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Annals of Plastic Surgery

Chia-Chin Tsai, Shyh-Jou Shieh
Locked thumb metacarpophalangeal joint caused by entrapment of the sesamoid bone is an uncommon entity. The intact volar plate, strong ligamentous attachment between the sesamoid bone and the joint, and altered axis of inserted muscle all contribute to failure of closed reduction. The patient's history, clinical presentation, and plain radiographic findings are all important clues to diagnosing this rare disease. We describe 2 patients with a similar mechanism of injury, where the sesamoid bones were displaced into the thumb metacarpophalangeal joint causing lock thumb...
November 13, 2018: Annals of Plastic Surgery
Che-Hsiung Lee, Nai-Jen Tommy Chang, Jo-Chun Hsiao, Yu-Ying Chu, Chih-Hung Lin, Huang-Kai Kao, Cheng-Hung Lin
BACKGROUND: The medial sural artery perforator (MSAP) flap has become increasingly popular because it is thin and pliable for small to moderate defect soft tissue reconstruction. Furthermore, chimeric MSAP flap, which includes a skin paddle and a separated piece of medial gastrocnemius muscle, allowed more freedom for flap insetting, especially in 3-dimensional defect reconstruction. Here we describe our experience regarding this clinical application. PATIENTS AND METHODS: From 2007 to 2016, 14 male patients (average age, 46...
November 13, 2018: Annals of Plastic Surgery
Ching-En Chen, Shang-Liang Wu, Wen-Chieh Liao, Cherng-Kang Perng, Hsu Ma, Chih-Hsun Lin
BACKGROUND: Most of the patients with hypopharyngeal cancer are still diagnosed with advanced stage, and total or partial pharyngectomy with free flap reconstruction is the mainstay of treatment. The aim of this study was to find out the possible risk factors related to surgical complications after free fasciocutaneous flap reconstruction for partial pharyngeal defect and its sequelae in the follow-up. PATIENTS AND METHODS: We retrospectively reviewed the charts of patients with advanced hypopharyngeal cancer who received free fasciocutaneous flaps for partial pharyngeal defects reconstruction...
November 13, 2018: Annals of Plastic Surgery
Oscar J Manrique, Kian Adabi, Tony Chieh-Ting Huang, Jorys Jorge-Martinez, Laura E Meihofer, Pierre Brassard, Ricardo Galan
BACKGROUND: Rapid increase in number of male-to-female vaginoplasties emphasizes the need for preoperative measures to optimize final surgical and patient-reported outcomes. Hormonal therapy and socioeconomic factors may contribute to a higher incidence of pelvic floor dysfunction in patients undergoing male-to-female vaginoplasty. The purpose of this study was to evaluate the incidence of pelvic floor dysfunction in this population and the role of physical therapy in its treatment. METHODS: From July 2016 to July 2018, patients scheduled to undergo male-to-female vaginoplasty were evaluated by a physical therapist for pelvic floor dysfunction...
November 13, 2018: Annals of Plastic Surgery
Samuel R Long, James A Butterworth
BACKGROUND: While complications of deep inferior epigastric artery perforator flaps are known and well documented, a thorough literature review revealed no other reports of a patient developing a chyle leak following the use of the internal mammary vessels for recipient vessels in autologous breast reconstruction. CASE: A 55-year-old woman underwent free autologous breast reconstruction. She developed a chyle leak during the postoperative period. This was verified through a computed tomography scan and fluid analysis demonstrating a high triglyceride count and the presence of chylomicrons...
November 13, 2018: Annals of Plastic Surgery
Jae Hyun Park, Seung Hyun You, Na Rae Kim
Nonshaven follicular unit extraction (NS-FUE) is the most state-of-the-art surgical technique in the field of follicular unit hair transplantation. It is particularly appealing because donor area shaving, one of the most serious impediments for the patient, can be omitted. In this article, we present our surgical approach for NS-FUE. We selectively used the direct or the pretrimming method of NS-FUE according to indication, determined by considering the location and purpose of transplantation, the condition of the recipient site, and the patient's preference...
November 9, 2018: Annals of Plastic Surgery
David Buziashvili, Jared M Gopman, Hope Weissler, Lawrence Bodenstein, Andrew J Kaufman, Peter J Taub
Pectus excavatum (PE) and pectus carinatum (PC) are the most common congenital chest wall anomalies. Current research suggests that PE and PC may result from overgrowth of the sternocostal cartilages. This can produce a deformation that displaces the sternum inward as in PE or outward as in PC. The etiology, clinical presentation, evaluation, and management of PE and PC are reviewed. Varied clinical presentations, cardiopulmonary effects, and psychosocial aspects are described.
October 31, 2018: Annals of Plastic Surgery
Mustafa Chopan, Lohrasb Sayadi, Patrick J Buchanan, Adam J Katz, Bruce A Mast
BACKGROUND: Highly cited publications are referred to as citation classics and can signify important contributions to a discipline. Although citation classics in plastic surgery have been identified, none were published before 1960. Citation classics in earlier periods may contain the historical roots or intellectual origins of the field. We set out to identify such scholarly works and analyze their characteristics. METHODS: A novel technique of citation analysis, referred to as reference publication year spectroscopy, was used to analyze the literature...
October 31, 2018: Annals of Plastic Surgery
Il Hwan Byun, Chan Woo Kim, Tae Hwan Park
INTRODUCTION: The reconstruction of extensive soft tissue defects from pressure ulcers is a great challenge. Resurfacing such defects with like tissues and minimizing morbidities are important. Here we present our surgical experience using a novel modified keystone flap for pressure ulcer patients. METHODS: We retrospectively reviewed the data of 13 consecutive cases reconstructed with the modified keystone flaps between March and December, 2017. The mean dimensions of the reconstructed defect were 7...
October 31, 2018: Annals of Plastic Surgery
Joshua A David, William J Rifkin, Ernest S Chiu
OBJECTIVE: Despite the presence of self-inflicted wounds (SIWs) across all of medicine, our current understanding of SIWs in surgery is limited. Here, we detail the pertinent aspects of the history, diagnosis, decision making, and management of SIWs as they relate to the field of surgery. In addition, we present the first comprehensive review of SIWs across the surgical literature. SUMMARY BACKGROUND DATA: Self-inflicted wounds have been recognized for much of recorded human history and span a wide spectrum of patient behaviors, motivations, and underlying psychiatric illnesses...
October 31, 2018: Annals of Plastic Surgery
Masoud Jafaripour, Seyed Abolfazl Kashfi
Lacrimal injury is very uncommon after osteotomy in rhinoplasty. We present 2 cases of lacrimal injury after osteotomy in rhinoplasty and present the steps to managing such an injury. These cases were finally treated with endoscopic dacryocystorhinostomy. We concluded that osteotomies must be at least 3 mm from the medial canthus or medial to the line from the medial canthus to the alar base. Also, it is recommended that osteotome blades be sharpened before each osteotomy.
October 15, 2018: Annals of Plastic Surgery
Yue Xing, Xi Wang, Yuan Cao, Xia Ding, Ming Lin, Jin Li, Xianqun Fan
BACKGROUND: This study aims to evaluate the effect of a modified approach on severe congenital ptosis treatment. METHODS: Through anterior approach, Müller muscle was preserved, meanwhile the upper tarsus was suspended to combined fascia sheath (CFS) and levator muscle (LM) complex. The main outcome measures included marginal reflex distance1 (MRD1), palpebral fissure height (PFH), MRD1 regression, MRD1 improvement, and patient self-satisfaction. RESULTS: There were 70 patients (90 eyelids) with severe congenital ptosis received treatment of modified operation, including 20 bilateral and 50 unilateral ptosis...
October 15, 2018: Annals of Plastic Surgery
Alain Joe Azzi, Sarah Zhou, Tyler Safran, Liqin Xu, Nayif Alnaif, Teanoosh Zadeh
INTRODUCTION: Radiation therapy (RT) is recommended for appropriately selected sarcoma patients to minimize the risk of local recurrence and to maximize outcomes of disease-free survival and function. The purpose of this study was to confirm the safety of vascularized tissue reconstruction in recently irradiated sarcoma defects. METHODS: A retrospective review of all patients treated by the senior author for sarcoma reconstruction from January 2005 to July 2017 was performed...
October 15, 2018: Annals of Plastic Surgery
Nicholas C Oleck, Farrah C Liu, Michael Conway, Eric Kalish, Joseph Belgrade, Peter Santoro, David Zabel
INTRODUCTION: Patients undergoing complex ventral hernia repair (VHR) often present with significant medical comorbidities, the most prevalent of which is obesity. Although recent advancements in abdominal wall reconstruction techniques have provided the general hernia patient population with markedly improved recurrence and postoperative complication rates, many patients have been precluded from these procedures owing to excessive body mass index (BMI). In this study, we investigate the viability of complex ventral hernia repair with epigastric artery perforator sparing skin incisions, component separation, and wide-spanning retrorectus mesh reinforcement for patients with BMI of greater than or equal to 40 kg/m (class III obesity)...
October 15, 2018: Annals of Plastic Surgery
Jonathan E Miller, Aparajit Naram, BaiJing Qin, Douglas M Rothkopf
BACKGROUND: Distal radius fractures represent some of the most common injuries to the upper extremity, yet current evidence demonstrates great variability in the management of this injury. Elderly patients, in particular, stand to benefit from the early mobilization provided by operative fixation with a volar bearing plate. METHODS: We conducted a retrospective chart review on all patients 65 years or older who underwent unilateral open reduction internal fixation of distal radius fractures using a volar bearing plate at a single institution between January 2014 and January 2016...
October 15, 2018: Annals of Plastic Surgery
Shanshan He, Jian Yin, Jingyan Sun, Qingfeng Huang, Jing Liu, Chunyong Han, Zhuming Yin
INTRODUCTION: Breast reconstruction for Chinese patients is vastly different given cultural differences, patient preferences, access to resources, and insurance coverage in China. Given these unique factors, a different approach for optimizing outcomes should be considered. METHODS: Retrospective review of all patients undergoing implant-based breast reconstruction from January 2013 to May 2016 was performed. Esthetic evaluations were made both by the patients and 1 nonoperative surgeon at least 6 months postoperative, and patient satisfaction was assessed using the Breast-Q...
October 15, 2018: Annals of Plastic Surgery
Lisa Bompy, Brice Gerenton, Sarra Cristofari, Alessio Stivala, Vivien Moris, Leslie-Ann See, Philippe Rizzi, Fabienne Braye, Jean-Paul Meningaud, Narcisse Zwetyenga, David Guillier
BACKGROUND: Exclusive breastfeeding is highly recommended by the World Health Organization during the first 6 months of life. In parallel, breast augmentation with implants is one of the most performed operations in aesthetic surgery. OBJECTIVE: The goal of our study was therefore to analyze the potential impact of aesthetic breast implants on breastfeeding. STUDY DESIGN: A retrospective study was carried out in 3 French university hospitals...
October 15, 2018: Annals of Plastic Surgery
Patrick J Buchanan, Tsun Law, Sam Rosas, Zachary Hubbard, Bruce A Mast, Harvey Chim
BACKGROUND: Diabetes mellitus is a well-known risk factor for infection after trigger finger (TF) injection and/or release. However, the effect of preoperative hypoglycemia before TF injection or release is currently unknown. The purpose of this study is to determine the effects of preoperative hypoglycemia on infection incidence after TF injection or release. METHODOLOGY: A retrospective cohort review between 2007 and 2015 was conducted using a national private payer database within the PearlDiver Supercomputer...
October 15, 2018: Annals of Plastic Surgery
Marek K Dobke, Brittany Yee, Gina A Mackert, William Y Zhu, Sarah L Blair
BACKGROUND: The landscape of surgical and medical management and patient choices for breast cancer treatment changes as breast reconstruction and oncoplastic approaches improve and diversify. Increased access to breast reconstruction, in addition to patient education, influences the breast cancer patient. Therefore, the examination of the possible impact of reconstructive surgery on all stages of the breast cancer management per se seemed timely. METHODS: Plastic surgery consults were arranged for 520 new patients diagnosed with breast cancer (2012-2016) including patients with noninvasive breast cancer but at high risk of further cancer development...
October 9, 2018: Annals of Plastic Surgery
Yihua Mao, Hong Li, Maochao Ding, Xiaodi Hao, Jing Pan, Maolin Tang, Shixin Chen
OBJECTIVE: Choke vessels, vascular anastomosis between adjacent angiosome, play an important role in flap expansion and survival. Here we established a flap model with single and multiple perforators to detect and compare the changes in choke vessels, discuss the effect of hemodynamics on the vascular morphology, and explore the underlying mechanism. METHODS: One hundred mice (7-8 weeks) were subjected to a "choke zone" surrounded by 4 perforators on their backs...
October 9, 2018: Annals of Plastic Surgery
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