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Microsurgery in plastic surgery

A Daigeler, M Lehnhardt, S Bauer, S Goldhammer, P M Vogt
Introduction: At the consensus meeting on "Plastic Surgery in the Palliative Situation" at the 37th Annual Meeting of the DAM 2015 in Bochum, treatment options were discussed with oncologists and palliative care anesthesiologists and recommendations were given. Methods: The literature was reviewed and the results of the expert-meeting options and limits of therapy were illustrated. The role of plastic surgery for palliative care patients was pointed out and recommendations given for successful cooperative treatment...
December 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Francesco M Egro, Nathaniel A Blecher, Michael L Gimbel, Vu T Nguyen
Background Desirable candidate characteristics for microsurgery fellowship applicants still remain unclear, as no data are available in the literature. This study aims to provide information on the criteria that are used to select and rank applicants for the microsurgery fellowship match. Methods A 38-question survey was sent in April 2015 to all microsurgery fellowship directors (n = 36) involved in the U.S. match, using QuestionPro Software. The survey investigated various factors used for selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics...
December 15, 2016: Journal of Reconstructive Microsurgery
Leonardo S Mattos, Darwin G Caldwell, Giorgio Peretti, Francesco Mora, Luca Guastini, Roberto Cingolani
Robotics has a significant potential to enhance the overall capacity and efficiency of healthcare systems. Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life. In particular, robotics can have a significant impact on microsurgery, which presents stringent requirements for superhuman precision and control of the surgical tools. Microsurgery is, in fact, expected to gain importance in a growing range of surgical specialties as novel technologies progressively enable the detection, diagnosis and treatment of diseases at earlier stages...
2016: Swiss Medical Weekly
I Tocco-Tussardi, B Presman, M Cherubino, C Garusi, F Bassetto
Post-burn contractures account for up to 50% of the workload of a plastic surgery team volunteering in developing nations. Best possible outcome most likely requires extensive surgery. However, extensive approaches such as microsurgery are generally discouraged in these settings. We report two successful cases of severe hand contractures reconstructed with free flaps on a surgical mission in Kenya. Microsurgery can be safely performed in the humanitarian setting by an integration of: personal skills; technical means; education of local personnel; follow-up services; and an effective network for communication...
March 31, 2016: Annals of Burns and Fire Disasters
Hoda Khorasani, Mats Højbjerg Lassen, William Kuzon, Christian Bonde
INTRODUCTION: Presentation at scientific meetings is the usual first step to communicate new research findings. However, without subsequent, peer-reviewed publication, the wider propagation and the permanent documentation of important scholarly work may be lost. Our aim was to analyze and compare the publication status of the work presented at the European Association of Plastic Surgeons' (EURAPS) and at the American Association of Plastic Surgeons' (AAPS) annual meetings. MATERIALS AND METHODS: By using the abstract booklets from the annual meetings, all presentations given over a 10-year period (2000-2009) were analyzed...
January 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Joseph A Ricci, Kayva Crawford, Olivia A Ho, Bernard T Lee, Ketan M Patel, Matthew L Iorio
BACKGROUND: Venous thromboembolism encompasses a spectrum of disease, ranging from asymptomatic deep vein thrombosis to fatal pulmonary embolism. As microsurgical techniques increase in complexity, the overriding benefit from a microsurgical versus a venous thromboembolism prophylactic regimen remains unclear. This study evaluated the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on the utility of prophylaxis in microsurgical procedures...
November 2016: Plastic and Reconstructive Surgery
Julie E Park, David W Chang
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. summarize the evolution of perforator, chimeric, and free style flaps; 2. define and give examples of supermicrosurgery as well as understand its application in treatment of lymphedema; and 3. appreciate the development and advancements of composite tissue allotransplantation. SUMMARY: Although microsurgery may seem like a highly specialized niche within plastic surgery, it is more than just a discipline that focuses on small anastomoses...
November 2016: Plastic and Reconstructive Surgery
Nidal Farhan Al Deek, Donald H Lalonde
Fu-Chan Wei is a world-renowned plastic and reconstructive surgeon. He is clearly one of the most influential and innovative surgeons in the history of plastic surgery. The Taiwanese legend is the innovator of the osteoseptocutaneous fibula flap, which revolutionized the reconstruction of composite bone and soft tissue defects in the jaw and extremities. He has pioneered several perforator flaps, including the free style variety. He has taken toe-to-hand microsurgical transplantation to a whole new level. He is not only recognized for his surgical skills and clinical innovations, but also for his vision, leadership, and teaching...
September 2016: Plastic and Reconstructive Surgery. Global Open
Antonio C Costa, Leandro Viecili, Marina T C Sambuy, Marcelo R Rezende, Ivan Chakkour
Background: A widely discussed subject, albeit with few associated studies and publications, centers on whether sacrifice of the radial artery to perform the radial forearm flap (RFF) is deleterious to the patient. The objective of this study was to assess, by questionnaire, the complications reported at the donor site, particularly those related to sacrifice of the radial artery. Methods: During the 2014 Symposium of the Brazilian Society of Reconstructive Microsurgery, surgeons were asked to answer a questionnaire on RFF cases and complications...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Bernardino M Mendez, Michael V Chiodo, Darl Vandevender, Parit A Patel
Traditional microsurgery can lead surgeons to use postures that cause musculoskeletal fatigue, leaving them more prone to work-related injuries. A new technology from TrueVision transmits the microscopic image onto a 3-dimensional (3D) monitor, allowing surgeons to operate while sitting/standing in a heads-up position. The purpose of this study was to evaluate the feasibility of performing heads-up 3D microscopy as a more ergonomic alternative to traditional microsurgery. A feasibility study was conducted comparing heads-up 3D microscopy and traditional microscopy by performing femoral artery anastomoses on 8 Sprague-Dawley rats...
May 2016: Plastic and Reconstructive Surgery. Global Open
Benoit Chaput, Ali Mojallal, Nicolas Bertheuil, Raphael Carloni, Jean Louis Grolleau, Raphael Sinna, Farid Bekara, Christian Herlin
Background The recent development of perforator flaps has changed the reconstructive strategy for common integumental defects and has refocused the attention of microsurgeons to donor site morbidity. We asked a representative panel of microsurgeons about the free flap they would use to cover a common integumental defect on their own body to investigate the best free-flap donor sites. Methods In total, 100 practitioners participated in the "FreeFlap4U" study, representing 77.3% of the French national plastic surgery teams practicing microsurgery...
October 2016: Journal of Reconstructive Microsurgery
Michael Sosin, Christine Yin, Poysophon Poysophon, Ketan M Patel
Surgical techniques such as lymphaticovenous anastomosis and vascularized lymph node (VLN) transfer are gaining momentum in the treatment of lymphedema. Although surgeons may be technically capable of performing these complex procedures, understanding the normal physiology of the lymphatic system and the pathophysiology of lymphedema is critical to the patient selection process, determining which specific procedure to perform, considering the specific anatomic location of surgery, and optimization of outcomes...
June 21, 2016: Journal of Reconstructive Microsurgery
Christian T Bonde, Lisa Toft Jensen, Tina Tos, Birgitte Jul Kiil, Gete Ester Toft, Søren Erik Larsen, Peter Birkeland, Jens Ahm Sørensen
The most common indication for free flap surgery is breast reconstruction. Deep inferior epigastric perforator flaps are safe, quick and provide excellent cosmetic results. The reconstruction in head and neck cancer patients is more complex. The aims are preservation of function and appearance. Free flaps are important in traumatology and the timing of intervention can make the difference between amputation and extremity conserving treatment. Due to the improvement in surgical technique failure rates as low as 2% can be seen...
June 6, 2016: Ugeskrift for Laeger
Michael Sosin, Eduardo D Rodriguez
BACKGROUND: Ten years after the first face transplantation, the available data in peer-reviewed literature, various media outlets, and recent specialty meetings and courses are conflicting and inconsistently reported. The purpose of this study was to consolidate the available data by means of multiple sources to reflect an accurate and current state of facial vascularized composite allotransplantation as of December of 2015. METHODS: Using applied search terms pertaining to face transplantation, a systematic PubMed search, Google search, and review of Plastic Surgery Education Network News Connection e-mailed newsletters were performed, and data presented at three meetings (i...
June 2016: Plastic and Reconstructive Surgery
Caroline Cunico, Alfredo Benjamim Duarte da Silva, Juliana Sperotto Brum, Rogério Ribeiro Robes, Renato da Silva Freitas
OBJECTIVE: Face transplantation from cadaveric donors is an alternative that has been explored as a way to overcome the disadvantages of reconstructive plastic surgery for patients with severe facial deformities, when its approaches are not able to offer good aesthetic and functional results. In this study, the authors describe the surgical technique of face transplantation in swine, investigating the reproducibility of the methods as an experimental model in transplantation. METHODS: Seven swines were operated upon...
May 2016: Journal of Craniofacial Surgery
Jonathan Kanevsky, Jason Corban, Richard Gaster, Ari Kanevsky, Samuel Lin, Mirko Gilardino
Medical decision-making is increasingly based on quantifiable data. From the moment patients come into contact with the health care system, their entire medical history is recorded electronically. Whether a patient is in the operating room or on the hospital ward, technological advancement has facilitated the expedient and reliable measurement of clinically relevant health metrics, all in an effort to guide care and ensure the best possible clinical outcomes. However, as the volume and complexity of biomedical data grow, it becomes challenging to effectively process "big data" using conventional techniques...
May 2016: Plastic and Reconstructive Surgery
C J Stewart, S K M Yusoff, D Widdowson, W L Lam
BACKGROUND: Recent emphasis on microsurgical skill acquisition at an earlier stage of plastic surgery training has seen a shift toward objective competence-based assessment. Yet no objective measures of spacing or alignment exist, with few validated models that assess ability. The authors propose a novel software analysis scoring system to objectively measure spacing, alignment and the overall improvement in a 1-day, introductory course setting. METHODS: Images of standard 4-mm latex strips that had been sutured by participants using the Microtrainer system were uploaded onto calibrated, online software...
June 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Katrina A Mason, Evgenia Theodorakopoulou, Georgios Pafitanis, Ali M Ghanem, Simon R Myers
Microsurgery is used in a variety of surgical specialties, including Plastic Surgery, Maxillofacial Surgery, Ophthalmic Surgery, Otolaryngology and Neurosurgery. It is considered one of the most technically challenging fields of surgery. Microsurgical skills demand fine, precise and controlled movements, and microsurgical skill acquisition has a steep initial learning curve. Microsurgical simulation provides a safe environment for skill acquisition before operating clinically. The traditional starting point for anyone wanting to pursue microsurgery is a basic simulation training course...
September 2016: Medical Teacher
Justin M Broyles, Sami H Tuffaha, Eric H Williams, Laurence Glickman, Taylor A George, A Lee Dellon
BACKGROUND: Breast procedures are among the most common surgeries performed by Plastic Surgeons. The prevalence of persistent pain remains unknown. Our experience has been that persistent breast pain is often related to intercostal nerve trauma. The purpose of this article was to increase awareness of this problem while describing the diagnostic and management strategies for patients with post-operative breast pain. METHODS: A retrospective review of 10 patients with breast pain was stratified according to the index surgical procedures: implant-based reconstruction (7), breast reduction (1), breast augmentation (1), and mastopexy (1)...
October 2016: Microsurgery
George Richard Francis Murphy, Graeme Ewan Glass, Abhilash Jain
The antifibrinolytic drug tranexamic acid (TXA) is effective in reducing blood loss and transfusion requirements in other fields of elective surgery and its use is emerging in a number of plastic surgical subspecialties. This systematic review and meta-analysis evaluates the current evidence for the efficacy and safety of TXA in craniomaxillofacial, head and neck, breast, aesthetic, burns, and reconstructive microsurgery. We searched PubMed, EMBASE, Medline, The Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials for randomized controlled trials of TXA in plastic surgery...
March 2016: Journal of Craniofacial Surgery
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