P M Vogt

Hannover Medical School, Hanover, Lower Saxony, Germany

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Publications (307)289.11 Total impact

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    ABSTRACT: After numerous experiments with free-fat transfer since 1893 , many promising methods and results of large-volume fat grafts have been published recently . A common disadvantage was the time of the procedure and a lack of proof of efficiency. In 2007 we developed the BEAULI™ method (Berlin autologous lipotransplantation), a new and reliable procedure to collect larger amounts of transplantable fatty tissue. It was evaluated in a prospective clinical study with 85 patients in 2 centres in Germany, the overall number of transplantations amounting to 216 treated breasts. Indications were general lack of breast volume, either genuine or acquired in the course of surgical procedures. The fat was harvested with the BEAULI™ method, which consists in general of the harvest of very small fat particles by means of water-assisted liposuction (Bodyjet®, Humanmed Ag, Germany) and reinjection of the fat after separation from superfluous water by means of the Lipocollector®. All procedures were performed in a standardised pattern, measurements were taken preoperatively, at day 1 postop, after 1 week, 4 weeks, 3 months, 6 months and then to be continued yearly. An MRI of the breasts was taken preop and 6 months postoperatively, the longest follow-up is 30 months. Average operation time was 1.5 h. In every case a definite increase of volume of the fatty layer in the treated areas was observed. We saw no macroscopic oily cysts, in two cases there were 3 months after the operation some palpable subcutaneous nodules which proved to be granulomas. The volume control of 35 aesthetic patients by means of BrainLab™ Software and MRI could verify a permanent take rate of 76±11% of the grafted fat. In aesthetic patients generally 2 (80%) fat-grafting procedures with an average gain in volume of ½ bra cup size or 100-150 ml) per procedure were required. After implant removal, satisfaction was usually reached after only a single procedure, for complete reconstruction after cancer surgery 4-5 grafting sessions were necessary. An extension of the skin envelope as well as improvement of existing scars were observed.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 02/2011; 43(1):65. DOI:10.1055/s-0031-1271814 · 0.54 Impact Factor
  • PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 02/2011; 61(02). DOI:10.1055/s-0031-1272392 · 1.02 Impact Factor
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    ABSTRACT: Extravasations of chemotherapeutic drugs may lead to tissue necrosis and subsequent tissue defects, sometimes resulting in loss of function. In the absence of therapy, approximately one-third of vesicant extravasations will result in ulcerations, some of which necessitate plastic microsurgery to cover the soft tissue defects. The aim of this study was to describe the surgical technique itself and to present clinical results of the procedure in a clinical series of chemotherapeutic extravasation injuries that benefitted from a subcutaneous wash-out procedure (SWOP) by minimisation of serious complications. Over a time period of 3 years, we treated 13 female patients following chemotherapeutic extravasation injury. Nine of the cases involved a high vesicant chemotherapy agent, and four patients involved chemotherapy with low vesicant potential. The therapeutic approach was performed using SWOP exclusively without the application of specific antidotes. The mean time interval between the extravasation injury and the SWOP was 345min (140-795min). In none of the cases was there a tissue breakdown, but there was a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues without additional complications over a 3-month follow-up period. The results of the study suggest that SWOP is a minimally invasive, safe and effective emergency treatment for chemotherapeutic extravasation injury. Based on the absence of comparative studies with regard to the efficacy of conservative therapy, SWOP should be offered as a therapeutic option for chemotherapeutic extravasations, especially in cases of medical malpractice and also as a defence in case of a legal conflict.
    Journal of Plastic Reconstructive & Aesthetic Surgery 02/2011; 64(2):240-7. DOI:10.1016/j.bjps.2010.04.040 · 1.47 Impact Factor
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    ABSTRACT: A case of autologous fat transplantation for labia majora augmentation after ablative surgery is presented. The patient reported pain and deformity of the left labium majus after resection for Bowen's disease. The symptoms had not been solved by classic plastic surgical reconstructions including a pudendal thigh fasciocutaneous flap. Use of autologous fat transplantation facilitated an improved aesthetic result while preserving residual sensation to the external genitalia and improving symptoms of mucosal exposure and dryness.
    Aesthetic Plastic Surgery 02/2011; 35(5):913-5. DOI:10.1007/s00266-011-9664-5 · 1.19 Impact Factor
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    ABSTRACT: Autologous fat transplantation to the female breast is becoming generally accepted as a standard procedure in plastic surgery. Periglandular planes and also intrapectoral planes are used, based on the idea of having a highly vascularised matrix. To assess this surgical technique a reproducible and exact tool for volume analysis is necessary. The volume of pectoral muscles and breast tissue including periglandular fat was analysed by MRI volumetry before and 6 months after autologous fat transplantation in 10 patients. The volume of the glandular tissue itself was also analysed to evaluate the effect of volume up-, and down-turns between the 6 months. A comparison of the volumes calculated with MRI volumetry preoperatively and postoperatively revealed a mean volume persistence of 64% (± 13%) within the pectoral muscle and of 81% (± 8%) within the periglandular fat. Glandular volume had a mean alternation of 7% (± 4%). In relation to the region of interest for breast volumetry the glandular tissue represented 15% (± 5%) preoperatively und 13% (± 4%) postoperatively. In autologous fat transplantation to the breast the periglandular plane is superior to the intramuscular plane in terms of volume persistence. As bolus injections of fat tissue must be strictly avoided, the pectoral muscles offer an additional receptor tissue for fat transplantation, and might be especially needed in smaller breasts to achieve the desired volume augmentation. The alternation of glandular tissue within the 2 points of time was low and in relation to the whole region of interest for breast volumetry rather inconsequential. Nevertheless consideration and subtraction of the glandular volume in mamma volumetry optimises the exactness of the volumetry.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 02/2011; 43(2):119-24. DOI:10.1055/s-0030-1269931 · 0.54 Impact Factor
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    ABSTRACT: Die Hand in ihrer Funktion als taktiles Greiforgan ist fortwährend der Kontamination durch pathogene Keime ausgesetzt. Infektionen an der Hand sind meist bakteriell bedingt. Neben großen Weichteiltraumen sind häufig kleinere Verletzungen mit oder ohne Fremdkörperverhalt ursächlich für schwere Infektionsverläufe. Besonders problematisch sind Bisswunden durch Mensch und Tier, da sie zu einer tiefen Inokulation hochvirulenter Keime im Handbereich mit Fortleitung der Entzündung entlang der anatomischen Kompartimente führen können. Entscheidend für den weiteren Verlauf ist die Erstdiagnose einer beginnenden Handinfektion. Die Therapie von Infektionen der Hand ist in erster Linie chirurgisch und erfordert ein umfassendes und radikales Débridement. Eine verzögerte Diagnose durch initiale Bagatellisierung der Verletzung kann zu einer fulminanten Entzündung mit erheblichen funktionellen Defiziten und im Endstadium zur Sepsis mit Multiorganversagen führen.
    Trauma und Berufskrankheit 02/2011; 14(1). DOI:10.1007/s10039-011-1788-y
  • C. Radtke, J.D. Kocsis, P.M. Vogt
    Plastic &amp Reconstructive Surgery 01/2011; 128(2):626. DOI:10.1097/01.prs.0000400386.71166.48 · 3.33 Impact Factor
  • J Redeker, P M Vogt
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    ABSTRACT: Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint.
    Der Chirurg 01/2011; 82(1):85-93; quiz 94. · 0.52 Impact Factor
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    ABSTRACT: Zusammenfassung Hintergrund Diese Arbeit soll den aktuellen Stand der Kooperation zwischen Plastischen Chirurgen und Gynäkologen in zertifizierten Brustzentren darstellen. Die Rate der Brustrekonstruktionen nach nichtbrusterhaltender Therapie ist mit 8–13% sehr niedrig. Der Plastische Chirurg ist auch bei zertifizierten Brustzentren häufig nicht Teil des Teams. Methoden Über das Westdeutsche Brustzentrum (WBC) wurden 220 im Jahr 2007 an das WBC angeschlossene Kliniken angeschrieben. 80 Kliniken schickten einen Fragebogen zurück. Die Untersuchung basiert auf den Daten von ca. 24.000 Patientinnen. Ergebnisse Von den 80 Kliniken waren zum Zeitpunkt der Untersuchung 60 Kliniken (75%) als Brustzentrum zertifiziert. Die Zertifizierung erfolgte nach unterschiedlichen Vorgaben: Land Nordrhein-Westfalen, DKG/DGS (Deutsche Krebsgesellschaft/Deutsche Gesellschaft für Senologie), EUSOMA, andere. In 8 Kliniken (10%) wurde ein Plastischer Chirurg als operativ tätiger Facharzt und Teil des Brustzentrums benannt. Die meisten Brustzentren (44 von 80 Kliniken) arbeiten mit 3 bis 4 operativ tätigen Fachärzten. Diskussion Die Zusammenarbeit innerhalb eines Brustzentrums zwischen Gynäkologen und Plastischen Chirurgen kann ausgebaut werden. Nicht jede Frau braucht nach einer Mastektomie einen (mikrochirurgischen) Brustaufbau, aber jede betroffene Frau hat das Recht auf eine Aufklärung über alle zur Verfügung stehenden Rekonstruktionsverfahren inklusive der mikrochirurgischen Verfahren.
    Der Chirurg 01/2011; 82(6):526-530. DOI:10.1007/s00104-010-1993-4 · 0.52 Impact Factor
  • J. Redeker, P.M. Vogt
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    ABSTRACT: Die karpale Instabilität kann als gestörte anatomische Ausrichtung der im Karpus artikulierenden Knochen untereinander verstanden werden. Diese gestörte Balance unter physiologischer Krafteinwirkung tritt entweder nur dynamisch (unter Bewegung) oder bereits statisch in Ruhe auf. Die häufigsten Ursachen für karpale Instabilitäten sind das Handgelenkstrauma mit Ruptur der stabilisierenden Bänder und die adaptive Fehlstellung nach Frakturen des Radius oder Karpus. Dabei nimmt der karpale Kollaps durch eine nicht verheilte Fraktur des Skaphoids eine besondere Rolle ein. Daneben können degenerativ entzündliche Veränderungen wie die Chondrokalzinose oder die Gicht, seltener aseptische Knochennekrosen des Lunatums oder Skaphoids oder anlagebedingte Fehlstellungen (Madelung-Deformität) zu einer Handwurzelinstabilität führen. Die fehlgestellten Gelenkflächen führen unter erhöhtem Druck zur Knochenarrosion mit sekundärer Arthrose des Handgelenkes. Um diesen unwiderruflichen Prozess aufzuhalten oder zu verlangsamen, ist die möglichst frühe Diagnostik notwendig. Zahlreiche Operationsmethoden sind erdacht worden, um eine erneute Stabilität herzustellen. Die Operationsmethoden reichen von der direkten Rekonstruktion verletzter Bänder über Bandersatzoperationen, bis hin zu Teilversteifungen der Handwurzelgelenke. Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint. SchlüsselwörterBiomechanik–Karpale Knochen–Gelenkinstabilität–Handgelenk–Karpale Ligamente KeywordsBiomechanics–Carpal bones–Joint instability–Wrist–Carpal ligaments
    Der Chirurg 01/2011; 82(1):85-94. DOI:10.1007/s00104-009-1867-9 · 0.52 Impact Factor
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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. DOI:10.1055/s-0029-1245818 · 0.28 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. DOI:10.1055/s-0029-1245820 · 0.28 Impact Factor
  • Handchirurgie · Mikrochirurgie · Plastische Chirurgie 12/2010; 42(06):379-385. DOI:10.1055/s-0030-1267913 · 0.54 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. DOI:10.1055/s-0030-1252044 · 0.54 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. DOI:10.1007/s00104-010-1978-3 · 0.52 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. DOI:10.1007/s00167-010-1280-4 · 2.84 Impact Factor
  • Handchirurgie · Mikrochirurgie · Plastische Chirurgie 10/2010; 42(03). DOI:10.1055/s-0030-1249617 · 0.54 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. DOI:10.1007/s10278-009-9264-y · 1.20 Impact Factor

Publication Stats

1k Citations
289.11 Total Impact Points

Institutions

  • 2001–2015
    • Hannover Medical School
      • Department of Plastic, Hand and Reconstructive Surgery
      Hanover, Lower Saxony, Germany
  • 2011
    • Klinikum Duisburg
      Duisburg-Hamborn, North Rhine-Westphalia, Germany
  • 2009
    • University of Colorado Hospital
      Denver, Colorado, United States
  • 2008
    • Leibniz Universität Hannover
      • Institute of Technical Chemistry
      Hanover, Lower Saxony, Germany
  • 2007
    • Hochschule Hannover
      Hanover, Lower Saxony, Germany
  • 2002–2007
    • Johns Hopkins University
      • Department of Plastic and Reconstructive Surgery
      Baltimore, MD, United States
  • 2006
    • University Hospital RWTH Aachen
      Aachen, North Rhine-Westphalia, Germany
    • University Medical Center Hamburg - Eppendorf
      Hamburg, Hamburg, Germany
  • 2000–2006
    • Ruhr-Universität Bochum
      • Klinik für Plastische Chirurgie und Schwerbrandverletzte
      Bochum, North Rhine-Westphalia, Germany
  • 1996
    • Weizmann Institute of Science
      Israel
  • 1995
    • Harvard University
      Cambridge, Massachusetts, United States
  • 1992–1994
    • Brigham and Women's Hospital
      • Division of Plastic Surgery
      Boston, MA, United States
    • Harvard Medical School
      • Department of Surgery
      Boston, Massachusetts, United States
  • 1993
    • University of California, Los Angeles
      Los Angeles, California, United States