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Plastic and Reconstructive Surgery. Global Open

James M Economides, David H Song
Background: Despite the popularity of latissimus dorsi (LD) flap in breast reconstruction, a breast implant is often necessary to achieve sufficient volume. Prior reports describe fat grafting to the LD flap as a secondary procedure to correct contour deformities and improve volume. Our institution has instituted autologous breast reconstruction with an LD flap and immediate fat transfer (LIFT). Methods: A retrospective review of all patients undergoing the LIFT procedure was undertaken...
January 2018: Plastic and Reconstructive Surgery. Global Open
Rami S Kantar, William J Rifkin, J Rodrigo Diaz-Siso, G Leslie Bernstein, Eduardo D Rodriguez
No abstract text is available yet for this article.
January 2018: Plastic and Reconstructive Surgery. Global Open
Feng-Shu Chang, Chieh Chou, Chuan-Yu Hu, Shu-Hung Huang
Background: The use of negative-pressure wound therapy (NPWT) for Fournier gangrene management is well documented; however, it is difficult to fixate GranuFoam dressings and maintain an airtight seal over the perineum area. We developed a simple method to facilitate GranuFoam fixation and improve airtight sealing. Methods: The Fournier's gangrene severity index (FGSI) score less than 9 was collected in from January 2015 to October 2016. All 13 patients underwent fasciotomy, and NPWT was applied directly on fasciotomy wounds after the debridement of infected tissue...
January 2018: Plastic and Reconstructive Surgery. Global Open
Gianfranco Frojo, Kashyap Komarraju Tadisina, Vilaas Shetty, Alexander Y Lin
Infection of the temporomandibular joint (TMJ) is a rare pediatric condition resulting from the introduction of pathogens into the joint by hematogenous seeding, local extension, or trauma. Early recognition of the typical signs and symptoms including fever, trismus, preauricular swelling, and TMJ region tenderness are critical in order to initiate further evaluation and prevent feared complications of fibrosis, ankylosis, abnormal facial structure, or persistence of symptoms. Contrast-enhanced computed tomography with ancillary laboratory analysis including erythrocyte sedimentation rate, C-reactive protein, and white blood cell count are beneficial in confirming the suspected diagnosis and monitoring response to therapy...
January 2018: Plastic and Reconstructive Surgery. Global Open
Koichiro Kiya, Tateki Kubo, Shien Seike, Ko Hosokawa
Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system...
January 2018: Plastic and Reconstructive Surgery. Global Open
Marco A Rendón-Medina, Laura Andrade-Delgado, Jose E Telich-Tarriba, Antonio Fuente-Del-Campo, Carlos A Altamirano-Arcos
Rapid prototyping models (RPMs) had been extensively used in craniofacial and maxillofacial surgery, especially in areas such as orthognathic surgery, posttraumatic or oncological reconstructions, and implantology. Economic limitations are higher in developing countries such as Mexico, where resources dedicated to health care are limited, therefore limiting the use of RPM to few selected centers. This article aims to determine the dimensional error of a low-cost fused deposition modeling 3D printer (Tronxy P802MA, Shenzhen, Tronxy Technology Co), with Open source software...
January 2018: Plastic and Reconstructive Surgery. Global Open
Tae Hwan Ahn, Sung Bin Cho
Most cases of severely contracted nose require revision rhinoplasty and septoplasty, wherein preoperative and/or intraoperative expansion of nasal soft tissue is necessary for tension-free revision surgery. The present study aimed to evaluate the efficacy and safety of pre- and postoperative adjuvant therapy using polydeoxyribonucleotide (PDRN) and invasive, pulsed-type, bipolar, alternating current radiofrequency (RF) for revision surgery of a contracted nose. In total, 30 patients were treated with 16 sessions (8 preoperative sessions and 8 postoperative sessions) of intralesional injection of PDRN and invasive RF treatment using microneedle electrodes at 1-week intervals...
January 2018: Plastic and Reconstructive Surgery. Global Open
Michael P Chae, David J Hunter-Smith, Marie Rostek, Julian A Smith, Warren Matthew Rozen
Optimizing preoperative planning is widely sought in deep inferior epigastric artery perforator (DIEP) flap surgery. One reason for this is that rates of fat necrosis remain relatively high (up to 35%), and that adjusting flap design by an improved understanding of individual perforasomes and perfusion characteristics may be useful in reducing the risk of fat necrosis. Imaging techniques have substantially improved over the past decade, and with recent advances in 3D printing, an improved demonstration of imaged anatomy has become available...
January 2018: Plastic and Reconstructive Surgery. Global Open
Bonnie C Carney, Jacqueline P McKesey, Dean S Rosenthal, Jeffrey W Shupp
Dyspigmentation in burn scars can contribute to the development of psychosocial complications after injury and can be detrimental to social reintegration and quality of life for burn survivors. Although treatments for skin lightening to treat hyperpigmentation have been well reviewed in the literature, skin-darkening strategies to treat hypopigmentation have not. The following potential treatment options in the context of burn hypertrophic scar will be discussed: use of the melanocyte-keratinocyte transplantation procedure, use of ectopic synthetic analogues of alpha-melanocyte stimulating hormone to initiate melanogenesis, and use of FK506 to induce melanogenesis...
January 2018: Plastic and Reconstructive Surgery. Global Open
Rishi J Gupta, Stephen T Connelly, Rebeka G Silva, Nat R Gwilliam
Keloids are the physical manifestation of an exaggerated inflammatory response resulting in excess collagen deposition. The resulting fibroproliferative mass can be distressing for patients due to appearance, pruritus, and/or pain. Despite extensive research into the pathophysiology of keloid formation and the development of numerous treatments, keloids remain a challenge to treat. Even when the initial treatment is successful, a risk of recurrence remains. Basic science research into viable cryopreserved placental membranes and viable cryopreserved umbilical tissue has demonstrated their anti-inflammatory and anti-fibrotic effects, which may decrease keloid recurrence after excision...
January 2018: Plastic and Reconstructive Surgery. Global Open
Shatha M Sulaiman, Abdulmalik A Alkhodair, Shahd M Sulaiman, Lama M Sulaiman, Ahmed S Elkafafy
Replantation is the reattachment of a severed body part, with attempts to restore neurovascular and musculoskeletal integrity, function, and aesthetics. On September 7, 1964, the first extremity replantation-a completely amputated hand-by vascular anastomosis technique was successfully performed.1 Soon after, the first replantation of a complete thumb amputation using microvascular anastomosis in a human was successfully conducted by Komatsu et al.2 in 1968. The overall success rate of limb replantation surgery is around 83...
January 2018: Plastic and Reconstructive Surgery. Global Open
Logan W Carr, Sebastian M Brooke, T Shane Johnson, Brett F Michelotti
Background: The lateral arm flap is used for composite defects in need of vascularized soft tissue, skin, and bone. From its original description, the distal humeral metaphysis can be included with the flap, supplied by the periosteal extensions of the posterior branch of the radial collateral artery. We sought to reexplore the anatomy of the lateral arm to determine its utility as a donor site for vascularized bone. Methods: Twelve fresh, silicone-injected cadaver dissections were performed...
January 2018: Plastic and Reconstructive Surgery. Global Open
Arezoo Astanehe, Claire Temple-Oberle, Markus Nielsen, William de Haas, Robert Lindsay, Jennifer Matthews, David C McKenzie, Justin Yeung, Christiaan Schrag
Background: The aim of this study was to develop, implement, and evaluate a standardized perioperative enhanced recovery after surgery (ERAS) clinical care pathway in microsurgical abdominal-based breast reconstruction. Methods: Development of a clinical care pathway was informed by the latest ERAS guideline for breast reconstruction. Key features included shortened preoperative fasting, judicious fluids, multimodal analgesics, early oral nutrition, early Foley catheter removal, and early ambulation...
January 2018: Plastic and Reconstructive Surgery. Global Open
Todd A Kuiken, Nicholas P Fey, Timothy Reissman, Suzanne B Finucane, Gregory A Dumanian
Background: Excess residual limb fat is a common problem that can impair prosthesis control and negatively impact gait. In the general population, thighplasty and liposuction are commonly performed for cosmetic reasons but not specifically to improve function in amputees. The objective of this study was to determine if these procedures could enhance prosthesis fit and function in an overweight above-knee amputee. Methods: We evaluated the use of these techniques on a 50-year-old transfemoral amputee who was overweight...
January 2018: Plastic and Reconstructive Surgery. Global Open
Ryuichi Azuma, Shimpo Aoki, Masahiro Kuwabara, Tetsushi Aizawa, Hisato Nagano, Tomoharu Kiyosawa
Hinge flaps are commonly used for closure of a pharyngocutaneous fistula (PCF) or laryngocutaneous fistula. These flaps are employed to augment the wall of the pharynx or larynx, but the junction between the reconstructed and native lumens can eventually become narrow and irregular after reconstruction with standard hinge flaps. We devised a method of adding a triangular extension to the end of either or both flaps and used it to treat 3 patients. In 1 patient who developed a PCF (4 × 10 cm) after laryngectomy followed by radiotherapy, the fistula was closed with 2 hinge flaps...
January 2018: Plastic and Reconstructive Surgery. Global Open
Lene Nyhøj Heidemann, Gudjon L Gunnarsson, C Andrew Salzberg, Jens Ahm Sørensen, Jørn Bo Thomsen
Background: Acellular dermal matrix was introduced in breast reconstruction in 2001 and is gradually becoming a standard component for immediate breast reconstruction and nipple-sparing mastectomy. The reconstructive technique allows for improved aesthetic outcomes. However, there seems to be uncertainty regarding complication rates. The aim of this review was to systematically evaluate complication rates related to this method. Methods: This systematic review was conducted according to the recommendations outlined in the Cochrane Handbook for reviews and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement...
January 2018: Plastic and Reconstructive Surgery. Global Open
Norbert V Kang, Nilesh Sojitra, Sinisa Glumicic, Jacobus A Vlok, Greg O'Toole, S Alam Hannan, Walid Sabbagh
Background: The Earfold system, a new treatment for the correction of prominent ears, consists of 3 components: the Earfold implant, the Earfold introducer, and the Prefold positioner. Methods: This is an interim report based on an ongoing analysis of safety in a series of patients treated for prominent ears with the Earfold implant between February 2013 and September 2014. Safety was assessed based on adverse event reports and the need for implant revision; follow-up is ongoing...
January 2018: Plastic and Reconstructive Surgery. Global Open
Jonathan D Packer, Wen-Teh Chang, Jason L Dragoo
Background: Adipose-derived stem cell (ADSC)-based treatments have the potential to treat numerous soft-tissue pathologies. It would be beneficial to develop an efficient and reliable intraoperative, nonenzymatic method of isolating ADSCs for clinical use. This study aims to determine the (1) viability and proliferative capacity of ADSCs after exposure to vibrational energies and (2) efficacy of vibrational energy as a method of ADSC isolation from surgically harvested infrapatellar fat pad (IFP)...
January 2018: Plastic and Reconstructive Surgery. Global Open
Raven Henderson, Debra A Reilly, Jeffrey S Cooper
Natural and synthetic fillers have revolutionized aesthetic facial rejuvenation and soft-tissue augmentation. We present a case highlighting the dangers of filler self-injection. A 37-year-old woman self-injected a dermal filler around both temples. She immediately experienced left--side hearing loss, blanching over the left face, and pain. Prompt treatment with hyaluronidase, topical nitro paste, and warm compresses ensued. An emergency computed tomography angiogram showed occlusion of a superficial temporal artery branch...
January 2018: Plastic and Reconstructive Surgery. Global Open
Andrea E Copeland, Caitlin E Hoffman, Vassilios Tsitouras, Dhruve S Jeevan, Emily S Ho, James M Drake, Christopher R Forrest
Background: The pattern of cranial venous drainage in syndromic craniosynostosis is unpredictable and not adequately understood. Collateral channels substitute for stenotic venous sinuses and pose potential risk for surgical intervention. The purpose of this study was to analyze the patterns of venous drainage in patients with syndromic craniosynostosis and their influence on operative planning and morbidity. Methods: A retrospective study of patients with syndromic craniosynostosis from 2000 to 2013 was performed...
January 2018: Plastic and Reconstructive Surgery. Global Open
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