P M Vogt

Hannover Medical School, Hanover, Lower Saxony, Germany

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Publications (294)281.99 Total impact

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    ABSTRACT: Eccentric training has become a popular treatment for patellar tendinopathy. Aim of this review is to display different exercise prescriptions for patellar tendinopathy, to help clinicians make appropriate choices and identify areas needing further research. Is eccentric training as a conservative treatment in chronic patellar tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines [Preferred Reporting Items for Systematic Reviews and Meta-Analyses]. National library of Medicine [NLM] between the years 1950 and 2010. Prospective randomised controlled trials (RCT). 7 articles with a total of 165 patients and in which eccentric training was one of the interventions, all published after 2000, were included. The median cohort study size was 20 subjects with a range from 15 to 35 subjects. Median follow-up duration was 12 weeks with a range from 4 to 12 weeks. Encouraging results, but variable study quality, with small numbers or short follow-up periods. The content of the different training programmes varied, but most were home-based programmes with twice daily training for 12 weeks. A number of potentially significant differences were identified in the eccentric programmes used: drop squats or slow eccentric movement, squatting on a 25° decline board or level ground, exercising into tendon pain or short of pain, loading the eccentric phase only or both phases, and progressing with speed then loading or simply loading. A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. Most studies suggest that eccentric training may have a positive effect, but our ability to recommend a specific protocol is limited. The studies available indicate that the treatment programme should include a 25° decline board and should be performed with some level of discomfort, and that athletes should be removed from sports activity. However, these aspects need further study. Because of the heterogeneous outcome variables (ordinal scale, VAS, VISA-P) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Patellar tendinopathy.
    Sportverletzung · Sportschaden 12/2010; 24(4):198-203. · 0.46 Impact Factor
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    ABSTRACT: Throughout the recent decade, eccentric training has become a widely accepted therapy option in the conservative treatment of chronic Achilles tendinopathy. Nevertheless, current recommendations are missing regarding dosage and duration of eccentric training as well as standardized training protocols. Is eccentric training as a conservative treatment in chronic Achilles tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). National library of Medicine (NLM) between the years 1950 and 2010. Prospective randomised controlled trials (RCT). 8 RCTs included 416 subjects with a median number of 42 subjects and a range of 17 to 116 subjects per trial. Median follow-up duration was 12 weeks with a range from 12 to 54 weeks. 124 papers met the eligibility criteria in the NLM, whereas only eight randomised controlled trials were included in this review after screening titles, abstracts and full texts. All included trials demonstrated an improvement in pain after performing equivalent training protocols of eccentric training in chronic Achilles tendinopathy. A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. In spite of different compliance, effects of eccentric training in conservative treatment of chronic mid-portion-Achilles tendinopathy are promising. Because of the heterogeneous outcome variables (ordinal scale, VAS, FAOS, AOFAS, VISA-A) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Achilles tendinopathy.
    Sportverletzung · Sportschaden 12/2010; 24(4):204-11. · 0.46 Impact Factor
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    ABSTRACT: Today split or full skin grafts are still the gold standard in the treatment of substance defects of the skin. Such results can be seen, for example, in the therapy for burn patients. However, in patients with more than 50% burned skin area, donor sites are limited. Likewise in chronic wound patients inferior take rates of skin grafts as compared to burn wounds are observed. This may be attributed, for example, to accompanying or underlying chronic diseases or a higher rate of local infections. These phenomena also lead to a lack of availability of transplantable skin grafts. Hence the need for cost effective and user friendly synthetic or engineered skin grafts, which can serve for acute and chronic wounds and which can be also used in critically ill patients, is at hand. During the last 30 years a huge number of biological and synthetic skin graft materials and products based on the patient's own cells were launched on the market. Researchers and clinicians are constantly working on further improvements. One possibility is the engineering of skin grafts in vitro, which have to be integrated into the wound bed after transplantation. Another approach is the fabrication of biocompatible and bioresorbable matrices, which can attract host cells and stimulate a wound-healing process without scars. However, the skin graft materials available today cannot yet replace split or full skin grafts completely because of their inherent limitations such as insufficient take rates and/or the lack of mechanical stability and differentiated structures of the grafted artificial skin. Thus researchers in the field of skin tissue engineering are still working on the final goal of developing a skin graft which has all the features of healthy human skin and is capable of replacing human skin completely. This article gives on overview of the currently available solutions and products in the field of skin tissue engineering.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 12/2010; 42(6):342-53. · 0.86 Impact Factor
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    ABSTRACT: Pleiotropic substances are characterized by their versatile and complex range of actions which makes them potential new active agents for the therapy of wounds. Besides its known effect to increase red blood cell production, the glycoprotein hormone erythropoietin (EPO) has been found to demonstrate a tissue protective effect in several other organs. The administration of EPO during skin wound healing is most likely essentially based on its cytopotective, proangiogenic, antiapoptotic and antiinflammatory effects. Herein EPO stimulates a coordinated interaction of different types of cells at a low or only a single dose. This review article aims to present the advantages and disadvantages of EPO administration in different experimental models to study the healing and regeneration processes of the skin and discusses possible clinical applications.
    Der Chirurg 11/2010; 81(11):993-8. · 0.52 Impact Factor
  • R Ipaktchi, K Knobloch, P M Vogt
    Burns: journal of the International Society for Burn Injuries 10/2010; 37(2):355-6; author reply 356-9. · 1.95 Impact Factor
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    ABSTRACT: As lipofilling of the female breast is becoming more popular in plastic surgery, the use of MRI to assess breast volume has been employed to control postoperative results. Therefore, we sought to evaluate the accuracy of magnetic resonance imaging (MRI)-based breast volumetry software tools by comparing the measurements of silicone implant augmented breasts with the actual implant volume specified by the manufacturer. MRI-based volume analysis was performed in eight bilaterally augmented patients (46 ± 9 years) with three different software programs (Brainlab© I plan 2.6 neuronavigation software; mass analysis, version 5.3, Medis©; and OsiriX© v.3.0.2. 32-bit). The implant volumes analysed by the BrainLab© software had a mean deviation of 2.2 ± 1.7% (r = 0.99) relative to the implanted prosthesis. OsiriX© software analysis resulted in a mean deviation of 2.8 ± 3.0% (r = 0.99) and the Medis© software had a mean deviation of 3.1 ± 3.0% (r = 0.99). Overall, the volumes of all analysed breast implants correlated very well with the real implant volumes. Processing time was 10 min per breast with each system and 30 s (OsiriX©) to 5 min (BrainLab© and Medis©) per silicone implant. MRI-based volumetry is a powerful tool to calculate both native breast and silicone implant volume in situ. All software solutions performed well and the measurements were close to the actual implant sizes. The use of MRI breast volumetry may be helpful in: (1) planning reconstructive and aesthetic surgery of asymmetric breasts, (2) calculating implant size in patients with missing documentation of a previously implanted device and (3) assessing post-operative results objectively.
    Journal of Digital Imaging 10/2010; 23(5):603-10. · 1.10 Impact Factor
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    ABSTRACT: In Germany, clinically and experimentally proven, evidence-based guidelines for the perioperative prophylaxis of thromboembolism in plastic surgery have not yet been developed. The ever-expanding complexity of microsurgical reconstructive procedures associated with the immense technical progress in the medical field have once more highlighted the urgent need for evidence-based guidelines. Moreover, this urgency is underlined by more and more complex reconstructive procedures needing to be performed in elderly patients presenting with grave comorbidities and the related high risk for thromboembolic events. These facts prompted us to review and discuss the relevance of the updated S3-guidelines on prophylaxis of venous thromboembolic events for the field of plastic and reconstructive surgery . The existing S3-guidelines represent the result of a consensus between 27 medical societies and organisations. Delegates of the German Society of Plastic, Reconstructive and Aesthetic Surgery (DGPRAEC) also participated in this consensus process and the development of the guidelines, which provide evidence-based and clinically oriented recommendations for the prophylaxis of venous thromboembolism for operative and non-operative as well as outpatient and inpatient settings. In the results section of this paper, general and specific recommendations with regard to plastic and reconstructive surgery are outlined. Indications for the pharmacological prophylaxis of thromboembolic events are oriented on the specific risk categories for surgical interventions with regard to the dispositional individual risk factors. Furthermore, the recommendations for the field of plastic and reconstructive surgery are subdivided into the various regions of the body. Evidence-based recommendations for perioperative prophylaxis of venous thromboembolism in plastic surgery are not available yet. The establishment of an algorithm to screen and estimate the procedure-associated risks for thromboembolism is needed. The discussed S3-guidelines of the AWMF Society on the prophylaxis of venous thromboembolism meet these formal requirements. Gathering of evidence-based data and the generation of recommendations leading to a reduction of the perioperative risk of thromboembolic events is a pivotal element to improve patient outcomes and safety in microsurgery.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 10/2010; 42(5):326. · 0.86 Impact Factor
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    ABSTRACT: cryotherapy and compression as integral part of the RICE regimen are thought to improve treatment outcome after sport injuries. Using standardized cryotherapy and compression perioperatively has been reported with conflicting clinical results. The impact of combined cryotherapy and compression is compared to standard care among patients undergoing wrist arthroscopy. fifty-six patients undergoing wrist arthroscopy were assessed, 54 patients were randomized to either Cryo/Cuff (3 × 10 min twice daily) or standard care over 3 weeks. Follow-up clinical visits were at postoperative days 1, 8, and 21. One patient in each group was lost during follow-up. Fifty-two patients were analyzed. Statistics were performed as Intention-to-treat analysis. Outcome parameters were pain, three-dimensional volume of the wrist, range of motion, and DASH score. the Cryo/Cuffgroup had a 49% reduction in pain level (VAS 3.5 ± 0.4 vs. VAS 1.8 ± 0.2 on the 21st postoperative day) when compared to a reduction of 41% in the control group (VAS 5.1 ± 0.6 preoperatively vs. VAS 3.0 ± 0.5 on the 21st postoperative day). Swelling and range of motion were not as significantly different between the two groups as were DASH scores (DASH-score Cryo/Cuff group preoperatively 37.3 ± 3.5 and postoperatively 36.9 ± 3.5; DASH-score control group preoperatively 42.8 ± 4.3 and postoperatively 41.9 ± 4.9). The CONSORT score reached 17 out of 22. there was no significant effect of additional home-based combined cryotherapy and compression using the Cryo/Cuff wrist bandage, following wrist arthroscopy regarding pain, swelling, range of motion, and subjective impairment assessed using the DASH score over 3 weeks in comparison with the control group.
    Knee Surgery Sports Traumatology Arthroscopy 10/2010; 19(2):314-9. · 2.68 Impact Factor
  • Handchirurgie · Mikrochirurgie · Plastische Chirurgie 10/2010; 42(03). · 0.54 Impact Factor
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    ABSTRACT: This study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8-13%. In certified breast centers plastic surgeons are often not members of the team. A total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients. At the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3-4 attending specialists for breast surgery. The cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.
    Der Chirurg 10/2010; 82(6):526-30. · 0.52 Impact Factor
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    ABSTRACT: While stem cells derived from the bone marrow are well-known in clinical medicine, fatty tissue as a source of mesenchymal stem cells is still the subject of recent research. However, adipose-derived stem cells (ASC) are not only harvested less invasively, i.e. via minimally invasive liposuction, but also yield higher numbers of multipotent stem cells.Due to cell-cell interactions and also because of the very favorable secretion profile of growth factors and cytokines ASCs displayed an extraordinary regenerative potential in recent preclinical and clinical applications and achieved a significantly better healing in ischemic muscle, heart, and brain insults and in impaired wound healing. ASCs enhanced regeneration in skeletal tissues such as cartilage or bone. They also revealed immunomodulatory effects and improved the clinical status in immunological diseases.In conclusion ASCs are comparable to bone marrow-derived stem cells concerning possible applications in clinical medicine.
    Der Chirurg 09/2010; 81(9):826-32. · 0.52 Impact Factor
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    ABSTRACT: Composite Tissue Allotransplantation (CTA) is a new medical field of growing importance. This paper focuses on the infrastructure and organisation of European CTA centres and discusses the differences between national health systems. Eight European centres (Valencia, Innsbruck, Munich, Lyon, Amiens, Creteil, Wroclaw, Monza) were sent with a specially-designed, standardized, 20-item questionnaire. Five of the eight centres returned our questionnaire: Munich, Innsbruck, Lyon, Amiens, Wroclaw. Since 1998, CTA has been performed at these centres. In both French centres and the Polish centre public funding is available in addition to the coverage provided by health insurers. In Munich the costs for a double upper-arm transplantation were Euro 150,000 with an additional Euro 50,000-70,000 per year. In Lyon the costs for a singular hand transplantation were Euro 70,000 per year and in Wroclaw (Poland) the costs for a hand or upper arm transplantation were Euro 20,000-30,000. As many as 17 different medical professions are involved in the CTA at the different centres. CTA is an innovative promising therapeutic tool that is based on the experiences of solid organ transplantation and profound microsurgical skills. Due to the complexity of the infrastructure, sourcing and the organisation CTA can only be successfully performed at specialized centres. A European network with an international European waiting list and a central coordination for CTA should be established. In order to advance CTA as an important tool in reconstructive surgery we must turn our attention to how the costs will be met, the legal environment for procurement of adequate donors and open ethical questions.
    Annals of transplantation: quarterly of the Polish Transplantation Society 09/2010; 15(3):87-92. · 1.43 Impact Factor
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    ABSTRACT: Während Stammzellen aus dem Knochenmark in der Klinik weithin bekannt sind, ist das Fettgewebe als Ressource mesenchymaler Stammzellen bisher eher Gegenstand aktueller Forschung. Diese Fettstammzellen („adipose-derived stem cells“, ASC) können nicht nur durch ein schonenderes Verfahren gewonnen werden, d.h. durch minimal-invasive Liposuktion, sondern die Ausbeute an multipotenten Stammzellen ist auch wesentlich höher. Aufgrund von Zell-Zell-Interaktionen, aber auch durch ihr äußerst günstiges Sekretionsprofil an Wachstumsfaktoren und Zytokinen zeigten Fettstammzellen in bisherigen präklinischen und klinischen Anwendungen ein außerordentliches regeneratives Potenzial. So führten sie in ischämischen Muskel-, Herz- oder Hirninfarkten und in schlecht heilenden Wunden zu einer signifikant besseren Heilung gegenüber der Placebogruppe. Zudem verbesserten sie die Regeneration von Halte- und Stützgeweben wie Knorpel und Knochen. Außerdem wirkten sie immunmodulatorisch und verbesserten deutlich den klinischen Status immunologischer Krankheitsbilder. Zusammenfassend lässt sich feststellen, dass ASC in Bezug auf den möglichen klinischen Einsatz durchaus mit Knochenmarkstammzellen vergleichbar sind. While stem cells derived from the bone marrow are well-known in clinical medicine, fatty tissue as a source of mesenchymal stem cells is still the subject of recent research. However, adipose-derived stem cells (ASC) are not only harvested less invasively, i.e. via minimally invasive liposuction, but also yield higher numbers of multipotent stem cells. Due to cell-cell interactions and also because of the very favorable secretion profile of growth factors and cytokines ASCs displayed an extraordinary regenerative potential in recent preclinical and clinical applications and achieved a significantly better healing in ischemic muscle, heart, and brain insults and in impaired wound healing. ASCs enhanced regeneration in skeletal tissues such as cartilage or bone. They also revealed immunomodulatory effects and improved the clinical status in immunological diseases. In conclusion ASCs are comparable to bone marrow-derived stem cells concerning possible applications in clinical medicine. SchlüsselwörterStammzellen-Fettgewebe-Adipose-derived stem cells-Isolation-Zellbasierte Therapie KeywordsStem cells-Adipose tissue-Adipose-derived stem cells-Isolation-Cell-based therapy
    Der Chirurg 09/2010; 81(9):826-832. · 0.52 Impact Factor
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Plastic &amp Reconstructive Surgery 07/2010; 126(2):726. · 3.33 Impact Factor
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Plastic &amp Reconstructive Surgery 07/2010; 126(2):718. · 3.33 Impact Factor
  • Bone 06/2010; 47. · 4.46 Impact Factor
  • K. Knobloch, P.M. Vogt
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    ABSTRACT: Mathes und Nahai schlugen 1982 die konventionelle rekonstruktive Leiter zur Deckung von Weichteildefekten beginnend mit der Primär- bzw. Sekundärnaht, gefolgt von der autologen Hauttransplantation, den regionalen Lappenplastiken, der Gewebeexpansion und schließlich den freien mikrovaskulär angeschlossenen Lappenplastiken vor. Trotz enormer Fortschritte auf jeder dieser rekonstruktiven Stufen gibt es klinische Situationen, die nicht adäquat mit diesen derzeitigen rekonstruktiven Maßnahmen adressiert werden können. Neue rekonstruktive Möglichkeiten ergeben sich durch die technologische Verbesserung in den Bereichen der Transplantationsmedizin, der Robotik und des „tissue engineering“. Die „composite tissue allotransplantation“ (CTA) von Teilen des Gesichts oder von ein- oder beidseitigen Unter- und Oberarmen ist ein vergleichsweise junges Gebiet der Transplantationsmedizin. Die ersten klinischen Ergebnisse sind im Vergleich zu den ersten Berichten der Organtransplantation seinerzeit ermutigend, wenngleich die kurz-, mittel- und langfristigen Probleme beispielsweise der Tumorinduktion durch die notwendige Immunsuppression sowie die chronische Abstoßung klar hervorgehoben müssen. Dies spielt insofern eine nicht unerhebliche Rolle, als die CTA gewöhnlich nicht lebensnotwendige Gewebekombinationen darstellen. Die Robotik ist ein weiteres neu zu erschließendes Feld, welches durch Operationssysteme wie das Da-Vinci-System für den Operateur oder das Penelope-System als Operationsassistenzroboter in der Chirurgie geprüft wird. Auch die mikrochirurgische Anastomosierung mit dem Da-Vinci-System ist beschrieben, wenngleich der zeitliche Aufwand der Bereitstellung derzeit noch erheblich ist. Die Regeneration und das Tissue Engineering können auch aus rekonstruktiver Sicht enorme Relevanz erlangen. Die stammzellbasierte Fetttransplantation kann neben Volumeneffekten bei Konturdefekten auch die Hautqualität verbessern im Sinne einer Regeneration. Eingedenk dieser Fortschritte schlagen wir vor, dass die rekonstruktive Sequenz des 21. Jahrhunderts diesen Entwicklungen Rechnung trägt. Wir sehen die CTA, die Robotik, und die Regeneration/Tissue Engineering als zukünftige integrale Zahnräder eines rekonstruktiven Uhrwerks des 21. Jahrhunderts an, in dem gerade die Kombination unterschiedlicher rekonstruktiver Maßnahmen neue Möglichkeiten der Wiederherstellungschirurgie eröffnen kann mit dem Patienten im Zentrum der Bemühungen. Mathes and Nahai introduced the conventional reconstructive ladder in 1982 to address tissue defects starting with primary and secondary closure of wounds followed by autologous skin grafting. Regional and local pedicled flaps, tissue expansion and free tissue transfer were further steps. Despite enormous achievements and refinements in these techniques, clinical situations and problems occur beyond the scope of these conventional reconstructive measures. Composite tissue allotransplantation (CTA) of partial faces or of unilateral or bilateral forearms and upper arms, are a novel part of transplantation medicine. The initially reported clinical results are encouraging, especially in light of the initial clinical reports of organ transplantation. However, short and long term problems such as potential tumor induction by immunosuppression and chronic rejection must be taken into consideration. Given the fact that patients receiving CTA have already undergone various reconstructive procedures before, patients often gain tremendous improvement in the quality of life. Robots such as the Da Vinci system for surgeons and the Penelope assistant robot have found their way into the surgical routine. While even microsurgical anastomosis has been accomplished using the Da Vinci system, the total amount of time and resources spent is beyond being practical at present. Regeneration and tissue engineering are of distinct interest in reconstructive surgery. Adipose-derived stem cell transfer is able not only to improve contour defects by volume effects, but also to improve the quality of the overlying skin. Therefore we would propose that these novel techniques, CTA, robotics, regeneration and tissue engineering should be considered as potential future integral cogs in the reconstructive mechanism for the 21st century with the patient being at the centre of the reconstructive efforts. SchlüsselwörterRekonstruktion-Tissue engineering-Composite tissue allotransplantation-Robotik KeywordsReconstruction-Tissue engineering-Composite tissue allotransplantation-Robotics
    Der Chirurg 05/2010; 81(5):441-446. · 0.52 Impact Factor
  • K Knobloch, P M Vogt
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    ABSTRACT: Mathes and Nahai introduced the conventional reconstructive ladder in 1982 to address tissue defects starting with primary and secondary closure of wounds followed by autologous skin grafting. Regional and local pedicled flaps, tissue expansion and free tissue transfer were further steps. Despite enormous achievements and refinements in these techniques, clinical situations and problems occur beyond the scope of these conventional reconstructive measures. Composite tissue allotransplantation (CTA) of partial faces or of unilateral or bilateral forearms and upper arms, are a novel part of transplantation medicine. The initially reported clinical results are encouraging, especially in light of the initial clinical reports of organ transplantation. However, short and long term problems such as potential tumor induction by immunosuppression and chronic rejection must be taken into consideration. Given the fact that patients receiving CTA have already undergone various reconstructive procedures before, patients often gain tremendous improvement in the quality of life. Robots such as the Da Vinci system for surgeons and the Penelope assistant robot have found their way into the surgical routine. While even microsurgical anastomosis has been accomplished using the Da Vinci system, the total amount of time and resources spent is beyond being practical at present. Regeneration and tissue engineering are of distinct interest in reconstructive surgery. Adipose-derived stem cell transfer is able not only to improve contour defects by volume effects, but also to improve the quality of the overlying skin. Therefore we would propose that these novel techniques, CTA, robotics, regeneration and tissue engineering should be considered as potential future integral cogs in the reconstructive mechanism for the 21st century with the patient being at the centre of the reconstructive efforts.
    Der Chirurg 04/2010; 81(5):441-6. · 0.52 Impact Factor
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    K.-H. Busch, P.M. Vogt
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    ABSTRACT: Chronische Wunden sind definiert als Wunden, die über einen Zeitraum von 4–8Wochen nicht spontan abheilen oder keine Heilungstendenzen zeigen. Sie gehen mit Schmerzen und, bei langjährigem Bestehen, mit einer zunehmenden gesellschaftlichen Isolierung bis hin zu einer akuten Bedrohung der Gesundheit einher. Zugrunde liegen häufig typische Erkrankungen des alten Menschen, somit ist aufgrund der demografischen Entwicklung eine Zunahme zu erwarten. Je nach Defektlokalisation und -tiefe kommen unterschiedliche Therapieverfahren zum Einsatz, bei oberflächlichen Wunden ist ein konservatives Vorgehen möglich, ansonsten kommen verschiedene operative Verfahren vom einfachen primären Wundverschluss über die Spalthauttransplantation und die lokalen Lappenplastiken bis zur Defektdeckung durch freie mikrochirurgische Gewebetransplantationen in Frage. Oberste Prämisse bei den Deckungsverfahren ist ein keimarmes Wundmilieu. Chronic wounds are defined as wounds which do not heal over a period of 4–8 weeks or which show no tendency to heal. They are associated with pain and increasingly pose an acute health risk when of many years’ standing. Their causes often lie in the typical diseases seen in old age; therefore, based on demographics, an increase in their incidence can be expected. Depending on wound location and depth, a variety of treatment methods may be used: a conservative approach is possible in small wounds, while various surgical procedures ranging from simple primary wound closure, split-thickness skin grafting and local flap plasty to defect coverage using free microsurgical tissue transplant are available. A low bacterial load is critical for any kind of a defect closure. SchlüsselwörterChronische Wunde-Alte Menschen-Keimbesiedelung-Konservative Therapie-Operative Defektdeckung KeywordsChronic wounds-The elderly-Bacterial colonization-Conservative therapy-Surgical wound coverage
    Trauma und Berufskrankheit 04/2010; 12:19-24.
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    ABSTRACT: Autologous lipotransfer is becoming more and more popular in plastic surgery. Until now the rate of fat survival was merely estimated by the surgeon and no proven data exist. To assess this surgical method a reproducible and exact tool for volume analysis is necessary. The volume of silicone implants was calculated in six healthy patients with silicone breast augmentation using the BrainLab(c) I Plan Software. In the same technique volumetry was performed in 10 patients before and six months after autologous lipotransfer using the water-jet assisted liposuction (BEAULI) to harvest the fat tissue. Comparison of the implant volumes calculated with MRI volumetry with the official volumes given by the manufacturer showed a very low mean deviation of 2.1+/-1.5%. Preoperative and postoperative MRI volumetry in patients after autologous lipotransfer revealed a mean volume augmentation of 147+/-18 mL. In these patients 72+/-11% of the transplanted fat tissue persisted in the area of injection six month after surgery. MRI volumetry is a useful tool for the fast, exact and reproducible volume analysis of breast tissue. Especially after autologous lipotransfer, where MRI examinations are performed on a regular basis to exclude possible complications, the use of these data to evaluate the rate of fat tissue survival is appealing and due to the high exactness of the method also reasonable.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 04/2010; 42(2):129-34. · 0.86 Impact Factor

Publication Stats

1k Citations
281.99 Total Impact Points

Institutions

  • 2001–2014
    • Hannover Medical School
      • Department of Plastic, Hand and Reconstructive Surgery
      Hanover, Lower Saxony, Germany
  • 2002–2012
    • Hochschule Hannover
      Hanover, Lower Saxony, Germany
  • 2011
    • Klinikum Duisburg
      Duisburg-Hamborn, North Rhine-Westphalia, Germany
  • 2009
    • University of Colorado Hospital
      Denver, Colorado, United States
  • 1993–2009
    • Ruhr-Universität Bochum
      • • Institut für Pathologie
      • • Klinik für Plastische Chirurgie und Schwerbrandverletzte
      Bochum, North Rhine-Westphalia, Germany
    • University of California, Los Angeles
      Los Angeles, California, United States
  • 2008
    • Leibniz Universität Hannover
      • Institute of Technical Chemistry
      Hanover, Lower Saxony, Germany
  • 2007
    • Johns Hopkins University
      • Department of Plastic and Reconstructive Surgery
      Baltimore, MD, United States
    • Yale University
      • Department of Neurology
      New Haven, CT, United States
  • 2006
    • University Medical Center Hamburg - Eppendorf
      Hamburg, Hamburg, Germany
  • 1992–1994
    • Brigham and Women's Hospital
      • Division of Plastic Surgery
      Boston, MA, United States