Browsing by Author "Hollins, Andrew"

Now showing 1 - 5 of 5
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    Antioxidant properties of citric acid interfere with the uricase-based measurement of circulating uric acid
    (Journal of Pharmaceutical and Biomedical Analysis, 2019-02) Ryan, Evan M; Duryee, Michael J; Hollins, Andrew; Dover, Susan K; Pirruccello, Samuel; Sayles, Harlan; Real, Kevin D; Hunter, Carlos D; Thiele, Geoffrey M; Mikuls, Ted R
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    Enrichment of malondialdehyde–acetaldehyde antibody in the rheumatoid arthritis joint
    (Rheumatology, 2017-10-01) Mikuls, Ted R; Duryee, Michael J; Rahman, Rafid; Anderson, Daniel R; Sayles, Harlan R; Hollins, Andrew; Michaud, Kaleb; Wolfe, Frederick; Thiele, Geoffrey E; Sokolove, Jeremy; Robinson, William H; Lingampalli, Nithya; Nicholas, Anthony P; Talmon, Geoffrey A; Su, Kaihong; Zimmerman, Matthew C; Klassen, Lynell W; Thiele, Geoffrey M
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    Surgical Techniques for Revascularization in Abdominal Wall Transplantation.
    (Journal of reconstructive microsurgery, 2020-04-25) Atia, Andrew; Hollins, Andrew; Shammas, Ronnie; Phillips, Brett T; Ravindra, Kadiyala V; Sudan, Debra L; Giele, Henk; Mithani, Suhail K; Erdmann, Detlev
    BACKGROUND: Abdominal wall vascularized composite allotransplantation (AW-VCA) can be considered as a technically feasible option for abdominal wall reconstruction in patients whose abdomen cannot be closed using traditional methods. However, successful initial abdominal wall revascularization in the setting of visceral organ transplantation can pose a major challenge as graft ischemia time, operating in a limited surgical field, and variable recipient and donor anatomy must be considered. Several techniques have been reported to accomplish abdominal wall revascularization. METHODS: A literature review was performed using PubMed for articles related to "abdominal wall transplantation (AWT)." The authors of this study sorted through this search for relevant publications that describe abdominal wall transplant anatomy, technical descriptions, and outcomes of various techniques. RESULTS: A total of four distinct revascularization techniques were found in the literature. Each of these techniques was described by the respective authors and reported varying patient outcomes. Levi et al published a landmark article in 2003 that described technical feasibility of AWT with anastomosis between donor external iliac and inferior epigastric vessels with recipient common iliac vessels in end-to-side fashion. Cipriani et al described a microsurgical technique with anastomosis between donor and recipient inferior epigastric vessels in an end-to-end fashion. Giele et al subsequently proposed banking the abdominal wall allograft in the forearm to reduce graft ischemia time. Recently, Erdmann et al described the utilization of an arteriovenous loop for synchronous revascularization of abdominal wall and visceral transplants for reduction of ischemia time, operative time, while eliminating the need for further operations. CONCLUSION: Vascularized composite allotransplantation continues to advance with improving immunotherapy and outcomes in solid organ transplantation. Optimizing surgical techniques remains paramount as the field continues to grow. Refinement of the presented methods will continue as additional evidence and outcomes become available in AW-VCA.
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    Synchronous Abdominal Wall and Small-bowel Transplantation: A 1-year Follow-up.
    (Plastic and reconstructive surgery. Global open, 2020-07-24) Atia, Andrew; Hollins, Andrew; Erdmann, Ralph F; Shammas, Ronnie; Sudan, Debra L; Mithani, Suhail K; Ravindra, Kadiyala V; Erdmann, Detlev
    Abdominal wall-vascularized composite allotransplantation (AW-VCA) has evolved as a technically feasible but challenging option in the rare event of abdominal wall reconstruction in patients whose abdomen cannot be closed by applying conventional methods. The authors conducted the first synchronous child-to-adult recipient AW-VCA using an arteriovenous loop technique. This article presents a 1-year follow-up of the patient's postoperative course. Frequent skin biopsies were performed in accordance with Duke Institutional Review Board protocol, with 3 episodes of rejection treated with high-dose steroids and Thymoglobulin (Genzyme Corp, Cambridge, Mass.). The patient developed an opportunistic fungal brain abscess secondary to immunosuppression, which led to temporary upper extremity weakness. Future considerations for AW-VCA include a modified surgical technique involving utilization of donor vein graft for arteriovenous loop formation. In addition, reduction in postoperative biopsy schedule and changes in immunosuppression regimen may lead to improved outcomes and prevent unnecessary high-dose immunosuppression.
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    Tissue Expander Scrotal Reconstruction.
    (Plastic and Reconstructive Surgery Global Open, 2020-03-24) Hollins, Andrew; Mundy, Lily R; Atia, Andrew; Levites, Heather; Peterson, Andrew; Erdmann, Detlev
    Fournier's gangrene is a life-threatening soft tissue infection requiring aggressive debridement of the perineum. Surgical debridement results in large defects of the scrotum requiring reconstruction for functional coverage of the testes. Several studies have described scrotal reconstruction utilizing split thickness skin grafts or local flaps. These procedures create additional morbidity in an unhealthy patient population. This report describes a patient who presents for delayed scrotal reconstruction utilizing tissue expansion. Tissue expander-based reconstruction provides reconstruction of native scrotal soft tissue without additional donor site morbidity. A 40-year-old man presented to an outside hospital with Fournier's gangrene and underwent significant soft tissue debridement. He had an almost complete loss of his native scrotum with his testes surgically banked in his bilateral thighs. He presented to our clinic for a delayed scrotoplasty. The patient was taken to the operating room and a single tissue expander was inserted into the perineum. He underwent serial insufflations in the clinic setting and returned to the operating room for expander removal and scrotal reconstruction. The patient followed up in clinic 4 months postoperatively with a well-healed scrotoplasty. Our case report demonstrates a 2-stage procedure for patients presenting with significant soft tissue loss of the perineum. This reproducible method of reconstruction can be considered for excellent aesthetic and functional scrotoplasty.