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Plastic and Reconstructive Surgery

Ari M Wes, Daniel Mazzaferro, Sanjay Naran, Scott P Bartlett, Jesse A Taylor
BACKGROUND: How hospital case-volume affects operative outcomes and cost continues to grow in importance. The purpose of this study is to examine the relationship of case volume with operative outcomes and cost in cleft palate repair. METHODS: Subjects undergoing cleft palate repair between 2004 and 2015 were identified in the Pediatric Health Information System (PHIS). Outcomes were compared between two exposure groups, those undergoing treatment at a high-volume institution (>85th percentile; >60 cases per year), and those undergoing treatment at a low-volume institution...
January 12, 2018: Plastic and Reconstructive Surgery
Yuki Fujihara, Helen E Huetteman, Ting-Ting Chung, Melissa J Shauver, Kevin C Chung
BACKGROUND: Following the publication of high level evidence demonstrating that corticosteroid inject is not an effective treatment for lateral epicondylitis, a reduction in the rate of corticosteroid injection would be expected. We aimed to clarify the current clinical practice pattern for lateral epicondylitis and to identify which factors hinder or encourage the introduction of evidence into clinical practice. METHODS: In this administrative claims analysis, we used the 2009 to 2015 Truven MarketScan databases...
January 12, 2018: Plastic and Reconstructive Surgery
Kyle D Lineberry, Shirley Shue, Kyle J Chepla
BACKGROUND: Penetrating trauma or lacerations within zone II of the flexor sheath may result in partial tendon injury. The proper management of this injury is controversial; the literature contains differing indications for surgical treatment and post-operative rehabilitation. METHODS: A literature review of the Cochrane, Medline and Pubmed databases was performed using the following search criteria: partial, flexor, tendon, laceration. All English language studies that evaluated biomechanical strength, complications, and outcomes after partial tendon injury in human and animal studies were included and reviewed by two of the authors...
January 12, 2018: Plastic and Reconstructive Surgery
Raymond W Tse, Babette Siebold
BACKGROUND: Fistulas following cleft palate repair impair speech, health, and hygiene and occur in up to 35% cases. The purpose of this study was to (1) describe the evolution of a surgical approach to cleft palate repair; (2) assess the rates, causes, and predictive factors of fistulas; (3) assess the temporal association of modifications to fistula rates during six years of a single surgeon experience. METHODS: Consecutive patients (N=146) undergoing cleft palate repair were included...
January 12, 2018: Plastic and Reconstructive Surgery
KyungHoon Chung, Lun-Jou Lo
BACKGROUND: The one-stage or two-stage approaches have been a widely used technique for patients with an asymmetric bilateral cleft lip (ABCL). There is insufficient long-term outcome data between these two methods. The purpose of this retrospective study is to compare the clinical outcome over the last 20 years. METHODS: The senior author's database was searched for patients with ABCL from 1995 to 2015. Qualified patients were divided into two groups: one-stage vs...
January 12, 2018: Plastic and Reconstructive Surgery
Jack C Fisher
No abstract text is available yet for this article.
January 10, 2018: Plastic and Reconstructive Surgery
Norman M Cole
The FDA silicone gel breast implant moratorium occurred 25 years ago. The immediate and long-term consequences of the moratorium are reviewed and assessed.
January 10, 2018: Plastic and Reconstructive Surgery
Donald S Mowlds, Val Lambros
The impression that cheek filling results in longitudinal shortening ("lift") of the skin and elevation of the nasolabial crease(NLC) or nasolabial fold (NLF) has become common within the facial injection community, but remains unsubstantiated. In this study, seventy-seven patients were evaluated pre and post-injection injection of the cheeks with an Hyaluronic Acid filler using a 3-dimensional camera system. A constant pattern of skin expansion away from the center of the injection and perpendicular to the surface of the skin was observed...
January 10, 2018: Plastic and Reconstructive Surgery
Safvet Ors
To determine the warping angle of the costal cartilage in vivo. A nasal framework reconstruction with a rib graft was performed in a total of 130 patients. After the cartilage specimens were prepared, the remaining grafts were used for the experimental study. The angle of warping in all grafts was measured at 0, 30, and 60 minutes, after 24 hours and after one week. In this study, 8 subgroups of graft thicknesses from central and peripheral groups, which were determined according to the perichondral distance of the grafts, were evaluated, and the warping angles of a total of 48 osteochondral and chondral grafts were individually measured...
January 10, 2018: Plastic and Reconstructive Surgery
Yuteng Zhang, Junrong Cai, Tao Zhou, Yao Yao, Ziqing Dong, Feng Lu
BACKGROUND: The apoptosis of mature adipocytes after fat grafting can result in chronic inflammation, absorption, and fibrosis, leading to unpredictable outcomes. Selective elimination of mature adipocytes may result in better outcomes and a different underlying retention mode. We previously developed a mature-adipocyte-free product, SVF-gel, derived from lipoaspirate, which eliminates adipocytes while preserving the stromal vascular fraction. This study investigated the retention and regeneration mode of SVF-gel grafting...
January 10, 2018: Plastic and Reconstructive Surgery
Akira Shinaoka, Seijiro Koshimune, Kiyoshi Yamada, Kanae Kumagishi, Hiroo Suami, Yoshihiro Kimata, Aiji Ohtsuka
BACKGROUND: Identification of the lymphatic system in cadavers is painstaking because lymphatic vessels have very thin walls and are transparent. Selection of appropriate contrast agents is a key factor for successfully visualizing the lymphatics. In this study, we introduce a new imaging technique of lymphatic mapping in whole body of fresh cadavers. METHODS: Ten fresh human cadavers were used for this study. We injected 0.1 mL of indocyanine green fluorescence (ICG) solution subcutaneously at multiple spots along the watershed lines between lymphatic territories and hand and foot regions...
January 10, 2018: Plastic and Reconstructive Surgery
Laura S Humphries, Essie K Yates, Julie M Mhlaba, John M Collins, Fuad M Baroody, Russell R Reid
BACKGROUND: We investigated the accuracy of virtual surgical planning (VSP) in predicting airway volume (AV) changes after mandibular distraction in patients with Pierre Robin Sequence (PRS) and associated tongue-based airway obstruction (TBAO). METHODS: We completed a retrospective review of patients for whom VSP was used during MDO for treatment of TBAO at a single institution. Pre-operative AV, VSP-predicted AV, and post-operative AV were calculated from 3-D CT scans using industry software...
December 15, 2017: Plastic and Reconstructive Surgery
Sirichai Kamnerdnakta, Helen E Huetteman, Kevin C Chung
BACKGROUND: Evidence is lacking to support the use of specialized anesthesia providers in minor surgical operations for patients without medical necessity. We sought to estimate the extent of potentially discretionary service use (anesthesiologist-administered anesthesia services among low-risk patients). METHODS: We performed a retrospective claims analysis using the Truven Marketscan Database to estimate the prevalence and cost of anesthesiologist-administered anesthesia services provided to patients undergoing minor hand surgery (carpal tunnel release, trigger finger release, or de Quervain release) from 2010-2015...
December 15, 2017: Plastic and Reconstructive Surgery
Lázaro Cárdenas-Camarena, Héctor Durán, José Antonio Robles-Cervantes, Jorge Enrique Bayter-Marin
BACKGROUND: Liposuction and gluteal lipoinjection are two of the most frequent surgical procedures in body contouring surgery, and two of the most important complications are microscopic fat embolism (MIFE) commonly called fat embolism syndrome (FES), and macroscopic fat embolism (MAFE). Despite having a high index of morbidity and mortality, few reports exist about these complications, and although they have the same causal agent, their etiopathogenesis, clinical evolution, treatment, prognosis and prevention are totally different...
December 15, 2017: Plastic and Reconstructive Surgery
Michel A Danino, Johnny I Efanov, Georges Dimitropoulos, Maxim Moreau, Charles Maalouf, Monica Nelea, Ali Izadpanah, Jean-Philippe Giot
BACKGROUND: Despite benefits in reducing capsular contractures, textured implants have been associated with significant pitfalls such a propensity for biofilm formation. Few studies have investigated whether the use of acellular dermal matrix (ADM) on textured implants produces similar findings. This study aims to characterize biofilm formation at the capsular-ADM interface with scanning electron microscopy (SEM). METHODS: We performed a prospective observational pilot study in patients undergoing two-stage expander-to-permanent implant exchange...
December 15, 2017: Plastic and Reconstructive Surgery
Ezgi Mercan, Makinna Oestreich, David M Fisher, Alexander C Allori, Stephen P Beals, Thomas D Samson, Thomas J Sitzman, Damir B Matic, Babette S Siebold, Raymond W Tse
BACKGROUND: Optimization of care to correct the unilateral cleft lip nasal deformity is hampered by lack of objective measures to quantify pre-operative severity and outcome.The purpose of this study was to: develop a consensus standard of nasal appearance using 3D stereophotogrammetry; determine if anthropometric measurements could be used to quantify severity and outcome; and determine if pre-operative severity predicts post-operative outcome. METHODS: We collected facial 3D images of 100 subjects in three groups: 45 infants before cleft lip repair; the same 45 infants after cleft lip repair; and 45 children age 8-10 years with previous repairs...
December 15, 2017: Plastic and Reconstructive Surgery
Zijin Qin, Junrong Cai, Tao Zhou, Yi Yuan, Jianhua Gao, Ziqing Dong
BACKGROUND: External volume expansion (EVE) devices are effective for adipose tissue regeneration. However, the detailed mechanisms by which EVE devices induce adipose tissue regeneration remain unclear. METHODS: An EVE device was used to construct expanded prefabricated adipose tissue (EPAT) in a rat model. CXCL12 levels in local exudate and serum were measured by ELISA, and CXCL12 expression in adipose tissue was assessed immunohistochemically. Fluorescent dye (CM-DiI) labeled bone marrow-derived mesenchymal stromal cells (MSCs) and labeled MSCs pretreated with the CXCR4 antagonist AMD3100 were transplanted into rats and tracked in vivo by fluorescence imaging...
December 15, 2017: Plastic and Reconstructive Surgery
Junrong Cai, Bin Li, Jing Wang, Kaiyang Liu, Yuteng Zhang, Yunjun Liao, Feng Lu
BACKGROUND: Fat grafting has become an important tool for breast reconstruction in breast cancer patients. Tamoxifen is the hormone therapy agent most frequently used for breast cancer. Moreover, tamoxifen can affect adipose metabolism and cause browning of adipose tissue. This study hypothesized that tamoxifen could increase fat graft survival by altering adipose metabolism. METHODS: C57/BL6 mice were divided into three groups receiving different treatments before and after fat grafting...
December 15, 2017: Plastic and Reconstructive Surgery
Brittany L Vieira, Ian Chow, Sammy Sinno, Robert G Dorfman, Philip Hanwright, Karol A Gutowski
BACKGROUND: Combined liposuction and abdominoplasty is a common procedure but is controversial due to concerns for increased complications, and potential for disruption of the vasculature of the abdominoplasty flap (1). Because of these concerns, the lipoaspirate volume in abdominoplasty has been a topic of regulatory concern with laws restricting liposuction volume to as little as 500 mL when done with an abdominoplasty. OBJECTIVES: This study aims to evaluate complication rates in abdominoplasty performed with and without abdominal liposuction, as well as evaluate the effect of lipoaspirate volumes on complications in abdominoplasty...
December 15, 2017: Plastic and Reconstructive Surgery
Elcin Esenlik, Jonathan M Bekisz, Travis Gibson, Court B Cutting, Barry H Grayson, Roberto L Flores
BACKGROUND: Gingivoperiosteoplasty (GPP) can avoid secondary alveolar bone graft (ABG) in up to 60% of patients with a cleft. However, preoperative predictors of success have not been characterized. This study reports on the preoperative alveolar segment position most favorable for successful GPP. METHODS: Single-institution, retrospective review of patients with a unilateral cleft who underwent NasoAlveolar Molding (NAM). Alveolar segment morphology was directly measured from maxillary dental models created before and after NAM...
December 15, 2017: Plastic and Reconstructive Surgery
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