The utility of the high-resolution ultrasound technique in the evaluation of autologous adipose tissue lipofilling, used for the correction of post-surgical, post-traumatic and post-burn scars.

PURPOSE: Lipofilling technique is significantly increasing and the need of a non-invasive method to assess the success of the procedure is becoming mandatory. In particular, US can be considered an alternative method to MRI for evaluation of tissue lipofilling due to the simplicity and easy access of the technique and can be also used for monitoring the efficacy of the surgical procedure. The goal of this study was to demonstrate, the utility of the high-resolution ultrasound technique in the evaluation of autologous adipose tissue lipofilling, used for the correction of post-surgical, post-traumatic and post-burn scars. MATERIALS AND METHODS: Twenty-five patients (21 females), aged between 14 and 62 years, underwent surgical correction of scars with ''lipofilling'' technique. To evaluate the effectiveness of such treatment serial ultrasound examinations were performed at both the region affected from skin dimorphism through the adjacent skin region, using a high frequency transducer. Furthermore, it was assessed the presence of complications ranging from oedema or hematoma to necrosis or adipocyte migration of the graft. Finally, was calculated the average percentage of one-year survival of autologous fat transplant. RESULTS: Quantitative evaluations obtained with time series of ultrasound showed that the greatest benefits of autologous adipose tissue lipofilling, are found at the level of the hypodermis, but that also all the other layers of the skin can benefit from this procedure. CONCLUSION: The data acquired demonstrate that the eco color Doppler with high resolution can be considered a valid non-invasive tool for the assessment of morphological and quantitative degree of engraftment of autologous adipose tissue transplanted. Lipofilling is an accurate and effective choice for the correction of congenital or acquired skin disorders for its filler effect and consequent benefit for all tissue layers.

High-resolution color-Doppler ultrasound for the study of skin growths.

UNLABELLED: High-resolution (17 MHz) color-Doppler ultrasound (US) is used in the evaluation of normal and pathological skin. To analyze retrospectively the sonographic pattern of healthy skin and of some skin lesions using Doppler US and to compare the results with dermoscopy examination and histology to identify specific patterns of ultrasound for differentiating benign from malignant lesions. To select among them the Melanomas to describe their US pattern, the presence and morphology of vascular signal and to compare their thickness at US with the Breslow index. After signing informed consent in accordance with the ethical standards laid down in the Declaration of Helsinki in 1964 and its subsequent amendments, 104 patients with skin lesions were retrospectively studied. Patients were evaluated with clinical dermatological examination and Doppler US, and underwent surgical excision with subsequent histological analysis. STATISTICAL ANALYSIS: the difference between variables was analyzed with statistical Chi square test or Fisher's when appropriate. The strength of the relationship between variables was analyzed with Pearson's r coefficient. The sensitivity and specificity of US tests were also calculated. Sixty-five malignant lesions and 39 benign lesions were identified at Doppler US. In the 34 melanomas, typical US and vascular patterns were identified depending on the thickness of the lesion and a strong correlation between the latter and Breslow index was confirmed. Doppler US is a valuable diagnostic tool for the study of skin and for pre-excision characterization of skin lesions.

Colonic perforation by a transmural and transvalvular migrated retained sponge: multi-detector computed tomography findings.

Transmural migrated retained sponges usually impact at the level of the ileo-cecal valve leading to a small bowel obstruction. Once passed through the ileo-cecal valve, a retained sponge can be propelled forward by peristaltic activity and eliminated with feces. We report the case of a 52-year-old female with a past surgical history and recurrent episodes of abdominal pain and constipation. On physical examination, a generalized resistance was observed with tenderness in the right flank. Contrast-enhanced multi-detector computed tomography findings were consistent with a perforated right colonic diverticulitis with several out-pouchings at the level of the ascending colon and evidence of free air in the right parieto-colic gutter along with an air-fluid collection within the mesentery. In addition, a ring-shaped hyperdense intraluminal material was also noted. At surgery, the ascending colon appeared irregularly thickened and folded with a focal wall interruption and a peri-visceral abscess at the level of the hepatic flexure, but no diverticula were found. A right hemi-colectomy was performed and on dissection of the surgical specimen a retained laparotomy sponge was found in the bowel lumen.