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Seminars in Plastic Surgery

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https://www.readbyqxmd.com/read/30046291/management-strategies-for-diastasis-recti
#1
REVIEW
Maurice Y Nahabedian
Diastasis recti is a relatively common condition in which there is a midline abdominal bulge that can affect a variety of individuals. The etiology and diagnosis is well understood and optimal management depends on the degree of severity. Patients at high risk for diastasis recti include multiparous women, obese patients, and those with multiple previous operations. Diagnosis includes clinical examination and assessment of symptoms. Physical characteristics include a midline abdominal bulge without a fascial defect...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046290/lateral-abdominal-wall-reconstruction
#2
REVIEW
Sahil K Kapur, Charles E Butler
Lateral abdominal wall defects, while rare, present a more challenging problem than commonly encountered ventral defects due to the complexity of the anatomy, physiologic forces, and impact of muscle denervation. The lateral abdominal wall encompasses a large surface area ranging from the costal margin superiorly to the iliac crest inferiorly and from the linea semilunaris anteriorly to the paraspinous musculature posteriorly. The ratio of muscle to fascia/aponeurosis is much higher, which makes repair through muscle tissue versus fascia less secure...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046289/flap-reconstruction-of-the-abdominal-wall
#3
REVIEW
Margaret S Roubaud, Donald P Baumann
Due to the abundant and lax tissue of the abdominal wall, most ventral trunk defects are amenable to local soft tissue closure. However, when abdominal defects are accompanied by a lack of soft tissue, the surgeon faces a more complex subset of reconstructions. Three important principles guide the reconstruction of these wounds: timing of closure, careful assessment of the true extent of the wound, and the components of the defect. This article focuses on these three guiding principles and suggests the authors' preferred technique for these difficult defects...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046288/management-of-the-open-abdomen
#4
REVIEW
Alexander F Mericli
Management of the abdominal catastrophe requires a multidisciplinary approach. The plastic surgeon is a key member of the surgical team assisting in the creation of a durable, functional anatomic abdominal wall reconstruction. Plastic surgeons must be familiar with the concepts and pathophysiology related to the open abdomen, techniques for temporary abdominal closure, and when such techniques are appropriate to implement. In this article, the authors provide a review of the open abdomen concept, which practicing plastic surgeons and trainees may find helpful if faced with this clinical scenario...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046287/retromuscular-sublay-technique-for-ventral-hernia-repair
#5
REVIEW
Irfan A Rhemtulla, John P Fischer
Rives and Stoppa described the sublay technique of hernia repair more than half a century ago, but it took almost three decades to become truly appreciated and even longer for its full clinical potential and benefits to be realized. Modifications to the original operation have significantly improved surgical approaches, postsurgical outcomes, and quality of life. The retromuscular approach requires technical expertise and a firm grasp of the anatomy. With constant substitution of the terms sublay, retrorectus, retromuscular, preperitoneal, and Rives-Stoppa throughout the literature, the nuances need to be distinguished to appreciate the surgical planes encountered during the operation...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046286/abdominal-wall-reconstruction-an-integrated-approach
#6
REVIEW
Stefanos Boukovalas, Geoffrey Sisk, Jesse C Selber
Abdominal wall reconstruction has undergone substantial evolution over the last few decades. The optimal method of repair should be tailored to each patient's unique condition; however, a general approach that integrates four major factors can be applied as a conceptual framework to most clinical scenarios. Major factors to be considered include selection of mesh material, mesh inset position and technique, selective component separation, and management of soft tissue. These topics are inextricably intertwined in the sense that each can have specific implications, and in some cases, a determinative impact on the other decisions...
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046285/abdominal-wall-reconstruction
#7
Jesse C Selber
No abstract text is available yet for this article.
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/30046284/jesse-c-selber-md-mph-facs
#8
Larry H Hollier
No abstract text is available yet for this article.
August 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765274/review-of-eyelid-reconstruction-techniques-after-mohs-surgery
#9
REVIEW
Sagar Yatin Patel, Kamel Itani
Mohs micrographic surgery achieves high cure rates while preserving healthy tissue making it the optimal treatment for skin cancer. The goals of eyelid reconstruction after Mohs surgery include restoring eyelid structure and function while attaining acceptable aesthetic results. Given the variety of eyelid defects encountered after Mohs surgery, a thorough understanding of the complex eyelid anatomy as well as an in-depth knowledge of the numerous reconstructive techniques available are required to accomplish these reconstructive goals...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765273/scalp-and-forehead-reconstruction
#10
REVIEW
Mofiyinfolu Sokoya, Jared Inman, Yadranko Ducic
Reconstructing the scalp and forehead is a challenging endeavor frequently undertaken by facial plastic and reconstructive surgeons. There are many anatomical factors to be considered in this area, including multiple neurovascular structure present that should be identified and preserved. Hair morphology and physiology should be considered, and trichophytic techniques should be incorporated into incision planning and closure. The reconstructive ladder must be used when considering options in reconstructing scalps and forehead defects...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765272/approach-to-reconstruction-of-cheek-defects
#11
REVIEW
Berkay Başağaoğlu, Mohin Bhadkamkar, Pierce Hollier, Edward Reece
The cheek is the largest facial unit with a prominent position on the face. Trauma, burns, and the resection of skin cancers constitute common sources of injury, potentially resulting in defects that, through natural healing, produce noticeable scarring. Surgical repair focuses on the reformation of three-dimensional geometries, proper establishment of symmetry, and the minimization of color and texture discrepancies to the surrounding. Defects located in this region may extend to the orbital, nasal, or buccal units and cause unique structural and functional disturbances...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765271/approach-to-reconstruction-of-nasal-defects
#12
REVIEW
Berkay Başağaoğlu, Kausar Ali, Pierce Hollier, Renata S Maricevich
The nose is the most central and anterior projecting facial feature. Therefore, the presence of a defect is easily noticeable to the untrained eye. Return of the defect to the original form is an achievable end goal of reconstruction, necessitating appropriate reformation of three-dimensional geometry, proper establishment of symmetry, and excellent color and texture match to the adjacent structures. Regarding its physiological importance, disruption of the normal function may cause respiratory obstruction and contribute to patient distress...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765270/simplifying-lip-reconstruction-an-algorithmic-approach
#13
REVIEW
Kyle J Sanniec, Jourdan A Carboy, James F Thornton
The authors provide an overview of lip reconstruction after Mohs surgery based on the senior author's practice. Lip reconstruction offers unique challenges to preserve not only lip function but also aesthetics. Lip reconstruction must take into consideration the three anatomical layers that comprise the lip and defects that involve the mucosa, the muscle, the skin or more than one layer will help determine the modality of repair. The authors offer an algorithm based on defect location, tissue involvement, and severity of defect to simplify an often complex decision-making process...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765269/mohs-micrographic-surgery-development-technique-and-applications-in-cutaneous-malignancies
#14
REVIEW
Eillen Luisa A Chen, Divya Srivastava, Rajiv I Nijhawan
Mohs micrographic surgery (MMS) is a specialized technique for treating skin malignancies that offers the highest cure rate by allowing histological evaluation of the entire peripheral and deep margins. MMS also maximally preserves as much uninvolved, normal adjacent tissue as possible, allowing for the best cosmetic and functional outcomes. When used for appropriate indications, this technique is also more cost-effective than other treatment modalities. In this article, the authors will discuss the development of MMS, the steps involved in this procedure, and the indications for this technique...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765268/approach-to-the-post-mohs-patient
#15
REVIEW
James F Thornton, Jourdan A Carboy
This article discusses the often unique patient presentations and management challenges of the post Mohs resection surgical patient. This includes social, economic, and health issues. Anesthesia considerations and pre- and postoperative care are also discussed in this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765267/facial-mohs-reconstruction
#16
James F Thornton
No abstract text is available yet for this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765266/james-f-thornton-md
#17
Larry H Hollier
No abstract text is available yet for this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29636654/new-and-emerging-treatments-for-lymphedema
#18
REVIEW
Mark V Schaverien, Melissa B Aldrich
Although nonoperative and operative treatments for lymphedema (LE) are well established, these procedures typically provide only partial relief from limb swelling, functional impairment, and the risk of cellulitis. The lack of a cure for LE, however, is due to an incomplete understanding of the underlying pathophysiological mechanisms, and current research efforts are focusing on elucidating these processes to provide new, targeted therapies for this prevalent disease for which there is no cure. This article reviews the current literature regarding the pathophysiological mechanisms that underlie LE, as well as new and emerging therapies for the condition...
February 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29636653/liposuction-treatment-of-lymphedema
#19
REVIEW
Mark V Schaverien, D Alex Munnoch, Håkan Brorson
In the Western world, lymphedema most commonly occurs following treatment of cancer. Limb reductions have been reported utilizing various conservative therapies including manual lymph and pressure therapy, as well as by microsurgical reconstruction involving lymphovenous shunts and transplantation of lymph vessels or nodes. Failure of these conservative and surgical treatments to provide complete reduction in patients with long-standing pronounced lymphedema is due to the persistence of excess newly formed subcutaneous adipose tissue in response to slow or absent lymph flow, which is not removed in patients with chronic non-pitting lymphedema...
February 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29636652/combining-autologous-breast-reconstruction-and-vascularized-lymph-node-transfer
#20
REVIEW
Edward I Chang, Jaume Masià, Mark L Smith
Breast cancer patients are at risk for developing postmastectomy lymphedema syndrome of the ipsilateral upper extremity following treatment for breast cancer in the setting of an axillary dissection, postoperative radiation, and chemotherapy. For patients suffering from lymphedema who are also seeking breast reconstruction, combining an autologous abdominal free flap with a vascularized inguinal lymph node transfer provides patients the opportunity to have an aesthetic breast reconstruction as well as the potential to improve their lymphedema in a single operation...
February 2018: Seminars in Plastic Surgery
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