Sakai, Shigeki



School of Medicine, Department of Plastic and Reconstructive Surgery (Shinanomachi)




Papers 【 Display / hide

  • A Novel Technique to Achieve Rapid Wound Healing of Donor Site Wounds in Split-Thickness Skin Grafts of a Patient Undergoing Anticoagulation Therapy

    Uoya Y., Ishii N., Sakai S., Kiuchi T., Uno T., Kishi K.

    International Journal of Lower Extremity Wounds (International Journal of Lower Extremity Wounds)  20 ( 2 ) 162 - 166 2021.06

    ISSN  15347346

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    Split-thickness skin grafts constitute an established and widely used procedure for treating skin ulcers. However, in patients on anticoagulation therapy, wound healing abnormalities can prevent smooth epithelialization of their donor site. We aimed to investigate the usefulness of a technique to facilitate smooth wound healing through partial dimension reduction, and spared skin grafts back of donor sites with split-thickness skin grafts for patients undergoing anticoagulation therapy and investigate its usefulness. Partial dimension reduction and spared skin grafting back was performed on the donor site in 4 cases (group A), and the conventional method (moist dressing) was performed in 3 cases (group B). We compared the time to achieve complete epithelialization, the degree of pain, the frequency of dressing changes during the perioperative period, and the cosmetic results 6 months after surgery in both groups. The spared skin graft achieved good circulation. The time to achieve complete epithelialization was 3.1 weeks (2.5-4 weeks) in group A and 5.7 weeks (3-8 weeks) in group B; group A tended to experience less pain and fewer dressing changes during the perioperative period than group B. In addition, group A yielded superior cosmetic results to group B. Our technique can contribute to increasing the defense against physical stimulation in the donor site. Therefore, rapid wound healing and easy wound management can be achieved. We believe that it may be useful in split-thickness skin grafts for patients undergoing anticoagulation therapy.

  • Early wound healing of the hard-palate mucosal harvest site using artificial dermis fixation by a transparent plate

    Suzuki Y., Tanaka I., Sakai S., Yamauchi T.

    Archives of Plastic Surgery (Archives of Plastic Surgery)  48 ( 2 ) 208 - 212 2021.03

    ISSN  22346163

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    Background There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting. Methods A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemosta-sis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8× 25 to 20× 40 mm. Results Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in de-creased pain and earlier epithelialization. Conclusions The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of con-ventional methods.

  • Embolization of congenital hemangioma with severe hemorrhage

    Kamata M., Aramaki-Hattori N., Okabe K., Sakai S., Nakatsuka S., Jinzaki M., Kishi K., Inoue M.

    Journal of Pediatric Surgery Case Reports (Journal of Pediatric Surgery Case Reports)  65 2021.02

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    Congenital hemangioma is a rare vascular lesion in children. Although most cases are asymptomatic, severe complications can arise, including severe bleeding. We describe the case of a female infant who was born with a congenital hemangioma on her right thigh. Ulceration appeared at the center of the tumor and gradually progressed over the following weeks. One month after birth, the lesion started hemorrhaging severely. Transfusions were required. The bleeding recurred repeatedly despite compression therapy. Embolization was performed urgently and succeeded in arresting the hemorrhage. Bleeding did not recur and the lesion involuted completely over the next few months. A literature review revealed that this is the eighth case where embolization was used to arrest severe hemorrhage of a congenital hemangioma. In the previous cases, embolization permanently (five cases) or temporarily (two cases) arrested the bleeding. In one of the latter cases, selective hemostatic surgery successfully arrested bleeding recurrence after embolization. In the other, the patient had Von Willebrand's Disease; while embolization arrested the hemorrhaging for several years, it restarted at the age of 18 years and the lesion had to be resected to manage the bleeding. Thus, embolization can be a first choice to arrest massive bleeding of congenital hemangioma.

  • Complications and Surgical Treatment of Breast Augmentation Using Autologous Fat Transfer and Fillers

    Sakai S., Ishii N., Nakamura Y., Matsuzaki K., Sakai S., Kishi K.

    Plastic and Reconstructive Surgery - Global Open (Plastic and Reconstructive Surgery - Global Open)   2021

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    Background: Breast augmentation with autologous fat grafting or hyaluronic acid injection requires minimal loss of healthy tissue. With an increasing trend of breast augmentation with these fillers, accompanying complications have also increased. Patients with complications often complain of induration, cyst formation, calcification, and infection, which require surgical treatment. We will discuss these complications and their surgical treatment through our experience of cases. Methods: This retrospective study included 20 patients who all required surgical treatment due to breast augmentation complications such as induration, cyst formation, calcification, and infection, and who visited us between May 2007 and June 2018. The patients' ages ranged from 25 to 63, and the mean age was 39.9. The material used for breast augmentation was fat for 17 cases, and hyaluronic acid, paraffin, and silicon for one case each. The results were analyzed through plastic surgeons at our hospital. Results: We performed a zigzag incision in the peri-areola margin to 17 of 18 patients for complications of autologous fat grafting and hyaluronic acid injection. The one excluded patient required an adipo-fascial flap from an inframammary fold incision. For one patient with silicon injection complication and one patient with paraffin injection complication, each required mammary gland resection. Conclusions: A zigzag incision in the peri-areolar margin was useful for treating complications of breast augmentation with autologous fat grafting and hyaluronic acid injection. All cases resulted in inconspicuous fine scars, with high patient satisfaction. However, this incision was insufficient to remove injected silicon and paraffin.

  • Making the upper edge of a silicone breast implant invisible by fat onlay-grafting harvested from the affected inframammary fold

    Ishii N., Harao M., Kiuchi T., Sakai S., Uno T., Ando J., Kishi K.

    Gland Surgery (Gland Surgery)  10 ( 9 ) 2656 - 2662 2021

    ISSN  2227684X

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    Background: In silicone breast implant (SBI)-based breast reconstructions, aesthetic outcomes are often low due to the visible upper edge of the SBI. To ameliorate this, grafting fat harvested from the SBI operative field has not been reported to date. Therefore, we aimed to develop a novel technique for fat onlay-grafting, harvested from the inframammary fold (IMF) of the reconstructed breast, and investigate its usefulness. Methods: A total of 90 patients who underwent SBI-based breast reconstruction after a simple mastectomy were included in this study. The harvested fat was recorded by weight and grafted evenly to the medial and median upper edge of the SBI on the pectoralis major muscle. We applied this technique to 30 patients (fat onlay-grafting group) and compared them with the 60 patients (no-grafting group) who did not undergo our technique using the postoperative 1-year aesthetic outcome scores of the medial and median upper edge of the SBI. Furthermore, we investigated the correlation between the weight of harvested fat and body mass index. Results: No postoperative wound complications occurred, and infection, hardened fat, and fat lysis were not found in the fat onlay-grafting group. The medial and total aesthetic outcome scores in the fat onlaygrafting group were significantly higher than those in the no-grafting group (P<0.05). The average weight of harvested fat was 11.9 [5-32] g. The correlation between the weight of the harvested fat and body mass index was significantly positive (R2=0.7119, P<0.05). Conclusions: Our technique made the upper edge of the SBI invisible. Further, it was simple and less invasive with safe augmentation. Therefore, we believe that this technique can contribute to better aesthetic outcomes in SBI-based breast reconstruction.

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • 皮膚再生に関与するFetalマクロファージの培養を用いた探索的研究


    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists , Principal investigator

  • 脱分化脂肪細胞を用いた体幹部皮下脂肪と眼窩脂肪の違いに関する基礎研究


    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists , Principal investigator


Courses Taught 【 Display / hide