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1
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Body Contouring after Massive Weight Loss – Case Report

100%
Zieliński T., Antoszewski B.
Polish Journal of Surgery
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2012
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vol. 84
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issue 11
585-589
EN
The paper presents a 25-year-old woman who is using a strict diet of 1000 kcal lost 83 kg in 18 months. Despite her young age, weight loss caused numerous cutaneous fatty folds, because her skin was not elastic or resilient enough. The patient undergo a multi-stage surgical treatment aiming to rectify the deformations. This example illustrates the problems of patients having undergone intensive slimming procedures and presents surgical treatment methods that rectify typical deformations in these patients.
2
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Prace Oryginalne Original Papers Why Women Who Have Mastectomy Decide Not to Have Breast Reconstruction?

81%
Zieliński T., Lorenc-Podgórska K., Antoszewski B.
Polish Journal of Surgery
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2015
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vol. 86
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issue 10
451-455
EN
Breast cancer is the most common malignancy occurring in women. The treatment of breast cancer is a complex, multistep process involving surgical treatment, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and very often rehabilitation. After the treatment of the underlying disease, or still in its course, there remains a problem of deformation of the chest. Although the number of women opting for breast reconstructive surgery increases every year, the number of such procedures in Poland is low. The aim of the study was to investigate the reasons why women after amputation of the breast due to cancer are not likely to undergo breast reconstructive surgery. Material and methods. The study comprised 73 women, residents of the province of Silesia, aged between 37 and 79 years, who had undergone mastectomy for malignancy in the years 1987-2013. Results. From all of the reasons given by women for refraining from breast reconstruction, the most frequently pointed was the fear of being subjected to further surgery (38.3%). 23 women (31.5%) admitted that they were also afraid of postoperative pain. Similarly, a common response (35.6%) was that it is not essential for their mental state, and 30% of respondents fully accepted their appearance after mastectomy. Concern about the effect of failed reconstruction was reported by 24.6% of the women, and the fear that the surgery could negatively affect the process of cancer treatment by 27.4% of respondents. Lack of information about the capabilities and knowledge of breast reconstruction methods was not an important factor in decision-making. Conclusions. Most of the surveyed women who abandon breast reconstruction surgery, make this decision on the basis of more than one reasons. Fear of undergoing a second surgical procedure and pain related to it were the most important reasons for the refusal of breast reconstruction. An important factor in the decision to desist from breast reconstruction is the age of the patients.
3
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Surgical Correction of a Webbed-Neck Deformity in Turner’S Syndrome

81%
Zieliński T., Lorenc-Podgórska K., Antoszewski B.
Polish Journal of Surgery
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2015
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vol. 87
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issue 3
134-138
EN
Turner’s syndrome occurs in approximately 1 out of every 2,000 to 2,500 live-born girls. This genetically determined pathology is characterised by multiple congenital anomalies. A typical form of this syndrome is associated with a lack of one of the sex chromosomes (karyotype 45, X). From the point of view of plastic surgery, one of the most important elements of the therapy is correction of the webbed neck deformity. The aim of the study was to present the possibilities of surgical treatment of a webbed neck of patients with Turner’s syndrome and the evaluation of treatment results. In the years 2000-2012, six children with Turner’s syndrome were treated because of the webbed neck deformity. The age of patients ranged from 9 to 17 years. In the case of all patients, the aim was to distribute the neck skin folds by using Z-plasty in conjunction with a shift to the back of glabrous skin flaps mobilised from the anterolateral surface of the neck. In the case of four operated patients, the folds were completely removed and a correct symmetrical outline of the neck was obtained. One patient was found to have unilateral moderate webbed neck recurrence after about 2 years of treatment. In one case, the correction was insufficient. The performed surgical procedures enabled correction of low hairline only in the lateral parts of the neck. The lower line of the scalp in the central part of the neck has remained unchanged. The lateral approach with a shift of glabrous skin flap to the back, which we performed, allows for effective reduction of the webbed neck, excision of bands of the connective tissue and correction of the low hairline on the side of the neck. Z-plasty enables an adequate extension of scars and improves the contour of the neck.
4
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Rekonstrukcja przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej wyspowym płatem zamałżowinowym u chorych z rakiem podstawnokomórkowym lub kolczystokomórkowym

71%
Iljin A., Antoszewski B., Durko M., Zieliński T., Pietruszewska W.
Polish Journal of Otolaryngology
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2018
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vol. 72
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issue 3
4-10
PL
Cel: Przedstawienie klinicznego doświadczenia z zastosowania wyspowego płata zamałżowinowego (Postauricular Island Flap; PIF) oraz ocena wyników rekonstrukcji przewodu słuchowego zewnętrznego (External Auditory Canal; EAC) i/lub muszli małżowiny usznej tą metodą u pacjentów po wycięciu złośliwej zmiany nowotworowej tej okolicy. Materiał i metody: Analizie poddano łącznie 19 chorych po wycięciu raka z zastosowaniem PIF (2000–2015) – 11 pacjentów po rekonstrukcji muszli małżowiny usznej, 8 pacjentów po rekonstrukcji muszli wraz z EAC. Oceniono wczesne i odległe wyniki leczenia operacyjnego. Porównano opinie chirurga i pacjenta. Wyniki: U wszystkich badanych zmiany wycięto w całości, nie stwierdzając wznowy w ciągu min. 2 lat obserwacji. Przekrwienie bierne wystąpiło u 5 chorych (26,3%), nadmierne przyleganie małżowiny usznej u 4 pacjentów (21%), u 3 chorych (15,8 %) zauważono odstawanie płatka, a u 3 osób (15,8%) zwężenie EAC. Wyniki pooperacyjne były bardzo dobre u wszystkich pacjentów (tak w ocenie chirurga, jak i chorych), za wyjątkiem pacjentów z nadmiernym przyleganiem małżowiny usznej i z odstawaniem płatka, u których oceny były satysfakcjonujące. Wnioski: 1) Operacje po wycięciu guza przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej połączone z rekonstrukcją wyspowym płatem zza małżowiny usznej pozwoliły na doszczętne wycięcie zmian (bez oznak wznów) oraz zachowanie właściwego konturu muszli operowanej małżowiny usznej. 2) Zastosowanie dostępu w okolicy zamałżowinowej u chorych z rakiem umiejscowionym w obrębie przewodu słuchowego zewnętrznego pozwoliło nie tylko na właściwą wizualizację i ocenę rozległości tych zmian, ale także stworzyło dobre dojście do pola operacyjnego.
5
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External auditory meatus and/or conchal bowl reconstruction with postauricular island flap in patients with Basal Cell Carcinoma or Squamous Cell Carcinoma

71%
Iljin A., Antoszewski B., Durko M., Zieliński T., Pietruszewska W.
Polish Journal of Otolaryngology
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2018
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vol. 72
|
issue 3
4-10
EN
Aims. Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with pif in patients after carcinoma resections. Methods. We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were reexamined and evaluated in respect of early and long-term results after surgical treatment considering both the plastic surgeon’s and the patient’s opinion. Results. The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3%), pinning of the operated ear in four patients (21%), prominent earlobe in three (15.8%), and eac constriction in three cases (15.8%). The postoperative result was very good in all cases (both in the opinion of the plastic surgeon and the patients), except for patients with pinning of the operated ear, with a prominent earlobe (moderately satisfied). Conclusions. 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and for the preservation of a proper conchal shape in the reconstructed ear. 2. A retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access.
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