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Plastic and Reconstructive Surgery. Global Open

Ross Rudolph, Guy Curtis
Cardiac pacemakers and implantable cardioverters/defibrillators are often placed in older patients with thin skin and scanty subcutaneous tissue. These devices and cardiac leads are at risk for progressive skin erosion and exposure leading to infection. To prevent this severe complication, we developed a reinforcing insertion of acellular dermal matrix. Twenty-two of 24 patients had successful implantation with long-term avoidance of skin erosion.
July 2018: Plastic and Reconstructive Surgery. Global Open
Hilton Becker, Olga Zhadan
Background: Skin expansion is commonly needed in order to reconstruct the breast following modified radical mastectomy. With the advent of skin-sparing and nipple-sparing techniques, expansion is no longer necessary. The natural ability of healing tissues to contract can be advantageously used to improve the outcomes of immediate prepectoral breast reconstruction. Methods: A prospective analysis of the results of 20 prepectoral breast reconstructions following skin-sparing or nipple-sparing mastectomies was performed...
July 2018: Plastic and Reconstructive Surgery. Global Open
Toyoko Okamoto, Yuka Hirota, Yusuke Kimura, Erina Senda, Koichi Ueda
Reconstruction with the use of local flaps always involves 3 dimensional movements. It is difficult to predict with 3D complex forms stereoscopic changes after local flap operations on the face. We have made 3-dimensional computer-assisted 2-layered elastic models of the face. The surface layer of the model can be detached from the inner layer. By observing the surface model after simulation surgery, it becomes possible to note the distortions caused by the flaps and to determine the tension of each stitch during suturing of the flap...
July 2018: Plastic and Reconstructive Surgery. Global Open
Charalambos K Rammos, Denise Mammolito, Victor A King, Aran Yoo
Wise pattern skin reduction mastectomy with prepectoral placement of the device is a recent technique for reconstruction in patients with large and ptotic breasts. Expanders in the first stage, followed by implant exchange in the second stage are placed above the pectoralis major muscle, totally covered by acellular dermal matrix and an inferior dermal flap. This technique was performed on 6 breasts in 4 obese patients with macromastia and grade 2 and 3 ptosis. Two patients experienced complications at the T-junction...
July 2018: Plastic and Reconstructive Surgery. Global Open
Ryo Karakawa, Hidehiko Yoshimatsu, Mitsunaga Narushima, Takuya Iida
Background: In a setting of flap congestion, early detection and rapid reexploration are important. Some studies described the efficacy of blood glucose measurement for flap monitoring.1 However, the sensitivity and specificity of this method were not high enough to determine whether reexploration should be done or not. The purpose of this study was to evaluate and establish a method using the ratio of blood glucose level change (RBGC) measurement for detecting venous thrombosis and to propose an algorithm for flap salvage after congestion...
July 2018: Plastic and Reconstructive Surgery. Global Open
Carlos E Sciaraffia, Macarena F Ahumada, Francisco J Parada, Esteban Gonzalez, Arturo Prado
Silicone chin implants are frequently used in cosmetic surgery to enhance a harmonic face. Obtaining an aesthetically pleasing face is increasingly becoming more important for people, and a considerable part of this goal can be achieved through different aesthetic modifications of the chin. The purpose of this study was to analyze the presence of bone resorption after the insertion of silicone chin implants, with lateral chin radiographs. Fifteen patients were studied, all of whom had a chin silicone implant inserted at least 1 year ago using the same surgical technique...
July 2018: Plastic and Reconstructive Surgery. Global Open
Christopher D Hughes, Kathryn V Isaac, Paul F Hwang, Ingrid Ganske, Mark R Proctor, John G Meara
Background: Sagittal synostosis is the most common form of single suture synostosis. It often results in characteristic calvarial deformities, including a long, narrow head, frontal bossing, a bullet-shaped occiput, and an anteriorly placed vertex. Several methods for correcting the phenotypic deformities have been described, each with their own advantages and challenges. In this study, we describe a modification of the Melbourne method of total calvarial remodeling for correcting scaphocephaly...
July 2018: Plastic and Reconstructive Surgery. Global Open
Sven Weum, Louis de Weerd
Vasospastic disorders in the hand have been treated with surgical sympathectomy and recently with botulinum toxin A (BTX) injections in the palm. The purpose of this study was to evaluate if it is possible to obtain precise administration of BTX around the radial artery using a single ultrasound-guided injection. We present a novel technique using 1 single ultrasound-guided BTX injection around the radial artery to treat vasospastic symptoms. Ten patients were included in a pilot study. All patients were referred by a rheumatologist after been diagnosed with primary or secondary Raynaud...
July 2018: Plastic and Reconstructive Surgery. Global Open
Lucas M Ritschl, Veronika Heinrich, Florian D Grill, Maximilian Roth, Dennis M Hedderich, Andrea Rau, Klaus-Dietrich Wolff, Franz X Bauer, Denys J Loeffelbein
Background: The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding. Methods: Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) were generated on the basis of computed tomography scans. A validated workflow, including segmentation, meshing, setting of boundary conditions, and implementation of a bone density-dependent material model, was carried out for each model...
July 2018: Plastic and Reconstructive Surgery. Global Open
Min-Hee Ryu, Lee Seng Khoo, Jay Ouk Lee, Dan Li
No abstract text is available yet for this article.
July 2018: Plastic and Reconstructive Surgery. Global Open
Yu Kagaya, Masaki Arikawa, Eisuke Kobayashi, Akira Kawai, Shimpei Miyamoto
The surgical management of abdominal wall tumor in women with childbearing potential is a thorny issue. A synthetic mesh is widely used for abdominal wall reconstruction but not necessarily applicable in case of women of childbearing potential because it has been reported to cause severe pain during pregnancy. Autologous reconstruction is usually considered a feasible option for such cases; however, there is no consensus on this approach and almost no evidence to support it. In the present 2 cases, 2 female patients (age, 17 years and 35 years) with abdominal wall desmoid tumor underwent primary radical resection and autologous reconstruction of an abdominal wall defect in the lateral oblique muscle area (defect size, 13 × 5 cm and 8 × 6 cm) using an anterolateral thigh and iliotibial tract flap...
July 2018: Plastic and Reconstructive Surgery. Global Open
Peter K Firouzbakht, Jacqueline S Israel, Brian M Christie, Venkat K Rao
A myxoma is a neoplasm comprised of mesenchymal connective tissue. Myxomas of the upper extremity, and particularly of the hand, are rare. We present a case of a hypothenar myxoma causing ulnar neuropathy in a patient with a history of acute inflammatory demyelinating process. Treatment and management of myxoma may vary depending on whether the process is malignant or benign; thus, histologic diagnosis is critical to determining treatment. The purpose of this article is to review the pathophysiology and clinical features of myxomas, and to provide recommendations for evaluating and treating individuals with extremity masses of unclear clinical diagnosis...
July 2018: Plastic and Reconstructive Surgery. Global Open
Shunjiro Yagi, Yoshiko Suyama, Kensaku Yamaga, Maki Morita, Kohei Fukuoka
No abstract text is available yet for this article.
July 2018: Plastic and Reconstructive Surgery. Global Open
İsmail Melih Kuzu, Reşit Burak Kayan, Kahraman Öztürk, Ethem Güneren
Background: Reconstruction of small joints of fingers is still challenging in hand surgery. Implant arthroplasty and arthrodesis have some limitations in the reconstruction of small finger joints. Free vascularized PIP joint transfer from second toe to finger is a promising autogenous reconstructive alternative. Methods: In this prospective study, 7 cases of free vascularized PIP joint transfer were analyzed. The measurements for active and passive range of motion (ROM), grip, and pinch strength has been done preoperatively and 1-year postoperatively...
July 2018: Plastic and Reconstructive Surgery. Global Open
Yara Bachour, Lisanne J Oei, Albert J Van der Veen, Bart E Vos, Andre Louis, Stan Heukelom, Marco J P F Ritt, Frank B Niessen, Phil W Koken, Hay A H Winters
Background: Silicone breast implants have been used for decades for cosmetic breast augmentation or reconstruction after mastectomy. In selected cases, postmastectomy adjuvant radiotherapy is given with the breast implants in situ. Previous clinical studies have shown that radiotherapy may lead to complications such as capsular contracture and infection and that removal of the implant may be required. Yet, the effect of radiotherapy on silicone breast implants themselves is unknown. The aim of this study was to investigate if irradiation of breast implants influences their mechanical properties...
July 2018: Plastic and Reconstructive Surgery. Global Open
Wesley N Sivak, M Asher Schusterman, Lorelei J Grunwaldt
Background: Pediatric plastic surgeons perform reconstructive surgeries for various congenital, oncologic, and traumatic injuries. Methods: Our Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC) Plastic Surgery team was tasked to care for a young man who suffered a proximal humeral amputation of his dominant upper extremity. Results: A multidisciplinary team collaborated throughout his entire acute care and postoperative course, guiding treatment and care in effort to maximize function of his replanted extremity...
July 2018: Plastic and Reconstructive Surgery. Global Open
Wasmiya A AlHayyan, Sharat Chandra Pani, Aziza J AlJohar, Fawzi M AlQatami
Background: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry. Methods: We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls...
July 2018: Plastic and Reconstructive Surgery. Global Open
Gert Blueschke, Alina Boico, Ayele H Negussie, Pavel Yarmolenko, Bradford J Wood, Ivan Spasojevic, Ping Fan, Detlev Erdmann, Thies Schroeder, Michael Sauerbier, Bruce Klitzman
Background: Enhancing drug delivery to the skin has importance in many therapeutic strategies. In particular, the outcome in vascularized composite allotransplantation mainly depends on systemic immunosuppression to prevent and treat episodes of transplant rejection. However, the side effects of systemic immunosuppression may introduce substantial risk to the patient and are weighed against the expected benefits. Successful enhancement of delivery of immunosuppressive agents to the most immunogenic tissues would allow for a reduction in systemic doses, thereby minimizing side effects...
July 2018: Plastic and Reconstructive Surgery. Global Open
Jonathan Zelken, Dalia Tobbia, Yi-Ling Lin, Ming-Huei Cheng
Background: The inframammary fold (IMF) approach for augmentation mammaplasty is less popular in Asia. The incision was modified to lateral IMF(L-IMF) for easy access and better outcome. The aim of this study was to evaluate if L-IMF approach is feasible in Asian women. Methods: Between 2002 and 2016, 53 patients with 96 augmentation mammaplasties were performed using lateral (L-IMF, 31 cases, 56 breasts) and traditional IMF approaches (T-IMF, 22 cases, 40 breasts)...
July 2018: Plastic and Reconstructive Surgery. Global Open
Kyle S Gabrick, Nickolay P Markov, Fouad Chouairi, Robin Wu, Sarah M Persing, Paul Abraham, Tomer Avraham, Michael Alperovich
Background: Two-stage tissue expander (TE)/permanent implant (PI) breast reconstruction remains the most commonly performed technique in breast reconstruction. Predictions for the PI size preoperatively impact on the number and range of implants made available at TE exchange. This study aims to identify critical preoperative variables and create a predictive model for PI size. Methods: Patients who underwent 2-stage implant breast reconstruction from 2011 to 2017 were included in the study...
May 2018: Plastic and Reconstructive Surgery. Global Open
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