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Annals of Plastic Surgery

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https://www.readbyqxmd.com/read/29781858/axillary-lymphadenectomy-and-wound-complications-in-implant-based-breast-reconstruction
#1
Matthew T Joy, Matthew D Rich, Kurtis E Moyer
BACKGROUND: The most common method of breast reconstruction in the United States today is implant-based reconstruction. However, reported complication rates are high, from 30% to 50%. Thus, it is important for reconstructive surgeons to identify factors associated with or contributing to wound complications after breast reconstruction. This study sought to identify associations between axillary lymph node dissection and postoperative wound complications in implant-based breast reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781857/a-combination-flap-for-nasal-defect-reconstruction
#2
Rajshree Jayarajan
BACKGROUND: Nasal reconstruction is a common plastic surgery procedure following cancer resection. Whereas most small and medium defects are managed using standard local flaps, reconstructive options available for large defects of the nose such as a heminasal defect are very few. Most of the large defects are usually managed using a forehead flap, which involves at least 2 stages or using free tissue transfer. The author describes a combination flap that can be used for reconstruction of heminasal defects as well as lateral wall defects...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781856/neoumbilicoplasty-with-a-pedicled-deep-inferior-epigastric-perforator-island-flap
#3
Matthew A DelMauro, Louis-Joseph Auguste, Peter T Korn
Management of the umbilicus is a common dilemma at the time of abdominoplasty and abdominal wall reconstruction. It is not uncommon for underlying pathologies, such as hernias and surgical scars, to result in a disfigured or obliterated native umbilicus or make the blood supply to the umbilical stalk unreliable. In these scenarios, the umbilicus is often sacrificed. Staged neoumbilical reconstruction may be offered and typically utilizes a small skin flap and full-thickness skin graft (Ann Plast Surg 2009;63:358-360)...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781855/improving-senescent-wound-healing-with-local-and-systemic-therapies
#4
Caroline Szpalski, Parag Butala, Meredith T Vandegrift, Denis Knobel, Robert J Allen, Pierre B Saadeh, Stephen M Warren
The population is aging, and the prevalence of chronic wounds is increasing. Because neovascularization is essential for tissue repair and both local and systemic factors affect new blood vessel formation, we hypothesize that altering either pathway would reciprocally enhance wound healing in the aged. To test this hypothesis, p53 was locally suppressed and endothelial progenitor cells (EPCs) were systemically mobilized in a murine model of senescent wound healing.Bilateral 6-mm full-thickness stented wounds were made on the dorsum of Zmpste24 mice...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#5
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781853/the-use-of-pedicled-perforator-flaps-in-chest-reconstruction-a-systematic-review-of-outcomes-and-reliability
#6
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781852/the-effect-of-postmastectomy-radiation-therapy-on-breast-implants-material-analysis-on-silicone-and-polyurethane-prosthesis
#7
Federico Lo Torto, Michela Relucenti, Giuseppe Familiari, Nicola Vaia, Donato Casella, Roberto Matassa, Selenia Miglietta, Franco Marinozzi, Fabiano Bini, Ilaria Fratoddi, Fabio Sciubba, Raffaele Cassese, Vincenzo Tombolini, Diego Ribuffo
INTRODUCTION: The pathogenic mechanism underlying capsular contracture is still unknown. It is certainly a multifactorial process, resulting from human body reaction, biofilm activation, bacteremic seeding, or silicone exposure. The scope of the present article is to investigate the effect of hypofractionated radiotherapy protocol (2.66 Gy × 16 sessions) both on silicone and polyurethane breast implants. METHODS: Silicone implants and polyurethane underwent irradiation according to a hypofractionated radiotherapy protocol for the treatment of breast cancer...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781851/the-international-fellowship-program-in-microsurgery-at-uppsala-university-hospital-a-paragon-throughout-europe
#8
Holger Jan Klein
Personal reports with valuable information on plastic surgery fellowships from all over the world are about to accumulate in recent years. Whereas some institutions have rightly become widely renowned for their excellent microsurgery fellow training in Taiwan, Canada, United States, and Australia, less is known about European fellowships focusing on reconstructive microsurgery. As former fellow at the Department of Plastic and Maxillofacial Surgery at Uppsala University Hospital, Sweden, the author hereby presents a survey on a unique and exemplary 6-month microsurgical fellowship offering hands-on training, academic education, and not last personal development to ambitious candidates who pursue a career in reconstructive microsurgery...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781850/comparing-processed-nerve-allografts-and-assessing-their-capacity-to-retain-and-release-nerve-growth-factor
#9
Alonda C Pollins, Richard B Boyer, Marlieke Nussenbaum, Wesley P Thayer
Peripheral nerve gap injuries continue to present a clinical challenge to today's surgeons. One method of surgical repair, implantation of acellular allografts, has been developed with the aim of bridging the gap with a cadaveric graft after removal of its cellular components, thereby accelerating axonal regeneration and eliminating the need for immunosuppression in recipient patients. Although decellularizing allografts reduces rates of graft rejection, the same chemical processing modifies the neural microenvironment, removing neutrotrophic factors and modifying the complex extracellular matrix...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781849/breast-reconstruction-among-commercially-insured-women-with-breast-cancer-in-the-united-states
#10
Andrea Barnow, Todd Canfield, Ray Liao, Sashi Yadalam, Iftekhar Kalsekar, Rahul Khanna
INTRODUCTION: This study evaluated trends related to breast reconstruction and the factors associated with reconstruction. METHODS: Women with breast cancer aged 19 to 64 years who underwent a mastectomy procedure between July 1, 2011, and September 30, 2014, were identified from the MarketScan Commercial Claims and Encounters Database. The first date of surgical procedure during this period was defined as the index date. Continuous enrollment during the 12-month preindex and postindex period was required, and the patient sample was followed for 12 months postindex...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762454/correction-of-tuberous-nipple-areolar-complex-deformity-in-gynecomastia-the-deformity-that-can-get-forgotten
#11
Yvette Godwin
The desired end point of surgical reduction of gynecomastia is a masculine breast appearance and symmetry. This article concentrates on the tuberous deformity of the nipple areolar complex (NAC) that can present in gynecomastia and is sometimes overlooked at surgical correction.This deformity can be corrected at primary surgery if it is recognized preoperatively. If missed, or not adequately corrected, the postoperative result of primary reduction may be deemed incomplete by the patient and they will request revision...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762453/microvascular-replantation-following-facial-dog-bites-in-children-systematic-review-and-management-algorithm
#12
Amanda J Williams, Jeremy M Powers, Jennifer L Rhodes, Andrea L Pozez
BACKGROUND: Pediatric dog bite injuries account for 1% of emergency department visits per year and represent an underrecognized and underreported public health problem. Reconstructive surgery is frequently utilized, and in the most extreme injuries, microvascular replantation may be considered. We sought to systematically review the available literature on microvascular replantation after facial dog bite injuries in children, with particular attention to perioperative morbidity and long-term follow-up...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762452/the-use-of-expanded-polytetrafluoroethylene-in-short-nose-elongation-fourteen-years-of-clinical-experience
#13
Jiao Wei, Tanja Herrler, Ning Deng, Hua Xu, Bowen Shi, Chuanchang Dai
BACKGROUND: Short nose elongation is a relatively common rhinoplasty procedure, especially in Asia. The selection of the adequate graft material is challenging. Previous reports have described the application of expanded polytetrafluoroethylene (ePTFE) for dorsal augmentation rhinoplasty, but studies using ePTFE for nose elongation are lacking. We propose ePTFE as an alternative treatment for short noses, describe the technique, and discuss outcomes, patient selection, and complications based on our 14-year experience...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762451/modified-design-of-anterolateral-thigh-flap-for-total-pharyngolaryngectomy-reconstruction-a-single-center-experience
#14
Li-Yen Cheng, Cha-Chun Chen, Hwang-Chi Lin, Chu-Hsu Jeng, Shang-Hsi Lin, Wei-Nung Jim Chen, Yu-Hsien Lin, Sheng-Po Hao
BACKGROUND: Defects after total pharyngolaryngectomy for hypopharyngeal cancer often require reconstruction via free tissue transfer. Recently, anterolateral thigh (ALT) flap has become the gold standard in many centers because of its advantages with respect to versatility, minimal donor-site morbidity, good speech quality, and relatively low fistula and anastomotic leakage rates. Moreover, ALT allows 2 surgical teams to work simultaneously. However, the height of the parallelogram in the ALT design for neoesophagus reconstruction is usually set at a minimum of 9...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762450/three-dimensional-analysis-of-mandibular-angle-classification-and-aesthetic-evaluation-of-the-lower-face-in-chinese-female-adults
#15
Xiaoyan Mao, Xi Fu, Feng Niu, Ying Chen, Qi Jin, Jia Qiao, Lai Gui
BACKGROUND: Reduction gonioplasty is very popular in East Asia. However, there has been little quantitative criteria for mandibular angle classification or aesthetics. The aim of this study was to investigate the quantitative differences of mandibular angle types and determine the morphologic features of mandibular angle in attractive women. METHODS: We created a database of skull computed tomography and standardized frontal and lateral photographs of 96 Chinese female adults...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762449/time-to-procedure-nuclear-imaging-and-clinicopathological-characteristics-as-predictive-factors-for-sentinel-lymph-node-metastasis-in-cutaneous-melanoma-a-single-center-analysis
#16
Ljiljana Jaukovic, Milica Rajović, Lidija Kandolf Sekulovic, Marija Radulovic, Nenad Stepic, Zeljko Mijuskovic, Nenad Petrov, Boris Ajdinovic
OBJECTIVE: Sentinel lymph node (SLN) biopsy is a widely accepted staging procedure for cutaneous melanoma patients who are at risk of clinically occult nodal metastases. Numerous predictive factors for regional lymph node metastases have been identified; however, few have been found to be reproducibly significant. Also, the role of blue dye in identification was questioned in recent trials. Time to procedure was also found to be predictive of SLN positivity, but this was not confirmed in other studies...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762448/pectoralis-major-musculocutaneous-flap-with-a-midline-sternal-skin-paddle-for-head-and-neck-reconstruction-a-new-design
#17
Jeongseok Oh, Hee Chang Ahn, Seungki Youn, Kyung Tae
PURPOSE: The pectoralis major musculocutaneous (PMMC) flap is a classic flap for head and neck reconstruction, relatively unpopular with the advancement of microsurgery and free flaps. The classic parasternal paddle design provided a thick flap with a small rotation arch leaving objectionable scarring. Our new symmetric midsternal design overcomes these problems. METHODS: Chart review was done from the years 2000 to 2017. Flap skin paddle was placed symmetrically on both sides of the midsternal line...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#18
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762446/prospective-analysis-of-the-greater-occipital-nerve-location-in-patients-undergoing-occipital-nerve-decompression
#19
Jacqueline S Israel, Steve J Kempton, Ahmed M Afifi
BACKGROUND: Migraine surgery and onabotulinumtoxinA injections aim to deactivate neurovascular trigger points implicated in chronic headaches. The greater occipital nerve (GON) is a common trigger point. The depth of this nerve has not been previously described. The purpose of this study was to report the intraoperative location, including depth, of the GON in human subjects undergoing migraine surgery. METHODS: We reviewed records of patients who underwent GON decompression by a single surgeon...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762445/functional-results-of-a-modified-extracorporeal-septoplasty-with-open-access
#20
Giovanni Francesco Marangi, Francesco Segreto, Matteo Signoretti, Vito Cazzato, Paolo Persichetti
BACKGROUND: Nasal septal deviation is one of the major causes of nasal respiratory flow disorders. During the rhinoseptoplasty, the septum can be treated through a closed traditional access or through an open access. To date, there are still no objective functional indications of the best access to use in rhinoseptoplasty. For this reason, we evaluated, objectively and subjectively, the functional efficiency of open access and compared it with that of closed access. The aim is to highlight any functional outcome differences between the 2 types of access...
May 14, 2018: Annals of Plastic Surgery
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