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Mon Aug 24, 2020 03:00
Given the scope of the field of plastic surgery, a comprehensive and varied training experience is imperative for the success of future plastic surgeons. Veterans Affairs Medical Centers and public county hospitals often have different training environments which can lead to varied impacts on plastic surgery resident education. Veterans affairs teaching hospitals provide residents with a large volume of complex and diverse plastic surgery cases. Public county hospitals also provide plastic surgery...
Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
Background: Breast implants are frequently used in cosmetic and reconstructive breast surgery. Capsular contracture, the most common long-term complication, is usually graded using the Baker classification. Despite its widespread use, its reliability has never been established. The aim of this study was to determine the inter-observer reliability and agreement of the Baker classification. Methods: Sixty women who had undergone cosmetic breast augmentation were included. They were examined...
Mon Aug 24, 2020 03:00
Background: Researches on the BIA-ALCL are trying to optimize medical and surgical treatments for early and advanced stages of this disease. The aim of this article is to share the experience gathered on our prospectively collected 46 well-documented cases. Methods: Italian Physicians are obliged to notify BIA-ALCL cases to the Italian Ministry of Health. Thanks to the cooperation with Health Care Professionals, the Competent Authority has coordinated and centralized the collection...
Mon Aug 24, 2020 03:00
Background: Scholarly output has typically been measured by citation-based metrics such as the Hirsch index (H-index). The Altmetric Attention Score has emerged as a substitute to measure digital attention given to a project. This study aims to determine if there is any correlation between H-index and the Altmetric Score in the plastic surgery literature. Methods: Article metrics (full text views, abstract views, PDF downloads, times emailed, Altmetric Attention Score, times tweeted,...
Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
Background: Advances in surgical technology and adjuvant therapies along with an aging and increasingly morbid U.S. population have led to an increase in complex spine surgery. With this increase comes an elevated risk of complications including those related to the surgical wound, with some studies demonstrating wound complication incidences approaching 45%. We hypothesize that immediate muscle flap closure improves outcomes in high-risk patients. Methods: Three hundred and one consecutive...
Mon Aug 24, 2020 03:00
Background: The medial sural artery perforator flap is a versatile option in reconstructive microsurgery. However, most reports of this flap have been limited by sample size. This study reviews the experience of a single large-volume center using the medial sural artery perforator flap and its variants for a variety of reconstructive purposes. Methods: A retrospective review of all patients who received the medial sural artery perforator flap reconstruction between March 2006 and July...
Mon Aug 24, 2020 03:00
Background: Risk for VTE formation and the relationship to post-operative free flap venous congestion and flap failure has not been adequately evaluated in a trauma population. We aim to use the Caprini Risk Assessment Model (C-RAM) to evaluate the association between VTE risk and post-operative flap venous congestion following lower extremity free tissue transfer. Methods: A retrospective analysis was conducted of all patients who underwent lower extremity free flap reconstruction...
Mon Aug 24, 2020 03:00
Background: Discovering alternatives to workhorse flaps that have more consistent anatomy and lower donor-site morbidity has become a focus of reconstructive surgery research. This study provides a simplified approach to profunda artery perforator (PAP) flap design and harvest based on reliable anatomical landmarks. Methods: A retrospective review was conducted of 70 patients who underwent 83 PAP flap reconstructions for post-oncologic defects from 2016 to 2018. We recorded and analyzed...
Mon Aug 24, 2020 03:00
BACKGROUND: Plastic surgery education consists of technical skills, surgical decision-making, and the knowledge necessary to provide safe patient care. Competency in these modalities is ensured by requiring case minimums and oral and written examinations. However, there is a paucity of information detailing what teaching modalities residency programs utilize outside of the operating room (OR). METHODS: A 16-question survey was sent to all integrated and independent program directors....
Mon Aug 24, 2020 03:00
Background: Pierre robin sequence (PRS) is a common cause of upper airway obstruction in newborns. Airway obstruction is often worse during sleep, leading to severe obstructive sleep apnea (OSA). Standardized management algorithms are lacking. Although mandibular distraction osteogenesis (MDO) is a frequently used surgical approach, literature regarding outcomes after treatment in early infancy is sparse. Herein we report sleep and respiratory parameters in a cohort of neonates undergoing external...
Mon Aug 24, 2020 03:00
BACKGROUND: Patients undergoing orthognathic skeletal correction present with a variety of comorbidities that may affect surgical outcomes. The purpose of this study is to understand how patient risk factors and operative technique contribute to complication rates after orthognathic surgery in the era of patient-specific implants. METHODS: Retrospective cohort analysis was conducted of pediatric patients undergoing LeFort I osteotomy, bilateral sagittal split osteotomy, and/or genioplasty...
Mon Aug 24, 2020 03:00
Background The purpose of this study was to evaluate the long-term outcome of successful fingertip replantations more than 10 years of follow-up post surgery. Methods A total of 34 successful replanted digits in 31 patients with a mean period to follow-up of 16.5 years were included into this study. The main outcome measures were time to return to work, pain, cold intolerance, sensory recovery, nail deformity, grip strength, range of motion of the thumb interphalangeal or finger distal...
Mon Aug 24, 2020 03:00
Introduction: Reduction mammaplasty provides symptomatic relief to patients with macromastia. Insurance companies act as gatekeepers of healthcare by determining the medical necessity of surgical procedures, including reduction mammaplasty. We sought to evaluate insurance coverage and policy criteria for reduction mammaplasty. Methods: We conducted a cross-sectional analysis of United States insurance policies on reduction mammaplasty. Insurance providers were selected based on their...
Mon Aug 24, 2020 03:00
Background: Flap monitoring in reconstructive surgery is particularly important because flap failure is a dramatic event for the patient as well as for the medical team. Noninvasive deep tissue oxygenation monitoring is a challenge. The aim of this experimental study was to assess the performance of time-resolved near-infrared spectroscopy (TR-NIRS) compared to continuous-wave (CW)-NIRS and to invasive oxygen partial pressure (PtO2) measurement in pigs. Methods: Thirty fascio-cutaneous...
Mon Aug 24, 2020 03:00
Introduction: Despite the rise in rate of contralateral prophylactic mastectomy (CPM), few studies have utilized patient-reported outcomes to assess satisfaction between unilateral and bilateral breast reconstruction using autologous tissue. The current study aims to investigate patient satisfaction and quality of life following autologous reconstruction to determine if differences exist between unilateral and bilateral reconstructions to better guide clinical decision-making. Methods: ...
Mon Aug 24, 2020 03:00
Background: Clinical examination alone is neither sensitive nor specific in predicting flap necrosis, so several technologies, including indocyanine green angiography (ICGA), thermal imaging (FLIR ONE), and near-infrared spectroscopy (NIRS), have been developed to supplement perfusion assessment. This study aims to compare the accuracy of these three methods for intraoperatively predicting clinical flap necrosis in a rat perforator flap model. We hypothesized that NIRS, assessing oxygenation...
Mon Aug 24, 2020 03:00
Background: Burn injuries commonly affect the hand, and the development of adduction contractures of the first webspace is frequent and deleterious, both functionally and aesthetically. Many corrective techniques and algorithmic approaches have been described to treat this problem, but there is no consensus on the optimal management. Methods: A retrospective review at a single high-volume pediatric burn center was undertaken to evaluate the clinical course of these patients. All pediatric...
Mon Aug 24, 2020 03:00
Background: Plastic surgeons commonly encounter skin and soft tissue defects of the fingertips. Their management is functionally and aesthetically important, but controversial, especially when bones are exposed. Recent advances in wound-healing technology allow the use of cells or biological dermis. This study aimed to demonstrate the clinical efficacy of tissue-engineered dermis grafts (TEDGs) and artificial dermis grafts (ADGs) versus immediate reconstructive procedures such as the reverse...
Mon Aug 24, 2020 03:00
Background Surgical site infection after implant based breast reconstruction remains a leading cause of morbidity. Doxycycline is an antibiotic used to treat soft tissue infections. We hypothesize that doxycycline-coated breast implants will significantly reduce biofilm formation, surgical site infection, and inflammation after bacterial infection. Methods Pieces of silicone breast implants were coated in doxycycline. In vitro studies to characterize the coating included: Fourier transmission...
Mon Aug 24, 2020 03:00
Background: The efficacy and safety of vulvovaginal restoration devices was called into question in an FDA Statement on July 30, 2018 claiming that women are being harmed by laser and other energy-based devices. The goal of this systematic literature review was to assess existing data, determine gaps in evidence, and propose opportunities for continued investigation pertaining to laser and energy-based vaginal restoration techniques. Methods: A review of literature using PubMed, Cochrane...
Mon Aug 24, 2020 03:00
Background: We conducted a cost-effectiveness analysis to answer the question: “Which motion preserving surgical strategy, 1) four corner fusion (FCF), 2) proximal row carpectomy (PRC), 3) total wrist arthroplasty (TWA), used for the treatment of wrist osteoarthritis (OA) is the most cost-effective?” Methods: A simulation model was created to model a hypothetical cohort of wrist OA patients (mean age of 45 years old) presenting with painful wrist and having failed conservative management....
Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
Summary: Telemedicine holds vast amounts of potential in changing the way outpatient Plastic and Reconstructive Surgery is practiced. Prior to the COVID-19 pandemic Video Conferencing (VC) was utilized by a small fraction of medical specialties. However, since the start of the pandemic, CMS and the largest private health insurance companies have relaxed regulations to allow the majority of specialties to use VC in lieu of in-person visits. Most importantly, VC minimizes patient and physician...
Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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Mon Aug 24, 2020 03:00
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