Lucian Fodor

County Emergency Hospital Cluj-Napoca · Department of Plastic Surgery

Aim Evaluating patient comfort during full awake local anesthesia in carpal tunnel release surgery, without tourniquet use, by using epinephrine to obtain a completely dry surgical field. Methods We included into the study 41 patients who underwent carpal tunnel syndrome surgery under full awake combined anesthesia, using a 9-point questionnaire....

Leiomyosarcomas of the lower extremity are heterogeneous tumors with high recurrence and metastasizing rates, which, rarely, can suffer a dedifferentiation process, making them extremely aggressive and unpredictable. We report the case of a 72-year-old female patient who presented the clinical and histopathological features of a rare leiomyosarcoma...

A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortality rate of 40% and an overall mortality rate of 60–80%. Open surgical repair for rAAA remains the principal method of treatment when endovascular repair is not available. Graft infection occurs in 1–4% of patients at 5 years, with a high incidence follow...

Critical limb ischemia (CLI) associated with lower extremity complex wounds is challenging for vascular and plastic surgeons. Despite a high risk of perioperative morbidity, complex reconstructive surgery in these patients is an alternative to primary major limb amputation. We present a patient with CLI and a complex foot wound treated with simulta...

The progresses in surgical field are amazing regarding the possibilities of soft tissue reconstruction. Techniques of breast reconstruction have been evolved since the last 40 years. There was a trend from pedicled flaps toward microsurgical free flaps. In the English literature have been reported several types of free flaps for BR. Although DIEP i...

Nanoparticles are defined as objects, which have one, two or three external dimensions in the nanoscale, ranging from 1 to 100 nm (ISO/TR 18401:2017). In order to reduce vascular complications like thrombosis, infection and graft rejection, nanoparticle technologies show growing applications in the field of angiology and vascular surgery. The aim o...

A schwannoma is a benign tumor that arises from the myelin-producing Schwann cells that surround nerves. We herein report a case involving a 55-year-old man who first presented to our clinic with a schwannoma of the posterior tibial nerve and 5 years later with a schwannoma of the ulnar nerve. This is the first report of schwannomatosis of the ulna...

The current paper presents a case report of lower eyelid reconstruction after removal of a basal cell carcinoma. Our novel reconstruction method consists of translation and rotation of a paramedian forehead flap into the defect, conjunctivorhinostomy for reconstruction of the nasolacrimal duct, and placement of a sandwich ear cartilage graft that i...

Patient selection is one of the most important parts of a successful aesthetic procedure. There are two main categories that make a patient an unlikely candidate for cosmetic procedures. One is anatomical unsuitability and the other is psychological unsuitability. Problematic patients are usually those with high expectations, excessive demands, ind...

The prices for IPL equipment vary from a few thousand dollars to more than $100,000, depending on the producer and the properties of the device. Acquisition of the equipment can be made by purchase, lease or rental. The room should be large enough to accommodate the treatment table, IPL device, stand tables, small stores cupboards, refrigerator and...

To get the best results after IPL therapy, the treatment itself is not sufficient. All post-treatment recommendations should be considered to obtain the expected results, to minimize side effects, to reduce the complications rate and to make this journey a pleasant one for the patient.

The rapid development of IPL technique has led to improvement in the safety of professional and of home-use devices. Covering such a large array of treatments in the medical office as well as at home, IPL devices prove to be a relatively safe technique. Some adverse effects can still be encountered, most with minor consequences. The complications c...

Even though the face remains the most important part of the body when it comes to human interaction, the hands and the cleavage come right after. Sun exposure along with smoking is the most important risk factor when it comes to skin aging. Photo-aged skin suffers from increased laxity, atrophy and wrinkles, while vascular problems such as telangie...

The goal of achieving a satisfied patient implies, beyond an accurate treatment, wise patient selection and management. While some patients will be satisfied with basically any result, others will need special attention and guiding before achieving a satisfying result. In both cases, the physician’s attitude plays a key role and can avoid bad revie...

The skin is the soft and superficial tissue that covers the body. It has multiple functions, which include protection, physiological regulation for the body and sensation. It is considered one oh the body’s largest organ, with a total surface in adults of 2 m². It weights more than 5 kg. The skin is composed of three layers: epidermis, dermis and s...

Cosmetic medicine benefits nowadays from intense advertising. The general perception regarding the cosmetic procedures is that they are quick, painless and with little risk.

The effects of light on skin are due to various degrees of absorption of electromagnetic radiation. The visible light spectrum has a 400–760 nm wavelength. The light-tissue interaction effects are due to absorption and excitation of photons. The Intense Pulse Light is situated in the visible light of the electromagnetic spectrum. Once the light rea...

This significantly revised second edition provides a practical guide to applications of Intense Pulsed Light (IPL) in aesthetic and non-aesthetic field. It features revised chapters focusing on skin anatomy, light tissue interactions and legal issues associated with IPL safety. New topics covered include the use of IPL for rosacea, pigmented lesion...

Primary lymphoma of a peripheral nerve is a very rare condition with only a few cases reported in the medical literature. Primary lymphoma of a peripheral nerve in the upper extremity was reported in only four cases in the English and French literature. We present a case of a 54-year-old man, in good health, without other medical conditions, who ca...

Currently there are no established adjuvant drugs for the acceleration of peripheral nerve regeneration. In this paper we reviewed the literature from the last 10 years and described the drugs proved to accelerate the functional and histological regeneration of the peripheral nerves, either after trauma or in neuropathy experimental models. The vas...

Pharyngocutaneous fistula is a major complication after total laryngectomy, leading to a severe adverse impact for the patient and social activity. The reported incidence ranges from 9% to 25% in the last decade. In this paper, the authors present our experience using chimeric lateral arm free flap for reconstruction of the pharyngo-esophageal segm...

Background: Wound healing is a complex process. Despite extensive studies, hypertrophic and keloid scars still occur, and can be functionally and cosmetically problematic. In an attempt to prevent hypertrophic scar formation, the effects of topical oxandrolone, using hyaluronic acid as a biomaterial, were studied on ear wounds in rabbits. Methods...

Introduction: We present a case of classical laryngeal mask insertion in prone position, followed by jet vomiting and pulmonary aspiration. Case: A 33 years old woman BMI¼33,5 was scheduled for an aesthetic operation in prone position. The patient had affirmatively drunken 250 mL of water 4 hours preintervention. The patient positioned herself in...

Frozen neck and hypopharyngeal fistula are sometimes present after tumor ablation of the larynx, multiple local surgeries with scar tissue, and radiotherapy and chemotherapy. This multiorgan involvement requires 1 or even 2 flaps. We present a 63-year-old heavy smoker with frozen neck tissue and simultaneous large hypopharyngeal fistula and neck de...

Complex scalp defects with poor recipient vessels represent a challenge for plastic surgeons. In these cases, free flaps are the last resort for solving the problem. The authors present 5 difficult cases with complex large scalp and calvarium defects with unsuitable small recipient vessels for anastomoses. For these cases, the lesser saphenous vein...

The purpose of the paper is to present the ultrasonographic and imaging appearance of two cases of peripheral nerve intraneural vascular anomalies and provide a comprehensive review of the publications on this subject.The clinical presentation, ultrasonographic appearance, corresponding imaging and outcome of a case of ulnar nerve venous malformati...

Penile cancer accounts for 1–10% of men neoplastic diseases and 30–60% of patients have inguinal metastases at the time of diagnosis. Inguinal metastases of penile cancer with femoral vessel involvement could lead to vascular fistula and hemorrhagic shock. We present 3 consecutive patients with inguinal metastases of penile cancer complicated by in...

Activitate stiintifica 2016

Recurrent laryngeal cancer has an incidence of 25-50% and a 23-35% fiveyear survival rate. Surgery is the best treatment in order to control local recurrence. Herein, we present our surgical strategy for a patient with a history of modified radical laryngectomy for laryngeal cancer and with recurrent tumor at the cervical tracheostomy site extended...

Pseudoaneurysms related to hemodialysis represent 2-10% of arteriovenous fistula (AVF) complications. They can be treated by percutaneous approach, endovascular procedures or surgery. We present a patient with a large brachial pseudoaneurysm of the upper extremity and critical finger ischemia. One-step surgery involved an extra-anatomic brachial -u...

Free flaps for breast reconstruction are among the most used procedures nowadays. Most common free flap procedures are DIEP, SGAP, IGAP, FCI and gracilis. The success rates in experienced centers range between 93-97%. Failure of a free flap can have many causes and the result can be a disaster for the patient, with loss of the new breast and donor...

Nipple areolar reconstruction (NAC) progressed in parallel with breast reconstruction. Being a part of the complex process of the reconstruction of the breast, it also respresents an important asset in the evaluation of the overall quality of this process. Patients associate this stage with the end of the treatment and with a sense of completeness....

Breast reconstruction using free flaps is a procedure often performed by plastic surgeons. Like any other procedure, it is not without complications, which may occur whether it is an immediate or delayed, unilateral or bilateral reconstruction, with or without pre-or postoperative radiotherapy, in obese or smoking patients. Both the clinical settin...

Health cannot be defined anymore just from a physiological point of view; good self-esteem, sexuality and quality of life are essential for a healthy patient. Today, medicine is more and more directed towards the patient, giving them more choices, control and information. To be able to accurately measure health care outcomes, patient satisfaction d...

Romanian recognition for research contribution

Complications in breast reconstruction are a wide-ranging subject. Knowing the possible complications and favoring factors is helpful in making decisions regarding the strategy of reconstruction. The authors discuss the various complications that may occur with free flap-based breast reconstruction, implant or tissue expander-based breast reconstru...

In the last decades, there has been a trend in breast reconstructions toward more and more free perforator flaps. The Deep Inferior Epigastric Perforator Flap is commonly used with the great advantage of not disturbing the rectus abdominis muscle. For thin patients, this donor area is unavailable and other options, such as implants or free flaps fr...

Nipple-areola complex (NAC) reconstruction represents the final stage of breast reconstruction and it is usually performed several months after the breast volume was restored. Ideally, the reconstructed areola should have the same size, color and texture as the opposite areola. Most common techniques are skin graft and tattooing. When the contralat...

Compartment Syndrome is a condition which signifies increased pressure in a confined anatomical space, resulting in compromised circulation and threatening the viability and function of the muscles. The paraspinal region is a potential area for developing compartment syndrome. The erector spinae muscles lay parallel to the dorsolumbar spine and hav...

Management of high-energy, complex limb injuries is a difficult challenge for orthopedic surgeons. Fractures do not heal without adequate soft tissue coverage and vascular supply. In cases of complex limb injuries, acute shortening and angulation is a viable option for treating both bone and soft tissue defects, providing early coverage and prevent...

Acute limb compartment syndrome (LCS) is determined by edema and bleeding in a restrained muscle compartment limited by fascia and bone. LCS leads to muscle and nerve ischemia, threatening limb function and viability. The most frequent etiological factors are trauma and reperfusion, followed by acute arterial occlusion. Left untreated, LCS can resu...

Plantar area reconstruction represents the most challenging part of the lower limb. The anterolateral thigh (ALT) flap proved to be a versatile flap for this special area. Herein, we present the application of bilateral ALT free flaps for foot salvage after frostbite injury and long-term follow-up. Single perforator bilateral ALT flaps (304 and 320...

Lower limb vascular injuries are often present in severe trauma. Frequently, the vascular lesions are associated with lower limb bone fractures, muscle contusion or rupture, burns and external limb compression. Among the most common causes are acute injuries by sharp objects, car accidents and fractures. Vein injuries are less often present but are...

Orbital compartment syndrome (OCS) is a rare but treatable ophthalmic surgical emergency, caused most often by a retrobulbar hematoma, facial trauma being the most frequent etiological factor. Iatrogenic causes are rarely discussed, and are most often overlooked. The prone position in long surgical procedures, such as posterior fossa or spinal surg...

Angiomatosis or diffuse hemangioma is a very rare benign vascular tumor, consisting of blood and lymphatic channels growing diffusely in the breast parenchyma. We report a case of diffuse breast angiomatosis in a 34-year-old woman with pubertal anisomastia. Ultrasound raised the suspicion of vascular tumor, by showing large cystic spaces separated...

The goal of our study was to find an easy and suitable skin burn model for rabbits, to identify the temperature and contact time to reach a deep 2nd degree burn, and to find the best wound dressing fixation method. We used New Zealand male rabbits as experimental models. On a pilot study, with a copper device heated to temperatures between 43-48 Ce...

Background About 240 million patients undergo surgery every year, worldwide. Roughly 50% of these patients report clinically significant pain. Numerous barriers impede provision of adequate management. Lack of evidence about appropriateness and effectiveness of interventions is one. A registry can provide such information, eventually facilitating b...

Rationale, aims and objectives: Management of post-operative pain is unsatisfactory worldwide. An estimated 240 million patients undergo surgery each year. Forty to 60% of these patients report clinically significant pain. Discrepancy exists between availability of evidence-based medicine (EBM)-derived knowledge about management of perioperative p...

Ear keloids are among the most challenging plastic surgery conditions and may have significant psychosocial impact for the patient. Their aesthetic considerations are serious and despite a variety of treatment options, they often proved to be recurrent. This paper reviews the management options of ear keloids available in literature up to date. Mul...

PAIN OUT is a European Commission-funded project aiming at improving postoperative pain management. It combines a registry that can be useful for quality improvement and research using treatment and patient-reported outcome measures. The core of the project is a patient questionnaire-the International Pain Outcomes questionnaire-that comprises key...

BACKGROUND: The Melkersson-Rosenthal syndrome (MRS) is a very rare clinical entity and its classical form is being characterized by the following triad: facial nerve palsy, swelling of the lips and fissured tongue. However, the monosymptomatic form is more common and the typical manifestation is facial edema and/or enlargement of the lips. CASE REP...

Limb injuries represent a constant and severe problem. Several lower limb injuries are more frequent than upper limb injuries. Over time, in an attempt to quantify the severity of traumas and to establish guidelines for the decision whether to save or amputate a mangled extremity, several scoring systems have been reported. Most refer to bone fract...

Sarcoid flexor tenosynovitis is rare. Isolated sarcoid tenosynovitis of the index finger in a young woman as an early manifestation of the disease is reported. Tenosynovectomy was performed as a therapeutic and diagnostic tool, followed by systemic corticosteroids. The patient had no signs of relapse 3 years after surgery.

Post-operative pain exacts a high toll from patients, families, healthcare professionals and healthcare systems worldwide. PAIN-OUT is a research project funded by the European Union's 7th Framework Program designed to develop effective, evidence-based approaches to improve pain management after surgery, including creating a registry for feedback,...

Atherosclerosis is a polypathogenic process encompassing a group of closely related vascular disorders. Chronic lower limb ischemia can appear when the arteries are affected by atherosclerosis. Overall, approximately one in four patients complains of increasing symptoms over time. Revascularization is needed in less than 20% of patients at 10 years...

Upper and lower limb trauma characterized by severe, complex injuries of the soft tissue, vessels, nerves and bones is frequently encountered in emergency rooms. Car accidents, work injuries and armed conflict are frequently responsible for these injuries. Severe limb trauma represents a challenge for surgeons dealing with these types of injuries....

Introduction Le syndrome du défilé thoraco-brachial (SDTB) correspond aux conséquences cliniques liées à la compression mécanique des vaisseaux sous-claviers et du plexus brachial dans l'espace délimité par les muscles scalènes, la clavicule, et la première côte. A ce jour, il n'existe pas d'explication réellement concluante concernant les véritabl...

The skin is composed of three layers: epidermis, dermis and subcutaneous tissue. The thickness of the layers varies with different anatomical regions. The epidermis is thickest on the palm and soles, and very thin on the eyelids, while the dermis is thickest on the back. Keratinocytes are the main component of the epidermis. Melanocytes are the cel...

Light and laser devices have common considerations and include hazards both to the patient and to the medical staff. The operating manual of the IPL device should be read by all personnel manipulating the device. Personnel in the treatment room should have protection against accidental exposure to the IPL, either directly or indirectly from a refle...

Hirsutism is represented by excessive growth of the coarse hairs in women, distributed in a male-like pattern. Hypertrichosis is represented by excessive growth of coarser and longer hair than is normal for the age, sex and race of the person. The hair growth cycle has three phases: anagen, catagen and telogen. The anagen phase is the growth phase,...

Patient selection is one of the most important parts of a successful aesthetic procedure. There are two main categories that make a patient an unlikely candidate for cosmetic procedures. One is anatomical unsuitability and the other is psychological unsuitability. Problematic patients are usually those with high expectations, excessive demands, ind...

As with any other medical technology, side effects and complications can occur after IPL treatment. Some complications can be prevented by knowing the principles of therapy and treatment strategies, and from having experience with the device. The complications caused by IPL treatments may be divided into two groups: those which are due to errors in...

Thoracic outlet syndrome (TOS) identifies the clinical condition determined by the mechanical compression and entrapment of the subclavian vessels and the brachial plexus cords within the space delineated by the scalene muscles, the clavicle, and the first rib. To date, there are no concluding explanations concerning the real causes of the appearan...

Breast reconstruction (BR) after radical mastectomy is intended to recreate symmetrical natural-appearing breasts while preserving patient safety and quality of life. To evaluate the esthetic results and the complications of various BR methods after radical mastectomy. Between August 2006 and March 2010, 36 women underwent BR after mastectomy in ou...

Pectus excavatum is the most common chest wall deformity. Women with pectus excavatum may have associated hypoplastic breasts and often desire breast augmentation. This report describes how to perform breast augmentation safely for a pectus excavatum patient. In the past 5 years, the authors have treated 11 women with hypoplastic breasts and pectus...

Background: Fifteen years have passed since the first Intense Pulsed Light (IPL) devices were introduced into the market. A variety of devices that use light energy for aesthetic puposes are currently manufactured by several companies, and newer devices offering improved performance and features are periodically being introduced. Herein we present...

Using the microsurgical technique for reconstruction in trauma cases represents a challenge for the reconstructive surgeon. Several methods of salvaging of a compromised free flap have been reported, among them: intravenous heparin washing, thrombolitic therapy, thrombectomy, use of grafts and others. Here, we present our experience from nine cases...

The term ‘photorejuvenation’ describes the simultaneous improvement of various epidermal changes related to aging. Sun exposure and smoking are the main factors that induce premature skin aging. Rhytides are due to a decrease in facial skin elasticity causing accentuation of lines and wrinkles. There are three main mechanisms of non-ablative techno...

The prices for IPL equipment vary from a few thousand dollars to more than $100,000, depending on the producer and the properties of the device. Acquisition of the equipment can be made by purchase, lease or rental. In analyzing which method is most feasible for his/her office, one must take into consideration the capital investment, maintenance co...

According to the International Society of the Study of Vascular Anomalies, vascular anomalies can be classified as vascular tumors (origin in the endothelial hyperplasiate and vascular malformations (normal endothelial turnover). Hemangiomas are the most common benign vascular tumors of infancy. Port-wine stains are present in 0.3–0.5% of newborns...

The skin is composed of three layers: epidermis, dermis and subcutaneous tissue. The thickness of the layers varies with different anatomical regions. The epidermis is thickest on the palm and soles, and very thin on the eyelids, while the dermis is thickest on the back. Keratinocytes are the main component of the epidermis. Melanocytes are the cel...

The advent of fishing rods made of carbon fiber and graphite rods has greatly increased the risks of electrical injuries associated with fishing. The braided fishing lines and metal hooks put the fishermen at risk for electrical injuries. We review our burn center's experience with electrical injuries related to fishing activities during the last f...

High resolution ultrasonography, using 20-50 MHz transducers, is a novel diagnostic procedure for the investigation of the skin and its specific conditions. Conventional ultrasonongraphy allows the identification of palpable pigmentary lesions without being able to establish the histologic type of the lesions. The method assesses the degree of tumo...

There are many reports of the use of free fibular flap for mandible reconstruction, but donor site morbidity is not uncommon. The authors present the case of a 52-year-old man who underwent mandible reconstruction with free fibular flap. After surgery, he developed severe compartment syndrome involving all four-calf compartments. Debridement of the...

The effects of light on skin are due to various degrees of absorption of electromagnetic radiation. The visible light spectrum has a 400–760 nm wavelength. The light-tissue interaction effects are due to absorption and excitation of photons. The Intense Pulse Light is situated in the visible light of the electromagnetic spectrum. Once the light rea...

A pseudoaneurysm of the gastroduodenal artery (GDA) is the rarest splanchnic artery aneurysm, comprising fewer than 10% of these lesions. Bleeding into the gastrointestinal tract is the most rapidly fatal complication of an arterial visceral pseudoaneurysm, affecting 4-10% of patients. We present an unusual case of a GDA pseudoaneurysm that rupture...

Various injectable fillers are used for soft-tissue augmentation, including liquid injectable silicone [LS]. This study evaluates patient satisfaction and long-term results after [LS] for lip augmentation. A total of 179 patients, who received medical grade [LS] for lip augmentation, were included in the study. The microdroplet technique was used i...

A varying period of training followed by examinations is the usual way to become a specialist in one of the many fields of Medicine. Plastic Surgery is one of the surgical fields that require good technical and cognitive skills. The best way to train and evaluate a candidate is hard to judge. The model of training and board examination varies, ever...

Clinical aspects, such as the long-term results after circular external fixation and functional rehabilitation after high-energy injuries of the elbow joint, have not received sufficient attention in the literature. Fourteen patients with high-energy elbow injuries were treated in our hospital over the last 15 years with a circular external fixatio...

There are very few studies in the English literature that evaluate the patient satisfaction after treatment using intense pulsed light (IPL) and there is no reported study comparing the results of the three major IPL applications: rejuvenation, hair removal, and treatment of small vascular lesions. This study was designed to compare results after I...

Microskin graft technique is a possible solution for treating major burns. The goal of this study was to investigate microskin graft techniques using a new model of grafting human skin onto athymic nude mice. Twenty female nude mice were randomly divided into a research group and a control group (14 mice in the research group, six in the control gr...

The incidence of prosthetic graft infection after bypass surgery ranges from 0.2 to 5%, depending on location, co-morbid diseases and host defense mechanisms. In spite of surgical treatment, the amputation rate can be up to 67%. Herein, we present our treatment strategy for a patient with severe Methicillin Resistant Staphylococcus Aureus infection...

Although not a medical condition, protruding ears can be disturbing to the extent that they cause social problems for affected individuals. It is well known that their correction can significantly improve the psychological condition of the patient. Several otoplasty techniques have been developed for the correction of this deformity. We present our...

Breast augmentation is one of the leading esthetic surgeries, enjoying high satisfaction rates. Pain, nausea, and vomiting are frequent shortcomings of the immediate postoperative period. The aim of this study was to compare breast augmentation from the anesthetic point of view: general anesthesia (GA) versus monitored anesthesia care (MAC). The ch...

Little information is available about the effect of music on the operating room (OR) staff. The objective of this study was to evaluate the perception of the influence of music on physicians and nurses working in the OR. A questionnaire was designed and 250 copies were distributed to the doctors and nurses working in the OR at three hospitals. One...

Background: The treatment of distal tibial osteomyelitis represents a challenge for orthopedic and plastic surgeons. The affected tissues should be debrided and good vascularized tissue should cover the defect, but the option of a muscle flap covering the area is limited. Free flaps are used but require longer operating time and experience with mic...

One of the most controversial topics in aesthetic breast surgery is the approach to a tuberous or to a mild to moderate hypoplastic and ptotic breast. In these situations, augmentation alone does not solve the problem and even the use of a bigger implant to elevate the nipple as much as possible results in more breast ptosis in the long term. These...

Removal of skin lesions is one of the most common surgical procedures, with the number increasing progressively since the 1980s. We tried to evaluate the satisfaction level of patients after removal of skin lesions and to identify the factors influencing it. The study group consisted of 138 patients who had skin lesions removed by shaving or primar...