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Todd A Kuiken, Ann K Barlow, Levi Hargrove, Gregorgy A Dumanian
Myoelectric devices are controlled by electromyographic signals generated by contraction of residual muscles, which thus serve as biological amplifiers of neural control signals. Although nerves severed by amputation continue to carry motor control information intended for the missing limb, loss of muscle effectors due to amputation prevents access to this important control information. Targeted Muscle Reinnervation (TMR) was developed as a novel strategy to improve control of myoelectric upper limb prostheses...
June 2017: Techniques in Orthopaedics: TIO
Jennifer E Fligor, Steven T Lanier, Gregory A Dumanian
BACKGROUND: Current ventral hernia repair risk estimation tools focus on patient comorbidities with the goal of improving clinical outcomes through improved patient selection. However, their predictive value remains unproven. METHODS: Outcomes of patients who underwent midline ventral hernia repair with retrorectus placement of mid-weight soft polypropylene mesh between 2010 and 2015 were retrospectively reviewed and compared with predicted wound-related complication risk from 3 tools in the literature: Carolinas Equation for Determining Associated Risk, the Ventral Hernia Working Group (VHWG) grade, and a modified VHWG grade...
March 2017: Plastic and Reconstructive Surgery. Global Open
Zari P Dumanian, Viktor Tollemar, Jixing Ye, Minpeng Lu, Yunxiao Zhu, Junyi Liao, Guillermo A Ameer, Tong-Chuan He, Russell R Reid
Large skeletal defects caused by trauma, congenital malformations, and post-oncologic resections of the calvarium present major challenges to the reconstructive surgeon. We previously identified BMP-9 as the most osteogenic BMP in vitro and in vivo. Here we sought to investigate the bone regenerative capacity of murine-derived calvarial mesenchymal progenitor cells (iCALs) transduced by BMP-9 in the context of healing critical-sized calvarial defects. To accomplish this, the transduced cells were delivered to the defect site within a thermoresponsive biodegradable scaffold consisting of poly(polyethylene glycol citrate-co-N-isopropylacrylamide mixed with gelatin (PPCN-g)...
2017: PloS One
Chad A Purnell, Kevin C Lewis, Lauren M Mioton, Philip J Hanwright, Robert D Galiano, Gregory A Dumanian, Mohammed S Alghoul
BACKGROUND: Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites. METHODS: We conducted an Enterprise Data Warehouse-based review of all the senior authors' (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-site complications, drain duration, and number of postoperative visits were collected and compared...
November 2016: Plastic and Reconstructive Surgery. Global Open
Chad A Purnell, Julian L Klosowiak, Jennifer E Cheesborough, Eugene Park, Andrew Bandy, Gregory A Dumanian
We present a case of a 66-year-old woman who developed heart failure and severe inflammatory reaction after the illicit cosmetic injections of polymethyl-methacrylate or polyacrylamide hydrogel from a primary care provider. After medical optimization, an en bloc excision of all injectable materials and gluteus muscle was performed, which resulted in exposure of bilateral sciatic nerves. Within 10 days, the patient's heart failure resolved and inflammatory state improved. This is the first known report of heart failure due to buttock injections and subsequent improvement after surgery...
October 2016: Plastic and Reconstructive Surgery. Global Open
Steven T Lanier, Gregory A Dumanian, Sumanas W Jordan, Kyle R Miller, Nada A Ali, Stuart R Stock
A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. METHODS: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. RESULTS: One hundred and seven patients underwent a mesh sutured abdominal wall closure...
September 2016: Plastic and Reconstructive Surgery. Global Open
Gregory A Dumanian
No abstract text is available yet for this article.
September 2016: Plastic and Reconstructive Surgery
Steven T Lanier, Jennifer E Fligor, Kyle R Miller, Gregory A Dumanian
BACKGROUND: Our objective was to determine outcomes for complex ventral hernia repairs in a large cohort of patients utilizing an operative construct employing retrorectus placement of a narrow, macroporous polypropylene mesh with up to 45 suture fixation points for force distribution. No consensus exists on the optimal technique for repair of complex ventral hernias. Current trends emphasize large meshes with wide overlaps and minimal suture fixation, though reported complications and recurrence remain problematic...
December 2016: Surgery
Lawrence Cai, Joseph Lippi, Jay Dumanian, Matthew Klein, Mohan Krishna Dangol, Vinita Puri, Yvonne Karanas, Shankar Man Rai, James Chang
Burn scar contractures remain a common source of severe disability in resource-limited countries. However, existing outcome measurements are unable to fully capture the impact of the scar contracture and surgical attempts at correction. To that end, we have developed a new outcome instrument, the Stanford-ReSurge Burn Scar Contracture Scale-Upper Extremity that can be used as a measurement of disability and reconstructive procedure outcomes. The outcome instrument was created through item generation, item reduction, and preliminary field testing...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Eugene Park, Jennifer E Cheesborough, Jason M Souza, Gregory A Dumanian
BACKGROUND: The Patient-Reported Outcomes Measurement Information System was used to evaluate the effects of open incisional ventral hernia repair on hernia-related pain. METHODS: All patients who underwent elective repair of a primary or recurrent midline incisional hernia over a 3-year period completed Patient-Reported Outcomes Measurement Information System pain surveys and rated their pain intensity on a visual analogue scale. A retrospective review of these patients was performed...
January 2017: American Journal of Surgery
Jason M Souza, Chad A Purnell, Jennifer E Cheesborough, Armen S Kelikian, Gregory A Dumanian
BACKGROUND: Localized nerve pain in the foot and ankle can be a chronic source of disability after trauma and has been identified as the most common complication following operative interventions in the foot and ankle. The superficial location of the injured nerves and lack of suitable tissue for nerve implantation make this pain refractory to conventional methods of neuroma management. We describe a novel strategy for management using processed nerve allografts to bridge nerve gaps created by resection of both end neuromas and neuromas-in-continuity...
October 2016: Foot & Ankle International
Chad A Purnell, Eugene Park, Sergey Y Turin, Gregory A Dumanian
BACKGROUND: Although there is a high incidence of flank defects after lateral abdominal access, there is a paucity of large studies discussing this problem. Most studies express nihilism regarding their surgical management. The goal of this study was to describe the authors' conceptualization of flank defects, with a determination of the number of true hernias versus bulges, and outcomes of surgical repair in these patients. METHODS: The authors carried out a 13-year retrospective review of 31 consecutive flank defects repaired by the senior author (G...
March 2016: Plastic and Reconstructive Surgery
Najib E El Tecle, Samer G Zammar, Youssef J Hamade, Tarek Y El Ahmadieh, Rami James N Aoun, Allan D Nanney, Hunt H Batjer, Gregory A Dumanian, Bernard R Bendok
BACKGROUND AND SIGNIFICANCE: The vessels of choice for cerebrovascular high-flow direct bypass procedures are the radial artery and the saphenous vein. Radial artery grafts have become favored over saphenous vein grafts because of higher patency rates and better size matching to appropriate recipient vessels. Radial grafts are prone to spasm however, and this may be seen in 4-10% of cases and can be associated with ischemic sequelae. The standard technique for radial artery harvest calls for complete separation of the artery from its adventitial attachments and associated venous network...
March 2016: Clinical Neurology and Neurosurgery
J Hu, D Lomanto, G Dumanian, J Cheesborough, J Ponten, M Hameeteman, S Nienhuijs, H Zahiri, M Benenati, U Sibia, B Sivak, A Park, I Belyansky, C S Huang, T Verhagen, M J A Loos, M R M Scheltinga, R M H Roumen, F Morfesis, B Rose, E Zarrinkhoo, S Towfigh, J Miller, A Messina Campanella, S Licheri, M Barbarossa, G Porceddu, G Ferraro, F Virdis, I Reccia, S Aresu, A Pisanu
No abstract text is available yet for this article.
April 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Y Tsai, N Ross, H Niebuhr, M Sailer, F Köckerling, L Sun, Y M Shen, J Chen, S J Liu, F Q Chen, G Y Yang, C Berney, P Malouf, D Suarez, J L Tavera, J Ocadiz, T Chen, J Wang, R Mancini, G Pattaro, F Ceci, E Spaziani, B Bansa, P Lal, R Sharma, G Pradhan, J Chander, V K Ramteke, S Wijerathne, N Agarwal, D Liem, D Lomanto, J Warren, W Cobb, J Ewing, A Carbonell, O Guillaume, E Holl, J Park, X Monforte, H Redl, A Petter-Puchner, S Gruber-Blum, A Teuschl, E Yoshihara, H Pottel, M D'Hondt, P Jadhav, T Nagahama, M Ando, K Ami, H Amagasa, H Ganno, K Arai, M Kitamura, K El-Hayek, J Yoo, M Phillips, E Pauli, J Bittner, M Kroh, D Garcia, T Furtado, L Alberti, C Neto, P Hubner, A Alves, C Oliveira, J Vianna, C Campolina, G Dumanian, Z Dumanian, A Tulaimat, S Chen, L J Liu, A Guttadauro, S Frassani, D Macchini, A Bertolini, M Maternini, F Gabrielli, V Subramanian, D Venditti, A De Majo, G Sena, G Lisi, F De Sanctis, G Petrella, A Porwal, M Jadhav, M Stein, L Kaveggia, J Clift, W Noda, H Niebuhr, N Ross, H Niebuhr, N Ross, H Niebuhr, N Ross, H Niebuhr, N Ross, H Niebuhr
No abstract text is available yet for this article.
April 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Gregory A Dumanian, Jennifer E Cheesborough
No abstract text is available yet for this article.
January 2016: Plastic and Reconstructive Surgery
Michael S Gart, Jason M Souza, Gregory A Dumanian
Targeted muscle reinnervation (TMR) offers the potential for improved prosthetic function by reclaiming the neural control information that is lost as a result of upper extremity amputation. In addition to the prosthetic control benefits, TMR is a potential treatment for postamputation neuroma pain. Here, we present our surgical technique for TMR nerve transfers in transhumeral and shoulder disarticulation patients.
September 2015: Journal of Hand Surgery
Jennifer E Cheesborough, Jing Liu, Derek Hsu, Gregory A Dumanian
BACKGROUND: Treatment of clean-contaminated and contaminated ventral hernia defects remains controversial. Newer prosthetic materials may play an important role in these patients. METHODS: Ten patients with Ventral Hernia Working Group types 3 and 4 were prospectively enrolled and subsequently treated with direct supported repairs with condensed fenestrated polytetrafluoroethylene mesh. The primary outcome was hernia occurrence at 1 year after surgery. Secondary outcomes included surgical site infection, surgical site occurrence, medical complications, pain, and other patient-reported outcomes...
January 2016: American Journal of Surgery
G A Dumanian, A Tulaimat, Z P Dumanian
BACKGROUND: The failure of sutures to maintain tissue in apposition is well characterized in hernia repairs. A mesh suture designed to facilitate tissue integration into and around the filaments may improve tissue hold and decrease suture pull-through. METHODS: In vitro, the sutures were compared for resistance to pull-through in ballistics gel. In vivo, closure of midline laparotomy incisions was done with both sutures in 11 female pigs. Tissue segments were subsequently subjected to mechanical and histological testing...
September 2015: British Journal of Surgery
Philip J Hanwright, Chad A Purnell, Gregory A Dumanian
BACKGROUND: Esophageal injury following anterior cervical discectomy and fusion (ACDF) poses a significant reconstructive challenge. Buttressing flap repairs have proven beneficial; however, there remains a paucity of evidence to guide optimal flap selection. METHODS: A retrospective chart review was performed for patients who presented to the senior author with esophageal perforations after ACDF from 1995 until present. Demographic, clinical, and postoperative details were collected...
May 2015: Plastic and Reconstructive Surgery. Global Open
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