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Reconstructive Surgery

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https://www.readbyqxmd.com/read/28551445/decreasing-post-operative-narcotics-in-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#1
Krista Ml Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Post-operative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multi-modal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea and constipation. Patients were randomized to either a "usual care" post-operative treatment regimen or a multimodal pain regimen...
May 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28551364/barriers-and-attitudes-to-research-among-residents-in-plastic-and-reconstructive-surgery-a-national-multicenter-cross-sectional-study
#2
The Canadian Plastic Surgery Research, Sarah Al Youha, Becher Alhalabi, Jill Stone, Helene Retrouvey, Osama Samargandi, Johnny Ionut Efanov, Michael Stein, Alexander Morzycki, Haley Augustine, Emilie Bougie, Diana Song, Hollie Power, Julian Diaz-Abele, Caitlin Symonette, Marie Noland, Chris Coroneos, Sophocles Voineskos, Joshua Vorstenbosch, Toni Zhong, Michael Bezuhly, Jason G Williams
OBJECTIVE: Research sets the foundation for developing plastic surgeons who think critically and approach clinical practice with an inquisitive mind. The objective of this study was to characterize current attitudes and perceived barriers towards conducting research during residency. DESIGN: A validated 36-item questionnaire was developed by a national task-force of Canadian plastic surgery trainees. The survey was distributed to all 13 plastic surgery programs in Canada...
May 24, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28551283/postoperative-nausea-and-vomiting-in-facial-fracture-patients-a-randomized-and-controlled-trial-on-the-effect-of-dexamethasone
#3
A Haapanen, H Thorén, J Törnwall, A L Suominen, J Snäll
This study aimed to establish the incidence of postoperative nausea and vomiting (PONV) in facial fracture patients. The specific aim was to investigate the effect of perioperative dexamethasone on PONV. A total of 119 adult patients with facial fractures were analysed in this prospective study. Patients were randomized to receive perioperatively either a total dose of 30mg of dexamethasone i.v. and i.m., or no glucocorticoid (control). PONV was evaluated every 6hours during the first postoperative 24hours and when pain medications were given...
May 24, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28551049/hypothermia-and-selective-antegrade-cerebral-perfusion-is-safe-for-arch-repair-in-type-a-dissection
#4
W Brent Keeling, Bradley G Leshnower, John C Hunting, Jose Binongo, Edward P Chen
BACKGROUND: Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest has been shown to be a safe and effective method of cerebral protection during surgery for acute type A dissection. This study evaluates the impact of this cerebral protection strategy on clinical outcomes after extended aortic arch reconstruction in patients undergoing emergent repair of acute type A dissection. METHODS: A retrospective review from 2004 to 2016 at a US academic center of patients undergoing surgery for acute type A dissections using moderate hypothermic circulatory arrest and selective antegrade cerebral perfusion was performed...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28550924/new-perspective-on-the-in%C3%A2-vivo-use-of-cold-stress-dynamic-thermography-in-integumental-reconstruction-with-the-use-of-skin-muscle-flaps
#5
Szymon Kolacz, Mateusz Moderhak, Jerzy Jankau
BACKGROUND: Among the problems encountered by plastic surgeons is the reconstruction of defects following tumors. One of the reconstructive options is trans rectus abdominis (TRAM) flap. Despite that anatomy is well explored, marginal flap necrosis may develop. To minimize the complications, imaging examinations were designed to determine the degree of flap perfusion. One of them is the thermographic examination. MATERIALS AND METHODS: We examined 38 patients who had undergone 10 reconstructive breast surgeries with a pedicled TRAM ipsilateral flap, 10 patients with a TRAM contralateral flap, and 18 patients with a TRAM supercharged flap...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550428/partial-component-retained-two-stage-reconstruction-for-chronic-infection-after-uncemented-total-hip-arthroplasty-results-of-sixteen-cases-after-five-years-of-follow-up
#6
Kun-Hui Chen, Shang-Wen Tsai, Po-Kuei Wu, Cheng-Fong Chen, Hsin-Yi Wang, Wei-Ming Chen
PURPOSE: Two-stage reconstruction with total implant removal and re-implantation after infection control is considered the gold standard treatment for infection after hip arthroplasty. However, removal of the well-fixed stem or cup may cause substantial bone loss and other complications, thereby making reconstruction difficult. We evaluated whether an infection post total hip arthroplasty can be treated without removal of the radiographically and clinically well-fixed femoral stem or acetabular cup...
May 27, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28550405/projective-biomechanical-depth-matching-for-soft-tissue-registration-in-laparoscopic-surgery
#7
Daniel Reichard, Dominik Häntsch, Sebastian Bodenstedt, Stefan Suwelack, Martin Wagner, Hannes Kenngott, Beat Müller-Stich, Lena Maier-Hein, Rüdiger Dillmann, Stefanie Speidel
PURPOSE: A key component of computer- assisted surgery systems is the accurate and robust registration of preoperative planning data with intraoperative sensor data. In laparoscopic surgery, this image-based registration remains challenging due to soft tissue deformations. This paper presents a novel approach for biomechanical soft tissue registration of preoperative CT data with stereo endoscopic image data. METHODS: The proposed method consists of two registrations steps...
May 26, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28549893/anesthetic-neurotoxicity-in-congenital-hand-surgery-an-overview-of-the-evidence-and-advice-for-counseling-parents
#8
REVIEW
Michael S Gart, Santhanam Suresh, Joshua M Adkinson
Millions of children undergo general anesthesia for surgical procedures each year, the implications of which are not fully understood. Animal models demonstrate neurotoxicity and long-term cognitive impairment following exposure to common general anesthetic agents. However, it is unclear if human brains are affected in a similar fashion and what-if any-the implications on cognitive development may be. Furthermore, it is not known if these effects are additive and if they can be avoided by delaying reconstruction...
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28549780/patient-specific-pointer-tool-for-corrective-osteotomy-quality-of-symmetry-based-planning-and-case-study-of-ulnar-reconstruction-surgery
#9
Samuel Mueller, Lueder A Kahrs, Johannes Gaa, Tobias Ortmaier, Jan-Dierk Clausen, Christian Krettek
Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their importance derives from the fact that malunion can often lead to severe pain as well as deformities causing loss of function and aesthetic issues not only in the forearm, but also the wrist and elbow joint. In this paper a clinical case will be presented using a Patient Specific Instrument (PSI) as navigational aid for reconstructive surgery after malunion of a proximal ulnar fracture combined with allograft surgery of the radial head and radial condyle due to chronic traumatic radial head luxation (Monteggia fracture)...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28549453/survival-and-axillary-recurrence-following-sentinel-node-positive-breast-cancer-without-completion-axillary-lymph-node-dissection-the-randomized-controlled-senomac-trial
#10
Jana de Boniface, Jan Frisell, Yvette Andersson, Leif Bergkvist, Johan Ahlgren, Lisa Rydén, Roger Olofsson Bagge, Malin Sund, Hemming Johansson, Dan Lundstedt
BACKGROUND: The role of axillary lymph node dissection (ALND) has increasingly been called into question among patients with positive sentinel lymph nodes. Two recent trials have failed to show a survival difference in sentinel node-positive breast cancer patients who were randomized either to undergo completion ALND or not. Neither of the trials, however, included breast cancer patients undergoing mastectomy or those with tumors larger than 5 cm, and power was debatable to show a small survival difference...
May 26, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28549282/fat-grafting-for-chronic-heel-pain-following-surgery-for-adult-flatfoot-deformity-pilot-study
#11
Edoardo Raposio, Filippo Calderazzi
INTRODUCTION: Autologous fat grafting is now a highly popular technique in plastic and reconstructive surgery, with broad applicability for various surgical procedures. Fat grafting can impart contours and augmentation, nourish tissue, modulate scar tissue, and produce regeneration at the recipient site. In this pilot study, the authors suggest that fat grafting may be useful therapeutic adjunct for cases of chronic heel pain following surgery for adult flatfoot deformity. MATERIALS AND METHODS: Eight patients with chronic heel pain following surgery for adult flatfoot deformity underwent autologous subcutaneous heel fat grafting and recorded their levels of pain relief for 6 months postoperatively...
February 24, 2017: Foot
https://www.readbyqxmd.com/read/28549026/the-use-of-rapid-deployment-valves-in-combined-aortic-and-mitral-valve-surgery-one-year-clinical-and-echocardiographic-outcomes
#12
Markus Schlömicher, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine, Justus Thomas Strauch
OBJECTIVE: Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. METHODS: Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548553/human-amniotic-membrane-is-not-suitable-for-the-grafting-of-colon-lesions-and-prevention-of-adhesions-in-a-xenograft-rat-model
#13
Dimitri Barski, Holger Gerullis, Thorsten Ecke, Gabriella Varga, Mihaly Boros, Isabel Pintelon, Jean-Pierre Timmermans, Thomas Otto
INTRODUCTION: New biological materials are needed for specific applications in reconstructive bowel surgery and for the prevention of adhesion formation. Amniotic membranes (AMs) are assumed to have a number of unique characteristics that enhance the ingrowth of the surrounding tissue. The aim of the present study was to provide proof of these qualities in a xenograft model. MATERIALS AND METHODS: A multilayer human AM (HAM) was applied to repair defined colon wall defects in Sprague-Dawley rats (n = 18)...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28546671/symptomatology-and-surgical-perspective-of-scar-endometriosis-a-case-series-of-16-women
#14
Sudha Sumathy, Janu Mangalakanthi, Kishore Purushothaman, Deepti Sharma, Chithra Remadevi, Sarala Sreedhar
AIM: The prevalence of scar endometriosis is increasing with the increasing caesarean deliveries and laparoscopic procedures done for pelvic endometriosis. To analyse the symptomatology and surgical perspective of scar endometriosis. MATERIALS AND METHODS: Retrospective review of 16 women who underwent surgery for scar endometriosis in the period of 4 years in Amrita institute of medical sciences. RESULTS: Mean age of the patients is 35.19 years...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28546042/occluded-superficial-femoral-artery-used-for-emergency-reconstruction-a-consecutive-case-series-about-the-proper-conduit-technique
#15
M S Marsman, A Kh Jahrome, F L Moll, G G Koning
INTRODUCTION: Deep wound infections in the groin region can result in an acute or life threatening condition. Especially when there is no suitable vein available because of many reasons (e.g. previous surgery, small vessel diameter). Synthetic prosthesis sometimes are not 'first-choice-technique' because of contamination or infection. It was ad hoc hypothesized in an acute setting that a segment of an occluded Superficial Femoral Artery (SFA) could be used as a conduit in combination with eversion technique, known from carotid surgery...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28544393/comparison-of-5-year-oncological-outcomes-of-breast-cancer-based-on-surgery-type
#16
Jeeyeon Lee, Jin Hyang Jung, Wan Wook Kim, Yee Soo Chae, Soo Jung Lee, Ho Yong Park
BACKGROUND: A standardized classification system for breast surgery that incorporates oncoplastic techniques is needed. We classified the surgical techniques for breast cancer treatment into five groups according to the extent of surgery and reconstructive methods, i.e. conventional breast-conserving surgery, partial mastectomy with volume displacement, partial mastectomy with volume replacement, simple mastectomy and total mastectomy with immediate reconstruction. We then evaluated the oncological outcomes for each of the five groups...
May 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#17
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28542689/review-of-facial-plastic-and-reconstructive-surgery-a-clinical-reference
#18
Gregory Kelts
No abstract text is available yet for this article.
May 25, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28542343/bone-marrow-cell-extract-promotes-the-regeneration-of-irradiated-bone
#19
Guillaume Michel, Pauline Blery, Michaël Henoux, Jérôme Guicheux, Pierre Weiss, Sophie Brouard, Olivier Malard, Florent Espitalier
Mandibular osteoradionecrosis is a severe side effect of radiotherapy after the treatment of squamous cell carcinomas of the upper aerodigestive tract. As an alternative to its treatment by micro-anastomosed free-flaps, preclinical tissular engineering studies have been developed. Total bone marrow (TBM) associated with biphasic calcium phosphate (BCP) significantly enhanced bone formation in irradiated bone. One mechanism, explaining how bone marrow cells can help regenerate tissues like this, is the paracrine effect...
2017: PloS One
https://www.readbyqxmd.com/read/28542101/clinical-impact-of-t1-slope-minus-cervical-lordosis-following-multilevel-posterior-cervical-fusion-surgery-a-minimum-2-year-follow-up-data
#20
Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the longer term relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life (HRQOL) scores following multilevel posterior cervical fusion, and to explore whether an analog of T1 slope - C2-C7 lordosis ('T1S-CL') impacts on patients' clinical outcomes. SUMMARY OF BACKGROUND DATA: A 6-month follow-up study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery...
May 25, 2017: Spine
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