J.-L. Grolleau

Paul Sabatier University - Toulouse III, Tolosa de Llenguadoc, Midi-Pyrénées, France

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Publications (125)73.68 Total impact

  • L. Chanel, A. André, J.-P. Chavoin, J.-L. Grolleau
    EMC - Cirugía Plástica Reparadora y Estética. 11/2014;
  • 11/2014; 12(4).
  • Burns: journal of the International Society for Burn Injuries 11/2014; · 1.95 Impact Factor
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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.
    Annales de chirurgie plastique et esthetique. 10/2014;
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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; · 0.59 Impact Factor
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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; · 0.59 Impact Factor
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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). · 0.59 Impact Factor
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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.
    Annales de chirurgie plastique et esthetique. 10/2014;
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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; · 0.59 Impact Factor
  • Source
    Plastic and reconstructive surgery. Global open. 09/2014; 2(9):e213.
  • 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.
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    ABSTRACT: Les tumeurs glomiques sont des lésions bénignes et rares qui se développent aux dépens des glomus neuro-myo-artériels. L’exérèse chirurgicale complète de la tumeur reste la référence. Difficiles à diagnostiquer, leur prise en charge est souvent tardive, laissant se dégrader progressivement la qualité de vie. Cet article a pour but d’évaluer l’amélioration de la qualité de vie après chirurgie. Une étude rétrospective menée de 1992 à 2011 a permis d’analyser 23 tumeurs glomiques du membre thoracique chez 22 patients. La douleur était le symptôme prédominant chez tous les patients. La qualité de vie des patients ainsi que le handicap ont été évalués en préopératoire et en postopératoire à l’aide de deux questionnaires chez 11 patients : le Medical Outcome Study Short Form (MOS-SF 36, version française) et l’Échelle d’incapacité fonctionnelle de la main de Cochin (EFMC). Une évaluation de la douleur par échelle visuelle analogique (EVA) a complété l’étude. L’âge moyen des patients était de 48 ans avec un sex ratio de 0,28. La localisation était digitale dans 20 cas (87 %). Le délai entre l’apparition des symptômes et la chirurgie était de 8,5 ans. Les patients avaient consulté en moyenne 2,8 praticiens. La douleur moyenne préopératoire sur l’EVA était de 8,7/10, alors qu’en postopératoire elle était notée à 0,8/10. Les échelles d’évaluation ont été soumises à 11 patients avec un recul moyen de 11 ans après la chirurgie. Les douleurs avaient disparu chez 10 patients (91 % des cas). Une limitation des efforts physiques avant la chirurgie était mentionnée par cinq patients (45 %), contre un (9 %) à distance (p = 0,006). L’amélioration était également significative pour les mouvements fins (p = 0,03). La chirurgie avait eu un impact positif sur la vie sentimentale pour trois patients (27 %). Avant la chirurgie, une gêne dans la vie sociale existait chez quatre patients (36 %), contre un (9 %) après chirurgie. Les tumeurs glomiques ne sont que rarement diagnostiquées lors des consultations de première intention, laissant de nombreux patients en errance diagnostique à l’origine d’une dégradation de la qualité de vie, entre douleur chronique et limitation des activités. L’amélioration significative de la qualité de vie après la chirurgie doit inciter à un diagnostic plus précoce de cette pathologie.
    Chirurgie de la Main 08/2014; · 0.25 Impact Factor
  • Journal of Plastic Reconstructive & Aesthetic Surgery 08/2014; · 1.47 Impact Factor
  • The Breast Journal 07/2014; · 1.43 Impact Factor
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    ABSTRACT: La correzione chirurgica dei seni piccoli è uno degli interventi più praticati in chirurgia estetica: questo inestetismo ha, infatti, una forte ripercussione psicologica sulla donna e sulla sua femminilità, di cui il seno è un simbolo. L’utilizzo di protesi mammarie ha dimostrato la sua efficacia da 60 anni. Il chirurgo deve conoscere bene la loro composizione e le loro modalità di fabbricazione, prima di impiantarle. È altrettanto importante che egli compia le scelte corrette di vie d’accesso e di volume e che, soprattutto, non esiti a correggere una ptosi, malgrado la legittima reticenza della paziente di fronte ai postumi cicatriziali. L’indicazione corretta, la protesi corretta e la tecnica corretta sono i tre pilastri del successo e della riconoscenza eterna delle pazienti.
    06/2014; 12(2):1–13.
  • EMC - Cirugía Plástica Reparadora y Estética. 06/2014; 22(2).
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    ABSTRACT: Introduction Hyaluronic acid has come to represent the most widely used injectable cosmetic product in the world. Brought into being by the Swedish company Q-Med, in 2007 Macrolane™ was authorized for use in France, and the year after, it received official European approval as a means of breast augmentation. Since then, however, numerous controversies pertaining to its side effects have led to its withdrawal from the worldwide breast augmentation market. The objective of this article is to carry out a review of the literature providing updated information on Macrolane™ and its recent indications. Materials and methods We carried out a review of the literature on the PubMed and PubMed Central data bases through use of the keywords “Macrolane™”, “NASHA”, “hyaluronic acid” and “soft filler”, and subsequently analyzed the levels of evidence and possible biases of the different publications. The official sites of the French, English, Spanish and American scholarly organizations of plastic surgery were likewise consulted. Perusal of the notifications and recommendations for use brought out by the Q-Med company completed our study. Results A large majority of the available clinical series on Macrolane™ with regard to not only breast augmentation, but also its other indications, offer an insufficient level of evidence and present a number of conflicts of interest. Since April 2012 Macrolane™ has been temporarily withdrawn by its distributors from the worldwide breast augmentation market. In point of fact, Macrolane™ injections have been found to interfere with breast imaging and screening for breast cancer. As regards the latest indications for this controversial product, it is not yet possible to step back and take stock. Conclusions Present-day scientific data fail to justify the market reappearance of Macrolane™ breast augmentation products. Q-Med has shown full awareness of the problem by imposing worldwide restrictions on products aimed at penis as well as breast enlargement. Larger cohorts of female patients are more necessary than ever, as is an approach based on stepping back and taking stock.
    Annales de Chirurgie Plastique Esthétique 04/2014; · 0.59 Impact Factor
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    ABSTRACT: La corrección quirúrgica de las mamas pequeñas es una de las intervenciones más practicadas en cirugía estética: esta falta de armonía tiene de hecho una importante repercusión psicológica sobre la mujer y su feminidad, de la cual la mama es un símbolo. El uso de las prótesis de mama ha demostrado su eficacia desde hace más de 60 años. Antes de implantarlas, es necesario que el cirujano esté familiarizado con su composición y su modo de fabricación. Es igualmente importante que tome las decisiones correctas en relación con las vías de acceso y de volumen y que, sobre todo, no dude a la hora de corregir una ptosis a pesar de las reticencias legítimas de la paciente ante el precio cicatricial que supone. Una buena indicación, una buena prótesis y una buena técnica son los tres pilares del éxito y de la gratitud eterna de las pacientes.
    EMC - Cirugía Plástica Reparadora y Estética. 03/2014; 22(1):1–13.
  • Plastic and Reconstructive Surgery 03/2014; 133(3):432e-4e. · 3.33 Impact Factor
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    ABSTRACT: Introduction Surgical treatment of perineal pressure sores could be done with various fascio-cutaneous or musculo-cutaneous flaps, which provide cover and filling of most of pressure sores after spinal cord injuries. In rare cases, classical solutions are overtaken, then it is necessary to use more complex techniques. We report a case of a made-to-measure lower limb flap for coverage of confluent perineal pressure sores. Patient and method A 49-year-old paraplegic patient developed multiple pressure sores on left and right ischial tuberosity, inferior pubic bone and bilateral trochanters with hips dislocation. Surgical treatment involved a whole right thigh flap to cover and fill right side lesions, associated to a posterior right leg musculo-cutaneous island flap to cover and fill the left tronchanteric pressure sore. Result The surgical procedure lasted 6.5 hours and required massive blood transfusion. Antibiotics were adapted to bacteriological samples. There were no postoperative complications; complete wound healing occurred after three weeks. Discussion A lower limb sacrifice for coverage of a giant perineal pressure sores is an extreme surgical solution, reserved to patients understanding the issues of this last chance procedure. A good knowledge of vascular anatomy is an essential prerequisite, and allows to shape made-to-measure flaps. The success of such a procedure is closely linked to the collaboration with the rehabilitation team (appropriate therapeutic education concerning transfers and positioning).
    Annales de Chirurgie Plastique Esthétique 02/2014; · 0.59 Impact Factor

Publication Stats

235 Citations
73.68 Total Impact Points

Institutions

  • 2014
    • Paul Sabatier University - Toulouse III
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 1996–2014
    • 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
  • 1994–2012
    • Centre Hospitalier Universitaire de Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2005
    • Institut Claudius Regaud
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 1998
    • Hôpitaux Universitaires de Genève
      Genève, Geneva, Switzerland