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Microsurgery in plastic surgery

Qing Zhao Ruan, Justin B Cohen, Yoonji Baek, Patrick Bletsis, Arthur R Celestin, Sherise Epstein, Alexandra E M Bucknor, Bernard T Lee
BACKGROUND: Conflict of interest among physicians in the context of private industry funding led to the introduction of the Physician Payments Sunshine Act in 2010. This study examined whether private industry funding correlated with scholarly productivity in the respective subspecialties of plastic surgery and the wider academic plastic surgery community. MATERIALS AND METHODS: Full-time plastic surgeons and their academic attributes were identified via institutional websites...
April 2018: Journal of Surgical Research
Beatrice J Sun, Jonathan Tijerina, Rahim S Nazerali, Gordon K Lee
INTRODUCTION: In recent years, there has been a push to publish higher level of evidence studies in medicine, particularly in plastic surgery. Well-conducted systematic reviews are considered the strongest level of evidence in medicine, recently becoming the key process indicators for quality delivery. A varying quality of systematic reviews, however, has led to concerns of their validity in clinical decision-making. We perform a quality analysis of systematic reviews published in head and neck microsurgery by the surgical specialties of plastic surgery and otolaryngology...
February 28, 2018: Annals of Plastic Surgery
Stephen Ali
Early year's plastic surgery trainees are faced with a large choice of microsurgery courses to select from. In the context of dwindling study budgets and busy on-call rotas, the pressure to select a high yield course that delivers value for money is of paramount importance.The Basic Microvascular Anastomosis Simulation Hub Microsurgery Course is a GBP £600 (US $790) 5-day 40-hour course based at Barts and The London School of Medicine and Dentistry increasing in popularity among junior trainees to fit this brief...
April 2018: Annals of Plastic Surgery
S Struk, Q Qassemyar, N Leymarie, J-F Honart, H Alkhashnam, K De Fremicourt, A Conversano, J-B Schaff, F Rimareix, F Kolb, B Sarfati
Robot-assisted surgery is more and more widely used in urology, general surgery and gynecological surgery. The interest of robotics in plastic and reconstructive surgery, a discipline that operates primarily on surfaces, has yet to be conclusively proved. However, the initial applications of robotic surgery in plastic and reconstructive surgery have been emerging in a number of fields including transoral reconstruction of posterior oropharyngeal defects, nipple-sparing mastectomy with immediate breast reconstruction, microsurgery, muscle harvesting for pelvic reconstruction and coverage of the scalp or the extremities...
February 2, 2018: Annales de Chirurgie Plastique et Esthétique
Mark M Leyngold
BACKGROUND: Pedicled transverse rectus abdominis myocutaneous (TRAM) flap was developed by Hartrampf in 1982 for breast reconstruction. Since deep inferior epigastric perforator (DIEP) flap was popularized, it has become the criterion standard for abdominally based breast reconstruction owing to its low donor site morbidity, excellent cosmetic outcomes, and high success rates. The purpose of this review is to determine if a unilateral pedicle TRAM flap has become obsolete to DIEP flap...
January 24, 2018: Annals of Plastic Surgery
Charles Yuen Yung Loh, Aline Yen Ling Wang, Vincent Tze Yang Tiong, Thanassi Athanassopoulos, Meiling Loh, Philip Lim, Huang-Kai Kao
BACKGROUND: The use of live and cadaveric animal models in surgical training is well established as a means of teaching and improving surgical skill in a controlled setting. We aim to review, evaluate, and summarize the models published in the literature that are applicable to Plastic Surgery training. MATERIALS AND METHODS: A PubMed search for keywords relating to animal models in Plastic Surgery and the associated procedures was conducted. Animal models that had cross over between specialties such as microsurgery with Neurosurgery and pinnaplasty with ear, nose, and throat surgery were included as they were deemed to be relevant to our training curriculum...
January 2018: Journal of Surgical Research
Alejandro Cruz-Segura, Pedro Grajeda-López
Microsurgery is one of the most fertile and innovative area in reconstructive surgery. Today it is considered an indispensable technique in plastic surgery with flaps survival rates over 95% in main healthcare centers. The factors involved in achieving these results are: the improvement of the surgical technique, adequate patient selection and careful perioperative care. Perioperative care starts at the initial assessment of the patient where it's very important to consider the indications and contraindications of these procedures...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
Tyler Safran, Kevin Gorsky, Alex Viezel-Mathieu, Jonathan Kanevsky, Mirko S Gilardino
INTRODUCTION: The modern medical era is in part characterized by the increased availability of portable imaging devices. Ultrasound devices are used for either high-resolution non-invasive imaging or as a focused acoustic energy source capable of sculpting and shaping tissue. Given the broad scope of the field, plastic and reconstructive surgeons have the unique ability to implement and tailor the use of ultrasound in a variety of clinical situations. This article will review novel uses for ultrasound in the field of plastic surgery...
September 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Myron Tsagkarakis, Georgia-Alexandra Spyropoulou, Leonidas Pavlidis, Othon Kritikos, Nikolaos Karakoukis, Evgenia Kyriopoulos, Dimosthenis Tsoutsos
INTRODUCTION: This is a retrospective study of the hospital data and autopsy reports of burn patients who died in the Burn Unit of the Department of Plastic and Reconstructive Surgery, Microsurgery and Burn Center of "G. Gennimatas" Hospital of Athens, Greece during the period 1999-2005. MATERIALS AND METHODS: The records of the burn victims deceased during the period 1999-2005 were reviewed and the cause of injury, percentage of body surface area (BSA) burned, age, gender, and co-morbidities were documented...
August 5, 2017: Burns: Journal of the International Society for Burn Injuries
Zita M Jessop, Ayesha Al-Sabah, Matthew D Gardiner, Emman Combellack, Karl Hawkins, Iain S Whitaker
Despite the increasing laboratory research in the growing field of 3D bioprinting, there are few reports of successful translation into surgical practice. This review outlines the principles of 3D bioprinting including software and hardware processes, biocompatible technological platforms and suitable bioinks. The advantages of 3D bioprinting over traditional tissue engineering techniques in assembling cells, biomaterials and biomolecules in a spatially controlled manner to reproduce native tissue macro-, micro- and nanoarchitectures are discussed, together with an overview of current progress in bioprinting tissue types relevant for plastic and reconstructive surgery...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Derek D Reformat, Joshua A David, J Rodrigo Diaz-Siso, Natalie M Plana, Annie Wang, Nicholas D Brownstone, Daniel J Ceradini
BACKGROUND: Intraoperative instrument recounts are performed to avoid retained foreign surgical items. These additional counts, however, beget risks of their own, including prolonged operative times, exposure to radiation, and increased cost. Our study aimed to identify factors that increase the likelihood of instrument recounts during plastic surgery procedures, and use our findings to guide potential solutions for preventing unnecessary recounts across all surgical fields. STUDY DESIGN: This is a retrospective review of all plastic surgical cases in the main operating setting at New York University Langone Medical Center (NYULMC) between March 2014 and February 2015...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
Asra Hashmi, Faraz A Khan, Floyd Herman, Nathan Narasimhan, Shaher Khan, Carrie Kubiak, Eti Gursel, David A Edelman
BACKGROUND: Plastic surgery training is undergoing major changes however there is paucity of data detailing the current state of training as perceived by plastic surgical trainees. Our aim was to determine the quality of training as perceived by the current trainee pool and their future plans. METHODS: A 25-item anonymous survey with three discrete sections (demographics, quality of training, and post-graduate career plans) was developed and distributed to plastic surgery residents during the academic year 2013...
June 27, 2017: BMC Research Notes
Georgios Pafitanis, Maria Raveendran, Simon Myers, Ali M Ghanem
This review aims to provide a summary of the flowmeter devices used in microvascular surgery and assesses their contribution to improving the clinical outcomes of free tissue transfer. Flowmeters are widely accepted as the standard method of intraoperative assessment of the patency of coronary vascular anastomoses, providing thresholds that predict outcome. There is limited evidence regarding the use of flow measurements in plastic surgery microvascular anastomoses; however, flowmetry appears to have some role in postoperative free flap monitoring and prevention of complications...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Dhalia Masud, Nadine Haram, Margarita Moustaki, Whitney Chow, Samer Saour, Pari Naz Mohanna
INTRODUCTION: Microsurgical techniques are essential in plastic surgery; however, inconsistent training practices, acquiring these skills can be difficult. To address this, we designed a standardised laboratory-based microsurgical training programme, which allows trainees to develop their dexterity, visuospatial ability, operative flow and judgement as separate components. METHOD: Thirty trainees completed an initial microsurgical anastomosis on a chicken femoral artery, assessed using the structured assessment of microsurgical skills (SAMS) method...
July 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Shimpei Miyamoto
BACKGROUND: Journal ranking based on the impact factor (IF) can be distorted by self-citation. The aim of this study is to investigate the present status of self-citation in the plastic surgery journals and its effect on the journals' IFs. METHODS: IF, IF without self-citations (corrected IF), self-cited rate, and self-citing rate for 11 plastic surgery journals were investigated from 2009-2015, by reviewing the Journal Citation Report(®). The correlations of the IF with the self-cited rate and the self-citing rate were statistically assessed...
May 9, 2017: Journal of Plastic Surgery and Hand Surgery
Catherine McMillan, Veerle D'Hondt, Alexandra H Marshall, Paul Binhammer, Joan Lipa, Laura Snell
Background  This study examined the need for improved training in the identification and management of free flap (FF) compromise and assessed a potential role for simulated scenario training. Methods  Online needs assessment surveys were completed by plastic surgeons and a subsample with expertise in microsurgery education participated in focus groups. Data were analyzed using descriptive statistics and mixed qualitative methods. Results  In this study, 77 surgeons completed surveys and 11 experts participated in one of two focus groups...
July 2017: Journal of Reconstructive Microsurgery
Pierre Burnier, Jérémy Niddam, Romain Bosc, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: Use of indocyanine green (ICG) near-infrared fluorescence as a dye to assess tissue vascularization is now well standardized. The aim of this literature review was to review and resume the most recent recommendations for ICG use in its plastic surgery applications. METHODS: A systematic literature review was performed using Medline, EMBASE, and PubMed databases to obtain the latest recommendations for ICG in plastic surgery. Inclusion criteria were all articles written in English language that evaluated pre-, intra-, or postoperative ICG applications in surgical procedures usually performed by plastic surgeons...
June 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Sarah Al-Himdani, Zita M Jessop, Ayesha Al-Sabah, Emman Combellack, Amel Ibrahim, Shareen H Doak, Andrew M Hart, Charles W Archer, Catherine A Thornton, Iain S Whitaker
Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind...
2017: Frontiers in Surgery
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