Optimizing non-opioid pain control after implant-based breast reconstruction: a review of the literature and proposed pain control algorithm.
Authors: Oliver JD, Knackstedt R, Gatherwright J Abstract Despite the intense focus on the opioid epidemic and its known association with surgical procedures, there is a paucity of evidence-based literature on pain management in implant-based breast reconstruction (IBR). Herein, we present an updated review of the literature aimed at identifying pain treatment protocols to minimize narcotic use and its associated potential addiction in IBR. A comprehensive review of the published English literature was conducted using Ovid Medline/PubMed Database without timeframe limitations. The inclusion criteria of selected art...
Source: Journal of Plastic Surgery and Hand Surgery - August 2, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Effect of unplanned excision of soft tissue sarcomas on skin defects and reconstructive procedures.
Authors: Tokumoto H, Akita S, Kubota Y, Mitsukawa N Abstract Unplanned excision (UE) is defined as a procedure wherein a surgeon operates a tumor resection without appropriate preoperative diagnostic modalities and without the intent to achieve tumor-free margins. Generally, the reconstruction rate after UE is higher than that after planned excision (PE). The present study aimed to investigate how the reconstructive procedure and size of skin defect could be influenced. We reviewed the cases of 442 patients who underwent the resection of soft tissue sarcoma. Patients were stratified into two groups (UE vs. PE). We ...
Source: Journal of Plastic Surgery and Hand Surgery - August 2, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Free flap reconstruction of sarcoma defects in the setting of radiation: a ten-year experience.
Authors: Othman S, Azoury SC, Weber KL, Kovach SJ Abstract Neoadjuvant treatment and surgical resection for sarcoma patients can often leave devastating wounds necessitating soft-tissue coverage in the form of free flaps. There is still debate as to the optimal flap for reconstruction of defects in irradiated fields. We aim to describe our experiences with free fasciocutaneous and free muscle flaps for sarcoma reconstruction in the setting of radiation therapy. A retrospective chart review was conducted encompassing all patients requiring soft-tissue reconstruction secondary to sarcoma resection from January 2010 t...
Source: Journal of Plastic Surgery and Hand Surgery - July 14, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Effect of perivascular low dose ethanol on rat femoral vessels: Preliminary study.
In this study, 27 Wistar albino male rats weighing 250-300 grams were used. The rats were randomly divided into three groups: saline (group S, n = 8), lidocaine (group L, n = 9) and 96% ethanol (group E, n = 9). According to group, 0.1 mL saline, 0.1 mL lidocaine and 0.1 mL ethanol were applied around the rat femoral neurovascular bundle. After the application, on the 0th day and 3th weeks, femoral artery and vein diameters were measured. After 3. weeks, histopathological samples from femoral artery, vein and nerve were evaluated. On the 0th day, the mean diame...
Source: Journal of Plastic Surgery and Hand Surgery - July 10, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Retrospective analysis of the predictive factors associated with good surgical outcome in brachioplasty in massive weight loss patients.
CONCLUSION: The authors' technique resulted in positive outcomes overall, considering the difficulty in dealing with the problems of MWL patients. Based on our results, we aim to suggest to perform brachioplasty in patient with the lower achievable BMI (preferably
Source: Journal of Plastic Surgery and Hand Surgery - July 10, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The management of acute fracture dislocations of proximal interphalangeal joints: a systematic review.
Authors: Breahna A, Mishra A, Arrowsmith J, Lindau T Abstract A systematic review was conducted to identify the best management for acute proximal interphalangeal joint fracture-dislocations. A study protocol was designed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Due to limited data in the primary assessment, the hypothesis was tested in a secondary analysis of articles that marginally met the inclusion criteria (i.e. studies that included patients under 18 years of age). A further tertiary analysis was conducted by dividing the studies into closed reducti...
Source: Journal of Plastic Surgery and Hand Surgery - July 9, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Mechanical emulsification of lipoaspirate by different Luer-Lok connector changes the viability of adipose derived stem cells in Nanofat.
Authors: Chen X, Hong S, Hong F, Yang B, Tong C, Zhang J Abstract Nanofat grafting is a fat transfer procedure that uses a thin needle to smooth out wrinkles, thereby achieving the goal of skin rejuvenation. The Luer-Lok connector is one of the most common methods for obtaining Nanofat. In the present study, we compared three different Luer-Lok connectors (2.0 mm, 1.5 mm and 1.1 mm in diameter) in terms of their impact on the viability of adipose-derived stem cells (ADSCs) to determine the optimal size of the connector for efficient Nanofat grafting. We observed that a smaller diameter of the L...
Source: Journal of Plastic Surgery and Hand Surgery - July 4, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Factors associated with chronic pain following breast reconstruction in Japanese women.
Authors: Makoto S, Sowa Y, Fujikawa K, Kodama T, Okamoto A, Numajiri T, Taguchi T, Amaya F Abstract Chronic pain after breast surgery including breast reconstruction is a major concern for patients. However, the factors associated with chronic pain after breast surgery are uncertain in Japanese population. The aim of this study was to identify patient-specific and medical/surgical factors that predict chronic pain after breast surgery in Japanese patients. The subjects were 189 Japanese women undergoing breast surgery including tissue expander/implant (TE/implant), deep inferior epigastric perforator (DIEP) procedu...
Source: Journal of Plastic Surgery and Hand Surgery - June 27, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Complications in skin grafts when continuing antithrombotic therapy prior to cutaneous surgery requiring skin grafting: an observational study.
Authors: Jørgensen L, Matzen RD, Albertsdottir E, Birk-Sørensen L Abstract Use of anticoagulants is common and practice regarding continuation or discontinuation of the medication peri-operatively for cutaneous surgery lacks evidence-based consensus. Therefore, we aimed to do a prospective observational study with patients who were referred to cutaneous surgery and needed full thickness or split skin grafting and using antitrombotic or non-antitrombotic therapies. Data on patients characteristics, diagnosis, location of surgery and surgery performed, antithrombotic medication and complications in skin...
Source: Journal of Plastic Surgery and Hand Surgery - June 24, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Physical activity with hindrances: a qualitative study of post bariatric patients' experiences of physical activity in relation to excess skin.
Authors: Fagevik Olsén M, Gren S, Heydeck Sundberg S, Biörserud C Abstract A common side effect after massive weight loss is excess skin. Knowledge about the experience of excess skin in relation to physical activity is limited. The aim of this study was therefore to investigate how post bariatric surgery patients experience physical activity in relation to excess skin. Fifteen semi-structured interviews were performed with individuals who experienced excess skin after massive weight loss after bariatric surgery. The interviews were transcribed, and data were analyzed by qualitative content analysis. An...
Source: Journal of Plastic Surgery and Hand Surgery - June 17, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The efficacy of nerve block for pain control after mammaplasty: a meta-analysis of randomized controlled studies.
Authors: Cai L, Li Z, Liu L, Cao D, Li K, Li Y, Wang D Abstract Background: Nerve block shows some potential in alleviating pain after mammaplasty. This systematic review and meta-analysis aims to investigate the efficacy of nerve block for pain control after mammaplasty.Methods: The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched for collecting the randomized controlled trials (RCTs) regarding the impact of nerve block on pain intensity after mammaplasty.Results: This meta-analysis has included four RCTs. Compared with the control group after ma...
Source: Journal of Plastic Surgery and Hand Surgery - June 14, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Comparison between stromal vascular fraction and adipose derived stem cells in a mouse lymphedema model.
Conclusion: The volume of the hindlimbs showed that treatment with SVF or ASC yielded very similar results compared to the control group when assessed after 8 weeks. In week two the biggest difference between ASC and NS was seen but the difference diminished during the 8 weeks. The secondary outcomes showed that the lymph vessel lumen decreased when treated with ASC compared to the control group. Lymphoscintigraphy yielded non-significant results. PMID: 32520635 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - June 12, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Beyond the anterolateral thigh: the descending branch intermuscular septal (DBIS) flap.
We describe a flap from the descending branch of the lateral circumflex system including the intermuscular septum (DBIS) without use of the perforator for use of an ultra-thin flap for defect closure. A retrospective review of all patients who underwent wound closure with use of the DBIS flap from March 2016 to August 2018 was performed. Data on patient demographics and date on operative time, defect type, defect size, flap size, vessel size, complications and need for revisions were collected. Seven patients were identified who underwent reconstruction with DBIS flap, six patients for ankle defects and one for a scalp def...
Source: Journal of Plastic Surgery and Hand Surgery - June 12, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Upper extremity replantation and revascularization in Finland between 1998 and 2016.
This study evaluated all emergency replantations and revascularizations in the upper extremity in Finland from 1998 to 2016. A total of 2,434 operations were identified within the study period. The average number of operations per year was 128 which corresponds with 2.4 operations per 100,000 person years. Operations were most common in persons aged 20 to 59 years and the rate of operations ranged from 1.4 to 5.0 per 100,000 person years. Thirteen percent of the patients were women and 87% were men. This study shows rates of emergency replantation and revascularization operations in upper extremity injuries and prov...
Source: Journal of Plastic Surgery and Hand Surgery - June 7, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Finger reconstruction with dorsal metacarpal artery perforator flaps and dorsal finger perforator flaps based on the dorsal branches of the palmar digital arteries - 40 consecutive cases.
Authors: Besmens IS, Guidi M, Frueh FS, Uyulmaz S, Lindenblatt N, Reissner L, Calcagni M Abstract Since the first description many variations of the dorsal metacarpal reverse island flap have been published but there is still uncertainty about which vascular component should be included for an optimal result. Therefore, it was the aim of this study to analyze vascular reliability and ischemic complications of dorsal metacarpal artery perforator (DMAP) flaps and dorsal finger perforator (DFP) flaps in our patient collective. We performed 40 of these flaps from the dorsum of hand and fingers for finger injuries. The ...
Source: Journal of Plastic Surgery and Hand Surgery - June 6, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Surgical management of isolated orbital floor and zygomaticomaxillary complex fractures with focus on surgical approaches and complications.
Authors: Schneider M, Besmens IS, Luo Y, Giovanoli P, Lindenblatt N Abstract Zygomaticomaxillary complex (ZMC) and orbital blow out fractures are commonly encountered midfacial fractures that may result in aesthetic and functional impairment. This retrospective study reports on the surgical treatment and associated postoperative complications in our patient collective. We evaluated 100 patients who underwent open reduction and internal fixation of midfacial fractures between 2010 and 2015. Preoperative clinical features, surgical technique and postoperative complications were analyzed. Surgery was performed with a ...
Source: Journal of Plastic Surgery and Hand Surgery - June 6, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Resveratrol inhibits proliferation and promotes apoptosis of keloid fibroblasts by targeting HIF-1 α.
In this study, keloid-derived fibroblasts were cultured under hypoxia environment and was treated by resveratrol. CCK-8 assay and Annexin V-FITC were used to evaluate cell activity and apoptosis level. Western blot and RT-qPCR were also used to assess the expression of HIF-α, Collagen I and Collagen III. Besides, siRNA was also used to explore the mechanisms of resveratrol's effect. In this study, hypoxia promotes proliferation and inhibits apoptosis of keloid fibroblasts. These findings highlight the potential obstacle in treating keloids. Furthermore, we demonstrated that resveratrol could reverse the effect of hyp...
Source: Journal of Plastic Surgery and Hand Surgery - June 6, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The effects of human amniotic membrane on silicone related capsule formation in rats.
Authors: Akyürek M, Orhan E, Aydın MŞ, Uysal Ö, Karşıdağ S Abstract Silicone breast implants are commonly used materials in plastic surgery for breast augmentation and reconstruction and the most severe complication of silicone implants are capsule contraction which occurs in 40% of patients. The aim of our study is to evaluate how the amniotic membrane alters the capsule formation effects of silicone 24 wistar rats were used in the study. We placed a bare silicone block into the left side (Subgroup A) and single layer amniotic membrane coated silicone block into the right side (Subgroup B) of the ra...
Source: Journal of Plastic Surgery and Hand Surgery - May 21, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Adipose-derived stem cells in wound healing of full-thickness skin defects: a review of the literature.
Authors: Huayllani MT, Sarabia-Estrada R, Restrepo DJ, Boczar D, Sisti A, Nguyen JH, Rinker BD, Moran SL, Quiñones-Hinojosa A, Forte AJ Abstract The complex process of wound healing can be delayed in circumstances when the natural niche is extremely altered. Adipose-derived stem cells (ADSC) seem to be a promising therapy for these type of wounds. We aim to describe the studies that used ADSC for wound healing after a full-thickness skin defect, the ADSC mechanisms of action, and the outcomes of the different ADSC therapies applied to date. We performed a review by querying PubMed database for studies that e...
Source: Journal of Plastic Surgery and Hand Surgery - May 21, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Satisfactory function 12 years after triscaphoid arthrodesis for chronic scapholunate ligament injury.
Authors: Reigstad O, Grimsgaard C, Holm-Glad T, Korslund J, Thorkildsen RD, Røkkum M Abstract Scapholunate ligament (SLL) injury represents a hazard to the wrist and the treatment of these injuries has been the focus of much debate. We performed a long-term follow (>10 years) of triscaphoid arthrodesis for symptomatic chronic SLL injuries in 10 (8 men) patients 37 (22-49) years of age. All arthrodesis healed. One patient was converted to total wrist arthrodesis during the follow-up period, and three had minor additional surgeries. At final follow-up, the patients had reduced active range of motion ...
Source: Journal of Plastic Surgery and Hand Surgery - May 17, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

On the role of the frontal projection in videoradiography of velopharynx in decision-making for a velopharyngeal flap plasty in patients with cleft palate.
Authors: Appelros F, Becker M, Salé H, Svensson H Abstract Despite uneventful primary surgery, patients with cleft palate may experience velopharyngeal insufficiency (VPI) and hypernasal speech. Videoradiography of velopharynx is a commonly used method to visualize velopharyngeal function and a velopharyngeal flap is often used to counteract VPI. The aim of this study was to investigate whether the frontal projection on videoradiography plays a role in the decision-making about velopharyngeal flap surgery, or possibly the width and orientation of the flap. A secondary aim was to evaluate the effect of the fl...
Source: Journal of Plastic Surgery and Hand Surgery - May 15, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Comment on hepatic artery reconstruction in living donor liver transplantation: strategy of the extension of graft or recipient artery.
Authors: Akbulut S, Sahin TT, Yilmaz S PMID: 32401665 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - May 15, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Reconstruction of large perineal defects after advanced malignant tumour resection: a simple gluteal thigh flap modification.
Authors: Shimizu Y, Kishi K Abstract Reconstruction of large defects in the perineal region, after resection of advanced malignant tumours is challenging because both coverage of the perineal skin defect and adequate filling of the pelvic space must be achieved simultaneously. This manuscript introduces a simple gluteal posterior thigh flap modification for the reconstruction of such defects. A trilobed flap, in the gluteal and posterior thigh regions, was designed to be of an adequate size to repair the dermal and pelvic floor defects. After the flap was elevated and rotated 90°, the posterior thigh portion wa...
Source: Journal of Plastic Surgery and Hand Surgery - May 15, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Capsular contracture in patients with prior breast augmentation undergoing breast conserving therapy and irradiation.
Authors: Serritzlev MS, Lorentzen AK, Matthiessen LW, Hölmich LR Abstract Radiation is considered to be a risk factor for developing capsular contracture in augmented women, but the studies reporting on this subject show conflicting results. In this systematic review we sought to understand the risk of capsular contracture in augmented patients with breast cancer treated with breast conserving surgery and radiotherapy. A search was conducted through PubMed for studies reporting on breast cancer, breast augmentation and radiotherapy, with capsular contracture as our primary outcome. To ...
Source: Journal of Plastic Surgery and Hand Surgery - May 8, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Use of a biopsy punch for end-to-side anastomosis in free-tissue transfer.
Authors: Chung JH, Sohn SM, You HJ, Yoon ES, Lee BI, Park SH, Kim DW Abstract Background: In end-to-side vessel-anastomoses, a side fenestration should be made by a slit incision or partial excision of the vessel wall. However, a slit incision might restrict blood flow across the anastomosis, and a partial vessel wall excision using micro-scissors may be time-consuming and result in irregular edges, which may weaken the vessel wall and cause flow disturbances. We used a biopsy punch for end-to-side anastomosis, and obtained satisfactory results.Methods: Between September 2015 and August 2017, 27 end-to-side anastom...
Source: Journal of Plastic Surgery and Hand Surgery - April 28, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Effect of dipyridamole on random pattern skin flap viability in rats.
Authors: Uslu AB Abstract Ischemic necrosis has been most dreaded complication of flap reconstruction. Therefore, researchers have tried to improvise modalities to prevent or treat it since the onset of flap surgery. So far these researches have failed to identify a pharmacological therapy equally effective as surgical delay in augmenting skin flap viability. In the path of search for this substance, dipyridamole attracted our attention as an antiaggregant agent. Put together with pathophysiological mechanisms underlying ischemic flap necrosis, we concluded dipyridamole might have beneficial effect on survival of s...
Source: Journal of Plastic Surgery and Hand Surgery - April 27, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

A new method measurement for finger range of motion using a smartphone.
This study was performed to determine the reliability and convenience of this new method. The ROM in 1007 finger joints was measured by both the standard and new method and the data were analyzed using the intraclass correlation coefficient (ICC). The smartphone ICC score was high (0.927), and the average measurement time per joint was 49% lower with the smartphone compared to the goniometer. The results indicated that the smartphone-based measurement method had the same reliability as the conventional goniometer, in addition to an excellent measurement time. PMID: 32329668 [PubMed - as supplied by publisher] (Source: ...
Source: Journal of Plastic Surgery and Hand Surgery - April 25, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Enzymatic debridement of hands with deep burns: a single center experience in the treatment of 52 hands.
Conclusions: Enzymatic debridement is a useful tool in the treatment of burned hands but the decision-making and correct timing of operative intervention in deep partial thickness burns after debridement requires experience. In our cohort, spontaneous healing of deep partial thickness burns was best in patients with contact burns and less than 15% burn TBSA. PMID: 32315252 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - April 23, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The effect of the macrophage migration inhibitory factor (MIF) on excisional wound healing in  vivo.
Conclusions: Our data suggest an inhibiting effect of MIF in wound healing with increased inflammation and perfusion. In flaps, by contrast, MIF may contribute to flap vascularization. PMID: 32281469 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - April 15, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Effects of arterial blood supply and venous return on multi-territory perforator flap survival.
This study aimed to design arterial ischemic and venous congested areas on the same multi-territory perforator flap, assessing the effects of arterial blood supply and venous return on flap survival. Totally 68 rats were randomly divided into the experimental (Exp) and control (Con) groups. In the Exp group, flaps were based on left superficial epigastric artery and right superficial epigastric vein. In the Con group, flaps were based on the left superficial epigastric artery and vein. Immediate postoperative ink-gelatin angiography, epidermal metabolite levels detection, tissue edema measurement, survival rate evaluation ...
Source: Journal of Plastic Surgery and Hand Surgery - April 4, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Impact of microbial findings on plastic reconstructive surgery outcomes in patients with deep sternal wound infection after cardiac surgery.
Authors: Arsalan-Werner A, Dick L, Arsalan M, Wölfle O, Walther T, Sauerbier M Abstract Deep sternal wound infection (DSWI) is a life threatening complication after cardiac surgery. In severe cases, flaps are needed to cover the wound. However, it is controversial if an aseptic environment is necessary at the time of wound closure. This is a retrospective study of 73 patients with DSWI treated by debridement and local or free flap from June 2008 until December 2017. The influence of positive microbiological findings at the time of plastic reconstructive surgery on reoperation rate and length of in-hospital sta...
Source: Journal of Plastic Surgery and Hand Surgery - March 14, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Intramedullary fixation with bioabsorbable and osteoconductive hydroxyapatite/poly-L-lactide threaded pin in digital replantation.
We describe a case series treated using hydroxyapatite/poly-L-lactide (HPLLA) threaded pins, which are not only bioabsorbable, but also osteoconductive, for osteosynthesis in crushed amputation or comminuted fracture, including distal phalanx amputation. Using an HPLLA threaded pin, 10 digital replantations were performed between July 2016 and April 2018. The precisely cut pin is manually pushed into the fracture site as an intramedullary nail. The pin is first pushed into the distal site, and then into the proximal site, after drilling with a K-wire of the same diameter as the pin. All amputations were crush type, and lev...
Source: Journal of Plastic Surgery and Hand Surgery - March 12, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Donor site of follicular unit excision hair transplantation: the relationship between appearance and actual hair density, and hair diameter.
We examined 103 male patients with adult androgenic alopecia. Patients were divided into three groups (Good, Fair, and Poor) based on visual assessment of the donor site. Hair density and hair diameter were measured using digital photography. A total of 72, 21 and 10 patients were classified into the Good, Fair and Poor appearance groups. The average hair density of each group was 127.8 ± 22.6 hair/cm2, 114.8 ± 23.1 hair/cm2 and 94.9 ± 25.4 hair/cm2. The hair density of the Good group was significantly higher than that of the Poor group (p = 0.003...
Source: Journal of Plastic Surgery and Hand Surgery - February 27, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The tongue flap for large palatal fistulas, a success or a failure? Our 15-year experience.
In this study, we present our 15-year surgical experience with tongue flaps for large palatal fistulas. A total of 34 patients who underwent tongue flap surgery at our institution between January 2000 and January 2015 were retrospectively analyzed. An anteriorly-based dorsal tongue flap was used for the treatment of anteriorly localized large palatal fistulas in all patients. Data including demographic characteristics of the patients, previous surgeries, localization of the fistula, time between the first and second surgery, and complications were recorded. Factors affecting the surgical success were evaluated. Of the pati...
Source: Journal of Plastic Surgery and Hand Surgery - February 25, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

New microvascular anastomotic device for end-to-side anastomosis using negative pressure; a preliminary study.
Authors: Tachi K, Furukawa KS, Koshima I, Ushida T Abstract We previously developed a device for end-to-end anastomosis powered by negative pressure and demonstrated that using the device allow the operator to anastomose semi-automatically with little stress. Here, we sought to build a device for and demonstrate that negative pressure can also be used in end-to-side anastomosis which is clinically popular as end-to-end anastomosis through animal experiment using rats.The devices were constructed with a laser lithographic/3D-printing machine. Nine SD rats were used. Each of the nine rats underwent end-to-side anasto...
Source: Journal of Plastic Surgery and Hand Surgery - February 25, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Reconstruction of postburn contractures due to tandir oven.
Authors: Cinal H, Barin EZ, Kara M, Yilmaz K, Karaduman H, Cengiz İZ, Boyraz O, Aydin OE, Tan O Abstract The aim of the study was to evaluate postburn contracture reconstructions caused by high temperature such as tandir. The records of our 58 patients who were operated for burn contracture between 2008 and 2018 were retrospectively reviewed. Duration elapsed after the burn, localization of contracture, surgery applied, and the recurrence rates were recorded. McCauley classification was used to evaluate the severity of hand contractures. One hundred and thirty-seven contracture release operations were performed in...
Source: Journal of Plastic Surgery and Hand Surgery - February 25, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Impact of skeletal muscle mass on postoperative delirium in patients undergoing free flap repair after oral cancer resection.
Authors: Makiguchi T, Yamaguchi T, Nakamura H, Ogawa M, Harimoto N, Shirabe K, Yokoo S Abstract Postoperative delirium (POD) is a major risk factor for an extended hospital stay and higher costs, and is associated with increased mortality. The incidence of POD is high in free flap procedures, and POD may also be a risk factor for flap loss and complications. Sarcopenia is a condition characterized by skeletal muscle mass (SMM) depletion and a decrease in muscle power or physical activity. The aim of this study was to investigate risk factors for postoperative delirium (POD), including SMM, in 122 patients undergoin...
Source: Journal of Plastic Surgery and Hand Surgery - February 8, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine - a randomized prospective study.
Authors: Bobik P, Kosel J, Świrydo P, Tałałaj M, Czaban I, Radziwon W Abstract One of the methods of anesthesia for orthopedic and plastic procedures for the upper limb is the brachial plexus block. The aim of the study was to compare the pharmacodynamic and pharmacokinetic properties of three commonly used local anesthetic solutions used for axillary brachial plexus blockade. Sixty patients scheduled for surgery of the upper limb were enrolled for the study. 3 different local anesthetic solutions: 0.375% bupivacaine with epinephrine (group B), 0.5% ropivacaine (group R) and a mixture of 0.5% bupivacaine with ep...
Source: Journal of Plastic Surgery and Hand Surgery - February 1, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Complications after pressure ulcer surgery - a study of 118 operations in spinal cord injured patients.
Authors: Lindqvist EK, Sommar P, Stenius M, Lagergren JF Abstract Our aim in this study was to examine which factors are associated with post-operative complications after surgery for pressure ulcers in individuals with spinal cord injury. We performed a retrospective cohort study including all spinal cord injured patients undergoing pressure ulcer surgery in our department between 2002 and 2019. Patient demographics and comorbidity were collected from medical records, as were treatment data and information on post-operative complications within 30 days. Assessment of outcomes was performed through t-tests, ...
Source: Journal of Plastic Surgery and Hand Surgery - February 1, 2020 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Comparison of inflammatory response and synovial metaplasia in immediate breast reconstruction with a synthetic and a biological mesh: a randomized controlled clinical trial.
Authors: Hansson E, Burian P, Hallberg H Abstract The aim of this study was to compare inflammatory response and synovial metaplasia in implant-based immediate breast reconstruction with a biological mesh (Veritas®) with that of a synthetic mesh (TIGR® Matrix Surgical Mesh). We hypothesize that the inflammatory response and formation of synovial metaplasia might be different and the rate of capsular contracture therefore different. The patients were recruited from the Gothenburg TIGR®/Veritas® Study (ClinicalTrials.Gov identifier NCT02985073). All referrals for bilateral immediate breast reconstruct...
Source: Journal of Plastic Surgery and Hand Surgery - December 22, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Perfusion dynamics of the medial sural artery perforator (MSAP) flap in lower extremity reconstruction using laser Doppler perfusion imaging (LDPI): a clinical study.
This study aimed to characterize the early post-operative perfusion dynamics of the medial sural artery perforator (MSAP) flap in lower extremity reconstruction using laser Doppler perfusion imaging (LDPI). 12 patients, recruited between 2014 and 2015, with lower extremity reconstructions using free MSAP flaps were assessed for perfusion using a hand-held colour Doppler ultrasound device on days 1, 3, and 5 post-operatively. Perfusion at four distinct zones was assessed; whole flap, control zone, perforator zone, and distal zone, by a single operator using a standardized technique. The perforator zone was noted to have the...
Source: Journal of Plastic Surgery and Hand Surgery - December 18, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The use of low-intensity pulsed ultrasound in hand and wrist nonunions.
The objective of this study is to present our experience using LIPUS in established nonunions of the hand and wrist. This is a retrospective cohort study of hand and wrist nonunions managed with LIPUS in two UK tertiary referral centers. Nonunion was defined as the failure of fracture healing at a minimum of 9 months post injury. Demographic and clinical data including nonunion site, union rates, surgery and time from surgery to LIPUS application were obtained from electronic patient and LIPUS device records. Patients were subcategorized into early or delayed LIPUS applications groups. Twenty-six hand and wrist nonunions w...
Source: Journal of Plastic Surgery and Hand Surgery - November 29, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Breast Reconstruction for Medicaid Beneficiaries: A Systematic Review of the Current Evidence.
Conclusion: There is wide disparity in reconstruction rates by insurance status. However, with continued increase in the adult Medicaid population due to widening eligibility expansion, disparities involving this vulnerable population should be examined for causes and solutions. PMID: 31766937 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - November 28, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius.
Authors: Andreasson I, Kjellby-Wendt G, Fagevik-Olsén M, Aurell Y, Ullman M, Karlsson J Abstract The aim was to investigate the long-term outcome after corrective osteotomy for malunion of distal radius fractures. Radiological findings, function, activity performance, pain, health-related quality of life and self-efficacy were studied. Evaluation of 37 patients 3-10 years after osteotomy fixated with a volar plate. Conventional radiographs were taken. Grip strength and range of motion were evaluated. Scores from the Patient Rated Wrist Evaluation (PRWE) were compared with normative values. The RAND-36 was us...
Source: Journal of Plastic Surgery and Hand Surgery - November 26, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Needle fasciotomy for Dupuytren's contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years.
Authors: Zachrisson A, Sörensen AI, Strömberg J Abstract Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers. Fifty-eight fingers in 42 patients (40 male and 2 female with a...
Source: Journal of Plastic Surgery and Hand Surgery - November 23, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Palmaris longus interposition in revision surgery for recurrent and persistent carpal tunnel syndrome: a case series.
Authors: Sun PO, Schyns MVP, Walbeehm ET Abstract Carpal tunnel syndrome (CTS) is the most frequently operated neurological disorder of the hand. Incidence of patients remaining symptomatic has been reported up to 30% after primary release. Revision surgery remains challenging although multiple surgical options have been described. In this case series a simple novel technique, the palmaris longus interposition, is described for the treatment of recurrent and persistent CTS. Patients who underwent PLI between October 2013 and 2018 and without underlying neurological or hand disorders severely affecting the operated ...
Source: Journal of Plastic Surgery and Hand Surgery - November 22, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Does age or frailty have more predictive effect on outcomes following pedicled flap reconstruction? An analysis of 44,986 cases †.
Does age or frailty have more predictive effect on outcomes following pedicled flap reconstruction? An analysis of 44,986 cases†. J Plast Surg Hand Surg. 2019 Nov 18;:1-10 Authors: Cuccolo NG, Sparenberg S, Ibrahim AMS, Crystal DT, Blankensteijn LL, Lin SJ Abstract The elderly population in the United States is expanding rapidly, and with advancements in modern medicine, the number of elderly patients undergoing surgery has risen in parallel. The aim of this study was to evaluate the effect of age and frailty on postoperative outcomes following pedicled flap reconstruction. The 2005-2016 ACS-NSQ...
Source: Journal of Plastic Surgery and Hand Surgery - November 19, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

The inverted love-heart flap: a new island flap design.
Conclusion: The inverted love-heart flap offers a reliable reconstruction for cutaneous defects. It has the advantage of a primary donor site closure, minimal patient morbidity and avoids the need for skin grafting and postoperative immobilization. PMID: 31709870 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - November 13, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Remote ischemic postconditioning as well as blood plasma from double-conditioned donor ameliorate reperfusion syndrome in skeletal muscle.
Authors: Burda R, Morochovič R, Némethová M, Burda J Abstract The aim of this study was to verify the possibility of preparation and effectiveness of the use of blood plasma containing an effector of ischemic tolerance activated by applying two sublethal stresses to a donor. As sublethal stresses, two periods of 20-minute hindlimb ischemia were used with a two-day interval between them. Active plasma was isolated six hours after the second hindlimb ischemia. The effectiveness of active plasma as well as remote postconditioning was tested after three hours of tourniquet-induced ischemia on the gastroc...
Source: Journal of Plastic Surgery and Hand Surgery - November 11, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research

Should immediate breast reconstruction be performed in the setting of radiotherapy? An ethical analysis.
In conclusion, given the current knowledgebase and established ethical norms within the healthcare system, we find strong ethical reasons not to offer IBR when PMRT is expected. PMID: 31702410 [PubMed - as supplied by publisher] (Source: Journal of Plastic Surgery and Hand Surgery)
Source: Journal of Plastic Surgery and Hand Surgery - November 11, 2019 Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research