Publications avec comité de lecture
Publications 2023 du Dr LUPON Élise
Response to: Parasacral Perforator Flaps for Buttock Enhancement
Publications 2022 du Dr LUPON Élise
Acellular Nipple Scaffold Development, Characterization, and Preliminary Biocompatibility Assessment in a Swine Model
Acellular Nipple Scaffold Development, Characterization, and Preliminary Biocompatibility Assessment in a Swine Model
Ruben V Oganesyan, Alexandre G Lellouch, Aylin Acun, Elise Lupon, Corentin B Taveau, Laura C Burlage, Laurent A Lantieri, Mark A Randolph, Curtis L Cetrulo Jr, Basak E Uygun
https://pubmed.ncbi.nlm.nih.gov/36472499/
Abstract
Background: The standard in nipple reconstruction remains the autologous skin flap. Unfortunately, the results are not satisfying, with up to 75% loss of nipple projection over time. Existing studies investigated the use of primates as a source of implants. The authors hypothesized that the porcine nipple can serve as a perfect shape-supporting implant because of functional similarities to the human nipple. A decellularization protocol was developed to obtain an acellular nipple scaffold (ANS) for nipple reconstruction.
Methods: Tissue samples were collected from eight disease-free female Yorkshire pigs (60 to 70 kg) and then decellularized. The decellularization efficiency and extracellular matrix characterization was performed histologically and quantitatively (DNA, total collagen, elastin, and glycosaminoglycan content). In vitro and in vivo biocompatibility was determined by human dermal fibroblast culture and subcutaneous implantation of six ANSs in a single Yorkshire pig (60 to 70 kg), respectively. Inflammation and adverse events were monitored daily based on local clinical signs.
Results: The authors showed that all cellular structures and 96% of DNA [321.7 ± 57.6 ng DNA/mg wet tissue versus 11.7 ± 10.9 ng DNA/mg wet tissue, in native and ANS, respectively ( P < 0.001)] can be successfully removed. However, this was associated with a decrease in collagen [89.0 ± 11.4 and 58.8 ± 9.6 μg collagen/mg ( P < 0.001)] and elastin [14.2 ± 1.6 and 7.9 ± 2.4 μg elastin/mg ( P < 0.05)] and an increase in glycosaminoglycan content [5.0 ± 0.7 and 6.0 ± 0.8 ng/mg ( P < 0.05)]. ANS can support continuous cell growth in vitro and during preliminary biocompatibility tests in vivo.
Conclusion: This is a preliminary report of a novel promising ANS for nipple reconstruction, but more research is needed to validate results.
Clinical relevance statement: Breast cancer is very common among women. Treatment involves mastectomy, but its consequences affect patient mental well-being, and can lead to depression. Nipple-areola complex reconstruction is critical, and existing methods lead to unsatisfactory outcomes.
Copyright © 2022 by the American Society of Plastic Surgeons.
A Dynamic Anatomic Study of Parasacral Perforators: Mapping, Perforasome, and Applications for Buttock Enhancement
A Dynamic Anatomic Study of Parasacral Perforators: Mapping, Perforasome, and Applications for Buttock Enhancement
Gilles Claro, Elise Lupon, Farouk Dargai, Farid Bekara, Fatima Zohra Mokrane, Benoit Chaput
https://pubmed.ncbi.nlm.nih.gov/35665801/
Abstract
Background: Due to the lack of knowledge about parasacral artery perforators, flaps from this region cannot be used with complete confidence in their security and effectiveness. Knowledge of the clusters and perforasome of these perforators could help in the design of more reliable flaps and extend the range of applications.
Objectives: This study aimed to identify the location, number, and density of perforators, and to subsequently analyze the perfusion flow and linking vessel distribution.
Methods: Five fresh cadavers were harvested and dissected. For the mapping, after injecting lateral sacral arteries with colored latex, perforators with a diameter of >0.5 cm were examined in 5 sacral regions. All data were collected on the suprafascial plane, with an orthonormal coordinate system placed on iliac crests and median lines. For perforasome analysis, 5 perforators and 3 three sacral flaps were injected with radiopaque dye. A dynamic (4-dimensional) computed tomographic angiography completed the analysis.
Results: A mean [standard deviation] of 8.4 [1.36] perforators per corpse, with a mean diameter of 0.72 [0.14] mm, were identified. There was a higher density of parasacral perforators close to the median line and 7.6 cm above the iliac crests. This pattern was not a random distribution (P < 0.05). The perfusion area was preferentially in the superior gluteal region. Perfusion flow was permitted by the dominant direct-linking vessels towards adjacent lumbar perforators, oriented diagonally upward and outward to the midline.
Conclusions: Parasacral perforator flaps appear to be a useful procedure in reconstruction and in aesthetic surgery, especially in gluteal augmentation. Their reliability depends on sound anatomic knowledge, with accurate preoperative perforator mapping.
© The Author(s) 2022. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
A Reliable Porcine Fascio-Cutaneous Flap Model for Vascularized Composite Allografts Bioengineering Studies
A Reliable Porcine Fascio-Cutaneous Flap Model for Vascularized Composite Allografts Bioengineering Studies
Victor Pozzo, Golda Romano, Marion Goutard, Elise Lupon, Pierre Tawa, Aylin Acun, Alec R Andrews, Corentin B Taveau, Basak E Uygun, Mark A Randolph, Curtis L Cetrul, Alexandre G Lellouch
https://pubmed.ncbi.nlm.nih.gov/35435906/
Abstract
Vascularized Composite Allografts (VCA) such as hand, face, or penile transplant represents the cutting-edge treatment for devastating skin defects, failed by the first steps of the reconstructive ladder. Despite promising aesthetic and functional outcomes, the main limiting factor remains the need for a drastically applied lifelong immunosuppression and its well-known medical risks, preventing broader indications. Therefore, lifting the immune barrier in VCA is essential to tip the ethical scale and improve patients’ quality of life using the most advanced surgical techniques. De novo creation of a patient-specific graft is the upcoming breakthrough in reconstructive transplantation. Using tissue engineering techniques, VCAs can be freed of donor cells and customized for the recipient through perfusion-decellularization-recellularization. To develop these new technologies, a large-scale animal VCA model is necessary. Hence, swine fascio-cutaneous flaps, composed of skin, fat, fascia, and vessels, represent an ideal model for preliminary studies in VCA. Nevertheless, most VCA models described in the literature include muscle and bone. This work reports a reliable and reproducible technique for saphenous fascio-cutaneous flap harvest in swine, a practical tool for various research fields, especially vascularized composite tissue engineering.
Breasts and congenital chest-wall deformities: Surgical strategy with 3D implants
Breasts and congenital chest-wall deformities: Surgical strategy with 3D implants
J-P Chavoin, S Gandolfi, P Leyx, F Facchini, C Schirmer, J-L Grolleau, E Lupon, B Chaput
https://pubmed.ncbi.nlm.nih.gov/35931576/
Abstract
Computer-aided design and manufacturing of custom-made elastomer implants leads from a CT scan to fill in with precision, a congenital chest wall congenital deformity, both bone (pectus excavatum) and muscle (Poland Syndrome), resulting in a natural repositioning of the breasts. We report our 25 years’ experience in 301 women (234 Pectus+64 Poland). Parietal correction must always be done in first intention. It is common to have to carry out a second stage in women with an additional mammaplasty especially in the presence of insufficient glandular volume or a fairly frequently associated tuberous breast.
Keywords: Asymétrie mammaire; Breast asymmetry; Computer-aided design; Computer-aided manufacturing; Conception assistée par ordinateur; Custom-made implants; Fabrication assistée par ordinateur; Implants de silicone; Implants sur mesure; Pectus excavatum; Poland syndrome; Seins tubéreux; Silicone Implants; Tuberous breasts.
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Combinatorial Use of Therapeutic ELP-Based Micelle Particles in Tissue Engineering
Combinatorial Use of Therapeutic ELP-Based Micelle Particles in Tissue Engineering
Beyza Bulutoglu, Aylin Acun, Sarah L Deng, Safak Mert, Elise Lupon, Alexandre G Lellouch, Curtis L Cetrulo Jr, Basak E Uygun, Martin L Yarmush
https://pubmed.ncbi.nlm.nih.gov/35373501/
Abstract
Elastin-like peptides (ELPs) are a versatile platform for tissue engineering and drug delivery. Here, micelle forming ELP chains are genetically fused to three therapeutic molecules, keratinocyte growth factor (KGF), stromal cell-derived growth factor 1 (SDF1), and cathelicidin (LL37), to be used in wound healing. Chronic wounds represent a growing problem worldwide. A combinatorial therapy approach targeting different aspects of wound healing would be beneficial, providing a controlled and sustained release of active molecules, while simultaneously protecting these therapeutics from the surrounding harsh wound environment. The results of this study demonstrate that the conjugation of the growth factors KGF and SDF1 and the antimicrobial peptide LL37 to ELPs does not affect the micelle structure and that all three therapeutic moieties retain their bioactivity in vitro. Importantly, when the combination of these micelle ELP nanoparticles are applied to wounds in diabetic mice, over 90 % wound closure is observed, which is significantly higher than when the therapeutics are applied in their naked forms. The application of the nanoparticles designed here is the first report of targeting different aspect of wound healing synergistically.
Keywords: cathelicidin; elastin-like peptides; keratinocyte growth factor; micelle particles; protein engineering; stromal cell-derived growth factor 1; wound healing.
© 2022 The Authors. Advanced Healthcare Materials published by Wiley-VCH GmbH.
Complications and quality of life after bodylift: About 143 patients
Complications and quality of life after bodylift: About 143 patients
J Heranney, E Lupon, D Guillier, D Feuvrier, I Pluvy
https://pubmed.ncbi.nlm.nih.gov/36028411/
Abstract
Introduction: The rise of bariatric surgery has led to a considerable increase in the demand for weight loss surgery. The lower body lift consists of removing the residual abdominal fat and skin excess and re-tensioning the surfaces. The objective of our study was to evaluate the associated complications, as well as the consequences of this surgery on the quality of life of the patients.
Materials and methods: A retrospective monocentric study was conducted in patients operated on for lower body lift between 2010 and 2019 at the University Hospital of Besançon. We collected postoperative complications and studied the satisfaction and quality of life of the operated patients using the Body-QoL and SF-36 questionnaires.
Results: One hundred forty-three patients were included with a mean age of 41.2 years. The mean body mass index was 26.6kg/m2 with a mean weight of 73.8kg and a mean weight loss of 54.4kg. Forty-one patients (29.7%) had at least one complication. Most complications were minor, with 16.8% of scar disunions, and 7% of complications were major, requiring revision surgery. Ninety-three patients (65%) responded to the satisfaction questionnaires with improvement mostly in physical symptoms and social life.
Conclusion: The lower body lift is an effective, safe procedure with mostly minor complications that do not influence quality of life. Patient satisfaction is high, and it is therefore justified to continue offering this procedure to correct the sequelae of massive weight loss.
Keywords: Amaigrissement massif; Bodylift; Complications; Massive weight loss; Quality of life; Qualité de vie.
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Engineering Vascularized Composite Allografts Using Natural Scaffolds: A Systematic Review
Engineering Vascularized Composite Allografts Using Natural Scaffolds: A Systematic Review
Elise Lupon, Alexandre G Lellouch, Aylin Acun, Alec R Andrews, Ruben Oganesyan, Marion Goutard, Corentin B Taveau, Laurent A Lantieri, Curtis L Cetrulo, Basak E Uygun
https://pubmed.ncbi.nlm.nih.gov/34238047/
Abstract
Vascularized composite allotransplantation (VCA) refers to the transplantation of multiple tissues as a functional unit from a deceased donor to a recipient with a severe injury. These grafts serve as potential replacements for traumatic tissue losses. The main problems are the consequences of the long immunosuppressive drugs and the lack of compatible donor. To avoid these limitations, decellularization/recellularization constitutes an attractive approach. The aim of decellularization/recellularization technology is to develop immunogenic free biological substitutes that will restore, maintain, or improve tissue and organ’s function. A PubMed search was performed for articles on decellularization and recellularization of composite tissue allografts between February and March 2021, with no restrictions in publication year. The selected reports were evaluated in terms of decellularization protocols, assessment of decellularized grafts, and evaluation of their biocompatibility and repopulation with cells both in vitro and in vivo. The search resulted in a total of 88 articles. Each article was reviewed, 77 were excluded, and the remaining 11 articles reported decellularization of 12 different vascular composite allografts in humans (4), large animals (3), and small animals (rodents; 5). The decellularization protocol for VCA varies slightly between studies, but majority of the reports employ 1% sodium dodecyl sulfate as the main reagent for decellularization. The immunological response of the decellularized scaffolds remain poorly evaluated. Few authors have been able to attempt the recellularization and transplantation of these scaffolds. Successful transplantation seems to require prior recellularization. Decellularization/recellularization is a promising, growing, and emerging developing research field in vascular composite allotransplantation. Impact statement Tissue engineering for vascular composite allotransplantation using decellularization and recellularization approach is a fast-growing area of interest in the reconstructive surgery field. This review will be a very useful tool to get a clear overview for researchers interested in this field.
Keywords: decellularization; recellularization; vascularized composite allotransplantation.
Juvenile and tuberous breast hypertrophy
Juvenile and tuberous breast hypertrophy
J L Grolleau, E Lupon, S Gandolfi
https://pubmed.ncbi.nlm.nih.gov/35902286/
Abstract
Adolescence is defined as the period extending from puberty to adulthood, the limit of which is difficult to determine. It is a delicate period, in which the distancing from one’s own body image can have deleterious consequences on psychological development and social-emotional life. Breast hypertrophy and the correction of hypertrophic tuberous breasts in adolescents raise some questions that we will attempt to answer in this article. There are specificities to manage, in relation to surgical indications, resection volume, postoperative follow-up and cutaneous healing.
Keywords: Adolescence; Breast Hypertrophy; Hypertrophie mammaire; Juvenile breast; Sein; Sein tubéreux; Tuberous breast.
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Modified nanofat grafting: Stromal vascular fraction simple and efficient mechanical isolation technique and perspectives in clinical recellularization applications
Modified nanofat grafting: Stromal vascular fraction simple and efficient mechanical isolation technique and perspectives in clinical recellularization applications
Paul Girard, Joelle Dulong, Jerome Duisit, Camille Mocquard, Simon Le Gallou, Benoit Chaput, Elise Lupon, Eric Watier, Audrey Varin, Karin Tarte, Nicolas Bertheuil
https://pubmed.ncbi.nlm.nih.gov/36177178/
Abstract
Background: Nanofat grafting (NG) is a simple and cost-effective method of lipoaspirates with inter-syringe passages, to produce stromal vascular fraction (SVF) and isolate adipose-derived stem cells (ASCs). This represents a tremendous interest in the future clinical needs of tissue engineering. In this study, we optimized the NG technique to increase the yield of ASC extractions.
Methods: We analyzed three groups of SVF obtained by 20, 30, and 40 inter-syringe passages. The control group was an SVF obtained by enzymatic digestion with Celase. We studied their cell composition by flow cytometry, observed their architecture by confocal microscopy, and observed immunomodulatory properties of the ASCs from each of the SVFs by measuring inflammatory markers of macrophages obtained by an ASC monocyte co-culture. Results: We have established the first cell mapping of the stromal vascular fraction of adipose tissue. The results showed that SVF obtained by 20 inter-syringe passages contains more statistically significant total cells, more cells expressing the ASC phenotype, more endothelial cells, and produces more CFU-F than the SVF obtained by 30 and 40 passages and by enzymatic digestion. Confocal microscopy showed the presence of residual adipocytes in SVF obtained by inter-syringe passages but not by enzymatic digestion. The functional study indicates an orientation toward a more anti-inflammatory profile and homogenization of their immunomodulatory properties.
Conclusion: This study places mechanically dissociated SVF in the center of approaches to easily extract ASCs and a wide variety and number of other progenitor cells, immediately available in a clinical setting to provide both the amount and quality of cells required for decellularized tissues.
Keywords: SVF; adipose derived stem cells; adipose tissue; clinical applicability; immunomodulatory properties; mechanical isolation; nanofat; recellularization.
Copyright © 2022 Girard, Dulong, Duisit, Mocquard, Le Gallou, Chaput, Lupon, Watier, Varin, Tarte and Bertheuil.
Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis
Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis
Camille Vaillant, Yanis Berkane, Elise Lupon, Michael Atlan, Pascal Rousseau, Alexandre G Lellouch, Jérôme Duisit, Nicolas Bertheuil
https://pubmed.ncbi.nlm.nih.gov/36233681/
Abstract
Introduction: Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new therapeutic alternative by ensuring reconstructions of large defects, reducing donor site morbidity, and enhancing functional recovery. The aim of this study was to achieve a systematic review of perforator flaps use in HS.
Patients and methods: PubMed and Cochrane databases were searched from 1989 to 2021. The PRISMA statement was used in the study selection process and the review was registered on PROSPERO. Furthermore, patient characteristics, operative technique, complications, and recurrences were searched.
Results: Thirty-six articles were selected including 286 patients and 387 flaps. Axillary localization was mostly represented (83.2%). Direct donor site closure was achieved in 99.1% of cases. In total, 15.1% of the flaps presented at least one of the following complications: wound dehiscence (5.5%), partial necrosis (2.9%), hematoma or seroma (2.1%), infection (2.1%), venous congestion (1.8%), and nerve injury (0.3%). Two cases of total necrosis were recorded. Recurrence of the disease was observed in 2.7% of the defects.
Conclusions: Pedicled perforator flaps are a reliable and reproducible technique in the reconstruction of HS defects. They are associated with a low recurrence rate while ensuring an effective reconstruction with reduced morbidity and faster recovery compared to the techniques classically used in this indication.
Keywords: complications; hidradenitis suppurativa; island flap; perforator flap; propeller flap; recovery; recurrence; verneuil disease.
Spotlight in Plastic Surgery: January 2022
Spotlight in Plastic Surgery: January 2022
Brett T Phillips, Daniel Boczar, Carter J Boyd, Joseph M Escandón, Sameer H Halani, Efstathios Karamanos, Karen B Lu, Elise Lupon, Maciej J Mazurek, Amanda R Sergesketter, Harsh R Shah, Amiteshwar Singh, Arun K Gosain
https://pubmed.ncbi.nlm.nih.gov/34851863/
Stent migration in the distal ulnar artery: A case report
Stent migration in the distal ulnar artery: A case report
H Paoli, E Lupon, S Gandolfi, I Pluvy, D Feuvrier
https://pubmed.ncbi.nlm.nih.gov/35077909/
Abstract
Angioplasty has taken an important place in treating cardiovascular ischemic lesions, and stenting has become a widespread routine practice. Stent loss is a complication that, although rare, can result in stent migration into a vessel with dramatic complications due to occlusion. We report the case of a 77-year-old woman who underwent surgery to remove a loose stent that had migrated into the right distal ulnar artery just before the superficial palmar arch following coronary angioplasty. The stent could be removed with the help of fluoroscopy and microscope while preserving vascular integrity. Different therapeutic strategies can be discussed in front of a stent lost in the general circulation, and those must be approached on a case by case basis.
Keywords: Angioplasty complication; Arcade palmaire; Complication de l’angioplastie; Hand; Main; Microchirurgie; Microsurgery; Migration de stent; Palmar arch; Perte de stent; Stent lost; Stent migration.
Copyright © 2022. Published by Elsevier Masson SAS.
Surgical management of slightly or non-displaced corporal scaphoid fractures by retrograde percutaneous screw fixation through the anterior trapezium horn: A single-center retrospective French study of 33 patients between January 2015 and January 2019
Surgical management of slightly or non-displaced corporal scaphoid fractures by retrograde percutaneous screw fixation through the anterior trapezium horn: A single-center retrospective French study of 33 patients between January 2015 and January 2019
E Lupon, J B De Villeneuve Bargemon, Y Dalmas, S Gandolfi, B Chaput, O Camuzard, P Mansat, S Delclaux
https://pubmed.ncbi.nlm.nih.gov/36216645/
Abstract
Introduction: Percutaneous screw fixation has recently gained popularity as an alternative to conservative treatment to avoid prolonged immobilization. The placement of a screw in the central axis of the scaphoid has been shown to be biomechanically superior to its eccentricity. Still, it poses difficulties in performing percutaneous screw fixation via both palmar and dorsal approaches.
Objective: We describe a palmar percutaneous screwing of corporal fractures of the scaphoid by a simple palmar transtrapezial approach allowing an optimal centering of the screw.
Method: We selected patients operated on by the same surgeon using the palmar transtrapezial approach between January 2015 and January 2019 based on the coding used for these fractures and the operative reports. In addition, pre- and postoperative data were collected from the patient’s computer and paper records and by telephone contact with the patients.
Results: Thirty-three patients were included. Percutaneous screw fixation of the scaphoid was performed under locoregional anesthesia in the operating room with one arm in the supine position on the arm table. No hyper-extension of the wrist was performed. The Kirchner guidewire passed through the anterior horn of the trapezium and then into the trapezium-scaphoid joint. A screw replaced it after satisfactory centering in the axis of the scaphoid. Management took place on average within 12 days after the trauma. 75.8% were A2 fractures, according to Herbert’s classification. The average operating time was 16.63minutes, and in 91% of the cases, the patient was hospitalized for one day. The variation of the scapholunate angle on the preoperative profile radiographs with the angle defined by the axis of the scaphoid screw and the lunate postoperatively was on average 2.94°. One patient presented nonunion, and four showed an undersized screw with a screw overhang requiring revision surgery.
Conclusion: The transtrapezial approach to fixation of acute scaphoid fractures facilitates precise percutaneous screw placement in the central axis of the scaphoid. A study of long-term complications, including the degenerative impact on the scaphotrapezial joint, is needed to assess the safety of passage through the anterior horn of the trapezium.
Keywords: Corporal fracture; Fracture corporéale; Fracture scaphoïde; Percutaneous screw fixation; Retrograde screw fixation; Scaphoid; Scaphoid fracture; Scaphoïde; Transtrapezium; Transtrapézien; Vissage percutané; Vissage rétrograde.
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Total Denervation of the Elbow: Cadaveric Feasibility Study
Total Denervation of the Elbow: Cadaveric Feasibility Study
Pierre Laumonerie, Suzanne Robert, Meagan E Tibbo, Elise Lupon, Patrick Chaynes, Nicolas Bonnevialle, Pierre Mansat
https://pubmed.ncbi.nlm.nih.gov/34074568/
Abstract
Purpose: Total elbow arthroplasty for the treatment of patients with severe elbow osteoarthritis is associated with postoperative activity limitations and risk of midterm complications. Elbow denervation could be an attractive therapeutic option for young, active patients. The aim of our study was to assess the feasibility of selective total elbow denervation via 2 anteriorly based approaches.
Methods: Selective total elbow denervation was performed in 14 cadaver elbows by 2 fellowship-trained elbow surgeons. Lateral and medial approaches to the elbow were used. The length of skin incisions and the minimum distance between them were noted. The number of articular branches identified and their respective distances from the lateral or medial epicondyle of the humerus were recorded.
Results: The anterolateral and anteromedial approaches allowed for the identification of all mixed and sensory nerves in all 14 cases. The mean number of resultant articular branches per cadaver was 1 for the musculocutaneous nerve, 2 (range, 1-3) for the radial nerve, 1 (range, 1-3) for the posterior cutaneous nerve of the forearm, 2 (range, 1-3) for the ulnar nerve, and 2 (range, 1-3) for the medial antebrachial cutaneous nerve; the collateral ulnar nerve was connected directly to the capsule. The length of the medial and lateral incisions was 15 cm (range, 12-18 cm) and 12 cm (range, 10-16 cm), respectively. The mean minimum distance between the incisions was 7.5 cm (range, 6.7-8.5 cm).
Conclusions: The findings suggest that selective elbow denervation via 2 approaches is feasible.
Clinical relevance: Selective elbow denervation via 2 approaches is feasible. Surgeons should target the articular branches of the musculocutaneous, radial, ulnar, and collateral ulnar nerves, posterior cutaneous nerve of the forearm, as well as medial antebrachial cutaneous nerves when carrying out this procedure.
Keywords: Anatomy; denervation; elbow; microsurgery; nerve; osteoarthritis.
Copyright © 2022 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Treatment of hyperpigmentation after burn: A literature review
Treatment of hyperpigmentation after burn: A literature review
Elise Lupon, Jérôme Laloze, Benoit Chaput, Paul Girard, Curtis L Cetrulo, Laurent A Lantieri, Jean Louis Grolleau, Olivier Camuzard, Alexandre G Lellouch
https://pubmed.ncbi.nlm.nih.gov/35537921/
Abstract
Objectify: Skin pigmentation disorders are one of the most frequent sequelae after burn injury. While these conditions often improve over time, some are permanent and cause severe psychological disorders (especially on the face). Given the frequency of these disorders and their benign nature, the scientific community has great difficulty postponing these patient follow-ups. Publications on their management are rare, and there is no consensus on the gold standard treatment for skin dyschromia. Herein, we performed a literature review including the various treatments currently proposed to manage these hyperpigmentations.
Methods: All reported articles up to February 2021 were reviewed on Pubmed. Studies on the treatment of hyperpigmented scars were included if they were secondary to burn injuries. Excluded articles evaluated transient treatments, such as makeup, and articles on inflammatory hyperpigmentation without etiological details or not secondary to burns.
Results: 201 articles were identified, and 13 studies were included. Topical creams used in inflammatory hyperpigmented lesions such as hydroquinone and first-line retinoids are controversial due to their inconstant efficacy. Various types of laser and pulsed light treatments have shown their effectiveness but can also aggravate pigmentation.
Conclusion: Dyschromia after burn remains a therapeutic challenge. Hyperpigmentations after burn should be treated on a case-by-case basis, using data from the literature, clinical experience and measuring the risk/benefit ratio.
Keywords: Dyschromia; Hydroquinone; Hyperpigmentation; Post-burn sequelae; Skin burn.
Copyright © 2022. Published by Elsevier Ltd.
Publications 2021 du Dr LUPON Élise
Augmentation mammaplasty by superolateral thoracic flap: a case report
Augmentation mammaplasty by superolateral thoracic flap: a case report
Elise Lupon, Benoit Chaput, Thomas Meresse
https://pubmed.ncbi.nlm.nih.gov/34784968/
Abstract
Background: The lateral chest wall is intimately associated with the esthetics of the breast. Patients with massive weight loss often have excess skin and fat in the lateral thoracic region causing functional, esthetic, and psychological discomfort. In addition, the breasts exhibit extreme ptosis after weight loss due to a reduction in volume and projection that is exacerbated by qualitative changes in the skin, with loss of its natural elasticity. This article describes a reliable new technique for simultaneous autologous breast augmentation and lateral thoracic dermolipectomy to provide autologous tissue for breast augmentation and simultaneous rejuvenation of the chest wall.
Case presentation: A 30-year-old Caucasian woman who had lost 58 kg after bariatric surgery had major skin excess sequelae combined with major breast ptosis. She wanted to correct her brachial and lateral thoracic skin and fat excess, as well as rejuvenate her breasts. The lateral thoracic panicle present was harvested and transposed in the retroglandular plane to perform autologous breast augmentation with lateral thoracic dermolipectomy.
Results: The patient was totally healed and complication-free at day 15. Both esthetic results and patient satisfaction were good at 6 months post-surgery.
Conclusions: Superolateral thoracic flap augmentation mammaplasty during thoracic dermolipectomy is a simple and safe procedure for selected patients. Durable and natural autologous breast augmentation may be achieved in a single step without the need for a breast implant, while rejuvenating the thoracic region.
Keywords: Autologous breast augmentation; Bariatric surgery; Fat compartment; Lateral chest wall; Superolateral thoracic flap.
© 2021. The Author(s).
Comment on “The Impact of Microsurgery on the Treatment of Ring Avulsion Injuries ”
Complications after Ravitch versus Nuss repair of pectus excavatum: What if none of these techniques are the right one?
Correction of Calf Atrophy With a Custom-Made Silicone Implant for Reconstruction: An Update
Local FK506 implants in non-human primates to prevent early acute rejection in vascularized composite allografts
Local FK506 implants in non-human primates to prevent early acute rejection in vascularized composite allografts
Alexandre G Lellouch, Corentin B Taveau, Alec R Andrews, Joseph Molde, Zhi Yang Ng, Philipp Tratnig-Frankl, Ivy A Rosales, Marion Goutard, Elise Lupon, Laurent A Lantieri, Robert B Colvin, Mark A Randolph, Joachim Kohn, Curtis L Cetrulo Jr
https://pubmed.ncbi.nlm.nih.gov/34422982/
Abstract
Background: Previous vascularized composite allograft (VCA) studies from our laboratory have shown that topical FK506 delivery in non-human primates (NHPs) was limited by inadequate dermal penetration and rejection persisted. Herein, we report the first utilization of FK506 via subcutaneously implanted discs to mitigate VCA rejection in NHPs.
Methods: Full major histocompatibility complex (MHC)-mismatched NHP pairs underwent partial-face VCA and FK506 disc implantation along the suture line. All allotransplants were maintained post-operatively for two months on the FK506 discs, methylprednisolone, mycophenolate mofetil, and supplemented with intramuscular FK506 if necessary. Group 1 (n=4) was used for optimization of the implant, while Group 2 (n=3) underwent delayed bone marrow transplantation (DBMT) after two months. VCA skin biopsies and peripheral blood samples were obtained for serial assessment of rejection and mixed chimerism by histopathology and flow cytometry respectively.
Results: In Group 1, two technical failures occurred. Of the remaining two NHPs, one developed supratherapeutic levels of FK506 (50-120 ng/mL) and had to be euthanized on postoperative day (POD) 12. Reformulation of the implant resulted in stable FK506 levels (20-30 ng/mL) up to POD12 when further intramuscular (IM) FK506 injections were necessitated. In Group 2, two NHPs survived to undergo conditioning and one successfully developed chimerism at 2-3 weeks post-DBMT (96-97% granulocytes and 7-11% lymphocytes of recipient-origin). However, all three NHPs had to be terminated from study at POD64, 77 and 86 due to underlying post-transplant lymphoproliferative disorder. All VCAs remained rejection-free up to study endpoint otherwise.
Conclusions: This study shows preliminary results of local FK506 implants in potentially mitigating VCA acute rejection for tolerance protocols based on mixed chimerism approach.
Keywords: Immunosuppression; tacrolimus; vascularized composite allograft (VCA).
2021 Annals of Translational Medicine. All rights reserved.
Measured Level of Human Adipose Tissue-Derived Stem Cells in Adipose Tissue is Strongly Dependent on Harvesting Method and Stem Cell Isolation Technique
Partial Heterotopic Hindlimb Transplantation Model in Rats
Partial Heterotopic Hindlimb Transplantation Model in Rats
Marion Goutard, Mark A Randolph, Corentin B Taveau, Elise Lupon, Laurent Lantieri, Korkut Uygun, Curtis L Cetrulo Jr, Alexandre G Lellouch
https://pubmed.ncbi.nlm.nih.gov/34180905/
Abstract
Vascularized composite allotransplantations (VCA) represent the most advanced reconstruction option for patients without autologous surgical possibilities after a complex tissue defect. Face and hand transplantations have changed disfigured patients’ lives, giving them a new aesthetic and functional social organ. Despite promising outcomes, VCA is still underperformed due to life-long immunosuppression comorbidities and infectious complications. The rat is an ideal animal model for in vivo studies investigating immunological pathways and graft rejection mechanisms. Rats are also widely used in novel composite tissue graft preservation techniques, including perfusion and cryopreservation studies. Models used for VCA in rats must be reproducible, reliable, and efficient with low postoperative morbidity and mortality. Heterotopic limb transplantation procedures fulfill these criteria and are easier to perform than orthotopic limb transplants. Mastering rodent microsurgical models requires solid experience in microsurgery and animal care. Herein is reported a reliable and reproducible model of partial heterotopic osteomyocutaneous flap transplantation in rats, the postoperative outcomes, and the means of prevention of potential complications.
Supplementation with Extracellular Vesicles Derived from Adipose-Derived Stem Cells Increases Fat Graft Survival and Browning in Mice: A Cell-Free Approach to Construct Beige Fat from White Fat Grafting
Surgery, the neglected child of the world's health systems
The Perception of Plastic Surgery by Community-Based, Private Practice Nurses: A French National Descriptive Study
The Perception of Plastic Surgery by Community-Based, Private Practice Nurses: A French National Descriptive Study
Elise Lupon, Paul Girard, Amélie Lupon, Loriane Jacques, Ludivine Jung, Zhi Yang Ng, Laurent Alexandre Lantieri, Jérôme Laloze, Alexandre Gaston Lellouch
https://pubmed.ncbi.nlm.nih.gov/33626557/
Abstract
Plastic surgery is a dynamic field but remains poorly understood by general practitioners, medical students, health professionals, and the public. The main health care professionals in the community who are involved in the follow-up of plastic surgery patients are nurses; they help to facilitate wound healing and rehabilitation in the postoperative period. In this study, the authors assessed the medical knowledge and perceptions of plastic surgery by nurses working in the community setting and explored their understanding of classical scenarios commonly encountered in reconstructive surgery. An online survey was designed to assess the demographics of nurses working in the community in France and their knowledge of plastic surgery. This was disseminated to all practicing nurses working outside of hospitals by means of an online social network from the period of April 2019 to June 2019. The survey was completed by 318 nurses. Specific training in plastic surgical nursing will be required to optimize the management of these patients following discharge from hospital. This gap in knowledge may affect patient recovery negatively.
Copyright © 2021 International Society of Plastic and Aesthetic Nurses. All rights reserved.
Vascularized Composite Allotransplantation in a Post-COVID-19 Pandemic World
Publications 2020 du Dr LUPON Élise
BCGitis of the wrist after intravesical BCG therapy: A case report
BCGitis of the wrist after intravesical BCG therapy: A case report
E Lupon, G Martin-Blondel, T Pollon, C Berthier, A G Lellouch, P Mansat
https://pubmed.ncbi.nlm.nih.gov/32659383/
Abstract
Septic arthritis of the wrist can result in joint destruction, making timely diagnosis crucial for initiating empiric antibiotics and surgical intervention. Mycobacterium is a rare cause of this disorder. A 47-year-old man with bladder cancer was treated surgically and received BCG intravesical therapy. Eleven months later, this patient developed severe carpal BCGitis requiring total carpal resection. The first step was addition of a cement spacer and radiometacarpal stabilisation (Masquelet technique). Secondary infections occurred aggravating the prognosis. This case emphasises the importance of taking into account the patient’s medical history. Tuberculosis of the wrist is a rare etiology for septic arthritis; delayed treatment leads to severe complications and functional sequelae.
Keywords: BCGite; BCGitis; Carpectomie; Carpectomy; Infection du poignet; Osteoarthritis of the wrist; Ostéite du poignet; Ostéoarthrite du poignet; Ostéomyélite du poignet; Tuberculose; Tuberculosis; Wrist infection; Wrist osteitis; Wrist osteomyelitis.
Copyright © 2020 SFCM. Published by Elsevier Masson SAS. All rights reserved.
Combating hypoxemia in COVID-19 patients with a natural oxygen carrier, HEMO2Life® (M101)
Combating hypoxemia in COVID-19 patients with a natural oxygen carrier, HEMO2Life® (M101)
Elise Lupon, Alexandre G Lellouch, Franck Zal, Curtis L Cetrulo Jr, Laurent A Lantieri
https://pubmed.ncbi.nlm.nih.gov/33308935/
Abstract
Background: Infection with SARS-CoV-2 is responsible for the COVID-19 crisis affecting the whole world. This virus can provoke acute respiratory distress syndrome (ARDS) leading to overcrowed the intensive care unit (ICU). Over the last months, worldwide experience demonstrated that the ARDS in COVID-19 patients are in many ways « atypical ». The mortality rate in ventilated patients is high despite the application of the gold standard treatment (protective ventilation, curare, prone position, inhaled NO). Several studies suggested that the SARS-CoV-2 could interact negatively on red blood cell homeostasis. Furthermore, SarsCov2 creates Reactive Oxygen Species (ROS), which are toxic and generate endothelial dysfunction. Hypothesis/objective(s) We hypothesis that HEMO2Life® administrated intravenously is safe and could help symptomatically the patient condition. It would increase arterial oxygen content despite lung failure and allow better tissue oxygenation control. The use of HEMO2Life® is also interesting due to its anti-oxidative effect preventing cytokine storm induced by the SARS-CoV-2. Evaluation of the hypothesis: Hemarina is based on the properties of the hemoglobin of the Arenicola marina sea-worm (HEMO2Life®). This extracellular hemoglobin has an oxygen capacity 40 times greater than the hemoglobin of vertebrates. Furthermore, the size of this molecule is 250 times smaller than a human red blood cell, allowing it to diffuse in all areas of the microcirculation, without diffusing outside the vascular sector. It possesses an antioxidative property du a Superoxide Dismutase Activity. This technology has been the subject of numerous publications and HEMO2Life® was found to be well-tolerated and did not induce toxicity. It was administered intravenously to hamsters and rats, and showed no acute effect on heart rate and blood pressure and did not cause microvascular vasoconstriction. In preclinical in vivo models (mice, rats, and dogs), HEMO2Life® has enabled better tissue oxygenation, especially in the brain. This molecule has already been used in humans in organ preservation solutions and the patients showed no abnormal clinical signs.
Consequences of the hypothesis: The expected benefits of HEMO2Life® for COVID-19 patients are improved survival, avoidance of tracheal intubation, shorter oxygen supplementation, and the possibility of treating a larger number of patients as molecular respirator without to use an invasive machine.
Keywords: COVID-19; HEMO2Life; Hypoxemia; M101; Oxygen Carrier; SARS-CoV-2.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Comments on ``Combined Non-Ablative Laser and Microfat Grafting for Burn Scar Treatment``
Comment on ``First Russian Experience of Composite Facial Tissue Allotransplantation``
Correcting of Calf Atrophy With a Custom-Made Silicone Implant: Contribution of Three-Dimensional Computer-Aided Design Reconstruction: A Pilot Study
Correcting of Calf Atrophy With a Custom-Made Silicone Implant: Contribution of Three-Dimensional Computer-Aided Design Reconstruction: A Pilot Study
Jean-Pierre Chavoin, Elise Lupon, Benjamin Moreno, Pierre Leyx, Jean-Louis Grolleau, Benoit Chaput
https://pubmed.ncbi.nlm.nih.gov/32593168/
Abstract
Background: Calf shape is an essential aesthetic parameter of the leg, and calf atrophy can lead to complex problems. The functional consequences of calf atrophy are generally moderate. Prefilled silicone gel implants represent the vast majority of currently placed prostheses, but this technique does not ensure optimal adaptation of the implant shape due to loss of volume.
Objectives: The aim of this study was to describe an innovative procedure for correcting acquired calf atrophy based on 3-dimensional (3D) modeling.
Methods: The study involved 22 patients treated for calf atrophy caused by illness. Implants were made with solid rubber silicone, and 3D reconstructions were created by computer-aided design based on computed tomography scans. The implants were introduced through a horizontal popliteal incision.
Results: Forty-one implants were placed. No cases of infection, hematoma, or compartment syndrome were encountered. We experienced 1 case of skin necrosis and 1 case of periprosthetic seroma. In addition, lipofilling was performed in 5 cases. Two patients sought to benefit from a surgical reduction in implant size.
Conclusions: Our innovative procedure to correct calf atrophy with custom solid rubber silicone implants produces a calf shape that better adapts to volume loss than prefilled silicone gel implants. The material maintains its shape and facilitates retrofitting of the prosthesis. There is no risk of hull formation or breakage, and the life span of the implants is limitless. This 3D computer-aided design approach has optimized our reconstructions.
© 2020 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.
Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report
Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report
Elise Lupon, Christine Chevreau, Alexandre Gaston Lellouch, Dimitry Gangloff, Thomas Meresse
https://pubmed.ncbi.nlm.nih.gov/32620140/
Abstract
Background: Soft tissue sarcomas affecting the root of an upper extremity raise the question of limb amputation depending on their location, size, and malignancy. Malignant triton tumors are a rare subtype of neurofibrosarcomas that have been poorly reported in the literature. We report the case of a challenging reconstruction of the upper extremity using a pedicled latissimus dorsal flap.
Case presentation: A 25-year-old Occidental man was referred to our sarcoma unit for the management of a large, high-grade malignant peripheral nerve sheath tumor with no regional or distant extension and very fast progression. He was treated first by concomitant neoadjuvant radiotherapy and chemotherapy. Carcinologic excision was performed « en bloc » including the skin, the tumor, and the flexor muscles of our patient’s elbow. Coverage of the skin defect and elbow flexion restoration were achieved by using a homolateral pedicled musculocutaneous latissimus dorsi flap. Histological analysis showed an R0 resection. The reconstruction process recovered a complete bending of his elbow. He is still in remission at 26 months follow-up.
Conclusions: A malignant triton tumor is a rare, aggressive, and high-grade sarcoma. It was successfully treated and this case report describes an effective treatment modality. Reconstructive surgery, allowing large, complete tumor removal, is indispensable after neoadjuvant chemotherapy and radiotherapy.
Keywords: Malignant peripheral nerve sheath tumor; Malignant triton tumor; Neurofibrosarcoma; Rhabdomyoblastic differentiation.
Muscle-Derived Stem Cell-Enriched Scaffolds Are Capable of Enhanced Healing of a Murine Volumetric Muscle Loss Defect
Prospective study of 80 volar wounds of the hand and wrist: Correlations between clinical examination and intraoperative findings
Prospective study of 80 volar wounds of the hand and wrist: Correlations between clinical examination and intraoperative findings
T Baron-Trocellier, M Rongières, O Mericq, E Lupon, P Mansat
https://pubmed.ncbi.nlm.nih.gov/32376508/
Abstract
Hand and wrist volar wounds are a common cause of emergency room (ER) visits. These wounds are explored surgically in the operating room at most hospitals. The main objective of our study was to prospectively assess the correlation between clinical examination in the ER performed by a surgical resident and the tendon, vascular and/or nerve damage found during surgery in hand and wrist volar wounds. The second objective was to describe the lesions based on their mechanism, as well as their topography. Eighty patients from two hand surgery referral centers were included. Patients’ past medical history was obtained, as well as records of their physical examination in the ER and description of lesions found during surgery. In 28% of wounds with a normal clinical examination, tendon, vascular or nerve damage was found on surgical exploration. Out of the cases that tested negative for tendon injury in the ER, 16% had partial tendon injury or digital tunnel wound discovered during surgery. Nerve damage was found during surgery in 12% of cases that had not been detected clinically preoperatively. Based on our findings, we recommend performing surgical exploration for all volar hand and wrist wounds in the operating room, as physical examination does not detect all tendons, vascular or nerve injuries.
Keywords: Clinical examination; Examen clinique; Hand lacerations; Pedicles; Plaies de main; Pédicules; Tendon.
Copyright © 2020 SFCM. Published by Elsevier Masson SAS. All rights reserved.
Surgical treatment of a digital metastasis of a large cell lung neuroendocrine carcinoma: A rare secondary anatomical localization
The perception of plastic surgery by physiotherapists: a French national descriptive study
The perception of plastic surgery by physiotherapists: a French national descriptive study
Elise Lupon, Arthur Bedet, Paul Girard, Jerome Laloze, Jean L Grolleau, Laurent Lantieri, Alexandre G Lellouch
https://pubmed.ncbi.nlm.nih.gov/32309331/
Abstract
Background: Plastic surgery is a transversal discipline that many people misunderstand, including general practitioners, medical students, paramedics and the public. Plastic surgeons often collaborate with physiotherapists for post-acute care and rehabilitation. They ensure optimal post-operative recovery of the patient. Herein, the authors assessed the medical knowledge and perceptions of plastic surgery by physiotherapists working outside health centers and explored their attitudes towards classic reconstructive surgery scenarios.
Methods: To assess physiotherapists’ medical knowledge and perceptions of plastic surgery, the authors conducted an online questionnaire survey. A total of 1,262 physiotherapists responded.
Results: The physiotherapists confirmed the suspected lack of knowledge regarding the plastic surgery field. Although they were generally aware that plastic surgeons perform cosmetic procedures and treat burns, they were largely unaware that plastic surgeons perform hand surgeries and microsurgical operations. More than 70% of them stated that they did not have the necessary knowledge to properly manage patients in this specialty. This lack of knowledge can sometimes have a negative impact on patients’ recovery, particularly for fear of making a mistake.
Conclusions: Physiotherapists, outside the hospital, have an incomplete conception of plastic surgery. They would need a specific plastic surgery training in order to manage these patients in an optimal way.
Keywords: Physiotherapists; perception; plastic surgery; rehabilitation; surgical physiotherapy.
2020 Annals of Translational Medicine. All rights reserved.
Want to Regain Motivation? Five Essential Publications You Should Read
Publications 2019 du Dr LUPON Élise
Comments on: An Open, Prospective Study to Evaluate the Effectiveness and Safety of Hyaluronic Acid for Pectus Excavatum Treatment
Hirschsprung disease in an adult with intestinal malrotation and volvulus: an exceptional association
Hirschsprung disease in an adult with intestinal malrotation and volvulus: an exceptional association
Elise Lupon, François Labbe, Emile Nini, Sixte Sondji
https://pubmed.ncbi.nlm.nih.gov/31030669/
Abstract
Background: Hirschsprung disease is a neonatal discovery in almost all cases, and the association of Hirschsprung disease in adults with symptomatic intestinal malrotation is unusual. This combination delays diagnosis and can lead to mistake in surgical strategy.
Case presentation: A 43-year-old patient with a history of colectomy for colonic inertia and megadolichocolon was admitted to the Carcassonne Hospital emergency room for a volvulus of small bowel obstruction in a chronic intestinal obstruction context with episodes of acute, variable-looking occlusive syndromes. Intestinal malrotation was discovered during surgical small bowel detorsion. The acute occlusion syndrome recurred after the procedure. In view of the unfavorable evolution, an emptying of the dilated small bowel and a discharge ileostomy upstream of the rectum were performed. In the face of postoperative improvement, rectal manometry and deep full parietal rectal biopsies made it possible to highlight the diagnosis of Hirschsprung disease. The patient thus had functional acute occlusive syndromes and chronic occlusion due to Hirschsprung disease of attenuated form and acute organic occlusive syndromes related to her incomplete common mesentery.
Conclusions: This rare association, which may be responsible for delayed diagnostic and therapeutic wandering, highlights the importance of performing manometry and deep full parietal biopsies before a colectomy for colonic inertia, as well as the possibility of suggesting a common Hirschsprung disease and/or mesentery in an adult with multiple occlusive syndromes of variable appearance.
Keywords: Adult Hirschsprung disease; Chronic occlusion; Constipation; Malrotation intestinal; Multiple occlusive syndrome; Small bowel volvulus.
Internes en médecine et cicatrisation des plaies : une étude descriptive multicentrique entre Février et Avril 2018
Internes en médecine et cicatrisation des plaies : une étude descriptive multicentrique entre Février et Avril 2018
E Lupon, U Turrian, J Malloizel-Delaunay, A Bura-Rivière, J L Grolleau
https://pubmed.ncbi.nlm.nih.gov/31474342/
Abstract
Objectives: Around 2.5 million wounds are recorded in France, representing, in terms of cost and quality of life, a real problem of public health issue. In France, residents are among the first line personnel having to manage wounds and their complications: this study is carried out to identify the view and feelings of residents concerning their preparation and training in this field.
Materials and methods: A questionnaire was distributed to residents throughout France. Residents’ characteristics, interests and training in wound healing, training courses and opinions concerning their training were recorded.
Results: Seven hundred and eleven French residents answered the questionnaire, the majority of whom (79 %) had not experienced training in wound healing. The majority of residents (69 %) believe that all physicians are concerned. Training in wound management and wound healing is considered insufficient (94 %) and most (79 %) had never received any training in wound management and wound healing. Ninety-eight percent stated they needed additional training courses in wound management.
Conclusions: Wound management and healing is a topic of interest to residents. Residents need more training in wound management in their curriculum to improve their practice.
Keywords: Cicatrisation; Dressing; Etudes médicales; Healing; Internes; Medical studies; Pansement; Plaie; Residents; Wound.
Copyright © 2019 Elsevier Masson SAS. All rights reserved.
Reconstruction of a dorsal thoracic wall defect by the intercostal artery perforator flap after removal of a bulky cutaneaous squamous cell carcinoma
Reconstruction of a dorsal thoracic wall defect by the intercostal artery perforator flap after removal of a bulky cutaneaous squamous cell carcinoma
E Lupon, A G Lellouch, F Deilhes, B Chaput, C Berthier
https://pubmed.ncbi.nlm.nih.gov/31526388/
Abstract
Introduction: Surgical reconstruction of large soft tissue defects of the upper back is challenging. Although the usefulness of free perforator flaps has been demonstrated, local options remain limited. The dorsal intercostal artery perforator flap was recently described but its use is still uncommon.
Case report: An 88-year-old Causasian woman presented with a large, ulcerated, left prescapular cutaneous squamous cell carcinoma (T3N0M0). Complete excision was performed, and the resulting defect was reconstructed with a dorsal intercostal artery perforator flap based on two perforators. Postoperative recovery was uncomplicated and adjuvant radiotherapy commenced 10 weeks later.
Conclusion: Compared to conventional muscle flaps, the dorsal intercostal artery perforator flap offers greater protection of muscle function, is less invasive, and lowers donor site morbidity. Based on these advantages, this flap should be considered a useful local option for reconstructing large cutaneous defects of the upper back.
Keywords: Carcinoma; Perforator flap; Squamous cell; Surgical flaps.
The palatal mucosal graft: The adequate posterior lamellar reconstruction in extensive full-thickness eyelid defects
The palatal mucosal graft: The adequate posterior lamellar reconstruction in extensive full-thickness eyelid defects
S Hendriks, C Bruant-Rodier, E Lupon, S Zink, F Bodin, C Dissaux
https://pubmed.ncbi.nlm.nih.gov/30795932/
Abstract
Introduction: Full-thickness eyelid defects exceeding 25% of the eyelid width should benefit from a skillful, immediate and simultaneous reconstruction of two layers; anterior and posterior lamella. In this article, we recall, through an original series of cases, the possibility of using a palatal fibromucosal graft during the reconstruction of the posterior lamella as well as the modalities of its optimal use.
Patients and methods: Retrospective study, including 8 patients with an extensive full-thickness eyelid defect affecting more than half of the upper and/or lower eyelid, after tumor excisions. 4 cases were involved in lower eyelid reconstruction, 2 in upper one and 2 in both. Posterior lamella was reconstructed using a palatal mucosal graft. Anterior lamella was reconstructed using different flaps: Esser-Mustardé flap, medially and laterally based orbicularis oculi myocutaneous flap, Tripier and orbitonasolabial flaps. Mean follow-up was 12.75 months.
Results: The survival rate of grafts and flaps was excellent with only one flap border necrosis. The donor site healed in an average time of 3 weeks. Functional recovery, complete eye closure and opening, was obtained in all cases. Lining, texture and color was considered satisfactory in all cases.
Conclusion: The palatal mucosal graft provides a good and lasting structural support to the eyelid, which is essential for the inferior eyelid, especially when combined with a flap. Slight overcorrection is recommended.
Keywords: Eyelid reconstruction; Full-thickness eyelid reconstruction; Greffe fibromuqueuse; Greffe palatine; Lambeau musculocutané palpébral supérieur; Mucosal graft; Orbicularis myocutaneous flap; Palatal graft; Reconstruction de paupières; Reconstruction des paupières pleine épaisseur.
Copyright © 2019 Elsevier Masson SAS. All rights reserved.
Publications 2018 du Dr LUPON Élise
Surgical antegrade transcatheter valve implantation and heavily calcified heart
Surgical antegrade transcatheter valve implantation and heavily calcified heart
Elise Lupon, Anais Lemaire, Christophe Cron, Bertrand Marcheix
https://pubmed.ncbi.nlm.nih.gov/29877717/
Abstract
It is well known that a heavily calcified mitral valve significantly increases the perioperative and postoperative risks of mitral valve surgery. A 71-year-old woman was referred to our department with severe mitral valve disease. Cardiac imaging revealed extremely severe calcification of the entire left heart. Surgery was performed through a median sternotomy with standard cardiopulmonary bypass. After dilating the mitral orifice with a balloon, we replaced the valve with a transcatheter Edwards Sapiens 3 aortic valve under direct vision. Seven months after the procedure, the patient was doing well and no longer suffered from dyspnea.
Keywords: Calcinosis; Coronary artery bypass; Heart valve prosthesis implantation; Mitral valve insufficiency; Mitral valve stenosis.
- E. Lupon, AG. Lellouch, M. Goutard, C.L.Cetrulo. Chapitre de livre intitulé « Decellularization and Recellularization of Composite Tissue Allografts” Book: « Two Decades of Experience in Clinical Reconstructive Transplantation – Lessons Learned” Taylor and Francis Special Edition: Reconstructive Transplantation and Regenerative Medicine – The Emerging Interface. 2020.
- E. Lupon, J. Saboye, JL. Grolleau, B. Chaput. “Chirurgie esthétique des paupières”. EMC (Encyclopédie Médico-Chirurgicale Elsevier Masson).(EMC Chirurgie Plastique et EMC Chirurgie Maxillo-faciale). http://dx.doi.org/10.1016/S1286-9325(20)85633-7
- E. Lupon, AG. Lellouch, P.Girard, P. Mansat, JL. Grolleau, J. Laloze, S. Riot. Total thumb reconstruction by an original groin Pocket Flap-Graft design. Journal of Clinical Images & Medical Case reports http://jcimcr.org/articles.php. ISSN 2766-7820. Mars 2021.
- Alexandre Bourcier, Anudari Zorigtbaatar, Elise Lupon, Daniel S. Nteranya, Arsène D. Nyalundja, Jean W. Lartigue, David Masheka, Ulrick S. Kanmounye. Qu’est-ce la chirurgie globale en 2020 ? Pan African Medical Journal Clinical Medicine. DOI: 10.11604/pamj-cm.2020.3.172.24474
Publications sans comité de lecture
- Alexandre G. Lellouch, Corentin Taveau, Alec R. Andrews, Marion Goutard, Philipp Tratnig-Frankl, Elise Lupon, Joseph Molde, Zhi Yang Ng, Mark A. Randolph, Joachim Kohn, Curtis L. Cetrulo. Local delivery of FK506 to prevent VCA early acute rejection in a delayed mixed chimerism protocol. Transplantation. DOI: 10.1097/01.tp.0000702016.20235.b7.
- Philipp Tratnig-Frankl, Alec R. Andrews, Corentin Taveau, Alexandre G. Lellouch, Michael M. Jonczyk, Marion Goutard, Elise Lupon, Joseph Molde, Zhi Yang Ng, Mark A. Randolph, Michael L. Morrison, Mark B. Roth, Curtis L. Cetrulo. The impact of oxygen free radical scavenger on acute rejection in a histocompatible miniature swine model. Transplantation. DOI: 10.1097/01.tp.0000699276.73135.b0.
- E. Lupon, A. Acun, Corentin Taveau, Alexandre G. Lellouch, Marion Goutard, Elise Lupon, L. Lantieri, Curtis L. Cetrulo, B.Uygun. VCA. Decellularization Protocol for porcine Fasciocutaneaous flap: An update. The American Society for Reconstructive Transplantation. DOI:10.17.7/20503121103534
- E. Lupon, A. Acun, R. Oganesyan, AG. Lellouch, C. Taveau, Marion Goutard, B. Uygun, Curtis L. Cetrulo. Decellularization of vascularized engineered scaffolds for face and ear reconstruction. VCA – The American Society for Reconstructive Transplantation. DOI:10.17.7/20503121103534
Chapitre / Livre
- Chronique dans le journal PRS et Plastic Surgery Resident Magazine :
* E.Lupon. Covid-19: A great Opportunity to Improve Our Surgical Residency Training. PRS.
* E.Lupon. COVID-19 and plastic surgery residency training: A French experience. Plastic Surgery Resident Magazine. Winter 2020.
https://imirus.com/tmp/13491/19121/-1/pm13491.pdf
* E.Lupon. Time Management. Plastic Surgery Resident Magazine. Spring 2021. https://view.imirus.com/1006/document/13537/page/12
Abstracts publiés
- E. Lupon, D. Gangloff, T.Meresse. Couverture et reconstruction de la flexion du coude par un lambeau de grand dorsal après exérèse d’un volumineux sarcome du bras dominant. SFCO Montpellier. (vidéo disponible sur « Oncostream »). 16 Mai 2019.
- E.Lupon. « Mon master 2 en 180 secondes ». SFCO Montpellier. 16 Mai 2019.
- E. Lupon, B. Chaput, JL.Grolleau, LA. Lantieri, AG Lellouch. Traitement permanent des dyschromies cutanées post brûlures. Société Française de Brûlologie- Cap d’agde. 6 Juin 2019.
- P. Girard, E. Lupon, J. Laloze, E. Watier, J. Duisit, B. Chaput, N. Bertheuil. Technique de couverture de perte de substance péri vulvaire par lambeau perforant de type IGAP (Inferior Gluteal Artery Perforator), Videocorner SOFCPRE 2019, Paris, 21 Novembre 2019.
- Berthier C, Lupon E, Gangloff D, Meresse T. Lambeau musculocutané de grand dorsal pédiculé dans la chirurgie du sarcome, Vidéocorner SOFCPRE 2019, Paris, 22 Novembre 2019
- E. Lupon. Vascularized Composite Allotransplantation. Decellularization/Revascularization project. Science Slam. Massachusetts General Hospital Research Institute. Boston, 14 Janvier 2020.
- Elise Lupon, Aylin Acun, Marion Goutard, Ruben Oganesyan, Alexandre Lellouch, Laurent Lantieri, Jean louis Grolleau, Basak Uygun, Curtis Cetrulo Decellularization of vascularized engineered scaffolds for facial reconstruction. Virtual Plastic Surgery (the meeting). 89th Annual meeting. Présenté le 16 Octobre 2020 (5 minutes).
