pendolino, Stefano Santoro, Pierluigi Gigliofiorito, and Paolo Persichetti
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Surgery ,RD1-811 - Published
- 2013
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26. Nicolau's Syndrome Complicated by Atypical Necrotizing Fasciitis
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Francesco Segreto, Daniele Tosi, Giovanni Francesco Marangi, Pierluigi Gigliofiorito, Alfonso Luca Pendolino, and Paolo Persichetti
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Surgery ,RD1-811 - Published
- 2013
27. The role of intense pulsed light (IPL) in the treatment of meibomian gland dysfunction (MGD)
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Stefania, Tenna, Piergiorgio, Turco, Beniamino, Brunetti, Di Zazzo, Antonio, Jacopo, Macchi, Stefano, Bonini, and Paolo, Persichetti
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- 2019
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28. The body perception, resilience, and distress symptoms in candidates for bariatric surgery and post bariatric surgery
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Antonella Sisto, Mauro Barone, Alessandro Giuliani, Livia Quintiliani, Vincenzo Bruni, Daniela Tartaglini, Paolo Persichetti, and Vittoradolfo Tambone
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Surgery - Published
- 2022
29. Use of auricular versus costal cartilaginous grafts for secondary rhinoplasty procedures: comparison of long-term outcomes
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Mauro Barone, Annalisa Cogliandro, and Paolo Persichetti
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Surgery - Published
- 2022
30. Perforator‐based chimeric anterolateral thigh flap U‐shaped insetting for total pharyngoesophageal reconstruction: Surgical technique and functional outcomes
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Rosa Salzillo, Filippo Boriani, Filippo Carta, Melania Tatti, Matteo Atzeni, Paolo Persichetti, Richard M. Haywood, Roberto Puxeddu, and Andrea Figus
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Surgery - Published
- 2022
31. Total autologous breast reconstruction with the Kiss Latissimus Dorsi Flap
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Beniamino Brunetti, Rosa Salzillo, Stefania Tenna, Barbara Cagli, Marco Morelli Coppola, Valeria Petrucci, Chiara Camilloni, Yi Xin Zhang, and Paolo Persichetti
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Postoperative Complications ,Treatment Outcome ,Mammaplasty ,Quality of Life ,Superficial Back Muscles ,Humans ,Breast Neoplasms ,Female ,Surgery ,Prospective Studies ,Retrospective Studies - Abstract
Patients presenting breast actinic damage or implant-related complications require an autologous approach to breast reconstruction. However, when they are not good candidates for microsurgical procedures, alternative solutions must be sought. Latissimus dorsi (LD) is a workhorse flap in breast reconstruction, but often the amount of skin and volume achievable are insufficient. Taking inspiration from the Kiss flap concept, the authors hereby describe the "Kiss" LD flap to achieve totally autologous breast reconstruction.A prospective service evaluation of all patients who underwent breast reconstruction with Kiss LD flap between 2018 and 2020 was performed. Patient demographics and operative variables were recorded, together with early and late complications. Patient satisfaction and quality of life were registered using the latest BREAST-Q reconstruction module, which includes specific LD scales. The questionnaire was administered to patients preoperatively and six months postoperatively.Thirty patients underwent total autologous breast reconstruction with Kiss LD flap. Breast cancer and breast sarcoma resection were followed by reconstruction. The timing of reconstruction was immediate in 3 cases and delayed in 27 cases. No major complications nor total flap loss were registered. BREAST-Q scores postoperatively were significantly higher than the preoperative ones in every domain (p0.0001) except for the physical well-being of back and shoulder, where the scores differed slightly and non-significantly (p=0.05).The Kiss LD flap allows to harvest a large amount of skin to restore the breast envelope and a considerable volume to reconstruct the breast mound in a completely autologous procedure.
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- 2022
32. Direct-to-Implant Breast Reconstruction After Unilateral and Bilateral Mastectomy: Cross-Sectional Study of Patient Satisfaction and Quality of Life with BREAST-Q
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Annalisa Cogliandro, Rosa Salzillo, Mauro Barone, Stefania Tenna, Barbara Cagli, and Paolo Persichetti
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Surgery - Abstract
Immediate single stage breast reconstruction is a challenging procedure with the goal of improving the quality of life of patients with breast cancer. The aim of this study is to evaluate using the BREAST-Q patient satisfaction, body perception and quality of life after direct-to-implant breast reconstruction comparing unilateral and bilateral reconstructions.In this study we enrolled 56 women who underwent mastectomy and immediate single-stage direct-to-implant (DTI) breast reconstruction at Campus Bio-Medico University of Rome between 2013 and 2020. One year after surgery they were administered electronically the BREAST-Q post-operative module.Our two cohorts of patients consisted in 34 women who received unilateral nipple-sparing mastectomy and DTI breast reconstruction and 22 women who underwent bilateral nipple-sparing mastectomy and DTI breast reconstruction. Twenty-four of the 34 patients belonging to the unilateral group responded to the questionnaire (70.5%), while in the bilateral group responders were 16 out of 22 (72.7%). The BREAST-Q scores were compared between the two groups: patients undergoing bilateral mastectomy and breast reconstruction showed higher scores in every BREAST-Q domain compared to patients undergoing unilateral mastectomy and breast reconstruction with a statistically significant difference in the Satisfaction with breast (P = 0.01), Sexual well-being (P = 0.03), and Satisfaction with implants (P = 0.01) domains.Patients undergoing bilateral DTI breast reconstruction have a favorable postoperative surgical cosmetic outcome with a better patient's body image perception and a higher post-operative level of satisfaction compared to unilateral DTI reconstruction after nipple-sparing mastectomy.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
- Published
- 2022
33. Unilateral immediate deep inferior epigastric artery perforator flap breast reconstruction following skin sparing mastectomy: A comparative study on revision surgeries to improve breast symmetry
- Author
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Matteo Atzeni, Rosa Salzillo, Richard M. Haywood, Paolo Persichetti, Diego Ribuffo, and Andrea Figus
- Subjects
Reoperation ,Case-Control Studies ,Mammaplasty ,Humans ,Female ,Breast Neoplasms ,Surgery ,Perforator Flap ,Epigastric Arteries ,Mastectomy ,Retrospective Studies - Abstract
The number of revision surgeries to improve breast asymmetry after deep inferior epigastric perforator (DIEP) flap breast reconstruction is still high worldwide with impact on both patients and healthcare systems. These procedures include fat grafting, contralateral breast symmetrization, scar revision, flap repositioning and remodeling. A previously published DIEP flap insetting algorithm has proven to be effective in selecting patient-tailored strategies to achieve excellent aesthetic outcomes. This study investigated whether this insetting algorithm was effective in reducing revision surgeries in patients undergoing SSM and immediate DIEP flap breast reconstruction to achieve the goal of a one-stage reconstruction.This retrospective case-control study included 60 patients (group A) treated without the DIEP flap standardized insetting algorithm and 60 patients (group B) treated with the standardized insetting algorithm, which considers among its variables the type of breast to be reconstructed, abdominal tissue thickness, rotation due to harvesting side. Demographic data, operative data, complications and number of revision surgeries were recorded.One hundred and twenty primary and 106 revision surgeries were performed. Groups were homogenous for age (p = .32), body mass index (p = .77), flap weight (p = .7), operative time (p = .87) and early complications (p = .78). When excluding isolated nipple reconstruction from the revision surgeries, one-stage reconstruction was successfully performed in 26 patients in group A (43.3%) and 39 patients (65.0%) in group B, with a statistically significant difference between the groups (p = .003).The introduction of a standardized insetting algorithm for immediate unilateral DIEP flap breast reconstruction can be effective in reducing the number of revision surgeries for breast asymmetry, making a one-stage reconstruction an achievable and reliable target.
- Published
- 2022
34. Abdominal wall reconstruction with the free functional L‐shaped latissimus dorsi flap: A case report
- Author
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Beniamino Brunetti, Rosa Salzillo, Stefania Tenna, Valeria Petrucci, Marco Morelli Coppola, Sergio Valeri, and Paolo Persichetti
- Subjects
Surgery - Published
- 2023
35. Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta‐analysis
- Author
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Mario Alessandri‐Bonetti, Andrea Costantino, Giuseppe Cottone, Riccardo Carbonaro, Federica Cardone, Francesco Amendola, Armando De Virgilio, Enrico Robotti, Paolo Persichetti, and Luca Vaienti
- Subjects
Otorhinolaryngology - Published
- 2023
36. The Correlation Between the Improvement in Patient's Quality of Life and Surgeon's Satisfaction Following Primary Breast Augmentation: A Prospective Study
- Author
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Giovanni Francesco Marangi, Marco Gratteri, Carlo Mirra, Annalisa Cogliandro, Luca Savani, Silvia Ciarrocchi, Federico Pagano, Barbara Cagli, Francesco Segreto, and Paolo Persichetti
- Subjects
Surgery ,General Medicine - Abstract
Background Patient satisfaction is the primary goal in breast augmentation, but in a few cases patient satisfaction and surgeon satisfaction are in disagreement. Objectives The authors try to explain the reasons associated with disparity between patient and surgeon satisfaction. Methods Seventy-one patients who underwent primary breast augmentation with dual-plane technique, with inframammary or inferior hemi-periareolar incision, were enrolled in this prospective study. Quality of life was evaluated with BREAST-Q preoperatively and postoperatively. Preoperative and postoperative photographic analysis was performed by a heterogeneous group of experts who completed the validated Breast Aesthetic Scale (BAS). The patient satisfaction score was compared with the overall appearance as determined by the validated BAS; a difference in score of 1 or more was considered a discordant judgement. Statistical analysis was performed with SPSS version 18.0, with values of P < .01 considered statistically significant. Results BREAST-Q analysis showed a significative improvement in quality of life on the psychosocial well-being, sexual well-being, and physical well-being chest scale and satisfaction with the breast (P < .01). Of the 71 pairs, 60 had a concordant judgment between patient and surgeon, and 11 were discordant. The score expressed by the patients (4.35 ± 0.69) was on average higher than that of the third-party observers (3.88 ± 0.58), with P < .001. Conclusions Patient satisfaction is the main goal following the success of a surgical or medical procedure. BREAST-Q and photographs during the preoperative period are helpful to understanding the patient's real expectations. Level of Evidence: 3
- Published
- 2023
37. 'Histological and Immunohistochemical Evaluation of Human Breast Capsules Formed Around Five Different Expander Surfaces'
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Barbara Cagli, Simone Carotti, Francesco Segreto, Maria Francesconi, Giovanni F. Marangi, Stefania Tenna, Michele Diomedi, Giuseppe Perrone, Sergio Morini, and Paolo Persichetti
- Subjects
Surgery - Published
- 2023
38. Melasma treatment: a systematic review
- Author
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Paolo Persichetti, Morariu Sh, Giovanni Pellacani, Iris Zalaudek, Claudio Conforti, Francesco Segreto, Giovanni Francesco Marangi, Domenico Piccolo, Caterina Dianzani, Nicoleta Neagu, Marina Agozzino, Neagu, Nicoleta, Conforti, Claudio, Agozzino, Marina, Marangi, Giovanni Francesco, Morariu, Silviu Horia, Pellacani, Giovanni, Persichetti, Paolo, Piccolo, Domenico, Segreto, Francesco, Zalaudek, Iri, and Dianzani, Caterina
- Subjects
medicine.medical_specialty ,Melasma ,medicine.medical_treatment ,Population ,Dermatology ,Intense pulsed light ,Administration, Cutaneous ,intense pulsed light ,Melanosis ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,medicine ,Humans ,education ,030203 arthritis & rheumatology ,education.field_of_study ,melasma ,business.industry ,Treatment options ,laser ,microneedling ,peeling ,tranexamic acid, melasma ,medicine.disease ,Treatment Outcome ,Tranexamic Acid ,Quality of Life ,business ,Tranexamic acid ,medicine.drug - Abstract
Melasma is a common chronic refractory disorder of pigmentation affecting people with darker skin types. Overall prevalence varies between 8.8% and 40%, depending on the ethnicity of the population and the geographical area. Therapeutic management of melasma is challenging, with high recurrence rates which significant impacts on the quality of life. No single treatment is universally efficacious. Systemic treatments with tranexamic acid and polypodium leucotmatous had promising results, although the former was related to systemic side effects. Microneedling and peeling were also efficacious, although their superiority to topical hydroquinone, the gold standard in melasma treatment, remains to be established. Similarly, laser and light devices have been beneficial. However, recurrence rates remain high in all treatment groups. Combination therapies, either in double or triple combinations yielded the best results when compared to single terapies. Treatment choice should be made after Wood's lamp examination, as well as dermatoscopic evaluation, in order to select the best treatment option, targeted at each melasma subtype.
- Published
- 2022
39. Perforator-Based Flap Reconstruction after Melanoma Resection: Evaluation of Oncological, Aesthetic, and Functional Outcomes
- Author
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Rosa Salzillo, Beniamino Brunetti, Stefania Tenna, Bruno Brunetti, Mario Alessandri Bonetti, Antonia Rivieccio, and Paolo Persichetti
- Subjects
Treatment Outcome ,Esthetics ,Humans ,Surgery ,Plastic Surgery Procedures ,Melanoma ,Perforator Flap ,Retrospective Studies - Abstract
Background Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps. Methods The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure. Results One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher's exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006). Conclusion This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.
- Published
- 2021
40. Extended latissimus dorsi flap with propeller ascending design for reconstruction of a complex lateral lumbar defect: A case report and review of the literature
- Author
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Paolo Persichetti, Paolo Marchica, Marco Morelli Coppola, Stefania Tenna, Rosa Salzillo, Franco Bassetto, and Beniamino Brunetti
- Subjects
Thoracodorsal artery ,medicine.medical_specialty ,business.industry ,Propeller ,Surgery ,Left Lumbar Region ,Lumbar ,Male patient ,medicine.artery ,Cuff ,medicine ,Latissimus dorsi flap ,business ,Trapezius muscle - Abstract
Lateral lumbar defects are rarely encountered and difficult to manage because of the limited reach of loco-regional flaps and the unfavorable position of recipient vessels for microsurgical transfer. The purpose of this report is to describe the innovative application of an extended latissimus dorsi (LD) flap with propeller ascending design in the field of lumbar reconstruction, reviewing current reconstructive options accepted for lateral lumbar defect. A 68-year-old male patient underwent wide full thickness resection for a solitary hepatocellular carcinoma metastatic lesion arising in the left lumbar region, resulting in an extensive soft-tissue defect (20 x 13 cm) with deep structures exposure. An extended LD flap with propeller ascending orientation was obliquely designed, with the distal third of the skin island laying over the trapezius muscle. The skin paddle measured 34 x 9 cm. The flap, including a cuff of proximal LD muscle spared by the oncological resection and a fasciocutaneous superior extension, underwent 90°clockwise rotation on the main thoracodorsal artery perforator and further caudal advancement allowed by section of the LD cranial tendinous insertion. The rotation-advancement movement allowed tension-free flap insetting, while donor site was closed by primary intention. The post-operative course was uneventful without any complications registered. At 12-months follow-up, a satisfactory result and a stable coverage were achieved. Due to the surgical complexity traditionally associated with the repair of defects located in the lumbar region, the case reported may help to provide a new alternative solution to extend the indications of local flaps in similar cases and simplify such reconstructions.
- Published
- 2021
41. Versatility of the lateral circumflex femoral artery sparing perforator‐based anterolateral thigh flaps in loco‐regional thigh reconstruction after skin cancer, melanoma, and sarcoma resection
- Author
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Paolo Persichetti, Marco Morelli Coppola, Stefania Tenna, Beniamino Brunetti, and Rosa Salzillo
- Subjects
medicine.medical_specialty ,Skin Neoplasms ,business.industry ,Skin cancer melanoma ,Sarcoma ,Plastic Surgery Procedures ,Anterolateral thigh ,medicine.disease ,Lateral circumflex femoral artery ,Resection ,Surgery ,Femoral Artery ,Thigh ,medicine.artery ,medicine ,Humans ,Operative time ,Thigh reconstruction ,Skin cancer ,business ,Melanoma ,Perforator Flap - Abstract
Background The anterolateral thigh (ALT) flap represents a workhorse in reconstructive microsurgery but its use in a free style fashion as perforator-based flap has yet to be popularized. We describe our experience with lateral circumflex femoral artery (LCFA) sparing perforator-based ALT flaps for thigh reconstruction after oncological resection in a case series of 24 consecutive patients. Methods Twenty-four patients underwent thigh reconstruction with 25 perforator-based ALT flaps between 2014 and 2020. Defect etiology was related to skin cancer, melanoma, and sarcoma resection in 3, 7, and 14 cases respectively. Mean defect size was 15 × 8 cm. Six months postoperatively, patients were asked to rate on a 5-point Likert scale the aesthetic and functional outcomes of the reconstructive procedure. Results Eight flaps were advanced in a V-Y fashion (33.3%), whether 16 flaps (66.7%) were rotated in a propeller fashion. The average flap size was 19 × 8 cm, while mean operative time was 197.2 min. Donor sites were always closed by primary intention. Minor complications were registered in 5 cases and managed conservatively. Overall patients' satisfaction was high, with mean aesthetic and functional ratings of 4.46 and 4.21 respectively. Conclusions LCFA sparing perforator-based ALT flaps proved to be a versatile and reproducible solution to address thigh reconstruction after oncological resection according to the different topographical sub-units involved.
- Published
- 2021
42. Acknowledgment to reviewers (2022)
- Author
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Horacio F. Mayer and Paolo Persichetti
- Subjects
Surgery - Published
- 2023
43. Delayed Mastopexy Following Breast-Conserving Surgery and Radiation Therapy: A Case–Control Study to Evaluate Safety and Versatility of the Central Mound Technique
- Author
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Paolo Persichetti, Barbara Cagli, Stefania Tenna, Annalisa Cogliandro, Beniamino Brunetti, Mauro Barone, Rosa Salzillo, and Marco Morelli Coppola
- Subjects
medicine.medical_specialty ,Esthetics ,business.industry ,Visual analogue scale ,Mammaplasty ,medicine.medical_treatment ,Scars ,Mastopexy ,Mammoplasty ,Mastectomy, Segmental ,Surgical Flaps ,Surgery ,Cohort Studies ,Radiation therapy ,Plastic surgery ,Treatment Outcome ,Otorhinolaryngology ,Case-Control Studies ,Breast-conserving surgery ,Humans ,Medicine ,medicine.symptom ,business ,Retrospective Studies - Abstract
Breast remodeling following breast-conserving surgery (BCS) and radiation therapy (RT) is challenging and often burdened by complications due to irradiated tissue atrophy. The authors present a case–control study to compare the central mound mastopexy (CMM) to more conventional techniques, applying it to different patterns of skin excision. A variation of the original central mound technique is presented separately addressing glandular and cutaneous deformities. Between 2012 and 2018, 17 consecutive patients presenting defects following unilateral BCS and RT underwent breast remodeling with CMM technique. Immediate and long-term complications together with patient-reported outcomes were evaluated and compared to a matched control group of sixteen patients who underwent superior pedicle mammoplasty. Two independent plastic surgeons reviewed pre- and postoperative photographs and rated the cosmetic outcomes on a visual analog scale from 1 to 5. In the study group, different patterns of skin excision, i.e., inverted-T pattern (41.2%), circumareolar (23.5%), skin-sparing type V (17.65%), omega (11.77%), and J (5.88%), were used to correct various breast deformities, and a decisional algorithm was developed. No major complications were registered. Retraction recurrence rate was higher in the control group (p = 0.037). Cosmetic results were considered more satisfying in the CMM group by both patients (4.18 vs 3.00, p
- Published
- 2021
44. Small Scars Lead to Better Results? Analysis of the Long-Term Outcomes of Patients Undergoing Male Chest Remodeling Surgery in Patients with Maximum Weight Loss
- Author
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Mauro Barone, Annalisa Cogliandro, and Paolo Persichetti
- Subjects
Surgery - Published
- 2022
45. Cultural Approach Defining Beauty
- Author
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Mauro Barone, Annalisa Cogliandro, and Paolo Persichetti
- Subjects
Surgery - Published
- 2022
46. The imperfect beauty
- Author
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Francesco Velardi, Annalisa Cogliandro, and Paolo Persichetti
- Subjects
Aesthetics ,business.industry ,media_common.quotation_subject ,Beauty ,Medicine ,Surgery ,Imperfect ,business ,media_common - Published
- 2021
47. 'Thou Shalt Not Throw Away a Living Thing': Innovative Use of Perforator Flaps in Abdominal Wall Reconstruction
- Author
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Beniamino Brunetti, Marco Morelli Coppola, Silvia Ciarrocchi, Rosa Salzillo, Stefania Tenna, and Paolo Persichetti
- Subjects
Abdominal Wall ,Abdominoplasty ,Humans ,Surgery ,Prostheses and Implants ,Plastic Surgery Procedures ,Surgery, Plastic ,Surgical Mesh ,Perforator Flap - Abstract
Abdominal wall reconstruction represents a complex challenge for plastic surgeons, given the variable range of clinical situations requiring restoration of abdominal wall integrity. When significant myofascial defects are encountered, repair with either a synthetic or biological mesh is indicated, both of which have advantages and drawbacks. Taking inspiration from Gillies' fourth commandment of plastic surgery- Thou shalt not throw away a living thing -an innovative technique to obtain a vascularized autologous mesh from the tissues usually discarded during abdominal contouring procedures was conceived. The authors describe how to maximize the use of perforator flaps derived from abdominoplasty excision patterns in abdominal wall reconstruction to simultaneously obtain restoration of abdominal wall integrity and improvement of the abdominal contour.
- Published
- 2022
48. Breast reconstruction using the Profunda Artery Perforator (PAP) flap: technical refinements and evolution, outcomes and patient satisfaction based on 116 consecutive flaps
- Author
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Matteo Atzeni, Richard M Haywwod, Paolo Persichetti, Andrea Figus, and Rosa Salzillo
- Subjects
medicine.medical_specialty ,Wound dehiscence ,business.industry ,Mammaplasty ,Deep Inferior Epigastric Artery ,Breast Neoplasms ,Arteries ,medicine.disease ,Surgery ,Venous thrombosis ,Hematoma ,Patient satisfaction ,Postoperative Complications ,Patient Satisfaction ,Seroma ,medicine ,Quality of Life ,Humans ,Fat necrosis ,Female ,Breast reconstruction ,business ,Perforator Flap ,Retrospective Studies - Abstract
Introduction When a Deep Inferior Epigastric Artery flap is not suitable, the Profunda Artery Perforator (PAP) flap can be a good alternative for autologous breast reconstruction. Popularity of the PAP flap is expanding, but it is still only slowly being adopted worldwide. We report our experience with 116 consecutive PAP flaps showing refinements and evolution of the technique towards improvement in outcomes and patients' satisfaction. Methods We prospectively collected data from consecutive PAP flap breast reconstructions performed from 2016 to 2019. Patients' demographics, pre-, intra-, postoperative data and revision procedures were analyzed. The BREAST-Q and a specific questionnaire investigating outcomes at the donor site were completed preoperatively and 12 months postoperatively. Results One-hundred and sixteen PAP flaps were performed in 86 patients, 64 unilateral and 22 bilateral breast reconstructions. Mean body mass index was 24.72 kg/m2 (range 18.9-29.2) and mean flap weight was 251.30g (range 152g – 455g). Complications included donor site hematoma (1.7%), seroma (2.6%), fat necrosis (1.7%) and wound dehiscence (2.6%). No arterial/venous thrombosis nor flap losses were recorded. Patients reported high satisfaction in all BREAST-Q domains, with mean postoperative scores being higher than preoperative ones, suggesting a positive effect in quality of life and satisfaction. Scores were significant in the satisfaction with breast domain (p= 0.0016). Conclusions Breast reconstruction with PAP flap yields a high success, low complications and excellent cosmetic outcomes in the breast and donor sites. It improves patients' satisfaction and quality of life; hence it can be considered an excellent option for autologous breast reconstruction.
- Published
- 2022
49. Characterization of Contractile Forces Generated by Stretch Marks Fibroblasts: In Vitro Study
- Author
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Umberto Rega, Francesco D'Andrea, Concetta Errico, Paolo Persichetti, Jean Paul Meningaud, Rosita Pensato, Simone La Padula, Chiara Pizza, Barbara Hersant, Pensato, R., Hersant, B., Pizza, C., Errico, C., D'Andrea, F., Rega, U., Persichetti, P., Meningaud, J. P., and La Padula, S.
- Subjects
Contraction (grammar) ,business.industry ,Fibroblasts ,Matrix (biology) ,Collagen lattice ,Ascorbic acid ,medicine.disease ,Stretch mark ,medicine.anatomical_structure ,Stretch marks ,medicine ,Biophysics ,Fibroblast ,Humans ,Striae distensae ,In vitro study ,Surgery ,Collagen ,Platelet rich plasma ,medicine.symptom ,Striae Distensae ,business ,Muscle Contraction - Abstract
Authors present a study about the contraction forces observed in striae distensae fibroblasts (SMF) in a collagen scaffold. Collagen lattices were used to study the mechanical behavior of SDF within the collagen matrix compared to the lattices produced using the healthy skin derived fibroblasts (NSF). A Forcebox device was used to measure the contractile forces. Striae Rubrae fibroblast’s contractile force was by 28% greater than that generated by the NSF and striae albae fibroblasts (P
- Published
- 2021
50. The Nonsurgical Rhinoplasty: A Retrospective Review of 5000 Treatments
- Author
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Annalisa Cogliandro, Paolo Persichetti, and Mauro Barone
- Subjects
Retrospective review ,medicine.medical_specialty ,business.industry ,General surgery ,medicine.medical_treatment ,medicine ,Surgery ,business ,Rhinoplasty - Published
- 2021
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