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Annals of Plastic Surgery

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https://www.readbyqxmd.com/read/29319575/duplex-ultrasonography-assisted-freestyle-pedicled-perforator-flaps-for-the-repair-of-myelomeningocele-defects
#1
Atsushi Imaizumi
BACKGROUND: Perforator flaps have unique advantages that may overcome the shortcomings of conventional approaches to myelomeningocele reconstruction. However, identifying and dissecting tiny perforators in neonates is arduous. We have overcome these obstacles with a freestyle flap approach that uses duplex ultrasonography to locate perforator vessels, allowing for limited superficial dissection. This report describes the duplex ultrasonography-assisted freestyle pedicled perforator flap technique for closure of myelomeningocele defects, with long-term clinical outcomes...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319574/risk-factors-of-vasopressor-induced-symmetrical-peripheral-gangrene
#2
Jung Woo Kwon, Min Ki Hong, Bo Young Park
BACKGROUND: Symmetrical peripheral gangrene (SPG) is an uncommon syndrome showing symmetrical gangrene in acral regions without evidence of large-vessel occlusion or vasculitis. Intravenous vasopressors are frequently used to manage hemodynamically unstable patients. There have been few reports about SPG after using inotropics. However, risk factors for SPG have not been extensively studied. Therefore, the objective of this study was to analyze several cases of SPG and identify risk factors for SPG...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319573/identifying-sources-of-funding-that-contribute-to-scholastic-productivity-in-academic-plastic-surgeons
#3
Qing Zhao Ruan, Justin B Cohen, Yoonji Baek, Austin D Chen, Andres F Doval, Dhruv Singhal, Eugene Y Fukudome, Samuel J Lin, Bernard T Lee
BACKGROUND: Scholastic productivity has previously been shown to be positively associated with National Institute of Health (NIH) grants and industry funding. This study examines whether society, industry, or federal funding contributes toward academic productivity as measured by scholastic output of academic plastic surgeons. METHODS: Institution Web sites were used to acquire academic attributes of full-time academic plastic surgeons. The Center for Medicare and Medicaid Services Open Payment database, NIH reporter, the Plastic Surgery Foundation (PSF), and American Association of Plastic Surgeons (AAPS) Web sites were accessed for funding and endowment details...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319572/vascularized-composite-allotransplantation-of-the-elbow-joint-a-cadaveric-study
#4
Mitchell A Pet, Angelo B Lipira, Yusha Liu, Dennis Kao, Jason H Ko
BACKGROUND: Surgical options for the unreconstructable elbow are limited to arthrodesis, total arthroplasty, or osteoarticular allograft reconstruction. Each of these options is limited by severe functional impairment and/or high complication rates. Vascularized allotransplantation of the elbow joint has the potential to mitigate these complications. In this study, we describe our technique for harvesting the elbow for vascularized joint transplantation and demonstrate the flap's vascularity using contrast angiography...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319571/topical-antimicrobials-in-burn-care-part-1-topical-antiseptics
#5
Janos Cambiaso-Daniel, Stafanos Boukovalas, Genevieve H Bitz, Ludwik K Branski, David N Herndon, Derek M Culnan
Burn wounds disrupt the body's primary defense against invasion and colonization by microorganisms. Topical antimicrobials are one component in burn wound care. These agents suppress microbial growth to advantage skin cells and wound healing. Topical antimicrobials can be divided into 2 superclasses: antiseptics and antibiotics. We review the 4 main classes of topical antiseptics (emulsifiers, acids, oxidizers, and heavy metals) and antiseptic-impregnated dressings in current clinical use and address the mechanisms, as well as the advantages and disadvantages of each antiseptic for burn wound management...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319570/analysis-of-operative-techniques-of-fractures-of-the-first-metacarpal-base
#6
Till Fischborn, Dominik Beckenbauer, Manuel Held, Adrien Daigeler, Fabian Medved
INTRODUCTION: Over time, the operative treatment of extra-articular and intra-articular fractures of the first metacarpal base has gained significant importance, and at present, there are many operative strategies available because of the different osteosynthesis procedures in practice today. PURPOSE: In this retrospective cohort study, we analyze the possible differences between 2 distinguished operative osteosynthesis techniques, in terms of patient outcome, operation time, duration of radiation exposure, and postoperative radiographic results...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319569/comparing-head-and-facial-computed-tomographic-imaging-in-identifying-operative-facial-fractures
#7
Joseph A Ricci, Bao Ngoc N Tran, Qing Z Ruan, Samuel J Lin, Dhruv Singhal, Bernard T Lee
BACKGROUND: Patients who present for a trauma workup often have a head computed tomography (CT) performed to identify intracranial pathology. Facial fractures are routinely identified in these patients, and further imaging is the norm with dedicated facial CT scans. Additional imaging increases radiation doses; however, it is unclear if additional operative fractures are identified. The aim of this study was to examine differences between these 2 CT imaging modalities. METHODS: A retrospective review of all operative facial trauma patients receiving both head and facial scans at a single institution was performed (1999-2012)...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319568/optimizing-radiotherapy-for-keloids
#8
Sebastian Q Vrouwe, Robert Cartotto, Alan David Rogers
No abstract text is available yet for this article.
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319567/clinical-epidemiology-of-acute-burn-injuries-at-nepal-cleft-and-burn-centre-kathmandu-nepal
#9
Bishal Karki, Shankar Man Rai, Kiran Kishore Nakarmi, Surendra Jung Basnet, Mangal Gharti Magar, Krishna Kumar Nagarkoti, Sunil Thapa
BACKGROUND: Burn injury is a global health problem mainly occurring in developing countries. The Nepal Cleft and Burn Centre at Kirtipur Hospital, Kathmandu, has been providing the acute burn care since 2013 with 7 intensive care unit beds, 30 general beds, and 2 dedicated operating rooms. A similar descriptive study was performed in this center in 2014. These studies will be helpful for developing prevention strategies and monitoring the progress in the standard of care of acute burn patients...
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29319566/the-joseph-m-still-burn-symposium
#10
William C Lineaweaver, Jocelyn Hills, Fred Mullins
No abstract text is available yet for this article.
January 9, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309334/retrospective-review-of-free-anterolateral-thigh-flaps-for-limb-salvage-in-severely-injured-high-voltage-electrical-burn-patients
#11
Jing-Chun Zhao, Kai Shi, Lei Hong, Zheng-Hua Jin, Xi Zhang, Xin-Xin Gao, Jia-Ao Yu
BACKGROUND: High-voltage electrical injuries usually cause extensive and devastating damages to the extremities. Timely and effective coverage of the wounds to maximally preserve the viable tissue is important for salvage and the ultimate functional outcome of the involved extremities. In this study, free anterolateral thigh flaps with a single-perforator pedicle were conducted to maximize tissue salvage and decrease late skeletal and neuromuscular complications of the involved extremities injured by high-voltage electricity...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309333/flap-mastopexy-in-autologous-breast-reconstruction-timing-and-technique
#12
Jared Troy, Andrea Little, Lauren Kuykendall, Deniz Dayicioglu
BACKGROUND: Techniques in breast reconstruction have significantly advanced the possibility to create more natural and aesthetically appealing breasts. Despite thorough preoperative planning and vigilant operative technique, symmetry remains a concern for select patients who have undergone autologous breast reconstruction. Although symmetry procedures of the contralateral breast have been well described in the literature, little has been published regarding secondary revision in the autologous reconstructed breast, leaving uncertainty as to the appropriate timing and technique for revision procedures that will not hinder the viability of the flap...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309332/magnetic-resonance-imaging-versus-3-dimensional-laser-scanning-for-breast-volume-assessment-after-breast-reconstruction
#13
Chenglong Wang, Jie Luan
No abstract text is available yet for this article.
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309331/adipose-derived-tissue-in-the-treatment-of-dermal-fibrosis-antifibrotic-effects-of-adipose-derived-stem-cells
#14
Anna A Borovikova, Mary E Ziegler, Derek A Banyard, Garrett A Wirth, Keyianoosh Z Paydar, Gregory R D Evans, Alan David Widgerow
Treatment of hypertrophic scars and other fibrotic skin conditions with autologous fat injections shows promising clinical results; however, the underlying mechanisms of its antifibrotic action have not been comprehensively studied. Adipose-derived stem cells, or stromal cell-derived factors, inherent components of the transplanted fat tissue, seem to be responsible for its therapeutic effects on difficult scars. The mechanisms by which this therapeutic effect takes place are diverse and are mostly mediated by paracrine signaling, which switches on various antifibrotic molecular pathways, modulates the activity of the central profibrotic transforming growth factor β/Smad pathway, and normalizes functioning of fibroblasts and keratinocytes in the recipient site...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309330/outcomes-of-ventral-hernia-repair-with-concomitant-panniculectomy
#15
Colton H L McNichols, Silviu Diaconu, Yuanyuan Liang, Eseigboria Ikheloa, Shivum Kumar, Saahil Kumar, Arthur Nam, Yvonne Rasko
PURPOSE: Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks and benefits of this procedure. METHODS: A retrospective database was collected using current procedural terminology codes for VHR/PAN. The patient-specific variables that were studied include the following: sex, body mass index (BMI), smoking, diabetes, chronic obstructive pulmonary disease, cirrhosis, immunosuppression, length of operation, acute incarcerated hernias, hernia size and location, mesh size and location, pannus weight, concomitant component separation, use of negative-pressure wound therapy, intestinal violation, follow-up duration, ventral hernia working group, history of bariatric surgery, previous hernia repair, skin dehiscence, skin necrosis, chronic wound, surgical site infection, seroma, hematoma, fascial dehiscence, hernia recurrence, unplanned return to operating room, and medical complication...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309329/extracorporal-shock-wave-therapy-enhances-receptor-for-advanced-glycated-end-product-dependent-flap-survival-and-angiogenesis
#16
Emrullah Birgin, Christoffer Gebhardt, Svetlana Hetjens, Sebastian Fischer, Felix Rückert, Matthias A Reichenberger
BACKGROUND/OBJECTIVES: Loss of skin flaps due to deteriorated wound healing is a crucial clinical issue. Extracorporal shock wave therapy (ESWT) promotes flap healing by inducing angiogenesis and suppressing inflammation. The receptor for advanced glycation end-products (RAGEs) was identified to play a pivotal role in wound healing. However, to date, the role of RAGE in skin flaps and its interference with ESWT are unknown. METHODS: Caudally pedicled musculocutanous skin flaps in RAGE and wt mice were treated with low-dose extracorporal shock waves (s-RAGE, s-wt) and analyzed for flap survival, histomorphologic studies, and immunohistochemistry during a 10-day period...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309328/a-new-option-for-the-reconstruction-of-primary-or-recurrent-ischial-pressure-sores-hamstring-adductor-magnus-muscle-advancement-flap-and-direct-closure
#17
Jin Sik Burm, Jungil Hwang, Yung Ki Lee
BACKGROUND: Owing to the high recurrence rates of ischial pressure sores, surgeons should consider the possibility of future secondary flap surgery during flap selection. The purpose of this article is to present a new surgical option for the reconstruction of primary or recurrent ischial pressure sores using a simple hamstring-adductor magnus advancement flap and direct closure. METHODS: After horizontal fusiform skin excision, complete bursa excision and ischiectomy were performed...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309327/graphical-calculation-of-estimated-energy-expenditure-in-burn-patients
#18
Francesco M Egro, Ernest C Manders, Ernest K Manders
BACKGROUND: Historically, estimated energy expenditure (EEE) has been related to the percent of body surface area burned. Subsequent evaluations of these estimates have indicated that the earlier formulas may overestimate the amount of caloric support necessary for burn-injured patients. Ireton-Jones et al derived 2 equations for determining the EEE required to support burn patients, 1 for ventilator-dependent patients and 1 for spontaneously breathing patients. Evidence has proved their reliability, but they remain challenging to apply in a clinical setting given the difficult and cumbersome mathematics involved...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309326/components-separation-for-abdominal-wall-reconstruction-in-the-recalcitrant-high-comorbidity-patient-a-review-of-311-single-surgeon-cases
#19
Sanjay Naran, Sameer Shakir, Kenneth C Shestak, James M Russavage, Vu T Nguyen
PURPOSE: Components separation of the abdominal musculature remains a mainstay for closure of complicated midline and paramedian abdominal wall defects. The authors critically analyzed their experience with this technique to identify prognosticators affecting long-term clinical outcomes. METHODS: A retrospective review was performed of patients undergoing components separation by a single senior surgeon (J.M.R.) between 2000 and 2010. Numerous perioperative patient characteristics were collected and analyzed to determine their effects on long-term clinical outcomes...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29309325/upper-extremity-injuries-seen-at-a-level-1-trauma-center-does-insurance-status-matter
#20
Eric Wenzinger, Robinder Singh, Fernando Herrera
BACKGROUND: Hand and upper extremity injuries are one of the leading causes of injury in the United States, making up 10% of all emergency department visits. The purpose of this study was to determine if there are any demographic differences between patients presenting primarily to our emergency department for upper extremity injuries versus those transferred from outside hospitals for the same diagnoses. METHODS: A retrospective review of our hand trauma database was performed between 2011 and 2014...
January 5, 2018: Annals of Plastic Surgery
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