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Plastic and Reconstructive Surgery. Global Open

Anne K Maxwell, Frederic W-B Deleyiannis
Indocyanine green angiography (SPY) was used to guide arterial selection for an anterolateral thigh free flap in the setting of severe peripheral vascular disease. SPY technology serves as a novel and sensitive intraoperative tool to predict decreased tissue perfusion from vessel sacrifice for flap harvest. Change in SPY time parameters measuring superficial blood flow distal to the donor site while temporarily intraoperatively clamping different possible arterial pedicles can optimize free flap design to avoid iatrogenic critical limb ischemia...
October 2016: Plastic and Reconstructive Surgery. Global Open
Eric Swanson
BACKGROUND: The prevailing theory for capsular contracture after breast augmentation is a subclinical capsular infection. A capsulectomy, site change, and implant replacement are recommended. An open capsulotomy leaves the capsule in the patient. Theoretically, such a procedure would be ineffective because it does not remove the infected tissue. Recurrences occurred frequently in women treated in the 1970s when leaky silicone gel implants were in use. Open capsulotomy has not been studied in women implanted with third-generation devices...
October 2016: Plastic and Reconstructive Surgery. Global Open
Lawrence A DiDomenico, Dennis P Orgill, Robert D Galiano, Thomas E Serena, Marissa J Carter, Jarrod P Kaufman, Nathan J Young, Charles M Zelen
BACKGROUND: Allogeneic grafts derived from amnion/chorion are known to be efficacious in healing chronic diabetic foot ulcerations (DFUs). The goal of this study was to compare aseptically processed dehydrated human amnion and chorion allograft (dHACA) versus standard of care (SOC) in facilitating wound closure in nonhealing DFUs. METHODS: Patients with DFUs treated with SOC (off-loading, appropriate debridement, and moist wound care) after a 2-week screening period were randomized to either SOC or wound-size-specific dHACA (AmnioBand, Musculoskeletal Transplant Foundation, Edison, N...
October 2016: Plastic and Reconstructive Surgery. Global Open
Wesley N Sivak, Edward J Ruane, Steven J Hausman, J Peter Rubin, Alexander M Spiess
Decellularized scaffold materials are capable of regenerating missing tissues when utilized under appropriate conditions. Fat grafting also has reported advantages in revitalizing damaged tissue beds. This report details a case of traumatic fingertip amputation treated with a combination of decellularized materials in conjunction with fat grafting, resulting in a supple and functional reconstruction of the affected digit. After traumatic fingertip amputation, a patient was initially treated with decellularized porcine urinary bladder matrix powder...
October 2016: Plastic and Reconstructive Surgery. Global Open
Lukasz Witek, Kimberly S Khouri, Paulo G Coelho, Roberto L Flores
No abstract text is available yet for this article.
October 2016: Plastic and Reconstructive Surgery. Global Open
Clifford C Sheckter, Robert M Menard
Bilateral cleft lip repairs can result in various secondary deformities. One more commonly seen deformity, the whistle deformity, is characterized by a reduced or absent tubercle, orbicularis muscle diastasis, and abnormalities of the philtrum with notched appearance of cupid's bow. Various techniques have been described to address these problems. One common procedure is the lip-switch flap originally described by Abbe in 1898, which has been modified by various surgeons. In these procedures, lower lip vermilion, mucosa, orbicularis, and lip skin are transposed to the upper lip on a pedicle that is later divided...
October 2016: Plastic and Reconstructive Surgery. Global Open
Melanie Major, Chris Devulapalli, Ricardo J Bello, Pablo A Baltodano, Myrna Eliann Reinhardt, Michele A Manahan, Carisa M Cooney, Gedge D Rosson
BACKGROUND: This study examines the effect of timing (immediate vs delayed) on postoperative morbidity in diabetic women undergoing breast reconstruction after mastectomy. METHODS: We reviewed the National Surgical Quality Improvement Program (NSQIP) databases from 2005 to 2012 for all diabetic women undergoing breast reconstruction. Multivariable logistic regression was used to estimate the risk of 30-day overall complications in the immediate versus delayed cohorts...
October 2016: Plastic and Reconstructive Surgery. Global Open
Takanobu Mashiko, Toshiharu Minabe, Tomomi Yamakawa, Jun Araki, Hitomi Sano, Kotaro Yoshimura
A deep burn wound is a critical condition that generally necessitates vascularized tissue coverage. We performed the injection of platelet-derived factor concentrates combined with non-cross-linked hyaluronic acid scaffolds for 2 patients with critical burn wounds with bone and tendon exposure and achieved successful healing. Hyaluronic acid was considered to have served as a controlled-release carrier of platelet-derived factors, being clinically effective for the treatment of deep burn wounds.
October 2016: Plastic and Reconstructive Surgery. Global Open
Ross I S Zbar
Significant and rapid changes in healthcare delivery are forcing surgeons into collaborative teams. Additionally, surgeons are faced with new bureaucratic requirements that do not directly impact patient care, but nevertheless require allocation of time and attention. Surgeons are required to communicate with an expanding group of individuals at various professional levels, adding further stress to daily tasks. Even the method of communication is undergoing rapid transformation. Some surgeons, especially those who are members of the Boomer or X Generation, find this revolution difficult to manage; whereas those who are members of the Y Generation may in fact be better equipped...
October 2016: Plastic and Reconstructive Surgery. Global Open
David A Hidalgo, Jan Baranski, Sammy Sinno
BACKGROUND: Lung cancer is the most common cancer worldwide and the leading cause of cancer death. With the development of targeted therapy against causative driver mutations, some patients have experienced dramatic responses that have converted their disease into a chronic, stable form. Shifting concerns away from survival and back to quality-of-life issues has led some of these patients to seek aesthetic surgery. METHODS: Three patient examples are presented to illustrate current lung cancer treatment modalities, disease responses, and subsequent experiences with aesthetic surgical procedures...
October 2016: Plastic and Reconstructive Surgery. Global Open
Roberto Amore, Hernán Pinto, Kostas Gritzalas, Carlota Hernández, Katarzyna Skwara-Guzikowska, Domenico Amuso, Vincenza Leonardi
BACKGROUND: Reconstruction intralipotherapy is a term commonly used in the field of aesthetic medicine, above all in Europe, which defines a specific injection technique developed for the treatment of localized fat with substances that provoke the lysis of adipocytes by means of an injection directly into the adipose tissue with a long needle. The aim of this study is to define the technique in detail and everything that is associated with it, on the basis of years of multicenter experience by doctors who perform it...
October 2016: Plastic and Reconstructive Surgery. Global Open
Katie G Egan, Jacqueline S Israel, Rezvaneh Ghasemzadeh, Ahmed M Afifi
BACKGROUND: Social media have been used to study many aspects of health and human behavior. Although social media present a unique opportunity to obtain unsolicited patient-reported outcomes, its use has been limited in plastic and reconstructive surgical procedures, including migraine nerve surgery. The goal of this study was to utilize the most popular social media site, Facebook, to evaluate patients' experience with migraine surgery. METHODS: Six months of data regarding nerve surgery, nerve stimulators, and radiofrequency nerve ablation were collected from posts and comments written by members of 2 Facebook groups...
October 2016: Plastic and Reconstructive Surgery. Global Open
Lauren N Oliver, Kongkrit Chaiyasate
The subject of our case report is a young girl who was attacked by a raccoon when she was 5 months old. She lost the majority of her nose, her entire right ear, and part of her upper lip. She had previous attempts at reconstructive surgery with poor results. Our collective goals were to provide lifelong reconstruction without the use of synthetic implants and to organize the steps in a way that provided psychological benefit early on while allowing her to continue education and childhood activities with minimal disruptions...
October 2016: Plastic and Reconstructive Surgery. Global Open
Michael L Bentz
Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work-home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons.
October 2016: Plastic and Reconstructive Surgery. Global Open
Chad A Purnell, Julian L Klosowiak, Jennifer E Cheesborough, Eugene Park, Andrew Bandy, Gregory A Dumanian
We present a case of a 66-year-old woman who developed heart failure and severe inflammatory reaction after the illicit cosmetic injections of polymethyl-methacrylate or polyacrylamide hydrogel from a primary care provider. After medical optimization, an en bloc excision of all injectable materials and gluteus muscle was performed, which resulted in exposure of bilateral sciatic nerves. Within 10 days, the patient's heart failure resolved and inflammatory state improved. This is the first known report of heart failure due to buttock injections and subsequent improvement after surgery...
October 2016: Plastic and Reconstructive Surgery. Global Open
Naohiro Ishii, Yusuke Shimizu, Marie Aoki, Ayaka Suzuki, Kazuo Kishi
Various techniques for nail reconstruction have been reported until now; however, a simple one providing good esthetic results was difficult to find. Arterialized venous toenail flap is a free flap that includes the nail bed and matrix with a pedicle formed solely by the subcutaneous vein of the toe. The use of this flap is minimally invasive and easy, and the flap has a high survival rate. The mechanism of graft survival remains unknown given the nonphysiologic circulation. To the best of our knowledge, no studies have explained this mechanism with reference to detailed postoperative course...
October 2016: Plastic and Reconstructive Surgery. Global Open
Akimitsu Nishibayashi, Koichi Tomita, Yuta Sugio, Ko Hosokawa, Kenji Yano
No abstract text is available yet for this article.
October 2016: Plastic and Reconstructive Surgery. Global Open
Kyle Sanniec, Sumeet Teotia, Bardia Amirlak
Tissue ischemia can be managed in several different ways based on the cause of the perfusion defect, including topical nitroglycerin or surgical intervention. However, there are times when tissue perfusion is questioned and clinical examination is unable to determine definitively the cause of ischemic tissue and whether it will survive. In this technique article, we describe our comprehensive algorithm for the management of tissue ischemia in mastectomy skin flaps, which can be applied to other plastic surgery procedures by integrating SPY angiography and topical nitroglycerin...
October 2016: Plastic and Reconstructive Surgery. Global Open
Maxwell B Johnson, Alex K Wong
BACKGROUND: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects...
October 2016: Plastic and Reconstructive Surgery. Global Open
George D Xipoleas, Daniel Woods, Joseph Batac, Tommaso Addona
Upper extremity reconstruction is most often encountered in trauma patients. Although the rate of complications from elective orthopedic procedures remains relatively low, these complications are oftentimes in the form of open joints or joint infections that can be devastating. Classically, wounds of the shoulder girdle have been treated with large muscles such as the pectoralis major, pectoralis minor, and latissimus dorsi. Flaps more local to the area including the deltoid muscle flap have been overlooked due to their small size...
October 2016: Plastic and Reconstructive Surgery. Global Open
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