Felmerer, Gunther

[["dc.bibliographiccitation.firstpage","53"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Clinical Hemorheology and Microcirculation"],["dc.bibliographiccitation.lastpage","63"],["dc.bibliographiccitation.volume","73"],["dc.contributor.author","Klingelhoefer, Eric"],["dc.contributor.author","Hesse, Karl"],["dc.contributor.author","Taeger, Christian D."],["dc.contributor.author","Prantl, Lukas"],["dc.contributor.author","Stepniewski, Adam"],["dc.contributor.author","Felmerer, Gunther"],["dc.contributor.editor","Wiggermann, P."],["dc.contributor.editor","Krüger-Genge, A."],["dc.contributor.editor","Jung, F."],["dc.date.accessioned","2020-12-10T18:44:09Z"],["dc.date.available","2020-12-10T18:44:09Z"],["dc.date.issued","2019"],["dc.identifier.doi","10.3233/CH-199213"],["dc.identifier.eissn","1875-8622"],["dc.identifier.issn","1386-0291"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/78347"],["dc.notes.intern","DOI Import GROB-354"],["dc.title","Factors affecting outcomes after supermicrosurgical lymphovenous anastomosis in a defined patient population"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","129"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","World Journal of Transplantation"],["dc.bibliographiccitation.lastpage","137"],["dc.bibliographiccitation.volume","11"],["dc.contributor.author","Felmerer, Gunther"],["dc.contributor.author","Behringer, Dominik"],["dc.contributor.author","Emmerich, Nadine"],["dc.contributor.author","Grade, Marian"],["dc.contributor.author","Stepniewski, Adam"],["dc.date.accessioned","2021-06-01T10:48:58Z"],["dc.date.available","2021-06-01T10:48:58Z"],["dc.date.issued","2021"],["dc.identifier.doi","10.5500/wjt.v11.i4.129"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/86118"],["dc.notes.intern","DOI-Import GROB-425"],["dc.relation.issn","2220-3230"],["dc.title","Donor defects after lymph vessel transplantation and free vascularized lymph node transfer: A comparison and evaluation of complications"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","Cureus"],["dc.contributor.author","Nerntengian, Ntenis"],["dc.contributor.author","Abboud, Tammam"],["dc.contributor.author","Stepniewski, Adam"],["dc.contributor.author","Felmerer, Gunther"],["dc.contributor.author","Rohde, Veit"],["dc.contributor.author","Tanrikulu, Levent"],["dc.date.accessioned","2022-10-04T10:21:28Z"],["dc.date.available","2022-10-04T10:21:28Z"],["dc.date.issued","2022"],["dc.description.abstract","Introduction\r\n\r\nDecompressive hemicraniectomy (DHC) is a last-resort treatment for refractory intracranial hypertension. Perioperative morbidity is associated with high risks of wound healing disturbances (WHD). Recently, a retromastoidal frontoparietooccipital (RMF) incision type was performed to avoid healing disturbance due to enhanced tissue flap perfusion compared to the classical reverse “question mark” (“Dandy flap”) incision. The goal of this study was to analyze the details of tissue healing problems in DHC. \r\nMaterials and methods\r\n\r\nA total of 60 patients who underwent DHC were retrospectively analyzed. In 30 patients the “Dandy flap” incision (group A) and in 30 patients the RMF incision (group B) was made. Since no evidence-based data for the incision type that favors better wound healing exists, the form of incision was left at the surgeon´s discretion. Documentation of the patients was screened for the incidence of WHD: wound necrosis, dehiscence, and cerebrospinal fluid (CSF) leakage. Patient age, the time interval from surgery until the appearance of WHD, the length of surgeries in minutes, and the indications of the DHC were analyzed. A Chi-square test of independence was performed to examine the relationship between the incision type and the appearance of WHD with the statistical significance level set at p<0.05. The mean age of the patients, the mean time interval from surgery until the occurrence of WHD, and the mean length of the surgery between the two groups were compared using an independent sample t-test with the statistical significance level set at p<0.05.\r\nResults\r\n\r\nThe most common indication for DHC in both groups was malignant MCA infarction (n=20, 66.6% for group A and n=16, 53.3% for group B). CSF leakage was 20% of the most frequent WHD in each group. Wound necrosis was observed only in group A. Although group B showed 13.3% fewer WHD than group A, this difference was not statistically significant. There was no statistically significant difference in the time range between surgery and the occurrence of WHD between the two groups. The length of surgery in group B was significantly shorter than in group A (120.2 mins vs. 103.7 mins).\r\nConclusion\r\n\r\nA noticeable trend for reduced WHD was observed in the patient group using the RMF incision type although the difference was not statistically significant. We praise that the RMF incision allows an optimized skin-flap vascularization and, thereby, facilitates better wound healing. We were able to show a statistically shorter length of surgery with the RMF incision in contrast to the classic “Dandy flap” incision. Larger multicenter studies should be implemented to analyze and address the major advantages and pitfalls of the routinely applied incision techniques.\r\nIntroduction\r\n\r\nDecompressive hemicraniectomy (DHC) is a life-saving procedure in patients with increased intracranial pressure (ICP) of vascular etiology (usually malignant middle cerebral artery infarction) or traumatic brain injury [1,2]. However, the morbidity of DHC is remarkably high and tissue healing complications amount to up to 40% for a major part of this morbidity, prolonging the duration of hospitalization and delaying cranioplasty [3,4]. Various incision techniques are used for DHC: the classic reverse “question mark” incision, also known as “Dandy flap” or “trauma flap”, and the alternative posterior “question-mark” incision, which is defined as the retromastoidal frontoparietooccipital (RMF) incision type [5,6]. The impact of different incision techniques on tissue healing in the immediate postoperative period after DHC is sparsely analyzed in detail and fewer studies deal with healing issues after cranioplasty. The core objective of our investigation was to determine if there was any difference in the incidence of tissue healing problems after DHC was performed with the aforementioned different incision characteristics.\r\nMaterials & Methods\r\n\r\nEthics approval for our retrospective study was granted by the Ethics Commission of the University Medical Center of Göttingen. We retrospectively analyzed 131 patients who underwent DHC between January 2018 and November 2020 in our institution. Patients with either “Dandy flap” or RMF incision who survived at least 14 days postoperatively were included in our analysis. DHC following osteoplastic craniotomies were excluded as they required different incision types based on the prior surgery. Due to lacking evidence-based data on which incision type favors better wound healing, the type of incision was left at the surgeon´s discretion. The dura was left open in all patients. A total of 60 patients who met the above criteria were included. In 30 patients “Dandy flap” incision (Figure 1) (group A) and in 30 patients RMF incision (Figure 2) (group B) was applied."],["dc.identifier.doi","10.7759/cureus.29260"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/114416"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-600"],["dc.relation.issn","2168-8184"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.relation.orgunit","Klinik für Neurochirurgie"],["dc.relation.orgunit","Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie"],["dc.title","Tissue Healing in Hemicraniectomy"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Scientific Reports"],["dc.bibliographiccitation.volume","10"],["dc.contributor.author","Felmerer, Gunther"],["dc.contributor.author","Stylianaki, Aikaterini"],["dc.contributor.author","Hollmén, Maija"],["dc.contributor.author","Ströbel, Philipp"],["dc.contributor.author","Stepniewski, Adam"],["dc.contributor.author","Wang, Anna"],["dc.contributor.author","Frueh, Florian S."],["dc.contributor.author","Kim, Bong-Sung"],["dc.contributor.author","Giovanoli, Pietro"],["dc.contributor.author","Lindenblatt, Nicole"],["dc.contributor.author","Gousopoulos, Epameinondas"],["dc.date.accessioned","2021-04-14T08:24:27Z"],["dc.date.available","2021-04-14T08:24:27Z"],["dc.date.issued","2020"],["dc.identifier.doi","10.1038/s41598-020-67987-3"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/81287"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-399"],["dc.relation.eissn","2045-2322"],["dc.title","Increased levels of VEGF-C and macrophage infiltration in lipedema patients without changes in lymphatic vascular morphology"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","Journal of Neurological Surgery Part A: Central European Neurosurgery"],["dc.contributor.author","Stepniewski, Adam"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Schilderoth, Maximilian"],["dc.contributor.author","Behringer, Dominik"],["dc.contributor.author","Emmerich, Nadine"],["dc.contributor.author","Daugardt, Julian"],["dc.contributor.author","von der Brelie, Christian"],["dc.contributor.author","Kauffmann, Philipp"],["dc.contributor.author","Felmerer, Gunther"],["dc.date.accessioned","2022-01-11T14:05:48Z"],["dc.date.available","2022-01-11T14:05:48Z"],["dc.date.issued","2021"],["dc.description.abstract","Abstract Background Scalp defects represent a therapeutic challenge. The aim of this study is to present our experience with local and regional flaps in the treatment of trauma-induced scalp defects. Furthermore, a comparison with other surgical techniques was performed. Methods A retrospective evaluation of patient records was performed. Only patients who underwent surgery using local flaps between January 2010 and September 2020 due to traumatic scalp defects were included in the study. Results In all, 10 cases were identified (3 females, 7 males, average age at surgery of 46.5 years [range: 18–82 years]). Six patients underwent surgery due to tissue defects and four due to scar keloids. Three patients experienced minor postoperative complications, one of which required additional surgery. The mean defect size was 35.75 cm2 (range: 4–79 cm2) among the four patients where the defect size could be determined retrospectively. The mean inpatient follow-up was 12.4 days (range: 2–34 days). Conclusions Local flaps can be widely used. In carefully selected cases, they have the fewest disadvantages of all surgical techniques. In our experience, large angiosomes of the main scalp arteries allow the treatment of defects larger than 30 cm2 with local flaps. Our experience also suggests that the dimensions of flap length to flap width can exceed a ratio of 2:1 in the scalp."],["dc.description.abstract","Abstract Background Scalp defects represent a therapeutic challenge. The aim of this study is to present our experience with local and regional flaps in the treatment of trauma-induced scalp defects. Furthermore, a comparison with other surgical techniques was performed. Methods A retrospective evaluation of patient records was performed. Only patients who underwent surgery using local flaps between January 2010 and September 2020 due to traumatic scalp defects were included in the study. Results In all, 10 cases were identified (3 females, 7 males, average age at surgery of 46.5 years [range: 18–82 years]). Six patients underwent surgery due to tissue defects and four due to scar keloids. Three patients experienced minor postoperative complications, one of which required additional surgery. The mean defect size was 35.75 cm2 (range: 4–79 cm2) among the four patients where the defect size could be determined retrospectively. The mean inpatient follow-up was 12.4 days (range: 2–34 days). Conclusions Local flaps can be widely used. In carefully selected cases, they have the fewest disadvantages of all surgical techniques. In our experience, large angiosomes of the main scalp arteries allow the treatment of defects larger than 30 cm2 with local flaps. Our experience also suggests that the dimensions of flap length to flap width can exceed a ratio of 2:1 in the scalp."],["dc.identifier.doi","10.1055/s-0041-1735890"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/97752"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-507"],["dc.relation.eissn","2193-6323"],["dc.relation.issn","2193-6315"],["dc.title","The Efficacy of Local Flaps in the Treatment of Traumatic Scalp Defects"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]