Introduction Tissue loss as a consequence of congenital anomalies, trauma, malignancy, or gangrene represents a major health care problem in the United States. Because younger individuals are disproportionately affected, the costs are magnified over time and the resultant individual and societal effects are tremendous. The currently available options to restore soft tissue defects are associated with donor site morbidities. Vascularized composite allotransplantation may provide form, function,...
Tue Nov 12, 2019 18:56
Background Phalloplasty is performed as genital gender-affirming surgery in transmasculine persons. It requires the harvest of sizeable autologous fasciocutaneous flaps, which is associated with donor-site morbidity and extensive scarring. Flap preexpansion has been used to facilitate wound closure and reduce scarring, but the efficacy of flap preexpansion in phalloplasty is unclear. The objective of this study was to assess the safety and effectiveness of preexpansion before phalloplasty. Methods...
Tue Nov 12, 2019 18:56
The middle ages in the Arab world etched medical advancements that laid the foundations of modern medical practice. Among the several renowned physicians of historical importance, Abu Alkasem al-Zahrawi (Albucasis) left his mark in the fields of medicine and surgery. He is notably famous for his 30-volume compendium Kitab-al Tasreef, which served as his magnum opus. The last volume of this work was reserved for surgery. During his lifetime, Albucasis made contributions of unparalleled luminosity...
Tue Nov 12, 2019 18:56
Background Suboptimal pain management is a common, yet largely unrecognized, problem in the postsurgical patient population. Current treatment protocols heavily rely on opioid use and, though generally effective in providing pain relief, are associated with multiple side effects. The present systematic review aims to offer plastic surgeons insight into the current state of literature on prolonged local anesthetic wound infusion regimens, evaluating both their efficacy in lowering pain scores and...
Tue Nov 12, 2019 18:56
No abstract available
Tue Nov 12, 2019 18:56
Introduction Despite hundreds of training models for microsurgery being available in the literature, very few of them are scientifically validated. We chose to validate our low-fidelity training model on flower petals by comparing it head-to-head with a moderate fidelity training model, the anastomosis on chicken leg femoral artery. Materials and methods A total of 16 participants of different levels of expertise were randomized into 2 groups, 1 training on flower petals and 1 on chicken...
Tue Nov 12, 2019 18:56
Aim Over the new year period, we recognized a high number of admissions with postoperative complications following cosmetic surgery abroad. We aimed to determine the driving forces behind this and financial impact on the National Health Service (NHS). Methods Cases of all patients attending the regional plastic surgery unit with complications following surgery abroad were reviewed. Patients completed a survey on the perioperative period abroad and driving forces. In addition, the costing...
Tue Nov 12, 2019 18:56
Background Primary leiomyoma is a rare cause of a mass in the hand, with few reported cases to date. To our knowledge, this constitutes the most comprehensive and up-to-date systematic review of the literature of all cases of primary hand leiomyoma. We also provide an additional case recently managed in our practice of confirmed primary vascular leiomyoma of the hand in a 44-year-old woman to add to the current body of literature. Methods We performed a comprehensive literature review of...
Tue Nov 12, 2019 18:56
Background There is an increasing prevalence of obesity in society, often associated with increased medical comorbidities and surgical complications. Some health providers are now placing a body mass index (BMI) limit on whom can be offered breast reconstruction. The objective of this study was to determine the impact of obesity on quality of life as measured by the BREAST-Q, in women undergoing breast reconstruction. Methods A review of the breast reconstruction database (n = 336) at the...
Tue Nov 12, 2019 18:56
No abstract available
Tue Nov 12, 2019 18:56
Esthetic masculinization of the chest wall is one of the first surgical steps in female-to-male transsexual (FTMTS) reassignment. This surgical procedure is not a simple mastectomy: it is required for removal of breast tissue with glandular resection and skin excess revision, to reduce and replace the nipple-areola complex in the right location, minimizing chest wall scars. The creation of an esthetically pleasing male chest allows the patient to live at ease in the male gender role. In this...
Tue Nov 12, 2019 18:56
Background Intravenous (IV) lines are ubiquitous in hospital settings. These lines can malfunction, leaking noxious contents into subcutaneous tissue. Existing literature describes invasive intervention and complex treatment protocols. These persist despite significant changes in the composition and administration of IV agents. The purpose of this study is to examine the consequences of IV infiltrations at a tertiary medical center to update protocols and treatment algorithms. Materials and...
Tue Nov 12, 2019 18:56
Background Health care disparities in Appalachia are well documented. However, no previous studies have examined possible differences in the utilization of breast reconstruction (BR) in Appalachia. This study aims to determine if a disparity in BR utilization exists in women from Appalachia Kentucky. Methods A retrospective, population-based cohort study was conducted from January 1, 2006, to December 31, 2015. The Kentucky Cancer Registry was queried to identify population-level data for...
Tue Nov 12, 2019 18:56
Introduction Patient perspectives on chaperone use during examinations, especially in surgical subspecialties, are understudied. We aimed to identify specific patient cohorts that desire the presence of chaperones and compare patient and surgeon perspectives, all in an effort to improve quality of care. Methods and Materials We prospectively administered a 15-question survey to all patients visiting 2 plastic surgery outpatient clinics between January 2015 and April 2016. Data on demographics,...
Tue Nov 12, 2019 18:56
Introduction The reconstruction of the postburn contracture area is always a challenge in the field of plastic surgery. Moreover, the joints are very sensitive to trauma and immobilization, showing a susceptibility to stiffness. The aim of this article is to emphasize the use of “Namaste flap”—modification of subcutaneous pedicle propeller flaps in the reconstruction of postburn axillary and elbow contractures. Methodology This is a prospective case study of axillary and elbow contractures...
Tue Nov 12, 2019 18:56
Treatment of cleft lip and palate ordinarily requires multiple interventions spanning the time of birth to adulthood. Restriction of facial growth, a common occurrence in affected children, is due to multiple factors. There are multiple surgical and therapeutic options, which may have influence on facial growth in these patients. As restriction to facial development can have significant implications to form, function, and psychological well-being, practitioners should have an appreciation for the...
Tue Nov 12, 2019 18:56
Background Burn sequelae involving the anterior neck and thorax produce a difficult challenge for reconstruction because contracture of anterior thoracic burns in addition to functional movement of the chest wall can result in downward displacement of the neck unit. The purpose of this study was to understand the influence of burn sequelae of the anterior thorax on anterior neck flap descent, function, and aesthetics. Methods Ten patients with burn sequelae of only the anterior neck (group...
Tue Nov 12, 2019 18:56
Fibrosis is a consequence of aberrant wound healing processes that can be debilitating for patients and often are associated with highly morbid disease processes. Myofibroblasts play an important role in determining an appropriate physiologic response to tissue injury or an excessive response leading to fibrosis. Specifically, “supermature” focal adhesions, α-smooth muscle actin, and the myocardin-related transcription factor/serum response factor pathway likely play a significant role in the differentiation...
Tue Nov 12, 2019 18:56
Background In our previous study, we used cross finger fascial flap combined with split-thickness toe nail bed graft to reconstruct large area defect of the nail bed with distal phalanx exposure. Fingertip avulsions are common injuries to the upper extremity and cause a great deal of distress for patients. Replantation, amputation and flap coverage are considered. However, all these methods have their limitations. Methods Five patients with fingertip avulsions were enrolled. We used the methods...
Tue Nov 12, 2019 18:56
No abstract available
Tue Nov 12, 2019 18:56
Purpose This study aimed to compare and analyze the outcomes of finger reconstruction using free distal ulnar artery perforator (FDUAP) and reverse dorsal homodigital island (RDHI) flaps. Methods The study included 27 patients with finger pulp defects that were reconstructed using FDUAP or RDHI flaps. Standardized assessment of outcomes included objective sensory recovery, duration of operation, range of motion in the repaired fingers, pain at the reconstructed finger pulps and donor sites,...
Tue Nov 12, 2019 18:56
Background Penile skin inversion vaginoplasty is a gender-affirming surgical procedure for transwomen with limited surgical analgesic protocol. This study compares the postoperative pain and opioid use in patients managed for surgery with general anesthesia (GA) with patients who were given combined epidural and general anesthesia (E/GA) with continuing postoperative epidural analgesia. Methods All patients who underwent penile inversion vaginoplasty between May of 2016 and May of 2018 under...
Tue Nov 12, 2019 18:56
Background There are various methods to correct the whistle deformity in bilateral cleft lip. In case of the central deficiency with concomitant lateral excess, local tissue rearrangement can be used to reposition the lateral tissue. We designed bilateral lateral advancement flap with reinforcement of the orbicularis oris muscle. Method Thirteen bilateral cleft lip patients with whistling lip deformity from July 2009 to February 2017 underwent our method of tubercle formation. Vertical upper...
Tue Nov 12, 2019 18:56
Introduction The lateral malleolar region is a prominent anatomic structure vulnerable to repetitive trauma and ulcer formation. The abductor digiti minimi (ADM) muscle flap offers a promising treatment option for the reconstruction of small- to moderate-sized defects that have exposed bone, joint, or tendons in the lateral malleolar area. Methods Between 2013 and 2016, 8 patients with foot ulcers were reconstructed with ADM muscle flap. The muscle component of the flap obliterated the dead...
Tue Nov 12, 2019 18:56
Background There is no quantitative evidence supporting one unilateral cleft lip (UCL) repair technique over the other with regard to scarring. We sought to evaluate the difference between the extended Mohler and Millard techniques, using 3 scar assessment scales. Methods Postoperative frontal and basal photographs of patients undergoing UCL repair were reviewed. Three validated scar assessment scales were used: the Manchester Scar Scale (MSS), modified scar-rating scale (MSRS), and Stony...
Tue Nov 12, 2019 18:56
Objective The aim of the study was to determine whether the bony orbital volume (BOV) changes with age in males and females. Methods This case-control study reviewed high-resolution (|W|) = 0.05). The mean (SD) BOV for males aged between 20 and 30 years was 22,2721 mm3 (2977.35), whereas that for males aged between 60 and 75 years was 22,892.92 mm3 (2389.46) (Fig. 1). The difference between these 2 groups was not significant (Pr(>|W|) = 0.40). The mean BOV was significantly greater for...
Tue Nov 12, 2019 18:56
Background Mandibular prognathism is a common dentofacial deformity in Asia. Treatment of such condition may vary from orthodontic camouflage to surgical orthodontics with orthognathic surgery depending on the severity of the condition. Because of the prominent position of the mandible, fractures involving different locations of the mandible commonly occur in maxillofacial trauma. Anatomical reduction of maxillofacial fractures and restoration of the pretraumatic occlusion are the primary goals...
Tue Nov 12, 2019 18:56
Background We compare the vascular territory of free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flaps, deep inferior epigastric perforator (DIEP) flaps, and crossover anastomosis (CA) flaps using intraoperative ex vivo angiography. We also use ex vivo angiography to analyze the vascular architecture of the MS-TRAM flap. Methods Our study includes 84 lower abdominal free flaps: MS-TRAM, DIEP-1 (1 perforator), DIEP-2 (2 perforators), and CA. We compare the arterial perfusion...
Tue Nov 12, 2019 18:56
Background Every year, there are significant numbers of motorcycle accident casualties in Taiwan. These accidents are the leading cause of maxillofacial trauma. Age should be an important factor of maxillofacial fracture patterns yet there is limited literature on the topic. Therefore, this study aims to evaluate the correlation of age with maxillofacial fracture in motorcycle accidents. Methods This is a retrospective descriptive analysis conducted over 2-year period at Linkou Chang Gung...
Tue Nov 12, 2019 18:56
Extracorporeal perfusion of organs has a wide range of clinical applications like prolonged vital storage of organs, isolated applications of drugs, bridging time to transplant, and free composite tissue transfer without anastomosis, but there are a limited number of experimental models on this topic. This study aimed to develop and evaluate a human extracorporeal free flap perfusion model using an extracorporeal membrane oxygenation device. Five patients undergoing esthetic abdominoplasty participated...
Tue Nov 12, 2019 18:56
The reconstruction of finger defects requires improved functional outcomes and acceptable esthetic outcomes, and small free flaps present a good alternative technique for repairing finger skin defects. From January 2006 to December 2018, we investigated the number and diameter of proximal digital artery perforators, medial plantar artery perforators, and peroneal proper plantar digital arteries of the hallux by dissection and then transplanted free digital arterial perforator flaps, free medial plantar...
Tue Nov 12, 2019 18:56
Polylactic acid (PLA) nanofiber nonwovens have recently come under more vigorous investigation for their use as tissue engineering scaffolds owing to its ability to mimic the physical properties of naturally occurring human extracellular matrix in a variety of host tissues. Currently, the majority of available research on PLA nanowebs has focused on their creation through electrospinning. The goal of this study was to evaluate meltblown nonwoven webs made of nanodiameter PLA fibers for their application...
Tue Nov 12, 2019 18:56
Background Complex limb trauma often involves both soft tissue and vascular defects, and is challenging for surgeons. The traditional musculocutaneous flap cannot achieve a 3-dimensional wound repair. Here we report our experience with a single-stage reconstruction and revascularization performed on complex extremity injuries using a free flow-through chimeric anterolateral thigh perforator (ALTP) flap. Patients and Methods Seventeen patients (16 men; aged 19–55 years) with complex soft tissue...
Tue Nov 12, 2019 18:56
Objective Over several decades, numerous national and international registries on breast implants went online, aiming to collect prospective data to provide increased safety for patients and surgeons. We performed a review of all published data on breast implant registries to assess availability and quality of data and determine its usefulness and impact. Materials and Methods PubMed, Ovid, and Web of Science were searched to identify all articles containing breast implant registries in English...
Tue Nov 12, 2019 18:56
Nasal reconstruction is a complex staged procedure. When optimal donor areas are unavailable, flap prefabrication and prelamination techniques can be used for total nasal reconstruction. A technique of total nasal reconstruction using neovascularization of the supraclavicular skin from a skin free flap used for internal lining, along with prelamination of the cartilage framework and surgical delays, is described in 2 patients with adverse anatomical conditions.
Tue Nov 12, 2019 18:56
Introduction Genital lymphedema (GL) surgery can be either palliative or functional. Palliative procedures involve excision of the affected tissue and reconstruction by either local flaps or skin grafts. Reconstructive procedures aim to restore lymphatic flow through microsurgical lymphaticovenous anastomoses (LVAs). This systematic analysis of outcomes and complication rates aims to compare outcomes between these surgical treatment options for GL. Methods A systematic review of the PubMed...
Tue Nov 12, 2019 18:56
Reconstruction of intraoral defects is one of the main aspects of head and neck cancer treatment. Since the advent of microvascular surgery in this field, free flap tissue transfer has become a common procedure, and various flaps have been described for soft tissue reconstruction. The lateral upper arm free flap is one of the most frequently used flaps for intraoral defect coverage. This article describes ossification of the corresponding vascular pedicle after soft tissue transfer with the lateral...
Tue Nov 12, 2019 18:56
Introduction Transplantation of the keratinocytes, fibroblasts, bone marrow, and adipose tissue–derived mesenchymal stem cells may improve chronic wound healing by delivery of different cytokines, chemokines, and growth factors, which play an essential role in wound healing. The purposes of this review were to check which cell lines are potentially beneficial in enhancement of wound healing and to describe the safety and efficacy of cell therapies in the clinical treatment of chronic wounds, as...
Tue Nov 12, 2019 18:56
Background The purpose of our study was to determine the incidence and average cost of nerve injuries in patients presenting with upper extremity trauma. Methods The Nationwide Emergency Department Sample database was queried using International Classification of Diseases, Ninth Revision codes specific to peripheral nerve injuries of the upper extremity. Data on the incidence, patient demographics, average number of associated diagnoses, Injury Severity Scale (ISS) score, mechanism of injury,...
Tue Nov 12, 2019 18:56
No abstract available
Tue Nov 12, 2019 18:56
Background The marginal mandibular branch (MMB) of the facial nerve provides lower lip symmetry apparent during human smile or crying and is mandatory for vocal phonation. In treating facial palsy patients, so far, little attention is directed at the MMB in facial reanimation surgery. However, isolated paralysis may occur congenital, in Bell's palsy or iatrogenic during surgery, prone to its anatomical course. A variety of therapies address symmetry with either weakening of the functional side...
Tue Nov 12, 2019 18:56
No abstract available
Tue Nov 12, 2019 18:56
Publication date: Available online 12 November 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Tai-Yu Chang, Ching-Yueh Wei
Tue Nov 12, 2019 17:41
Publication date: Available online 12 November 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Dr James Davies, Mr John Kiely, Mr Will JM Holmes
Tue Nov 12, 2019 17:41
We appreciate the opportunity to respond to the comments of Davies et al regarding our recent publication “Increasing body mass index increases complications but not failure rates in microvascular breast reconstruction: A retrospective cohort study”.1
Tue Nov 12, 2019 02:00
The medial plantar flap in its anterograde form is considered to be the gold standard for heel reconstruction. This flap can be also raised as distally based for the reconstruction of the weight-bearing forefoot. However, terminal branches of the medial plantar artery, together with their connection with distal and dorsal systems can be variable. Our objective was to provide a comprehensive anatomic description that could match all technical possibilities in raising the distally based MPA flap. A...
Tue Nov 12, 2019 02:00
Tue Nov 12, 2019 02:00
Abstract Background Autologous fat transfer is widely used in plastic surgery for both reconstructive and esthetic purposes. The aim of this study is to identify the results of autologous fat graft to the breast through the rate of fat necrosis, cyst formation, and calcification patterns to avoid unnecessary breast biopsies. Methods This prospective study...
02:00
Abstract Background Psychological functioning of rhinoplasty must be evaluated in the community of Iran as the most prevalent center of rhinoplasty worldwide. Making a realistic public view about rhinoplasty psychological outcomes is necessary. In the present study, quality of life, anxiety, depression, and self-esteem alteration in rhinoplasty patients among the Iranian population were assessed....
Tue Nov 12, 2019 02:00
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