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Annals of Plastic Surgery

Hilmi Şen, Melike Oruç, Veysel Murat Işik, Murat Sadiç, Hamide Sayar, Rana Çitil, Meliha Korkmaz, Uğur Koçer
BACKGROUND: Necrosis of random pattern flaps caused by inadequate blood flow, especially in the distal part of the flap is one of the biggest challenges in reconstructive surgery. Various agents have been used to prevent flap ischemia. In this study, we used omeprazole, which is a potent inhibitor of gastric acidity to increase flap viability. METHODS: In this study, 35 Wistar-Albino type rats which were divided into 5 equal groups were used. Random-pattern dorsal skin flaps were raised in all groups at seventh day of the study...
October 24, 2016: Annals of Plastic Surgery
Xiucun Li, Jianli Cui, Suraj Maharjan, Ziping Jiang, Laijin Lu, Xu Gong
OBJECTIVE: The posterior thigh region has been neglected as a donor site for free perforator flaps, likely due to difficulties in positioning the patient during surgery. This study describes the clinical application of the posterior thigh perforator flap based on the third perforating artery of the profunda femoris artery (PFA). METHODS: The free posterior thigh perforator flap based on the third perforating artery of the PFA was used for reconstruction of soft tissue defects in nine patients between February 2010 and May 2014...
October 19, 2016: Annals of Plastic Surgery
Katelyn G Bennett, Theodore A Kung, James A Hayman, David L Brown
BACKGROUND: Management of keloids has remained a conundrum, because an optimum treatment regimen has yet to be elucidated. Currently, treatment varies widely between more conservative measures, such as steroid injections, topical medications, and silicone sheeting, to more aggressive options, such as surgery and postoperative radiation. The latter combination has been touted to have superior results, with the lowest rates of pathologic scar recurrence. METHODS: We performed a retrospective review to critically evaluate the effectiveness of surgical excision and radiation treatment in patients with keloids...
October 19, 2016: Annals of Plastic Surgery
Hai-Fei Liu, Feng Zhang, William C Lineaweaver
Advances in burn care have a long history with accelerated development within the last 50 years. The principal areas of burn treatment include dressings, antimicrobials, fluid resuscitation, burn wound excision, grafting of skin, and skin substitution. This review presents a historical outline of these areas, their current status, and prospects for the future of burn care.
October 19, 2016: Annals of Plastic Surgery
Debra W Yen, Dennis C Nguyen, Gary B Skolnick, Sybill D Naidoo, Kamlesh B Patel, Lynn Marty Grames, Albert S Woo
BACKGROUND: Reconstruction of the levator musculature during cleft palate repair has been suggested to be important in long-term speech outcomes. In this study, we compare the need for postoperative speech therapy between 2 intravelar veloplasty techniques. METHODS: Chart review was performed for patients with nonsyndromic cleft palate who underwent either primary Kriens or overlapping intravelar veloplasty before 18 months of age. All subjects completed a follow-up visit at approximately 3 years of age...
October 17, 2016: Annals of Plastic Surgery
Yuhong Chen, Chenyang Ji, Biying Wu, Weiqiang Liang, Jinming Zhang
OBJECTIVE: To investigate the application of MEDPOR surgical implant in modified penile elongation. METHODS: The suspensory ligaments were divided, and cavernous bodies of crus were partially mobilized, so as to release part of the cavernous bodies from inferior ramus of pubis. Then, the penis was elongated sufficiently. MEDPOR surgical implants (MEDPOR; high-density porous polyethylene, Howmedica Osteonics Corp. Newnan, Ga) were inserted between the cavernous bodies and pubic symphysis...
October 17, 2016: Annals of Plastic Surgery
Steven A Ovadia, Yasmina Zoghbi, Seth R Thaller
BACKGROUND: Surgical site infections, also referred to as wound infections, are commonly studied within the plastic surgery literature. The definition of these terms is not standardized in the literature. Individual studies may select criteria to use in identifying infection. This may have important implications upon interpretation of study results. METHODS: Studies evaluating surgical site infection in the plastic surgery literature were identified through search of the MEDLINE database across the five year period ending March 2016...
October 17, 2016: Annals of Plastic Surgery
Nelson A Rodriguez-Unda, Ricardo J Bello, Emily M Clarke-Pearson, Abanti Sanyal, Carisa M Cooney, Michele A Manahan, Gedge D Rosson
BACKGROUND: Changes in breast sensation after reconstruction are expected. Return of breast sensation after reconstruction and whether nipple-sparing mastectomy offers a substantial benefit in terms of sensation has been inconsistently documented in the literature. We conducted the current study using the pressure-specified sensory device to quantify postoperative breast sensation in patients undergoing nipple-sparing versus non-nipple-sparing mastectomy. METHODS: Consecutive adult women who underwent nipple-sparing (NSM) and non-NSM (NNSM) and were at least 18 months postreconstruction were included...
October 17, 2016: Annals of Plastic Surgery
Jochen-Frederick Hernekamp, Florian Neubrech, Tomke Cordts, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
PURPOSE: The clinical course after major burns is characterized by microcirculatory changes and consecutive capillary leakage. However, current clinical monitoring does not properly assess microcirculation, whereas macrohemodynamic changes are continuously evaluated. Here, we assess if macrohemodynamic and microhemodynamic parameters after burn trauma are correlated in a rat model. METHODS: Burn plasma harvested from donor rats 4 hours after thermal injury (30% total body surface area, 100 °C water, 12 seconds) was administered intravenously to healthy animals during 2 hours of intravital microscopy (burn group [BG])...
October 17, 2016: Annals of Plastic Surgery
Arvind U Gowda, Colton H L McNichols, Ishan Asokan, Jamil A Matthews, E Bryan Buckingham, Jennifer Sabino, John S Maddox, Sheri Slezak, Yvonne Rasko, Devinder P Singh
PURPOSE: The purpose of this study was to compare clinical outcomes of incisional hernia repair in solid organ transplant patients using non-cross-linked porcine acellular dermal matrix (PADM), human derived acellular dermal matrix (HADM) and synthetic mesh. METHODS: A retrospective review of patients who underwent hernia repair with PADM after pancreas and/or renal transplant at the University of Maryland Medical Center from 2008 to 2012 was conducted. Repair type, postoperative infection, hernia recurrence, mesh removal, and length of follow-up were recorded...
October 17, 2016: Annals of Plastic Surgery
Ryan P Cauley, Sean A Hickey, Charles Scott Hultman, Katie Mathews, Jeremy Goverman
BACKGROUND: Postburn axillary contractures are common and significantly impact quality of life. Simple release combined with split thickness skin grafting necessitates a donor site, requires immobilization, and may result in poor functional outcome. Common methods of adjacent tissue rearrangement are not well designed to treat broad linear contractures. Flaps from the back, flank, or arm can be used, but may come with significant donor site morbidity. We demonstrate the use of the STARplasty, a novel adjacent tissue rearrangement initially developed to treat neosyndactyly, as a useful reconstructive option for the release of Kurtzman type 1 posterior or anterior axillary contractures...
October 17, 2016: Annals of Plastic Surgery
Nirav Patel, Justine Pierson, Timothy Lee, Bruce Mast, Bernard T Lee, Irene Estores, Dhruv Singhal
BACKGROUND: Integrative medicine (IM) is currently used by 40% of Americans. Our objective is to examine the prevalence and perception of IM utilization in patients being evaluated for elective plastic surgery. METHODS: In July 2014, 402 consecutive patients presenting to plastic surgery clinics at the University of Florida, Veterans Affairs (VA), and Private Practices in Gainesville, Florida were requested to complete a survey regarding utilization of and attitudes towards IM...
October 17, 2016: Annals of Plastic Surgery
Minyan Zhang, Xiaochen Tian, Jun Shi, Huxian Liu, Ning Liu, Zhengjun Cui
OBJECTIVE: This study aims to observe the efficacies of microsurgical technique combined with the Zhuang's skin soft tissue expander in treating Hunter type III congenital microtia. METHODS: Fifty-eight patients (61 ears) were enrolled from 2003 to 2012; the skin tissue expander was embedded subepidermally in the first stage via the intrahairline longitudinal incision in the postauricular mastoid area, the diseased-side rib cartilage was then taken for preparing the ear bracket in the second stage, and the tragus was surgically reconstructed in the third stage...
October 17, 2016: Annals of Plastic Surgery
Katelyn G Bennett, John M Ingraham, Lisa F Schneider, Pierre B Saadeh, Christian J Vercler
BACKGROUND: The ethical practice of medicine has always been of utmost importance, and plastic surgery is no exception. The literature is devoid of information on the teaching of ethics and professionalism in plastic surgery. In light of this, a survey was sent to ascertain the status of ethics training in plastic surgery residencies. METHODS: A 21-question survey was sent from the American Council of Academic Plastic Surgeons meeting to 180 plastic surgery program directors and coordinators via email...
October 6, 2016: Annals of Plastic Surgery
Cassio Eduardo Raposo-Amaral, Rafael Denadai, Enrico Ghizoni, Cesar Augusto Raposo-Amaral
BACKGROUND: Although craniofacial bone correction is the essential step in hypertelorbitism correction, the final result depends on the management of soft tissue deformities. The purpose of this study was to review our surgical strategies for soft tissue reconstruction in hypertelorbitism correction. METHODS: A retrospective study was performed of consecutive patients with hypertelorbitism, undergoing hypertelorbitism correction between 2007 and 2014. All aspects related to the craniofacial surgical procedures (number and type of procedures, outcomes, and complications) were verified through medical records, clinical photographs, and interviews with all patients...
October 6, 2016: Annals of Plastic Surgery
Eva Placheta, Ines Tinhofer, Melanie Schmid, Lukas F Reissig, Igor Pona, Wolfgang Weninger, Thomas Rath, David Chwei-Chin Chuang, Chieh-Han John Tzou
INTRODUCTION: Facial reanimation surgery is performed in severe cases of facial palsy to restore facial function. In a 1-stage procedure, the spinal accessory nerve can be used as a donor nerve to power a free gracilis muscle transplant for the reanimation of the mouth. The aim of this study was to describe the surgical anatomy of the spinal accessory nerve, provide a guide for reliable donor nerve dissection, and analyze the available donor axon counts. METHODS: Dissections were performed on 10 nonembalmed cadavers (measurements of 20 nerves)...
October 6, 2016: Annals of Plastic Surgery
Woo Young Choi, Ki Wook Sung, Young Seok Kim, Jong Won Hong, Tai Suk Roh, Dae Hyun Lew, Jong Hee Chang, Kyu Sung Lee
Skull base reconstruction is a challenging task. The method depends on the anatomical complexity and size of the defect. We obtained tissue by harvesting fat-containing perifascial areolar tissue (PAT) for reconstruction of limited skull base defects and volume augmentation. We demonstrated the effective option for reconstruction of limited skull base defects and volume augmentation. From October 2013 to November 2015, 5 patients underwent operations using fat-containing PAT to fill the defect in skull base and/or perform volume replacement in the forehead...
October 6, 2016: Annals of Plastic Surgery
Jin Yong Shin, Si-Gyun Roh, Nae-Ho Lee, Kyung-Moo Yang
BACKGROUND: There are many treatment modalities associated with osmidrosis. The purpose of this study was to identify and compare effective osmidrosis treatments. METHODS: A systematic literature review and meta-analysis were performed using MEDLINE, EMBASE, and Cochrane databases. The osmidrosis treatment modalities were extracted as predictor variables, and recurrence and complications were extracted as outcome variables. Subgroup analysis was performed with regard to combined curettage, and fixed and random effect models were applied...
October 6, 2016: Annals of Plastic Surgery
Kristen S Higgins, Joshua Gillis, Jason G Williams, Martin LeBlanc, Michael Bezuhly, Jill M Chorney
Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed to examine the psychosocial experience of flap failure from the patient's perspective. Seven women who had experienced unilateral flap failure after deep inferior epigastric perforator flap surgery in the past 12 years completed semistructured interviews about their breast cancer treatments, their experiences with flap failure, the impact of flap failure on their lives, and the coping strategies they used...
October 6, 2016: Annals of Plastic Surgery
Shimpei Miyamoto, Masahide Fujiki, Fumihiko Nakatani, Eisuke Kobayashi, Masanobu Sakisaka, Minoru Sakuraba
BACKGROUND: Complex groin defects after sarcoma resection require reconstruction of multiple vital structures that can include the major vessels, the overlying skin, the abdominal wall, and the hip joint. We investigated the feasibility of limb preservation after complex groin reconstruction. METHODS: The subjects were 12 consecutive patients who underwent complex groin reconstruction after sarcoma resection. In all patients, the defect included a major artery (external iliac or femoral) and overlying skin...
October 6, 2016: Annals of Plastic Surgery
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