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en: Analysis of Characteristics and Outcomes of Multimodal Therapy for Soft Tissue Sarcoma

ja: 当科で治療した悪性軟部腫瘍の内容と予後および術後機能に関する分析

en: Journal of Japan Society of Plastic and Reconstructive Surgery

ja: 日本形成外科学会会誌


en: Cyclical Stretching Induces Excess Intracellular Ca2+ Influx in Human Keloid-Derived Fibroblasts In Vitro

en: The incidence of keloids is higher in the case of darker skin. It is more common in the parts exposed to stretching (thorax, abdomen, and joints). Cyclical stretching reportedly induced each Ca2+ spike through differential mechanosensitive channels in human synovial and dermal fibroblasts. Therefore, the authors hypothesized that cyclical stretching also induces a specific Ca2+ spike in keloid-derived fibroblasts. This in vitro study compared the intracellular calcium dynamics induced by cyclical stretching between control (human dermal fibroblasts) and keloid (human keloid-derived fibroblasts) groups. Each group was exposed to two-dimensional stretch using an originally developed stretch microdevice. Intracellular Ca2+ was observed for 5 minutes, including 30 seconds of baseline, under a fluorescent confocal laser microscope. The intracellular Ca2+ concentration was evaluated every 0.5 second using the fluorescence intensity ratio. A positive cellular response was defined as a rise of the ratio by greater than or equal to 20%. The normal response cutoff value was determined by receiver operating characteristic analysis. The keloid groups were significantly more responsive than the control groups (15.7% versus 8.2%; P = 0.029). In the cellular response-positive cells, the keloid groups reached significantly higher intracellular Ca2+ concentration peaks than the control groups (2.20 versus 1.26; P = 0.0022). The cutoff value was 1.77, and 10.4% of the keloid-derived fibroblasts exhibited a hyper-Ca2+ spike above the normal range. Keloid-derived fibroblasts with a hyper-Ca2+ spike might constitute a keloid-specific subpopulation. Hereafter, the authors will study whether the normalization of excessive intracellular Ca2+ concentration leads to keloid treatment in vivo. This study result provided a clue to the onset mechanism of keloids, which the authors hope will lead to the development of new therapy in the future.

en: Plastic and Reconstructive Surgery

ja: Plastic and Reconstructive Surgery


en: 四肢機能温存のために筋肉移植と関節包再建を行った症例の検討:最善の Orthoplastic Surgery を考える

en: 第49回日本マイクロサージャリー学会学術集会

ja: 第49回日本マイクロサージャリー学会学術集会


en: 第49回日本マイクロサージャリー学会学術集会

ja: 第49回日本マイクロサージャリー学会学術集会


en: BIA ALCLを疑い検査を施行した乳房インプラント破損の2症例

ja: BIA ALCLを疑い検査を施行した乳房インプラント破損の2症例

en: 第10回日本乳房オンコプラスティックサージャリー学会総会

ja: 第10回日本乳房オンコプラスティックサージャリー学会総会


en: Radiographic Study Evaluating Perforator Vessels in the Ischiorectal Fossa for Safe Elevation of Island Flaps

en: Perforator flaps based on the ischiorectal fossa (IRF) (ie, internal pudendal artery perforator flaps) are useful for perineal reconstruction. The three-dimensional characterization of perforator arteries in the IRF remains unclear, as the IRF contains thick adipose tissue as well as organs, such as the rectum, vagina, and urethra. This study aimed to evaluate perforators in the IRF to guide the safe elevation of skin flaps designed based on the IRF. IRF vessels were examined in 200 bilateral computed tomography angiography scans performed in 100 patients. We examined branching patterns arising from the internal iliac artery and the origins of the skin perforators in the IRF. The branching patterns of the internal iliac artery were divided into three groups: perforators derived exclusively from the internal pudendal artery (78%), perforators derived from the internal pudendal artery and the inferior gluteal artery (18%), and perforators derived exclusively from the inferior gluteal artery (4%). The average number of perforators in the IRF was 1.5 ± 0.7. The number of perforators was significantly higher in women than in men. The perforator arteries were found exclusively around the medial and dorsal sides of the ischial tuberosity. We found that perforators in the IRF were stable. All cases had more than one skin perforator, which was mainly derived from the internal pudendal artery. Although perforators cannot be identified during flap elevation because the fatty tissue in the IRF is very thick, physicians must focus on preserving the perforator-containing fatty tissue around the ischial tuberosity.

en: Plastic and Reconstructive Surgery. Global Open


en: One-Stage Perifascial Areolar Tissue and Skin Grafting Combined with Negative Pressure Wound Therapy for a Refractory Wound with an Exposed Elbow Joint and Extensive Skin Defect

en: The Indian Journal of Surgery

ja: The Indian Journal of Surgery


en: Massive Weight Lossによる余剰皮膚切除後に膝部にリンパ漏を生じた1例

en: 第45回日本美容形成外科学会総会・第145回学術集会

ja: 第45回日本美容形成外科学会総会・第145回学術集会


en: 頚椎後方固定術後の離開創に対して異物除去を行わず僧帽筋皮弁による再建を施行した一例

en: 第81回中国・四国形成外科学会学術集会

ja: 第81回中国・四国形成外科学会学術集会


en: 下眼瞼欠損再建手術における術後変形に関する実態調査および内容についての全例前向き調査

en: 第81回中国・四国形成外科学会学術集会

ja: 第81回中国・四国形成外科学会学術集会


en: LVAの吻合部決定に術前エコー検査が有用であった症例の検討

ja: LVAの吻合部決定に術前エコー検査が有用であった症例の検討

en: 第6回日本リンパ浮腫治療学会学術総会

ja: 第6回日本リンパ浮腫治療学会学術総会


en: Ischial and Sacral Pressure Ulcers A Review of Optimal Treatments, Historical Management, and Surveillance Studies of the Japanese Population

en: International Journal of Surgical Wound Care


en: Treatment of Critical Limb Ischemia Using Microsurgery Techniques

ja: マイクロサージャリーの技術を用いた重症下肢虚血治療とその成績

en: Journal of Japanese Society of Reconstructive Microsurgery

ja: 日本マイクロサージャリー学会会誌


en: 頚椎後方固定術後の離開創に対して異物除去を行わず僧帽筋皮弁による再建を施行した1例

en: 第26回徳島形成外科集談会

ja: 第26回徳島形成外科集談会


en: 第26回徳島形成外科集談会

ja: 第26回徳島形成外科集談会


en: Relationship between fluctuations in skin perfusion pressure values and wound healing in patients with chronic limb-threatening ischemia undergoing hemodialysis

en: Background : Patients with chronic limb-threatening ischemia are often on hemodialysis. It is unclear which skin perfusion pressure (SPP) values, i.e., those measured immediately after hemodialysis on a hemodialysis day or those measured on a non-hemodialysis day, reflect the actual wound healing course in chronic limb-threatening ischemia. Methods : Eighteen patients undergoing hemodialysis (49 measurements) who were treated for leg ulcers due to critical limb ischemia were included in the study. The SPP values were divided into two groups : those measured immediately after hemodialysis (HD day group) and those measured on non-hemodialysis days (non-HD day group). The wound healing outcomes were investigated. The cutoff SPP value for predicting wound healing was set to ≥ 35 mmHg. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SPP in each group were measured. The relationship between SPP and blood pressure was analyzed by regression analysis. Results : Significant differences were observed in the positive predictive value (HD day : 100%, non-HD day : 50% ; P = 0.002), The correlation coefficient was 0.698 in the HD day group and 0.292 in the non-HD day group. Diastolic blood pressure had a significant effect on SPP (P = 0.039). Conclusions : The measurements are best taken immediately after hemodialysis for more accuracy. J. Med. Invest. 69 : 294-298, August, 2022.

en: The Journal of Medical Investigation : JMI


en: 5G・ドコモオープンイノベーションクラウド™を用いた形成外科遠隔診療

ja: 5G・ドコモオープンイノベーションクラウド™を用いた形成外科遠隔診療

en: 第265回徳島医学会学術集会

ja: 第265回徳島医学会学術集会


en: 彫刻刀を用いた修正術が有効であったカリフラワー耳の2例

ja: 彫刻刀を用いた修正術が有効であったカリフラワー耳の2例

en: 第14回日本創傷外科学会総会・学術集会

ja: 第14回日本創傷外科学会総会・学術集会


en: A Case of Macrodystrophia Lipomatosa of the Lower Extremity: An Effective Measuring of the Dynamic Plantar Pressure for Severe Congenital Deformity

en: Journal of Plastic and Reconstructive Surgery


en: 耳下腺に浸潤した耳介部基底細胞癌の1例

ja: 耳下腺に浸潤した耳介部基底細胞癌の1例

en: 日本形成外科学会会誌


en: 褥瘡手術後の早期創離開の要因とリスク因子

ja: 褥瘡手術後の早期創離開の要因とリスク因子

en: 第65回日本形成外科学会総会・学術集会

ja: 第65回日本形成外科学会総会・学術集会


en: Lateral Nasal Artery Perforator Flap for Nasal Reconstruction Clinical Applications and Risk Factors Associated With Nasal Deformities

en: Nasal reconstruction is challenging because of the difficulty in balancing superior aesthetic outcomes and less invasive surgery. The use of the lateral nasal artery (LNA) perforator flap has been reported for nasal reconstruction. However, few reports have described appropriate applications of nasal reconstruction and assessments of nasal deformity. This study aimed to quantify the aesthetic outcomes on using this flap and reveal the risk factors associated with nasal deformities. Twenty patients underwent nasal reconstruction using the LNA flap with a cranial perforator adjacent to the nasal defect. Postoperative protuberant deformities were scored by 2 independent plastic surgeons using a 5-point Likert scale and classified as excellent, good, or poor. The risk factors of deformities were identified using univariate analyses. A nasal alar deviation index was developed to analyze correlations with flap harvesting. The sensory function was assessed by the Semmes-Weinstein test. Flaps survived in 19 patients (95%), and 1 flap showed distal necrosis. All arterial perforators used remained within 5 mm lateral to the boundary between the cheek and nasal ala. The flaps were most often used to cover 2 subunits, including the nasal sidewall defects. Protuberant deformities in 6 (30%), 8 (40%), and 6 (30%) patients were classified as excellent, good, and poor, respectively. Nasal defects involving more than 3 subunits caused severe protuberant deformity. Only 2 patients (5%) in the good and fair groups underwent additional debulking surgery. Nasal alar deviation was not significantly correlated with flap harvesting, when the nasal alar deviation index before and after surgery were compared. Sensory function was retained in all patients. Aesthetic outcomes and sensory function were good on using the LNA perforator flap as a propeller flap having a wide arc of rotation. This flap is suitable for nasal reconstruction involving less than 2 nasal subunits without any severe nasal alar deviation deformity. In addition, this flap allows for better outcomes because it requires less invasive 1-stage surgery.

en: Annals of Plastic Surgery

ja: Annals of Plastic Surgery


en: Sentinel lymph node biopsy for cutaneous malignant melanoma ; clinical significance

ja: 徳島大学病院で実施された皮膚悪性黒色腫に対するセンチネルリンパ節生検の臨床的意義について

en: Skin Cancer

ja: Skin Cancer


en: Critical limb ischemia as a consequence of multiple spontaneous arteriovenous fistula and peripheral arterial disease.

ja: International Journal of Surgical Wound Care


en: Analysis of Risk Factors Associated With Drooping Deformity After Lower Eyelid Reconstruction

en: Lower eyelid reconstruction is challenging because of the risk of severe postreconstruction deformities of the lower eyelid, such as drooping, entropion, and ectropion. However, the risk factors for these postreconstruction deformities are unclear. The present study aimed to quantify the drooping deformity of the lower eyelid after reconstruction using a cheek rotation flap and to identify risk factors associated with postreconstruction deformities. Our study group included 28 patients who underwent full-thickness lower eyelid reconstruction using a cheek rotation flap for anterior lamella reconstruction. We developed the drooping index to classify postreconstruction outcomes as good (index <1.2), fair (index between 1.2 and 1.5), and poor (index >1.5). We identified risk factors for a drooping deformity using univariate analyses (Mann-Whitney U or Spearman rank correlation, depending on data distribution). Overall, the drooping index ranged between 1.0 and 2.11, with an average value of 1.3. A good outcome was obtained in 11, a fair outcome in 12, and a poor outcome in 5 patients. Clinically severe ectropion was observed in five of the 17 patients in the fair and poor outcome groups, with four of these patients requiring revision surgery. Risk factors for postreconstruction drooping deformity included medial location of the tumor, resection involving more than 50% of the horizontal width of the lower eyelid, and dissection of subcutaneous tissue of the cheek extending below the zygomatic arch. A cheek rotation flap provides satisfactory outcomes for full-thickness reconstruction of the lower eyelid. Extension of dissection of subcutaneous tissue of the cheek below the zygomatic arch increases the risk of postsurgical drooping deformity. Our drooping index provides a quantitative measure of drooping deformity and is clinically useful to classify outcomes.


en: Risk factors for delayed healing at the free anterolateral thigh flap donor site

en: The free anterolateral thigh (ALT) flap has been widely used for various kinds of reconstructions. However, delayed healing at the donor site occasionally occurs due to wound dehiscence or the partial loss of grafted skin at the donor site. The aim of the present study was to identify reliable predictive factors for delayed healing at the donor site after the harvest of a free ALT flap. This study included 52 patients who underwent reconstructive procedures using free ALT flaps. The delayed healing group included patients with wounds at the donor site that had not healed over 3 weeks after surgery, and the normal healing group included patients who showed wound healing within 3 weeks after surgery. Multivariate logistic regression models were created to identify the risk factors for delayed healing at the ALT flap donor site. Among the 52 patients, 24 (46.2%) showed delayed healing at the donor site, and 6 patients required additional operative treatment. A high preoperative body mass index (BMI), smoking, and skin grafting were found to be significantly associated with delayed healing at the ALT donor site. Of the 37 patients who underwent skin grafting, 23 (62%) experienced delayed healing at the donor site. A high preoperative BMI, smoking, and skin grafting were risk factors for delayed healing at the free ALT donor site. Skin grafting at the ALT donor site should be avoided in patients with a high BMI or a habit of smoking.

en: Archives of Plastic Surgery

ja: Archives of Plastic Surgery


en: Proximal nail fold flap for digital mucous cyst excision

en: The skin covering a digital mucous cyst is often very thin and is often excised with the cyst. Thus, transfer of a skin flap is needed for the defect. We have developed a proximal nail fold flap technique by which the thin skin covering the cyst can be preserved. We conducted a retrospective study to assess the effectiveness and reliability of this technique for digital mucous cyst excision. The study group comprised 26 patients treated for 28 digital mucous cysts. The flap was elevated on the nail matrix to expose the distal interphalangeal joint capsule. To preserve the skin in cases in which the skin covering the cyst was exceptionally thin, we did not excise the upper part of the cyst wall. Excision of the cyst and stalk was successful in all cases. Additional excision of the joint capsule or osteophyte(s) was achieved in 20 cases and 5 cases, respectively. No flap necrosis, skin defect or nail deformity resulted. Three of the cysts recurred and were treated successfully by reoperation involving the same flap elevation technique. We conclude that the proximal nail fold flap is useful for excision and reliable for wound coverage after digital mucous cyst excision. J. Med. Invest. 63: 278-280, August, 2016.

ja: The Journal of Medical Investigation : JMI


en: Reduction mammaplasty and mastopexy for the contralateral breast after reconstruction surgery following canser resection : A report of 3 cases

en: Breast reconstruction generally involves autologous tissue transplantation and placement of a mammary prosthesis. When the patient's breasts are extremely large and ptotic, breast reconstruction often results in significantly asymmetrical appearance. However, a good aesthetic outcome after reconstruction surgery following cancer resection is an important quality-of-life factor. We evaluated the efficacy of touch-up surgery, either reduction mammaplasty or mastopexy, performed on the contralateral breast for symmetrization. Reduction mammaplasty was performed on the contralateral breast in 2 patients and mastopexy was performed on the contralateral breast in 1 patient after reconstruction surgery following cancer resection, between 2008 and 2014. We reviewed each patient's medical record for general clinical information and for the methods of breast cancer resection and breast reconstruction used, wait time between breast cancer resection and touch-up surgery, preservation of the sensitivity of the nipple-areola complex after the touch-up surgery, and aesthetic outcome (based on visual analog scale score). Wait times in the 3 cases were 4, 9, and 18 months. Nipple-areolar sensitivity was well preserved in all 3 cases. Aesthetic outcomes were judged "excellent" or "very good." Revision surgery on the contralateral breast 4 to 18 months after breast reconstruction substantially improves the aesthetic outcome. J. Med. Invest. 63: 281-285, August, 2016.

en: The Journal of Medical Investigation : JMI


en: 切除術より20年後に再発した足部の筋血管周皮腫の1例

ja: 切除術より20年後に再発した足部の筋血管周皮腫の1例

en: Tokushima Red Cross Hospital Medical Journal

ja: 徳島赤十字病院医学雑誌