Breast surgeons updating on the thresholds of COVID-19 era: results of a multicenter collaborative study evaluating the role of online videos and multimedia sources on breast surgeons education and training.

OBJECTIVE: Current trends show a rise of attention given to breast cancer patients' quality of life and the surgical reconstructive result. Along with this trend, surgical training quality and efficacy are gaining importance and innovative training methods such as online videos shared on social media portals, are becoming main updating tools. In hazardous times like COVID-19 pandemic nowadays, online communication becomes of vital importance and adaptation and innovation are fundamental to keep research and education alive. The authors aimed to investigate the role of video and multimedia sources on the daily activity and surgical training of a representative group of surgeons specifically dedicated to oncologic, oncoplastic and reconstructive breast surgeries. MATERIALS AND METHODS: A survey was produced and administered to 20 major Italian Breast Centers. Collected data were analyzed with Fisher's Exact Test. RESULTS: From October 2019 to March 2020, a total of 320 surveys were collected. Among the responders, there were 188 trainees (intern medical doctors and residents) and 110 faculty, 72% of them belonged to a plastic surgery environment, while 28% to general surgery environment. Almost all respondents have ever watched videos concerning breast surgery. CONCLUSIONS: The results of the study show how breast surgeons rely on videos and web platforms, mostly YouTube, when searching for training info about surgical procedures. Social media offer great opportunities for sharing knowledge and diffusion of new ideas but greater attention to their reliability is mandatory.

Hypopharynx reconstruction with pectoralis major myofascial flap: our experience in 45 cases.

A pectoralis major myofascial flap (PMMF) is a simple variant of the pectoralis major myocutaneous flap (PMMC), and allows avoiding some of the disadvantages of Ariyan's technique while reducing well-known, overall complications. This is a retrospective analysis of 45 hypopharyngeal reconstructions (40 immediate reconstructions after subtotal pharyngolaryngectomy and 5 performed during revision surgery) using PMMF flap, performed from February 1995 to February 2008 in the Department of Otolaryngology at the "San Camillo- Forlanini" Hospitals in Rome, in collaboration with the Department of Plastic Surgery. In our series, we observed postoperative flap-related complications in 6.7% of cases. The incidence of major flap complications requiring surgical revision was 2.2%. Two minor complications were seen: hypopharyngeal stenosis and a salivary fistula, both of which were managed without surgery. Total or partial necrosis did not occur in any case. There were four postoperative deaths, but which were not related to flap complications in any case. In the remaining cases, oesophageal X-ray imaging showed the absence of fistulas and adequate calibre of the reconstructed tract; oral intake started within postoperative day 10-12, without swallowing problems of liquid or solid food. Postoperative radiotherapy performed in 30 patients was well tolerated. The PMMF flap is safe one-step procedure with low morbidity that is particularly useful for partial hypopharyngeal reconstructions, overcoming the disadvantages of the PMMC flap and offering comparable results to fasciocutaneous free flaps.

[Environmental and occupational factors in skin carcinogenesis. Indications for therapy and prevention]. / Fattori ambientali e professionali nella cancerogenesi cutanea. Indicazioni di terapia e prevenzione.

The authors review the environmental and occupational factors in cutaneous cancerogenesis, group them according to their characteristics, and in particular distinguish between factors of physical and chemical nature. The authors also discuss the influence of predisposing factors related to the somatic makeup (xeroderma pigmentosus) and to work environment. Particular emphasis is given to skin precancerous and therefore to the importance of a mass screening and an effective health education. The authors illustrate the disorder with their clinical pictures.

Variation in acute phlogistic reactions in the skin of rabbit fetuses.

There is little in the literature on cutaneous inflammatory reactions in mammal fetuses. The subject now has practical import since advances in medical science allow surgical intervention in premature infants. A study was performed on 45 rabbit fetuses. They were inoculated in the derma of the dorsum with 0.01 ml of a 1% solution of carrageenan, a strong inflammatory drug. Treatment was performed on the nineteenth, twenty-third, and twenty-seventh days of pregnancy. Two rabbits were treated twenty-four hours after birth, and 6 adult rabbits were treated. Histological examination and a count of inflammatory cells were performed on each fetus. The results showed that, during fetal life, the cellular inflammatory reaction is low in the earliest stages but increases gradually during gestation. It is only after birth that there is a great increase, and even then the level remains lower than in adults.