Abstract:
PURPOSE:Hand transplantations have been initiated and have been encouraged by promising results for more than 1 decade. The aim of this study was to present the first case of hand transplantation performed in Taiwan. MATERIALS AND METHODS:On September 3, 2014, we transplanted the left distal forearm and hand of a brain-dead managed 37 years to a man aged 45 years who had traumatic amputation of the distal third of his right forearm 30 years ago. The total ischemic time during the transplantation was 6 hours and 45 minutes. Immunosuppression included anti-thymocyte globulins, and methylprednisolone (Solumedrol) was used for the induction. Maintenance therapy included systemic tacrolimus, mycophenolic acid [mycophenolate mofetil (MMF)], and prednisone. A combination of systemic (tacrolimus/MMF/prednisolone) and topical immunosuppressant cream (clobetasol and tacrolimus) was applied if acute rejection occurred. Follow-up included routine posttransplant laboratory tests, skin biopsies, intensive physiotherapy, and psychological support. RESULTS:The initial postoperative course was uneventful. No surgical complications were observed. Immunosuppression was well tolerated using tacrolimus, MMF, and prednisone, except for some immune-related complications. One episode of mild clinical and histological signs of cutaneous rejection was seen at 105 days after surgery. These signs disappeared after pulse therapy with Solumedrol and the topical application of immunosuppressive creams (tacrolimus and clobetasol). One infection episode occurred due to local cellulitis and axillary lymphadenopathy on day 140 and was successfully treated with antibiotics. The patient developed cytomegalovirus infection at 7 months that responded to medication. Intensive physiotherapy led to satisfactory progress in motor functioning. Sensory progress (Tinel sign) was good and reached the wrist by 3 months for the median and ulnar nerves, and could be felt in the finger tip by 9 months in response to deep pressure and light touch sensations. The patient has a lateral pinch that allows him to pick up and grip objects during daily living, although his muscle power is still insufficient. CONCLUSIONS:Hand allotransplantation is technically feasible. Currently available immunosuppression methods seem to control vascularized composite tissue allotransplantation rejection. A combination of topical and systemic immunosuppressants is a useful method to prevent acute hand allotransplant rejection.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Kuo YR,Chen CC,Chen YC,Yeh MC,Lin PY,Lee CH,Chang JK,Lin YC,Huang SC,Chiang YC,Chiu NM,Lee Y,Huang YC,Liang JL,Wu RW,Siu KK,Chung KC,Chiang MH,Pan CC,Wei FCdoi
10.1097/SAP.0000000000000758subject
Has Abstractpub_date
2016-02-01 00:00:00pages
S12-5eissn
0148-7043issn
1536-3708journal_volume
77 Suppl 1pub_type
杂志文章abstract::Full-thickness excision wounds infected with Staphylococcus hyicus, a pig pathogen, or Staphylococcus aureus, a human pathogen, were produced in pigs. The inoculated wounds were kept occluded for 2 days and then exposed and biopsied at intervals for 9 to 12 days. The exposed lesions were edematous and exudative. The S...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198909000-00004
更新日期:1989-09-01 00:00:00
abstract::The thickness of the upper eyelid is a bothersome condition that can be alleviated by blepharoplasty in Asians. Preseptal fat lies widely deep to the orbicularis oculi in the lower part of the upper eyelid, and the retro-orbicularis oculus fat (ROOF) pad lies in the lateral supraorbital area. We demonstrate the effect...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000263094.74682.5f
更新日期:2008-02-01 00:00:00
abstract::With the current tendency of increasing minimally invasive cosmetic surgeries, some rare but disastrous complications of facial filler injections come into sight, such as visual loss. The study aims to investigate the possible route that the injected droplet accesses the ophthalmic artery to explain and prevent such d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000000572
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Evidence suggesting that adipose tissue is a metabolically active tissue has generated debate on the effects of large-volume liposuction (LVL) on metabolic and cardiovascular health. Given the inconsistency in the literature, the authors performed a systematic review to identify available evidence in order t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001195
更新日期:2017-12-01 00:00:00
abstract::Women over the age of 30 who had undergone single (N = 20) and multiple (N = 16) facial cosmetic surgery were compared with a control group (N = 49) on five personality measures. Cosmetic surgical patients were found to be more narcissistic (p = 0.05) and to have more problems with separation-individuation (p = 0.01) ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199709000-00001
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Despite a heightened appreciation for wellness in medicine, there exists little information specific to plastic surgery. The purpose of this research was to assess happiness within the field of plastic surgery. METHODS:A cross-sectional study was conducted in July of 2017 by distributing an American Society...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002001
更新日期:2020-01-01 00:00:00
abstract::Currently, 50 cases of craniocarpotarsal dysplasia, or whistling face syndrome (WFS), have been reported, with more than 60 anatomical anomalies involving the head, hands, and feet, in addition to the face. In spite of the fact that there is much information concerning the surgical correction of many of these deformit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::The aim of the present study was to evaluate in young animals the dynamics of calvarial bone healing when exposing a bone defect to continuous forces for up to 13 weeks. Six-week-old rabbits after a sagittal suture strip craniectomy were randomized for either of the following protocols: (1) no spring was applied (n = ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000229019.29857.14
更新日期:2006-11-01 00:00:00
abstract::The quantitative and morphological characteristics of microbial adherence of four organisms--Staphylococcus epidermidis, S. aureus, Escherichia coli and Candida albicans--to the surfaces of different breast prostheses were observed. Semiquantitative adherence studies based on a modification of Maki's roll culture tech...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198904000-00009
更新日期:1989-04-01 00:00:00
abstract::Immediate breast reconstruction with expander implants is a safe, simple procedure that allows for a rapid physical and emotional postmastectomy recovery. When complications occur, the patient may be left with a prolonged reconstructive course. Such complications may result from thin mastectomy flaps and resulting mar...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000154855.89547.ee
更新日期:2005-04-01 00:00:00
abstract::We have developed a new in vivo model for the study of fetal wound healing. Fetal ICR mice (total gestation, 21 days) received a full-thickness incisional wound in the hind limb at gestational day 14 (N = 100). The wound was made with a 28.5-gauge needle that was passed transplacentally into the amniotic cavity. The w...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199710000-00008
更新日期:1997-10-01 00:00:00
abstract::Long-term follow-up of free flaps used for skull coverage in this experience has revealed that serious sequela are more likely after muscle-only free flaps. Over the past 2 decades, 8 muscle and 6 composite free flaps have been used in 12 patients. Debulking was the only secondary procedure necessary in 1 composite fl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000123024.80566.8c
更新日期:2004-05-01 00:00:00
abstract::The relative merit of cartilage scoring versus suturing in otoplasty remains a subject of debate among leading plastic surgeons. We compared a variety of otoplasty techniques in 42 rabbit ears using anterior or posterior scoring, horizontal or vertical mattress sutures, and combinations of scoring and suturing. The ea...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199501000-00009
更新日期:1995-01-01 00:00:00
abstract::The painful, boil-like lesion of furuncular myiasis is a result of the invasion of subcutaneous tissues by larvae of Dermatobia hominis, the human botfly. This arthropod is indigenous to Mexico, and Central and South America, and imported cases to the United States are increasing as travel to these regions continues t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-200102000-00011
更新日期:2001-02-01 00:00:00
abstract::The reverse sural artery flap is frequently used for reconstruction of the distal third of the leg, ankle, and heel. The major disadvantage of the flap is compression of the pedicle within the subcutaneous tunnel and venous congestion. Others have cited a decrease in this problem by harvesting a midline cuff of gastro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract::Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199201000-00007
更新日期:1992-01-01 00:00:00
abstract::Benign hypertrophy of the masseter muscle is an uncommon entity important in the differential diagnosis of head and neck masses, particularly a unilateral mass located in the cheek. Ten cases of benign masseteric hypertrophy are reviewed, current surgical treatment is described, and the pertinent literature is summari...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198406000-00007
更新日期:1984-06-01 00:00:00
abstract::Facial contours are thought to depend on the appropriate balance of hard and soft tissue. To obtain aesthetically good results in head and neck reconstruction, surgeons should know the exact three-dimensional shape and volume of both hard and soft tissue to be reconstructed. The authors used computer-assisted three-di...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200104000-00006
更新日期:2001-04-01 00:00:00
abstract::The indications for and limitations of cryosurgery for various types of hemangiomas on the body surface or in the intraoral region are reported based on our clinical experience. In our opinion, cryosurgery is not the method of choice in the management of hemangiomas but is useful under certain conditions, as with a lo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198006000-00005
更新日期:1980-06-01 00:00:00
abstract::Positioning extremities after soft-tissue reconstructive procedures can be difficult, particularly when flaps or skin grafts have been placed for posterior or circumferential defects. We describe a method using the patient's existing external fixator, when present, to aid in the postoperative care and positioning of t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199102000-00017
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Component separation techniques (CSTs) have allowed for midline fascial reapproximation in large midline ventral hernias. In certain cases, however, fascial apposition is not feasible, resulting in a bridged repair that is suboptimal. Previous estimates on myofascial advancement are based on hernia location ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182773915
更新日期:2013-09-01 00:00:00
abstract::In this study we present the first experimental vascularized penile allogenic transplantation model in the rat. In group 1 (n = 6), the vascular anatomy of the male rat perineal region was determined. In 12 Lewis rats of group 2 (n = 24), the penile composite graft was transplanted as isotransplant by microvascular an...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31817dc4d8
更新日期:2009-03-01 00:00:00
abstract::Eight patients with fronto-orbito-sphenoidal fibrous dysplasia, aged between 9 and 37 years, half of them male, were radically or nearly radically excised with immediate autogenous bone graft reconstruction. They had had frontal bulging and proptosis on the affected sides for 3 to 20 years. Four had decreased vision o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198509000-00002
更新日期:1985-09-01 00:00:00
abstract:INTRODUCTION:The reconstruction of the postburn contracture area is always a challenge in the field of plastic surgery. Moreover, the joints are very sensitive to trauma and immobilization, showing a susceptibility to stiffness. The aim of this article is to emphasize the use of "Namaste flap"-modification of subcutane...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002076
更新日期:2019-12-01 00:00:00
abstract::Dupuytren's contracture, a benign condition characterized by fibrosis of the palmar and digital fascia, may be a debilitating condition that limits daily function. Several techniques exist for managing symptomatic contractures of the hand related to Dupuytren's. These techniques include the more invasive open fascioto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001607
更新日期:2018-12-01 00:00:00
abstract::The principles and techniques of gene transfer are presented. Common concepts are defined, and the frequently used transfer vectors are described herein. Several gene transfer applications are discussed briefly. Areas of particular interest to the plastic surgeon such as gene transfer to skin and wounds are included. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199510000-00018
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Patients with craniofacial anomalies can have hard and soft tissue deficiencies. In some cases, distraction osteogenesis can restore the bony deficiencies, but the soft tissue contour defect remains problematic. For these patients, the union of distraction osteogenesis and microvascular free flaps (MVFF) can...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000263453.42788.67
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Quality of life and functional improvement have emerged as important goals for patients with oncologic disease. For patients with head and neck cancer, free anterolateral thigh (ALT) flaps serve as reliable reconstruction and provide functional restoration. Nevertheless, factors affecting the resumption of o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002652
更新日期:2021-02-01 00:00:00
abstract::Apert syndrome is characterized by craniosynostosis, central nervous system anomalies, midface hypoplasia, and syndactyly. Current research has focused on genetic and neurologic correlates. Cognitive assessment has been primarily limited to global intellectual evaluations, which can fail to detect the diverse cognitiv...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000149387.95212.df
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Although aging changes of the female perioral region and aesthetic procedures for perioral rejuvenation are described in literature, specific data for the male population are lacking. This study aims to evaluate perioral aging process in the male population to compare quality and quantity of the observed cha...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000931
更新日期:2017-03-01 00:00:00