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Plastic AND Surgery

Molka Ariane, Jean-David Bouaziz, Adèle de Masson, Marie Jachiet, Martine Bagot, Clémence Lepelletier
Non peristomal postoperative pyoderma gangrenosum (PPG) is a rare subtype of pyoderma gangrenosum that occurs in the early postoperative period at surgical incisions, most commonly after breast surgery. Early diagnosis and treatment is essential to prevent severe scaring. TNF alpha inhibitor infliximab was reported to be efficient in treatment of PPG refractory to systemic corticosteroids. However infliximab can be not well tolerated. We report the first case of etanercept efficacy in post-plastic breast surgery pyoderma gangrenosum after infliximab serum sickness...
October 20, 2018: Dermatologic Therapy
Tomohiro Yamada, Goro Sugiyama, Ken Higashimoto, Azusa Nakashima, Hiroyuki Nakano, Tomoki Sumida, Hidenobu Soejima, Yoshihide Mori
Beckwith-Wiedemann syndrome (BWS) is a congenital disorder with 3 main features-overgrowth in infancy, macroglossia, and abdominal wall defects. Here, we report on a 5-month old girl with hemihyperplasia and macroglossia caused by paternal uniparental disomy (pUPD) asymmetric mosaic on chromosome 11p15.5. She could not retract her tongue into her mouth and the midline of the tongue was shifted to the left. Glossectomy was performed at age 1 year. A specimen of the tongue showed normal skeletal muscle, but the muscle fibers were closely spaced, and there were fewer stroma components in the tissue from the right side of the tongue than that from the left side...
August 22, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Stefan K Plontke, Marie-Luise Metasch, Jonas Zirkler, Thomas Zahnert
After approximately 100 years of development and stepwise improvement, stapes surgery is a succesful strategy of managing hearing loss in otosclerosis, although challanges remain. Contraindications include too poor speech understanding (not enough inner ear reserve), and acute or chronic inflammation of the external ear and middle ear. Stapes surgery in the last hearing ear can today be indicated in exceptional cases, especially if the contralateral ear was supplied with a cochlear implant. In case of simultaneous occurrence of pronounced external auditory canal exostoses, a staged procedure may be useful...
October 2018: Laryngo- Rhino- Otologie
Aris Giannos, Sofoklis Stavrou, Athanasios Douskos, Peter Drakakis, Dimitrios Loutradis
INTRODUCTION: BRCA1 inherited mutation carriers face a lifetime risk of 72% to develop breast cancer and a percentage of 44% risk for ovarian cancer. PRESENTATION OF CASE: We present a case of a 35-year old Caucasian woman who, after the excision of a possible malignant finding on the right breast, was diagnosed with ductal breast carcinoma. The patient treatment included first chemotherapy and radiotherapy and then prophylactic bilateral mastectomy with plastic reconstructive surgery...
October 12, 2018: International Journal of Surgery Case Reports
Matthew A Applebaum, Erin L Doren, Ali M Ghanem, Simon R Myers, Michael Harrington, David J Smith
Objective: Microsurgical education is an integral aspect of plastic surgery training. Like most traditional surgical education models, microsurgical skills are taught on an apprenticeship model. This study aims at evaluating microsurgery skill acquisition within an integrated plastic surgery residency using electromagnetic hand-motion analysis and a global rating scale. Methods: This is a cross-sectional study of an integrated plastic surgery residency program. Participants performed microsurgical arterial anastomoses on cryopreserved rat aortas...
2018: Eplasty
Martin Flück, Claudio Viecelli, Andreas M Bapst, Stephanie Kasper, Paola Valdivieso, Martino V Franchi, Severin Ruoss, Jean-Marc Lüthi, Martin Bühler, Helgard Claassen, Hans Hoppeler, Christian Gerber
We investigated molecular and cellular parameters which set metabolic and mechanical functioning of knee extensor muscles in the operated and contralateral control leg of 9 patients with a chronically insufficient anterior cruciate ligament (ACL; 26.6 ± 8.3 years, 8 males, 1 female) after open reconstructive surgery (week 0), after ambulant physiotherapy under cast immobilization (week 9), succeeding rehabilitation training (up to week 26), and subsequent voluntary physical activity (week 260). Clinical indices of knee function in the operated leg were improved at 52 weeks and remained at a comparable level at week 260...
2018: Frontiers in Physiology
Zoran Domitran, Danko Brezak, Tomislav Staroveski, Miho Klaic, Tomislav Bruketa
The aim of this study was to perform a finite element and experimental comparative analysis of the mechanical characteristics of surgical drill bits used in bone and joint surgery applications with and without an irrigation channel. Internally cooled drills are very efficient in maintaining the drilling temperature below the critical level. However, a cooling channel could potentially have a negative influence on the drill structure, particularly in the flutes zone. A commercially available type of surgical drill bit without irrigation channel and a modified variant with the built-in channel were simultaneously loaded with torque, axial and bending forces with magnitudes similar to and higher than those utilized in clinical practice...
October 15, 2018: Medical Engineering & Physics
Manraj Kaur, Andrea Pusic, Chris Gibbons, Anne F Klassen
Background: Patient-reported outcome measure (PROM) data are increasingly being collected over the internet or on a smart device using electronic versions (e-PROMs). Limited evidence exists about factors influencing e-PROM implementation in outpatient clinics. Objectives: To identify barriers to collection of PRO data from different locations (home or cosmetic surgery office) and using different modes (paper vs. e-PROM) from the perspective of patients, plastic surgeons and clinic administrative staff; and to explore patient preferences for the design of e-PROM platforms...
October 18, 2018: Aesthetic Surgery Journal
Saeid Atighechi, Zahra Sarafraz, Mohammadhossein Baradaranfar, Mohammadhossein Dadgarnia, Vahid Zand, Mojtaba Meybodian, Mohammad Mandegari, Shima Shirkhoda, Sedighe Vaziribozorg
INTRODUCTION: Rhinoplasty is a common plastic surgery that potentially has some complications such as postoperative deformities and breathing problems. A humpy nose is among the main reasons for rhinoplasty. Nasal valve (the narrowest part of the nasal airway) collapse may be occurred after nasal hump removal. Spreader graft is essential after more than 3 mm nasal hump removal. But the value of this graft is unknown for patients with nasal hump smaller than 3 mm. Mattress suture is another technique for widening the nasal valve angle...
October 16, 2018: Journal of Craniofacial Surgery
Christine Naczki, Bincy John, Chirayu Patel, Ashlyn Lafferty, Alia Ghoneum, Hesham Afify, Michael White, Amanda Davis, Guangxu Jin, Steven Kridel, Neveen Said
The tropism of ovarian cancer (OvCa) to the peritoneal cavity is implicated in widespread dissemination, suboptimal surgery, and poor prognosis. This tropism is influenced by stromal factors that are not only critical for the oncogenic and metastatic cascades, but also in the modulation of cancer cell metabolic plasticity to fulfill their high energy demands. In this respect, we investigated the role of Secreted Protein Acidic and Rich in Cysteine (SPARC) in metabolic plasticity of OvCa. We used a syngeneic model of OvCa in Sparc -deficient and proficient mice to gain comprehensive insight into the paracrine effect of stromal-SPARC in metabolic programming of OvCa in the peritoneal milieu...
October 16, 2018: Cancers
Werner Girsch, Rohit Arora, Eva-Maria Baur, Markus Gabl, Dietmar Hager, Thomas Hintringer, Lars-Peter Kamolz, Rupert Koller, Christian Krasny, Martin Leixnering, Walpurga Lick-Schiffer, Matthias Rab, Ingrid Schlenz, Gottfried Wechselberger, Gerlinde Weigel, Armin Zadra, Robert Zimmermann
Dupuytren's contracture (DC) or Dupuytren's disease (DD) is a progressive fibro-proliferative disease of palmoplantar connective tissue, resulting in characteristic nodal and/or cord formation from collagen disposition. When the disease progresses, the thickening and shortening of the cords eventually leads the affected fingers to being pulled into flexion, which may be associated with marked disability, especially with bilateral disease. DD is relatively common in Europe, with the highest prevalence in Nordic countries...
October 17, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Beina Azadgoli, Daniel J Gould, Emma Vartanian, Ketan M Patel
Background: Breast reconstruction outcomes have traditionally been measured by evaluating the opinions of patients and surgeons. Objective: Our goal was to assess the views of the general public. Methods: A survey was designed and distributed through a crowdsourcing website called Amazon Mechanical Turk. Questions assessed participant demographics, personal experience with breast reconstruction, perceptions on breast reconstruction, and opinions regarding aesthetics results...
October 17, 2018: Aesthetic Surgery Journal
Ting Jiang, Jun Li, Jun Ren
BACKGROUND: A randomized prospective trial to compare the effects on minimizing complications using continuous negative pressure drain and intermittent suction mode in plastic surgeries. METHODS: There were 174 cases of stage II post-auricular flap expansion and ear reconstruction, 76 cases of skin expansion flap repair, 56 cases of breast augmentation surgery, 58 cases of abdominoplasty, and 76 cases with free skin grafts. Patients were randomized to intermittent suction mode group (control group) and continuous negative pressure external drain group (intervention group) stratified by surgery types...
October 16, 2018: Aesthetic Plastic Surgery
Xiaoxuan Lei, Pengcheng Xu, Biao Cheng
BACKGROUND: In recent years, platelet-rich plasma (PRP) has been widely applied in orthopedics, maxillofacial surgery, burns, and plastic surgery, especially in facial rejuvenation. Research is ongoing into new indications and mechanisms of PRP to promote its wider, safer, and more effective use in the clinic. This article reviews the possible mechanisms of PRP in facial rejuvenation and related research. It is expected that the application of PRP in this field will increase. METHODS: The use of PRP in facial rejuvenation was screened using inclusion and exclusion criteria...
October 16, 2018: Aesthetic Plastic Surgery
Mythri Pullela, Mehmet N Agaoglu, Anand C Joshi, Sevda Agaoglu, David K Coats, Vallabh E Das
Purpose: Although widely practiced, surgical treatment of strabismus has varying levels of success and permanence. In this study we investigated adaptive responses within the brain and the extraocular muscles (EOM) that occur following surgery and therefore determine long-term success of the treatment. Methods: Single cell responses were collected from cells in the oculomotor and abducens nuclei before and after two monkeys (M1, M2) with exotropia (divergent strabismus) underwent a strabismus correction surgery that involved weakening of the lateral rectus (LR) and strengthening of the medial rectus (MR) muscle of one eye...
October 1, 2018: Investigative Ophthalmology & Visual Science
Ya Wei Tseng, S Swaroop Vedula, Anand Malpani, Narges Ahmidi, Kofi D O Boahene, Ira D Papel, Theda C Kontis, Jessica Maxwell, John R Wanamaker, Patrick J Byrne, Sonya Malekzadeh, Gregory D Hager, Lisa E Ishii, Masaru Ishii
Importance: Daytime sleepiness in surgical trainees can impair intraoperative technical skill and thus affect their learning and pose a risk to patient safety. Objective: To determine the association between daytime sleepiness of surgeons in residency and fellowship training and their intraoperative technical skill during septoplasty. Design, Setting, and Participants: This prospective cohort study included 19 surgical trainees in otolaryngology-head and neck surgery programs at 2 academic institutions (Johns Hopkins University School of Medicine and MedStar Georgetown University Hospital)...
October 11, 2018: JAMA Facial Plastic Surgery
Natalie M Plana, William J Rifkin, Rami S Kantar, Joshua A David, Samantha G Maliha, Scott J Farber, David A Staffenberg, Barry H Grayson, J Rodrigo Diaz-Siso, Roberto L Flores
BACKGROUND: Simulation is progressively being integrated into surgical training, yet its utility in plastic surgery has not been well described. We present a prospective, randomized, blinded trial comparing digital simulation to a surgical textbook for conceptualization of cleft-lip repair. METHODS: Thirty-five medical students were randomized to learning cleft repair using a simulator or textbook. Participants outlined markings for a standard cleft-lip repair before (pre-intervention) and after (post-intervention) 20 minutes of studying their respective resource...
October 12, 2018: Plastic and Reconstructive Surgery
Kevin J Guzman, Natacha Gemo, Deborah B Martins, Pedro Santos, Daniel A DeUgarte, Fatima Ademo, David Kulber, Celma Issufo
Background: Limited data exist on plastic surgery practices in Sub-Saharan Africa. The aim of this study was to characterize the spectrum of disease and operative procedures at a teaching hospital in Maputo, Mozambique to help understand the challenges of providing care for the local providers and to provide contextual relevance for training through partnerships. Methods: A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review was performed of plastic surgery operative records, ward admissions records, and death records in a tertiary-care hospital in Maputo, Mozambique for the period January 2015 to December 2015...
August 2018: Plastic and Reconstructive Surgery. Global Open
Sarah A Mess
Background: Breast implant removal followed by fat transfer to the breast (lipoaugmentation) is a newer procedure and as such there is a need for empirical aesthetic comparisons between breast augmentation with implants versus fat transfer. Fat transfer to the breast is becoming an important option for women seeking reoperation of breast augmentation. Methods: A survey was created using standardized before and after photographs of 12 patients who underwent implant removal and lipoaugmentation...
August 2018: Plastic and Reconstructive Surgery. Global Open
Lauren C Nigro, Michael J Feldman, Nadia P Blanchet
Burns to breast reconstructions, both autologous and implant-based, are well described in the plastic surgery literature. The mechanism has often been contact; however, burns secondary to sun exposure have also been reported. With the increasing number of prepectoral breast reconstructions, including irradiated prepectoral reconstructions, we would like to highlight the increased susceptibility of these reconstructions to thermal and ultraviolet injury. We present the case of a patient who underwent prepectoral implant-based breast reconstruction years after irradiation, who subsequently developed full-thickness injury to her mastectomy flap after minor sun exposure...
August 2018: Plastic and Reconstructive Surgery. Global Open
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