The Three-Bite Technique: A Novel Method of Dog Ear Correction

Jaber, Omar,Vischio, Marta,Faga, Angela,Nicoletti, Giovanni Korean Society of Plastic and Reconstructive Surge 2015 Archives of Plastic Surgery Vol.42 No.2

The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a 'dog ear'. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear's margin, thus allowing for flattening the dog ear by anchoring the over-projecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply.

The Three-Bite Technique: A Novel Method of Dog Ear Correction

Omar Jaber,Marta Vischio,Angela Faga,Giovanni Nicoletti 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.2

The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a ‘dog ear’. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear’s margin, thus allowing for flattening the dog ear by anchoring the overprojecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply.

The oval technique for nipple-areolar complex reconstruction

Vozza, Amalia,Larocca, Fabio,Ferraro, Giuseppe,Nicoletti, Giovanni Francesco,D'Andrea, Francesco Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.2

Background Nipple-areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, pigmentation, and permanent projection, and although many technical descriptions of NAC reconstruction exist in the medical literature, there is no gold standard technique. The technique devised by the authors is very versatile, with excellent results, and it enables 1-step reconstruction with optimal results in terms of shape and nipple projection. Methods Our technique consists of a combination of modified local flaps and a full-thickness skin graft. Patients were observed for 18 months to estimate the amount of retraction. This procedure was performed in 40 patients, four of them bilaterally. The duration of the follow-up was 30 months. Complications occurred in 10% of patients, and included infections (5%), ischemia (2.5%), and hematoma (2.5%). Results No cases of total nipple necrosis were reported. The NAC shape remained optimal in all cases, with a very small reduction of the vertical and horizontal diameters of the areola, which maintained its designed round shape well, and negligible retraction in the diameter and projection of the nipple. Conclusions The oval technique represents a major step forward, involving a combination of existing techniques, such as the C-V flap and the cutaneous graft, to achieve excellent results regarding areola shape and nipple projection, significantly reducing the cases of nipple ischemia. These results were substantially obtained through subcutaneous equatorial sutures, skin grafting, and flattening of the apexes of the flap.

Contrasting genetic diversity and intra-population polymorphism of the invasive pest Henosepilachna vigintioctopunctata (Coleoptera, Coccinellidae): A DNA barcoding approach

Pushparaj Karthika,Chithravel Vadivalagan,Natraj Krishnaveni,Kadarkarai MURUGAN,Marcello Nicoletti,Angelo Canale,Giovanni Benelli 한국응용곤충학회 2017 Journal of Asia-Pacific Entomology Vol.20 No.1

Henosepilachna vigintioctopunctata (Coleoptera: Coccinellidae) is one of the most important pests attacking Solanaceae crops in Asian countries. Despite its agricultural importance, little information is available on the molecular ecology and evolution. In this study, we used DNA barcoding to explore the genetic diversity and intrapopulation polymorphisms of H. vigintioctopunctata. Haplotype analysis of the partial COI gene sequences of H. vigintioctopunctata fromfour localities in South India and other globally available haplotypes revealed two genetically distinctive lineages. The TCS haplotype network with the main clusters G1, G2, G4 and G6 represented intra-population polymorphismamong the Indian lineages,while other clusterswere differentiatedwith unique mutational steps. High substitutions in the 1st and 3rd codon suggested the dominance of synonymous substitutionswith significant p-values b 0.05, that inferred for purifying selection. The genetic diversity indices Fu's Fs and neutrality index Tajima-D had negative values that implied for recent population expansion and lowfrequency of polymorphism. Further, high genetic divergences among certain haplotype comparisons evidenced the influence of micro-evolutionary pressures. The threshold value was 1.26%, which was supported by the postulates of 10× rule. Overall, the study firstly reported the genetic diversity and intra-population polymorphism of H. vigintioctopunctata populations attacking Solanaceae species in Asian countries.

Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: ATime and Cost Analysis

Verdura Vincenzo,Guastafierro Antonio,Di Pace Bruno,Faenza Mario,Nicoletti Giovanni Francesco,Rubino Corrado 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.1

Background Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure.Methods Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat.Results In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system.Conclusion Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively.

Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: ATime and Cost Analysis

Verdura Vincenzo,Guastafierro Antonio,Di Pace Bruno,Faenza Mario,Nicoletti Giovanni Francesco,Rubino Corrado 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.2

Background Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure.Methods Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat.Results In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system.Conclusion Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively.