Two Adjacent Capillary Perforator Flaps? A Reconstruction of a Full-thickness Alar Defect
We present a simple case of full thickness alar and partial lateral nasal defect for malignant melanoma, and how we were fortunate to reconstruct the defect successfully in a single operation using two adjacent local capillary perforator flaps: one for inner lining and the other for outer lining. A touch-up was performed after 3 months for improved cosmesis. A successful reconstruction is displayed with a video showing key steps of the procedure and results before and after a simple touch-up correction for improved appearance. This is a case of successful reconstruction of a full-thickness alar defect using a combination o...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Ideas and Innovations Source Type: research
Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
Conclusions:
Changes in the peripheral and central nervous systems following amputation should not be viewed as separate pathologies, but rather two interdependent mechanisms that underlie the development of pathological pain. A better understanding of the physiological changes following amputation will allow for improvements in therapeutic treatments to minimize pathological pain caused by amputation. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Peripheral Nerve: Special Topic Source Type: research
A Technical Guide for Sciatic Nerve Targeted Muscle Reinnervation in a Transfemoral Amputee
Conclusions:
TMR has proven potential as a therapy for amputation-related, neuropathic pain. With this technical guide to TMR, surgeons should feel more comfortable adding this technique to their armamentarium, to be utilized either at the time of amputation or as a secondary measure. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Peripheral Nerve: Original Article Source Type: research
Microsurgical Complications after Finger Reimplantation Treated with Negative Pressure Wound Therapy: A Case Report
Summary:
Venous congestion is the most critical complication following microsurgical finger replantation and can present within the first postoperative days or even in the immediate postoperative period. This is a case series of three patients who underwent digit replantation. The postoperative complication was venous congestion, and immediately, negative pressure wound therapy (NPWT) was applied to reduce the risk of failure. Three patients with a range of 35 years of age were included. One index finger, one thumb, and one ring finger were the fingers amputated; the surgical technique was described; our anticoagulant ...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Reconstructive Surgery in a Patient with High Radial Nerve Palsy Using the WALANT Technique
We describe the technique and results of a triple tendon transfer using wide-awake local anesthesia no tourniquet in a patient with a high radial nerve palsy. This was a complex case of reconstruction after five operations at the level of the humerus. This left him with a pseudoarthrosis of the humerus and a complete radial nerve palsy. We performed tendon transfers of pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to extensor pollicis longus tendons. Eighteen months after the triple tendon transfer surgery for the radial nerve palsy, the patient h...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Reverse Flow Shunt Restricted Free Venous Flap for a Ring Avulsion Injury
Summary:
Arterialized venous flaps can be an excellent option for reconstruction of digital defects. Previously, they remained unpopular owing to the high rate of venous congestion. Different techniques of restriction of the arteriovenous shunting have been described to mitigate this problem. In this article, the authors discuss a unique case whereby a reverse flow shunt restricted venous flap was used in an Urbaniak type III ring avulsion. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Unique Variation of Barber’s Disease: A Case Report
Summary:
Barber’s disease is an occupational-related disease in which small hair fragments penetrate the dermis of the hand. Although there is limited literature related to the topic, barber’s disease classically involves the interdigital space of hairdressers’ hands. In this case report, we report an undescribed variation of the condition. The case involves a female hair stylist who presented to the office with numerous hair splinters under the nail plate of her dominant thumb. Subsequent evaluation revealed cystic destruction of the distal phalanx of the thumb. Despite preoperative suspicion for osteomyelitis, ...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Little Finger Duplication
In this report, we describe a case of a bifid 5th digit on the right hand. The aim of this report was to report a new variant of type IIIB described by Duran (2015). This will possibly lead to the modification of the current classifications, which will improve the diagnosis and treatment of patients. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Volar Plate Interposition Arthroplasty of the Proximal Interphalangeal Joint: A Novel, Modified Malerich’s Technique
We report the case of a 49-year-old woman who developed diffuse arthritis of the finger joints, especially at the PIP joint of the third right finger. Radiographs showed destruction of the PIP joint, large osteophytes, marked narrowing of joint space, severe sclerosis, and deformation of bone contour. Through a volar approach, we removed the osteophytes, reshaped the joint, and performed an arthroplasty with volar plate interposition. The patient had an improved range of motion at 3 months postoperatively. This case study gives a detailed description and discussion, together with literature revision, of volar plate interpo...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Case Report Source Type: research
Predictors of Success following Microvascular Replantation Surgery of the Upper Extremity in Adult Patients
Background:
The purpose of this study is to ascertain which factors are associated with successful replantation in the upper extremity. Secondarily, the purpose was to determine patient factors that differentiate those patients who undergo initial replantation versus initial amputation.
Methods:
Data gathered for this retrospective study were obtained from a custom subset of the 2015–2020 IBM Truven MarketScan Commercial and IBM Truven MarketScan Medicare Supplemental databases. Data were sorted using Current Procedural Terminology codes and International Classification of Disease, Ninth and Tenth Revision, di...
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit?
Conclusions:
We observed no difference in the reconstructive outcomes of hand free-flaps and reconstruction between ETE or ETS digital arteries anastomoses. The successful microsurgical reconstruction was independent of anastomotic technique. In particular, the results of our study demonstrated no statistically significant increase of the ischemia time; thus, no prolongation of operative time can be attributed to the higher technical challenge of the anastomosis. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
Thinking Out of the Box: Use of the Radial Artery Distally to the Snuffbox as Recipient Vessel
Conclusions:
The RA is the primary vessel in the dorsum of the distal upper limb; performing the anastomosis distally to the EPL tendon may offer various advantages, making the surgery safer and less invasive. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction
Conclusions:
This study showed that the GTP flap is the optimal choice for fingertip reconstruction, providing excellent functional and aesthetic results with durable and glabrous skin, satisfactory pulp contour, and sensory restoration. These results could be achieved with no need for nerve suture, especially in defects with no injuries proximal to the loss of substance. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
Tailored Skin Flaps for Hand Reconstruction
Conclusions:
When planning a hand reconstruction, it is vital to ensure that the outcomes are not only functional but also aesthetic, with minimum donor site morbidity; in this study, we showed a variety of flaps that can be applied to achieve this goal. We believe that the final decision should be made after comprehending the defect and the patient’s preferences. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
Beauty and Function: The Use of Trimmed Great Toe in Thumb and Finger Reconstruction
Conclusions:
The trimmed great toe flap has proven to be a viable alternative to finger amputation in the reconstruction of thumb and long finger defects, leading to high aesthetic results. The morbidity of the donor site is reduced compared with the classic great toe flap, allowing a direct closure in most cases. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - September 1, 2022 Category: Cosmetic Surgery Tags: Hand: Original Article Source Type: research
