liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
Wyckman, Alexander
Publications (4 of 4) Show all publications
Wyckman, A., Assareh, A., Steinvall, I. & Zdolsek, J. (2024). Breast Reconstruction Using the Extended Latissimus Dorsi Myocutaneous Flap—A Long-term Follow-up Utilizing BREAST-Q. Aesthetic Surgery Journal Open Forum, 6, Article ID ojae002.
Open this publication in new window or tab >>Breast Reconstruction Using the Extended Latissimus Dorsi Myocutaneous Flap—A Long-term Follow-up Utilizing BREAST-Q
2024 (English)In: Aesthetic Surgery Journal Open Forum, E-ISSN 2631-4797, Vol. 6, article id ojae002Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background The latissimus dorsi (LD) flap is a commonly used method for breast reconstruction after mastectomy. In this study, we present a long-term follow-up and effects of refining surgery on patient satisfaction and quality of life after breast reconstruction with the extended LD flap, using the BREAST-Q questionnaire.

Objectives The aim of this study was to investigate the patient-reported long-term results after breast reconstruction with the extended LD myocutaneous flap.

Methods A retrospective cohort study of adult patients (n = 101) who were operated on using the extended LD flap for breast reconstruction at the Linköping University Hospital during 1997 to 2012 was made using data retrieved from medical records. The patients were asked to complete the BREAST-Q questionnaire at 2 different postoperative time points.

Results Eighty-three patients replied to the first questionnaire, and 56 patients also replied to the second. Mean follow-up was 11.7 years. Higher age and living together with someone correlated to higher BREAST-Q results, while postoperative infection, bilateral LD flaps, smoking, and prior breast surgery had a negative impact on the results. Overall BREAST-Q results increased over time. No independent effect of refining surgery could be shown.

Conclusions Patient satisfaction after breast reconstruction with the LD flap as measured with the BREAST-Q questionnaire is high and in line with other studies. The overall satisfaction with the reconstruction method seems to increase with time, but no further increase in satisfaction after refining surgery could be established. Level of Evidence: 3 

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
follow-up; mammaplasty; surgical procedures; operative; breast
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-200856 (URN)10.1093/asjof/ojae002 (DOI)001157814200001 ()
Note

Funding: Department of Hand Surgery, Plastic Surgery and Burns, Linkoping University Hospital, Region Ostergotland, and the Linkoeping University, Linkoeping, Sweden

Available from: 2024-02-12 Created: 2024-02-12 Last updated: 2024-02-23
Nööjd, M., Wyckman, A., Steinvall, I. & Elmasry, M. (2023). Flap Survival after Reconstructive Surgery for Pressure Ulcers: A Cohort Study. Plastic and Reconstructive Surgery - Global Open, 11(12), e5451-e5451
Open this publication in new window or tab >>Flap Survival after Reconstructive Surgery for Pressure Ulcers: A Cohort Study
2023 (English)In: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 11, no 12, p. e5451-e5451Article in journal (Refereed) Published
Abstract [en]

Background: Pressure ulcers are troublesome for patients and require considerable resources to resolve. Previous studies have focused on recurrence, whereas there are few studies on flap survival. The aim was to describe the group and to analyze possible factors for flap survival.

Method: A descriptive retrospective analysis of all operations between 2008 and 2020 was carried out. Flap survival at 40 days was assessed. A flap was classified as a failure if a reoperation with removal or replacement was planned before, or in connection with, the first return visit. Variables of patient demographics, details of the pressure ulcers, and surgical treatment and care were analyzed with multivariable logistic regression for their effect on flap survival.

Results: A total of 111 flaps were included [78 (70%) with random blood supply and 33 (30%) with axial or perforator-based blood supply]; 54 (49%) of the flaps were fasciocutaneous. Body mass index was 25 (IQR 22–28). Flap survival rate was 90%. Variables associated with flap failure were higher body mass index, congenital spinal cord injury, type of blood supply to the flap, and the use of methylene blue to guide debridement of the wound.

Conclusions: The findings show factors that can be modified to improve future results, including a normalized body mass index and use of methylene blue in surgery to outline wound edges and depth, as this has been shown to protect against flap failure. Our data suggest that random flaps, such as V-Y, are preferable to axial flaps in the studied group.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2023
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-199650 (URN)10.1097/gox.0000000000005451 (DOI)001125354000008 ()38098948 (PubMedID)
Available from: 2023-12-15 Created: 2023-12-15 Last updated: 2024-02-09Bibliographically approved
Ellabban, M. A., Wyckman, A., Abdelrahman, I., Steinvall, I. & Elmasry, M. (2021). Dual Reconstruction of Lumbar and Gluteal Defects with Freestyle Propeller Flap and Muscle Flap. Plastic and Reconstructive Surgery - Global Open, 9(1), Article ID e3376.
Open this publication in new window or tab >>Dual Reconstruction of Lumbar and Gluteal Defects with Freestyle Propeller Flap and Muscle Flap
Show others...
2021 (English)In: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 9, no 1, article id e3376Article in journal (Refereed) Published
Abstract [en]

Background: The reconstruction of complex tissue defects in the lumbar and gluteal areas is a surgical challenge. The use of freestyle perforator-based flaps has gained popularity in the reconstruction of these defects due to several advantages: versatility, minimal donor-site morbidity, and tension-free closure. The present study reports the outcome of using a dual coverage of lumbar and gluteal defects with a gluteus maximus rotation flap as a deep layer and a freestyle propeller perforator-based flap as a superficial layer. Methods: A retrospective analysis of 18 patients who had a dual coverage of complex wounds of the lumbar and the gluteal areas was conducted. Different propeller flaps were used as superior gluteal artery perforator flap (SGAP), inferior gluteal artery perforator flap (IGAP), and posterior thigh perforator flap (PTP). Results: The study included 15 men and 3 women. The mean age was 26.3 years. The causes of the defects were: pressure ulcers in 14 patients and post-traumatic in 4 patients. A total of 28 freestyle flaps was used: 11 patients had 1 flap, 4 had 2 flaps, and 3 had 3 flaps. The mean postoperative follow-up was 12.2 months. The complications registered in the medical records were venous congestion in 2 patients, partial flap necrosis in 2 patients, and wound dehiscence in 1 patient. Conclusions: A freestyle propeller perforator-based flap combined with a gluteus maximus muscle flap is a solution that provides well-padding over bony prominence with a low complication rate. However, a long-term follow-up is needed to verify these results. Published online 26 January 2021. Received for publication October 7, 2020; accepted November 23, 2020. Disclosure: The authors have no financial interest to declare in relation to the content of this article. Mohamed A. Ellabban, MSc, MRCS, MD, FEBOPRAS Plastic and Reconstructive Surgery Unit Surgery Department Faculty of Medicine Suez Canal University Ismailia, Egypt E-mail: Mohamed.ellabban@med.suez.edu.eg This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2021
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-173121 (URN)10.1097/GOX.0000000000003376 (DOI)000663824700048 ()33564594 (PubMedID)
Available from: 2021-02-04 Created: 2021-02-04 Last updated: 2024-01-17Bibliographically approved
Wyckman, A., Abdelrahman, I., Steinvall, I., Zdolsek, J., Granfeldt, H., Sjöberg, F., . . . Elmasry, M. (2020). Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap. Scientific Reports, 10(1), Article ID 8380.
Open this publication in new window or tab >>Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap
Show others...
2020 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 8380Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The pectoralis major flap, which is usually harvested bilaterally, is considered a workhorse flap in the reconstruction of sternal defects. After a median sternotomy for open heart surgery, 1%-3% of patients develop deep infection and dehiscence of the sternal wound, some of which will eventually require reconstructive surgery. Our aim was to describe the clinical feasibility and associated complications of the unilateral pectoralis major advancement flap in the reconstruction of sternal defects.

METHODS: A retrospective analysis of all adult patients who were operated on using a unilateral pectoralis major flap for reconstruction of the chest wall at the Linköping University Hospital during 2008-18 was made using data retrieved from medical records.

RESULTS: Forty-three patients had reconstructions with unilateral pectoralis major flaps. Three flaps failed completely, and another 10 patients developed complications that required further operation. The factors that were independently associated with loss of the flaps and complications were: older age, male sex, the number of different antibiotics used, and a long duration of treatment with negative wound pressure. Fewer wound revisions before the reconstruction resulted in more complications. The factors that were independently associated with prolonged time to complete healing were emergency reoperation after the initial operation and complications after reconstruction.

CONCLUSION: The unilateral pectoralis major advancement flap has proved to be a useful technique in the reconstruction of most sternal defects after sternal wound infection in older patients. There is, however, need for a follow-up study on a larger number of procedures to evaluate the long-term outcome compared with other methods of sternal reconstruction.

Place, publisher, year, edition, pages
Nature Publishing Group, 2020
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-165783 (URN)10.1038/s41598-020-65398-y (DOI)000540464700002 ()32433505 (PubMedID)2-s2.0-85085157668 (Scopus ID)
Note

Funding agencies: Linkoping University

Available from: 2020-05-25 Created: 2020-05-25 Last updated: 2024-01-10Bibliographically approved
Organisations

Search in DiVA

Show all publications