J.-L. Grolleau

University of Toulouse, Tolosa de Llenguadoc, Midi-Pyrénées, France

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Publications (134)68.21 Total impact

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    ABSTRACT: Background: Currently, increased interest in the perforator-pedicled propeller flap (PPF) should not obscure the fact that it is, in reality, a complex procedure that requires experience and monitoring similar to free flaps. Through a systematic review and meta-analysis, we aimed to identify the risk factors of PPF failure in lower-extremity defects. Methods: The MEDLINE, PubMed central, Embase and Cochrane databases were searched from 1991 to May 2014 for articles describing PPF in the lower extremity. The study selection process was adapted from the PRISMA statement. Fixed-effects models were used. Publication bias was evaluated using funnel plots and Egger's tests. Results: Forty articles complied with our inclusion criteria. They represented 428 PPFs in 428 patients (mean age, 49.4 years). The most common etiology was post-traumatic (55.2%). Most of the defects were at the distal third of the lower leg (45.6%). The arc of rotation was 180° for 34.3%. Complications were found in 25.2%, including partial necrosis (10.2%), complete necrosis (3.5%), and epidermolysis (3.5%). Complete flap survival was found in 84.3%. We identified three significant risk factors: age>60 years (RR=1.61; 95% CI:1.04-2.48; p=0.03), diabetes (RR=2.00; 95% CI:1.12-3.59; p=0.02) and arteriopathy (RR=3.12; 95% CI:1.26-7.70; p=0.01). No significant results were found regarding smoker status but a tendency (p=0.06), acute etiology (p=0.59), post-traumatic etiology (p=0.97), distal third of the lower leg (p=0.66), fascia inclusion (p=0.70), and pedicle rotation>120° (p=0.41). Conclusions: We propose several practice recommendations to surgeons performing this procedure. Age greater than 60 years, diabetes or arteriopathy are significant risk factors of PPF complications in the lower extremity.
    Plastic and Reconstructive Surgery 09/2015; DOI:10.1097/PRS.0000000000001891 · 2.99 Impact Factor
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    ABSTRACT: Negative-pressure wound therapy (NPWT) has been marketed for about 20 years and remains popular. The only real obstacle to NPWT is the cost; therefore, we designed an inexpensive NPWT connected to a wall vacuum. Here, we report the feasibility and safety of this product, which we call PROVACUUM (Z-Biotech, Saint-Avertin, France). As a first step, the constraints imposed on the manufacturer were equipment quality similar to that of commercial NPWT systems, with an average treatment cost of $15/d. Then, we conducted a prospective study of patients with indications for NPWT from September 2013 to January 2015. Data collected included ease of use, quality of materials, and occurrence of complications during treatment. We enrolled 23 patients with a mean age of 50.8 years. The average duration of treatment was 8.5 days (range, 3-21 days). The dressings were changed every 3.3 days (range, 2-4 days). Two hematomas occurred that required surgical revision and the transfusion of 2 units after large debridement of pressure ulcer. No other adverse events or infections occurred. The surgeons found that our device was similar to commercial NPWT devices. We developed an inexpensive NPWT that costs an average of $15/d. Our process is not intended to replace portable or stand-alone devices with batteries, but rather offers a less expensive alternative for hospitalized patients and makes NPWT accessible to the most precarious countries and institutions.
    06/2015; 3(6). DOI:10.1097/GOX.0000000000000347
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    ABSTRACT: Breast augmentation is one of the most popular aesthetic surgical procedures. The only potential alternative is autologous fat grafting (AFG), which is not new in principle. This procedure has been used on native breasts since 2009, following the recommendations of some learned societies. We performed a systematic review to determine the current worldwide status of fat grafting for aesthetic breast augmentation. A systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria was conducted using the PubMed, EmBASE, and Cochrane library databases. This protocol was registered at the National Institute for Health Research, Prospective Register of Systematic Reviews. A total of 42 articles published between 1987 and July 2014 were included. Most of the studies had a low level of evidence, with only one level 2 study, published by Spear (2014), a prospective cohort study which included 10 patients. The publications were from North America, Europe, and Asia. The indications were aesthetic augmentation (92.4%) and congenital malformation (7.6%). Two cases of cancer were reported among the 2023 patients included (0.09%), with a mean follow-up of 22 months, although the follow-up was insufficient for medium- and long-term cancer diagnoses. AFG seems to be a major tool in this field, but we must remain cautious about its systematization for this indication. Preoperative patient selection is essential but underreported. AFG appears particularly relevant in breast malformations. We believe that this method should be practiced within the scope of a national or international registry with proper follow-up of patients. 3 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.
    Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 05/2015; 35(4):378-93. DOI:10.1093/asj/sjv030 · 1.84 Impact Factor

  • Plastic &amp Reconstructive Surgery 04/2015; 136(2):1. DOI:10.1097/PRS.0000000000001424 · 2.99 Impact Factor
  • A. André · N. Bonnevialle · J.-L. Grolleau · P. Mansat ·
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    ABSTRACT: La couverture de la région olécranienne est une situation problématique en orthopédie et en traumatologie. Elle s’explique notamment par les conditions anatomiques locales (peau fine, absence de couverture musculaire, pannicule adipeux absent) qui entraîne une exposition de l’olécrane ou du matériel mis en place en cas de trouble cicatriciel ou de perte de substance post-traumatique. Nous présentons une technique de couverture de la région olécranienne par un lambeau musculo-cutané de flexor carpi ulnaris (FCU) à pédicule proximal tout en précisant ses limites et ses indications. Sa faible morbidité, sa fiabilité et sa rapidité de réalisation sans microchirurgie, en a fait notre lambeau de choix dans les pertes de substances cutanées de l’olécrane puisqu’il répond par ailleurs aux impératifs fonctionnels d’une mobilisation précoce de l’articulation.
    Revue de Chirurgie Orthopédique et Traumatologique 12/2014; 100(8):686-689. DOI:10.1016/j.rcot.2014.10.003
  • B. Chaput · J.-P. Chavoin · I. Garrido · J.-L. Grolleau · T. Méresse ·

    11/2014; 12(4). DOI:10.1016/S1769-6704(14)68885-9
  • L. Chanel · A. André · J.-P. Chavoin · J.-L. Grolleau ·

    11/2014; 22(2). DOI:10.1016/S1634-2143(14)69322-5
  • B Chaput · N Bertheuil · S Gandolfi · J L Grolleau · C Herlin ·

    Burns: journal of the International Society for Burn Injuries 11/2014; 41(1). DOI:10.1016/j.burns.2014.07.029 · 1.88 Impact Factor
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    ABSTRACT: L’utilisation clinique des adipose-derived stromal/stem cells (ASC) en médecine réparatrice est en plein essor sur la dernière décennie. Les ASC font partie des cellules stromales mésenchymateuses initialement obtenues à partir de la moelle osseuse. Leurs capacités limitées de différenciation in vivo en cellules matures fonctionnelles ont conduit à une réévaluation de leurs mécanismes d’action. Ainsi, leur intérêt clinique semble essentiellement lié à des effets paracrines par le biais d’une production transitoire de facteurs à la fois trophiques et immunomodulateurs. Nous souhaitons faire ici une mise au point sur les dernières connaissances acquises en matière d’ASC ainsi que les perspectives cliniques qui en découlent que ce soit en thérapie cellulaire ou dans le cadre des transferts de tissu adipeux en chirurgie plastique. Nous rappellerons la méthode d’obtention des ASC et leurs mécanismes d’action avec un intérêt particulier pour leurs propriétés immunosuppressives/immunomodulatrices.
    Annales de Chirurgie Plastique Esthétique 10/2014; 60(2). DOI:10.1016/j.anplas.2014.09.014 · 0.31 Impact Factor
  • N Bertheuil · B Chaput · C Ménard · A Varin · I Garrido · J L Grolleau · L Sensébé · E Watier · K Tarte ·
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    ABSTRACT: Over the last decade, the clinical use of adipose-derived stromal/stem cells (ASC) in regenerative medicine is rapidly increasing. ASC belong to the mesenchymal stromal cells initially obtained from the bone marrow. Their limited differentiation capacity in vivo into functional mature cells has led to a reassessment of their mechanisms of action. One of the major clinical interests appears related to paracrine effects through a temporary production of trophic and immunomodulatory factors. Our purpose is to provide a review on the latest knowledge in the field of ASC, mechanisms of action, mainly immunomodulatory/immunosuppressive properties, methods of obtention, with a focus on clinical perspectives particularly in the field of cellular therapy and fat grafting technique in plastic surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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    ABSTRACT: Objectives Tobacco addiction is a risk factor for complication in plastic surgery. The authors have assembled concrete arguments detailing the risks of perioperative and postoperative complication that are incurred by a patient with continued tobacco intoxication who wishes to undergo a surgical intervention. Research strategy Through application of the PRISMA criteria, we have carried out a systematic review of the literature, in which we explored five databases while using predefined keywords. We selected randomized, controlled observational studies on the perioperative and postoperative complications related to tobacco use in actively smoking, abstinent and non-smoking patients. Data collection and analysis The levels of evidence for each article were evaluated. Risk of bias was assessed using the Newcastle-Ottawa Scale. Incidence parameters including the Odds Ratio and relative risk were calculated for each complication of which the number of occurrences had been indicated. Meta-analysis of the results was carried out. Results We included 60 observational studies. In the cosmetic surgery group, we calculated a combined Odds Ratio of 2.3 [1.51–3.54] P < 0.001 for surgical site infections and 2.5 [1.49–4.08] P < 0.001 for delayed wound healing. In the bariatric surgery sequelae group, we found a combined Odds Ratio of 3.3 [1.90–5.64] P < 0.001 with regard to delayed wound healing and 3.1 [1.39–7.13] P = 0.006 for cutaneous necrosis. No proof was provided as to the possible influence of tobacco on the success rate of free flap microsurgery, but it is difficult to extrapolate results on the latter to digital reimplantation. Conclusions The review underlines the fact that patients with smoking habits run a significantly heightened risk of cutaneous necrosis, particularly in the event of major detachment (cervico-facial lift, skin-sparing mastectomy, abdominoplasty), of additionally delayed wound healing and of addition surgical site infections. Rigorous preoperative evaluation of smokers could help to diminish these risks.
    Annales de Chirurgie Plastique Esthétique 10/2014; 60(1). DOI:10.1016/j.anplas.2014.09.011 · 0.31 Impact Factor
  • I. Pluvy · I. Garrido · J. Pauchot · J. Saboye · J.P. Chavoin · Y. Tropet · J.L. Grolleau · B. Chaput ·
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    ABSTRACT: Objectifs Le patient tabagique bénéficiant d’une intervention de chirurgie plastique est exposé à un risque majoré de complications péri- et postopératoires. Il nous semblait utile d’établir une mise au point sur le retentissement négatif, en particulier cicatriciel, du tabagisme et sur les bénéfices incontestables du sevrage. Nous souhaitons proposer un délai minimal de sevrage pré- et postopératoire en vue de réduire les risques et d’optimiser les résultats de l’intervention. Méthodes Une revue de la littérature a été réalisée sur la période 1972–2014 en interrogeant cinq bases de données (Medline, PubMed Central, Cochrane library, Pascal et Web of Science). Résultats La fumée de cigarette agit de manière diffuse et multifactorielle dans l’organisme. L’hypoxie et l’ischémie tissulaire ainsi que les désordres immunitaires induits par le tabac sont responsables de l’altération du processus cicatriciel. Une partie de ces effets est réversible au sevrage. Les données de la littérature conseillent un délai d’arrêt du tabagisme préopératoire situé entre 3 et 8 semaines et allant jusqu’à 4 semaines postopératoires. L’utilisation de traitements substitutifs nicotiniques double le taux d’abstinence à court terme. Le chirurgien doit s’aider d’un tabacologue en cas de dépendance importante de son patient. Conclusions Un sevrage tabagique total de 4 semaines préopératoires et jusqu’à la cicatrisation primaire du site opératoire, soit 2 semaines postopératoires, semble optimiser les conditions chirurgicales sans majorer le risque anesthésique. Un accompagnement du sevrage aussi bien humain que médicamenteux est recommandé.
    Annales de Chirurgie Plastique Esthétique 10/2014; 60(1). DOI:10.1016/j.anplas.2014.06.011 · 0.31 Impact Factor
  • T Ménez · B Chaput · A Bonte · J M Alet · J L Grolleau · A Michot · P Pélissier ·
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    ABSTRACT: Complex heel injuries in children are rare and their management requires coverage combining resistance and thinness, to allow walking and footwear. The objective of this study was to create a decision-making algorithm for heel defect in children.
  • T. Ménez · B. Chaput · A. Bonte · J.M. Alet · J.L. Grolleau · A. Michot · P. Pélissier ·
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    ABSTRACT: Introduction Complex heel injuries in children are rare and their management requires coverage combining resistance and thinness, to allow walking and footwear. The objective of this study was to create a decision-making algorithm for heel defect in children. Materials Children received for heel defect, reconstructed with flap in our plastic surgery unit of Bordeaux with a follow-up greater than 10 years were investigated. Three children operated between 1999 and 2003 were included. A free contralateral reinnervated medial plantar flap, a free latissimus dorsi flap and a lateral supramalleolar flap were performed. Patients were reviewed in consultation to assess quality of reconstruction and functional outcomes. Three scores were used, the Foot Function Index (FFI), the AOFAS Ankle and Hindfoot Scale and the Maryland Foot Score. Results No growth disorder has been found. Scores greater than 80 for the Maryland Foot Score and AOFAS Ankle and Hindfoot Scale and less than 10 for the FFI were very satisfactory in cases 1 and 3. We found pain and greater functional impairment in the second case. Conclusions “Like-with-like” reconstruction remains the gold standard, whether in loco-regional or free flap. The fasciocutaneous flaps allow custom reliable coverage with little donor site morbidity. Loco-regional flaps remain easily accessible but donor site sequelae are not negligible.
    Annales de Chirurgie Plastique Esthétique 10/2014; DOI:10.1016/j.anplas.2014.09.001 · 0.31 Impact Factor
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    09/2014; 2(9):e213. DOI:10.1097/GOX.0000000000000143
  • L. Chanel · A. André · J.-P. Chavoin · J.-L. Grolleau ·
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    ABSTRACT: Le gamme di medicazioni si arricchiscono ogni giorno con nuove associazioni di principi attivi. La medicazione ideale deve mantenere un ambiente umido, essere permeabile agli scambi gassosi, rimuovere l’essudato in eccesso e le componenti tossiche ed essere impermeabile ai liquidi e non aderente alla ferita. La sua scelta dipende dalle caratteristiche semeiologiche della ferita. Noi precisiamo le indicazioni e le regole di utilizzo di ogni categoria: idrogel, alginato, idrocolloide, idrofibra, idrocellulare, medicazione grassa e interfaccia, medicazione all’argento e al carbone, film di poliuretano e medicazioni adesive.
    09/2014; 12(3):1–9. DOI:10.1016/S1769-6704(14)68033-5
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    D. Faisan Smilevitch · B. Chaput · J.-L. Grolleau · M. Rongieres · P. Mansat ·
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    ABSTRACT: Glomus tumors are benign and rare tumors that develop through a neuro-myo-arterial glomus. Complete surgical excision of the tumor remains the standard intervention. Due to the difficulty of diagnosis, management is often late, resulting in poor quality of life. This study aimed to assess improvement in quality of life after surgery in patients with glomus tumors. We performed a retrospective study from 1992 to 2011 to analyze 23 glomus tumors of the upper limbs in 22 patients. Pain was systematically the predominant symptom. Quality of life and disability were assessed preoperatively and postoperatively using two questionnaires in 11 patients: the Medical Outcome Study Short Form (SF-36 French version) and the Cochin Hand Functional Disability Scale. An evaluation of the visual analog scale (VAS) completed the study. The average age of patients was 48 years with a sex ratio of 0.28. The location of the tumor was in the fingers in 20 (87%) cases. The average delay between onset of symptoms and surgery was 8.5 years. Patients consulted an average of 2.8 practitioners. The average preoperative VAS was 8.7, whereas it was 0.8 postoperatively. Eleven patients were evaluated using the assessment scales, a mean of 11 years after surgery. Pain disappeared in 10 patients (91% of cases). A limitation of physical effort before surgery was found in five (45%) patients, while one patient (9%) had such limitation for a long period after surgery (P = 0.006). The improvement in fine motion was also significant (P = 0.03). Surgery had a positive impact on the emotional life of three patients (27%). Discomfort arose in the social life of four (36%) patients before surgery vs. one (9%) after surgery. Glomus tumors are rarely diagnosed during the first visit, leading to misdiagnosis and deterioration in quality of life, a cause of chronic pain, and limitations in activity. The significant improvement in quality of life provided by surgery necessitates earlier diagnosis of this tumor.
    Chirurgie de la Main 08/2014; 33(5). DOI:10.1016/j.main.2014.07.001 · 0.29 Impact Factor
  • B. Chaput · J.L. Grolleau · N. Bertheuil · H. Eburdery · J.P. Chavoin · I. Garrido ·

    Journal of Plastic Reconstructive & Aesthetic Surgery 08/2014; 67(8). DOI:10.1016/j.bjps.2014.03.027 · 1.42 Impact Factor

  • The Breast Journal 07/2014; 20(5). DOI:10.1111/tbj.12314 · 1.41 Impact Factor
  • B. Chaput · J.-P. Chavoin · I. Garrido · J.-L. Grolleau · T. Méresse ·

    06/2014; 22(2). DOI:10.1016/S1634-2143(14)69325-0

Publication Stats

333 Citations
68.21 Total Impact Points


  • 1996-2015
    • University of Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France
    • Centre Léon Bérard
      Lyons, Rhône-Alpes, France
    • CHU de Lyon - Groupement Hospitalier Edouard Herriot
      Lyons, Rhône-Alpes, France
  • 2014
    • Paul Sabatier University - Toulouse III
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 1994-2013
    • Centre Hospitalier Universitaire de Toulouse
      • Service de Chirurgie Plastique, Reconstructrice et Esthétique
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2005
    • Institut Claudius Regaud
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 1998
    • Hôpitaux Universitaires de Genève
      • Service de chirurgie plastique, reconstructive et esthétique
      Genève, Geneva, Switzerland