Biomedical subjects

D Voulliaume

Publications and source records attributed to D Voulliaume.

7 recordsLinked to original sources

PubMed2005

[The abdominal flap-graft for coverage of soft tissue defects of the dorsum of hand and fingers in burn patients. Six cases reports].

We report six cases of abdominal flap-graft used to cover post-burn soft tissue defects of hands. The technique used was first described by Colson and is applied in our study to an abdominal donor site. Debulking of the flap at the time of elevation resulted in a skin quality as good as a full thickness graft without jeopardizing flap vitality and reliability. Digit mobilization was possible after separation. Long term functional results were found to be satisfactory, specially for the hand. For the fingers it is mostly a digit-rescue surgery. The application of this technique remains sparse. Still, the abdominal flap-graft is often useful in cases of burn patients because of the poor local conditions, as well as the magnitude and nature of injury, which limit the coverage options.

Adolescent↗

PubMed2005

[Reduction mammaplasty using superior pedicle in macromastia].

SUBJECT: The authors present technical details, complications, morphologic and aesthetic results of 26 breast reduction mammaplasty for macromastia (breast reduction more than 1000 g) showing advantages and reliability of technique. MATERIALS AND METHODS: From January 2000 to December 2001, 223 patients underwent bilateral reduction mammaplasty with superior-based pedicled dermo-glandular flap. In 26 of them the weight of removed mammary tissue was over 1000 g in each breast. These 26 cases were evaluated, and the criteria adopted to analyse the results was morphologic and aesthetic evaluation of patient herself (very good, good, acceptable, unacceptable). RESULTS: Mean follow-up for all patients was 15 months. Twenty-six patients (mean age 33.2 years) underwent an average weight of 1131 g (930/2200 g) removed per breast. The following complications were observed: 1 Nipple Areolar Complex ischemia without necrosis; three infections (abscess); four delayed wound closure. The patient subjective evaluation of result was: "very good" in 19 cases (73%); "good" in 5 cases (19.2%) and "acceptable" in the others two cases (7.8%). No case was evaluated "unacceptable". CONCLUSION: Superior dermoglandular pedicle mammaplasty represent a very good and reliable solution for the treatment of macromastia, giving satisfactory cosmetics results with good nipple viability without necrosis. This technique is actually our first choice in the management of macromastia.

Adolescent↗

PubMed2005

[Severe hand burns and flaps: indications].

Deep hand burns often leads to major deformities, involving cosmetic and functional disease as scar contracture, stiffness, or even amputation. Early surgical treatment and rehabilitation are always challenging but crucial in order to prevent burn sequelae. When tendinous, osseous, nervous or vascular component are involved, even hand vitality is engaged: cutaneous, fasciocutaneous, muscular or musculocutaneous flaps are then the only way of salvage for the hand. The purpose of this surgery is the early covering of essential components, allowing early rehabilitation and mobilisation. The problem remains the choice of surgical covering, according to the site, size, and depth of the burn, and local reliable opportunities. Care must be taken to preserve surgical ways for final sequela reconstruction.

Burns↗

PubMed2004

[Clinical evaluation of structural fat tissue graft (Lipostructure) in volumetric facial restoration with face-lift. About 100 cases].

INTRODUCTION: Adipose tissue has been used for volume restoration for over a century. Coleman's Lipostructure is a recent procedure for adipocyte transfer, based on strict methodology and the use of specific material. Our aim in this work is to provide an answer to several questions: what is the place of this technique in the restoration of facial volumes? Do aesthetic subunits have an impact on the result? MATERIAL AND METHODS: This retrospective study concerned 100 patients who had undergone volumetric facial restoration with face-lift and Lipostructure. A five-member jury carried out subjective evaluation through a questionnaire sent to the patients, and objective evaluation by assessment of pre- and postoperative photographs. RESULTS: Mean time since surgery was 15 months. Overall patient satisfaction was 82% with a mean score of 15/20 on subjective evaluation and of 13.3/20 on objective evaluation. The results differed significantly according to the facial aesthetic subunit involved, the best results being obtained in the malar region and the cheek, and the least satisfactory in the upper and lower lips. This technique has few drawbacks. Prolonged oedema is the only complication (8%). CONCLUSION: We consider that at the present time Lipostructure is the best means of restoring facial volume. It is a simple, effective and reproducible technique. Its application in all fields of plastic surgery is an essential adjunct to our specialty.

Adipose Tissue↗

PubMed2004

[Surgical repair of flexor tendon pulley rupture in high level rock climbing].

INTRODUCTION: Twelve high-level rock climbers were operated on for flexor tendon pulley rupture. Circumstances of pulley rupture and contributing factors are studied; postoperative improvement is evaluated by rock climber level increase, compared to the initial level. METHOD: Average age was 28 years and there were nine males and three females; all of them were high-level rock climbers, succeeding at least in 7a climbing ways before the accident. The surgical procedure was to replace the deficient pulley using an extensor retinaculum graft. RESULTS: The non-dominant hand was the most frequently involved, and especially A2 pulley of the fourth finger. Diagnosis was easy and clinically established. DISCUSSION: Medical or functional treatments never allowed climbers to reach their former level. The only efficient treatment was surgical, whatever the time elapsed between injury and surgery. After this surgical procedure, five of the twelve patients improved their results, five recovered their former level and two decreased. The results are analysed and compared to other surgical procedures. CONCLUSION: Surgical repair of rupture of flexor tendon pulley during sport is the only efficient treatment allowing the rock climber to recover and improve its performance.

Adult↗

PubMed2003

[An unusual risk of liposuction: liposuction of a malignant tumor. About 2 patients].

Liposuction is a simple and elegant way to treat fatty excess; it has been even used for the treatment of lipomas and some gynecomasties. The goal of this article is to present 2 patients with an unusual complication of this use: the liposuction of a malignant tumor. The first patient consulted following the liposuction of a "gynecomasty", which was in fact a breast cancer. The second was treated by liposuction for an ankle "lipoma"; it proved to be a liposarcoma. In order to avoid liposuction and dissemination of a malignant tumor, the pre-operative investigations have to search clinical peculiarities evoking the diagnosis: an unilateral "gynecomasty", irregular, hard or painless, in a 50-years-old patient, must incite the surgeon to perform a classical excision, just as a recurrent "lipoma", deeply located, voluminous or quickly extensive, situated on the limbs or in the humeroscapular area. Paraclinic investigations may be indicated; doubtful cases must be right away rejected for liposuction, and treated by a surgical excision with strict safety margins and complete anatomopathologic examination of the lesion. Liposuction has become a very useful technique for the plastic surgeon; however, we must not forget, despite of its many advantages the risk for dissemination of an unknown malignant tumor. Every surgeon must keep it in mind and prefer a surgical removal in atypical cases.

Breast Neoplasms↗

PubMed2003

[Anchovy dacron arthroplasty in the treatment of basal osteoarthritis of the thumb: long term results].

INTRODUCTION: Fifteen patients were treated for arthritis of the base of the thumb by trapieziumectomy and anchovy interposition using Dacron[symbol: see text]. The results are described. METHODS: The 15 patients were between 42- and 68-years-old at the time of operation. The mean postoperative follow-up was 3 years. Pain, pinch strength, opposition, opening of the first web space and height of the space formerly occupied by the trapezium were clinically and radiologically evaluated. RESULTS: Pain had completely disappeared in more than 80% of the patients. The mean post-surgical opposition was 8.9/10 (Kapandji score). The pinch strength and first web-space opening were improved, whereas the height of the trapezium site was always reduced by 25%. The only complication was one case of reflex sympathetic dystrophy: no case of foreign body reaction was reported. Eleven of the 15 patients were satisfied with the operation, and noted better thumb function in everyday life. DISCUSSION: The treatment of arthritis of the base of the thumb by means of trapieziumectomy and anchovy interposition is effective with respect to pain in all the studies previously published, whatever the technique used. Mobility is preserved, contrary to arthrodesis, and grip strength remains compatible with the patient's daily life. The choice of a synthetic anchovy such as Dacron[symbol: see text] allows a quicker operation and better than the ones involving sacrifice of a tendon at the wrist. Anchovy interposition remains the preferred alternative among other procedures in the treatment of basal osteoarthritis of the thumb.

Adult↗