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Microsurgery in plastic 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
Calum Sinclair Honeyman
Undertaking a microsurgical course is a key adjunct to trainee development in plastic surgery, otololaryngology and oral and maxillofacial surgery. Traditionally, these courses last approximately 5 days and can cost upward of US $2000 (£1500).The North East Microsurgery Training Course and Workshop is a new 2-day course costing just US $760 (£500). This course was set up in 2015 by reconstructive microsurgeon Mr Maniram Ragbir at the Freeman Hospital in Newcastle, England.The aim of the course is provide maximum hands-on experience in microsurgery for surgical trainees interested in relevant specialties under close supervision of experienced consultant faculty...
September 2016: Annals of Plastic Surgery
Aditya Sood, Paul J Therattil, Stella Chung, Edward S Lee
PURPOSE: The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors' aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type. METHODS: Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs...
2015: Eplasty
Lauren Tracy Daly, Donald Mowlds, Merrick A Brodsky, Michael Abrouk, Jessica R Gandy, Garrett A Wirth
Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature. Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors' geographic location, study design, and level of evidence (LOE, I-V)...
May 2016: Journal of Reconstructive Microsurgery
Florian Bauer, Niklas Rommel, Steffen Koerdt, Andreas Fichter, Klaus-Dietrich Wolff, Marco R Kesting
Interest in a surgical career is declining among medical students, and many more need to commit themselves to becoming surgeons to cope with this. We have therefore developed a one-day practical lesson in surgical skills to find out whether a short course such as this can make students more enthusiastic about surgery, and about subsequently pursuing a career in one of its subspecialties. Fifty-four randomly-selected medical students did a one-day practical course in the skills required for maxillofacial surgical specialties...
May 2016: British Journal of Oral & Maxillofacial Surgery
Isabelle Citron, George Galiwango, Andrew Hodges
BACKGROUND: Free tissue transfer is an invaluable resource for reconstruction of complex defects. There is very little evidence as to the feasibility and outcomes of microsurgery performed in East Africa. This study will analyse outcomes of 114 consecutive free flaps, performed over 6 years at a single plastic surgery unit in Uganda. It aims to demonstrate that despite its challenges, successful microsurgical practice can be set up in East Africa. METHODS AND PATIENTS: The notes of 100 consecutive patients who underwent 114 free flaps between 01/06/2009 and 01/07/2015 at CoRSU Hospital, Uganda were analysed...
February 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Karan Chopra, Edward W Swanson, Srinivas Susarla, Sarah Chang, W Grant Stevens, Devinder P Singh
BACKGROUND: Objective measures of research productivity depend on how frequently a publication is cited. Metrics such as the Hirsch index (h-index; total number of publications h that have at least h citations) allow for an objective measurement of the scientific impact of an author's publications. OBJECTIVES: The purpose of this study was to assess and compare the h-index among aesthetic plastic surgery fellowship directors to that of fellowship directors in craniofacial surgery and microsurgery...
June 2016: Aesthetic Surgery Journal
Saif Al-Bustani, Eric G Halvorson
PURPOSE: Various simulation models for microsurgery have been developed to overcome the limitations of Halstedian training on real patients. We wanted to assess the status of microsurgery simulation in plastic surgery residency programs in the United States. METHODS: Data were analyzed from responses to a survey sent to all plastic surgery program directors in the United States, asking for type of simulation, quality of facilities, utilization by trainees, evaluation of trainee sessions, and perception of the relevance of simulation...
June 2016: Annals of Plastic Surgery
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