Sleep Surgery in the Era of Precision Medicine.
PMID: 30717917 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Liu SY, Wayne Riley R, Pogrel A, Guilleminault C Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Nasal Surgery for Sleep-Disordered Breathing.
PMID: 30717918 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Thakker JS, Vuong C, Nguyen K, Inman JC Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Tonsillectomy and Pharyngoplasty: Tissue-Preserving Techniques.
PMID: 30717919 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Awad M, Gouveia C, Capasso R, Liu SY Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Genioglossus and Genioplasty Advancement.
PMID: 30717920 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Cheng A Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Maxillomandibular Advancement: Contemporary Approach at Stanford.
Abstract Maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea (OSA) has remained a reliable and highly effective surgical intervention since its introduction in 1989. Modifications have been made to maximize skeletal movement and upper airway stability without compromising facial balance. Contemporary indications of recommending MMA prior to other soft tissue surgery are described. MMA poses unique challenges to surgeons. There are patient-related factors, including OSA, a chronic inflammatory condition with associated cardiovascular and metabolic comorbidity. Perioperative management i...
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Liu SY, Awad M, Riley RW Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Maxillomandibular Advancement: The Canadian Experience.
PMID: 30717922 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Paris M, Jean S, Bouchard C Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Bilateral Temporomandibular Joint Reconstruction and Maxillomandibular Advancement for Concomitant Temporomandibular Joint Degeneration and Obstructive Sleep Apnea.
PMID: 30717923 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Gupta RJ, Silva R, Connelly ST Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Upper Airway (Hypoglossal Nerve) Stimulation for Treatment of Obstructive Sleep Apnea.
PMID: 30717924 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Gupta RJ, Kademani D, Liu SY Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Transoral Robotic Surgery for the Tongue Base.
PMID: 30717925 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Ghali GE, Meram AT Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Pediatric Sleep Surgery: Skeletal Procedures.
PMID: 30717926 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Resnick CM Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Drug-Induced Sleep Endoscopy.
PMID: 30717927 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Awad M, Okland TS, Nekhendzy V Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Pediatric Tongue Base Surgery.
PMID: 30717928 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Lee GS, Katwa U Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Sleep Surgery: From Reconstruction to Restoration and Re-education.
PMID: 30717929 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - February 6, 2019 Category: Surgery Authors: Liu SY Tags: Atlas Oral Maxillofac Surg Clin North Am Source Type: research

Patient Selection for Kidney Transplant.
This article describes factors to address in selection of renal transplant candidates and discusses commonly encountered perioperative events. Paramount to selecting appropriate candidates is the collaboration between a multidisciplinary team focused on a systematic process guided by protocols and common practices. PMID: 30471735 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Marroquin CE Tags: Surg Clin North Am Source Type: research

Small Bowel Transplantation.
Abstract Intestinal and multivisceral transplants are complex technical procedures that present unique challenges in the field of solid organ transplantation. This review aims to highlight the indications, techniques, outcomes, and complications specific to intestinal transplantation. PMID: 30471736 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Kesseli S, Sudan D Tags: Surg Clin North Am Source Type: research

Is This Organ Donor Safe?: Donor-Derived Infections in Solid Organ Transplantation.
Abstract Infection is an inevitable complication of solid organ transplantation. Unrecognized infection may be transmitted from a donor and result in disseminated disease in the immunosuppressed host. Recent outbreaks of deceased donor-derived infections resulting in high rates of mortality and severe morbidity have emphasized the need to be cautious in using donors with possible meningoencephalitis. Screening of organ donors for potential transmissible infections is paramount to improving transplantation outcomes. PMID: 30471737 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Fischer SA Tags: Surg Clin North Am Source Type: research

Composite and Multivisceral Transplantation: Nomenclature, Surgical Techniques, Current Practice, and Long-term Outcome.
Abstract The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Recent data documented significant improvement in the long-term therapeutic indices of all types of visceral transplantation close to that achiev...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Costa G, Parekh N, Osman M, Armanyous S, Fujiki M, Abu-Elmagd K Tags: Surg Clin North Am Source Type: research

Safe Living Following Solid Organ Transplantation.
Abstract Living safely after organ transplantation starts before transplant and continues after transplant. To minimize a solid organ transplant (SOT) recipient's risk for infection and risk for injury, it is important to plan for numerous potential exposures after transplant. These include potential exposure to others with viral or bacterial illness, potential exposure to food and water sources, participation in recreational activities, resuming sexual activity, living with pets, and opportunities for travel, especially internationally. Addressing these risks head-on ensures that an SOT recipient and their provid...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Blair BM Tags: Surg Clin North Am Source Type: research

Living Kidney Donation: Strategies to Increase the Donor Pool.
Abstract End-stage renal disease (ESRD) is a significant health care burden. Although kidney transplantation is the optimal treatment modality, less than 25% of waiting list patients are transplanted because of organ shortage. Living kidney donation can lead to better recipient and graft survival and increase the number of donors. Not all ESRD patients have potential living donors, and not all living donors are a compatible match to recipients. Kidney paired exchanges allow incompatible pairs to identify compatible living donors for living donor kidney transplants for multiple recipients. Innovative modifications ...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Lee LY, Pham TA, Melcher ML Tags: Surg Clin North Am Source Type: research

Posttransplant Malignancy.
Abstract Posttransplant malignancy is a leading cause of death after solid organ transplantation (SOT). Recipients of SOT are at significantly higher risk of multiple cancers compared with the general population, most notably nonmelanoma skin cancer and posttransplant lymphoproliferative disorders. Risk factors for posttransplant malignancy include history of malignancy, immunosuppression, oncogenic viral infections, sun exposure, and disease-specific associations. Early detection and treatment of malignancies can improve survival. PMID: 30471741 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Rossi AP, Klein CL Tags: Surg Clin North Am Source Type: research

Liver Transplantation: Patient Selection, Perioperative Surgical Issues, and Expected Outcomes.
Abstract Liver transplant rates are at an all-time high, with nearly 8000 liver transplants in 2015. Despite the increasing number of liver transplants performed per year, there is a widening gap of supply and demand on limited donor resources. Patient selection is a complex but necessary process to evaluate patients who will benefit from liver transplant while minimizing futile transplants. Efforts should also continue to focus on minimizing perioperative complications resulting in retransplantations and more targeted immunosuppression to minimize side effects and prolong patient survival. PMID: 30471742 [Pu...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Maynard E Tags: Surg Clin North Am Source Type: research

Pediatric Abdominal Organ Transplantation.
Abstract Pediatric liver and kidney transplantation have become the standard and accepted treatment for children with end-stage renal and liver disease. Since the first successful kidney transplant in 1954 by Dr Joseph Murray and the first liver transplant by Dr Thomas Starzl, the scope of indications for visceral organ transplantation as well as the range of recipient and donor ages has expanded. The first pediatric liver and kidney transplants, simultaneous multivisceral transplants, living-donor and donation-after-cardiac-death organs have evolved rapidly into the standard of care for end-stage renal and liver ...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Hwang CS, Macconmara M, Desai DM Tags: Surg Clin North Am Source Type: research

Pancreas Transplantation: Indications, Techniques, and Outcomes.
Abstract Pancreas transplantation treats insulin-dependent diabetes with or without concurrent end-stage renal disease. Pancreas transplantation increases survival versus no transplant, increases survival when performed as simultaneous pancreas-kidney versus deceased-donor kidney alone, and improves quality of life. Careful donor and recipient selection are paramount to good outcomes. Several technical variations exist for implantation: portal versus systemic vascular drainage and jejunal versus duodenal versus bladder exocrine drainage. Complications are most frequently technical in the first year and immunologic...
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Samoylova ML, Borle D, Ravindra KV Tags: Surg Clin North Am Source Type: research

Transplant 2018.
PMID: 30471745 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 27, 2018 Category: Surgery Authors: Martin RF Tags: Surg Clin North Am Source Type: research

The Treatment of Laryngeal Cancer.
Abstract Successful management of laryngeal cancer depends on careful pretreatment evaluation of patient and disease factors to arrive at accurate staging, leading to appropriate treatment selection for patients with this highly impacting disease. Surgical modalities, including transoral laser microsurgery, open partial laryngectomy, and total laryngectomy, offer options, alone or in combination with radiation and chemotherapy. Treatment strategy for laryngeal cancer should strive for cure while maintaining the best quality of life possible for the patient. Achieving the goals of initial and salvage treatment for ...
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Obid R, Redlich M, Tomeh C Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Contemporary Osseous Reconstruction of the Mandible and the Maxilla.
Abstract Cancers of the oral cavity and paranasal sinuses often require ablative surgery with adjuvant therapy in most cases. Large, postablative defects of the mandible and the maxilla present several challenges to the reconstructive surgeon. Functional and cosmetically satisfactory restoration requires a thorough understanding of the underlying disease process, a firm grasp of the nuances of head and neck anatomy, and an ability to plan and execute a reconstruction with the most suitable tissue for each particular patient. The authors outline the components of osseous reconstruction of the facial skeleton with a...
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Likhterov I, Roche AM, Urken ML Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Salivary Gland Malignancies.
This article examines the epidemiology and pathology of malignant tumors of the major and minor salivary glands and provides recommendations for the most successful treatment approaches. PMID: 30449524 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Carlson ER, Schlieve T Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Current Concepts in Chemotherapy for Head and Neck Cancer.
This article highlights the evidence-based data to support systemic treatment options for patients with head and neck squamous cell carcinoma (HNSCC). The discovery of the human papillomavirus epidemic in HNSCC and its favorable prognosis has led to a major focus of research. Patients are stratified into clinical or pathologic risk categories and enrolled in trials comparing standard treatment paradigms with deintensification, in low-risk disease, or to intensification, in intermediate-risk or high-risk disease. Immunotherapy has proven beneficial in second-line palliative therapy and is under investigation in first-line p...
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Sindhu SK, Bauman JE Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Soft Tissue Reconstruction for Head and Neck Ablative Defects.
Abstract Soft tissue reconstruction of head and neck ablative defects is a broad, challenging, and subjective topic. The authors outline goals to keep in mind when deciding on a primary reconstructive option for defects created by oncologic resection. Factors considered in local, regional, and distant flap selection are discussed. Based on the goals of reconstruction and factors involved in flap selection, a defect-based reconstructive algorithm is developed to help choose the ideal reconstructive option. The authors also discuss indications, pearls, pitfalls, and challenges in the harvest and inset of commonly us...
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Patel SY, Meram AT, Kim DD Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Management of the Neck in Oral Squamous Cell Carcinoma: Background, Classification, and Current Philosophy.
Abstract Nodal metastasis is the single most prognostic determinant in patients with oral squamous cell carcinoma (OSCC). Since its inception more than a century ago, the management of the neck has led to decreased surgical morbidity, with continued preservation of oncologic safety for OSCC. Nodal metastasis is the single most prognostic determinant in patients with OSCC. The decision for the extent of the neck dissection is tailored to tumor-specific characteristics, which dictate the probability and extent of nodal metastasis, including tumor size, location, histopathologic characteristics, and the presence or a...
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Afzali P, Ward BB Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Immunotherapy for Head and Neck Cancer.
This article provides an overview of the interaction between immune infiltrating cells in the tumor microenvironment, and the immunologic principles related to HNSCC. Current immunotherapeutic strategies and emerging results from ongoing clinical trials are presented. PMID: 30449528 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Sim F, Leidner R, Bell RB Tags: Oral Maxillofac Surg Clin North Am Source Type: research

The Head and Neck Cancer Patient: Neoplasm Management.
PMID: 30449529 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Milas ZL, Shellenberger TD Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Gene Therapy in Head and Neck Cancer.
This article provides insight into some gene therapy targets and varied techniques being evaluated for patients with head and neck cancer. Techniques include corrective gene therapy, cytoreductive gene therapy, and gene editing, in addition to a discussion on gene therapy vectors. PMID: 30454787 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Farmer ZL, Kim ES, Carrizosa DR Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Oral Cavity Cancer.
This article provides clinicians with a synopsis of the most contemporary management strategies for oral cavity squamous cell carcinoma, framed within the context of historical treatment philosophies. PMID: 30454788 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Ettinger KS, Ganry L, Fernandes RP Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Radiation Oncology for Head and Neck Cancer: Current Standards and Future Changes.
Abstract Treatment of head and neck cancer with curative intent consists of surgery and/or radiotherapy (RT) sometimes combined with adjuvant chemotherapy depending on the tumor site, extent, and histology. Herein, the authors review the role of RT in the management of head and neck mucosal squamous cell carcinoma (SCC). The authors focus on the outcomes of definitive RT and, depending on the primary site, postoperative RT. Unless otherwise specified, outcomes data cited are from the University of Florida. PMID: 30454789 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 21, 2018 Category: Surgery Authors: Mendenhall WM, Dagan R, Bryant CM, Fernandes RP Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Nonmelanoma Skin Cancer.
This article reviews the most common nonmelanoma skin cancers affecting the head and neck region. Although the most common of these malignancies rarely result in mortality, local morbidity caused by the tumors and their extirpation cannot be underestimated. Complete tumor extirpation with pathologically confirmed negative margins is the gold standard. Regional and distant metastases are rare, but must be treated appropriately should they occur. Although reconstructive surgery can be life changing for the patients and rewarding for the clinicians, it behooves the treating surgeons to remain true to oncologic principles abov...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Brandt MG, Moore CC Tags: Facial Plast Surg Clin North Am Source Type: research

Periocular Reconstruction.
Abstract Options for periorbital reconstruction include primary wound closure, local flaps, regional/distant flaps, or full-thickness skin grafts. Optimal aesthetic and functional outcomes are achieved by assessing regional contours, skin type, and facial aesthetic units. Like tissue should replace like tissue; for example, skin with skin, tarsus with tarsus (or equivalent material, eg, hard palate, ear cartilage, or autologous substitute), and conjunctiva with mucous membrane or like substitute (buccal mucous membrane, amniotic membrane). Patient characteristics including wound care needs, transportation needs, s...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Segal KL, Nelson CC Tags: Facial Plast Surg Clin North Am Source Type: research

The Role of Sentinel Lymph Node Biopsy in the Management of Cutaneous Malignancies.
Abstract Sentinel lymph node biopsy uses the concept of selective lymphatic drainage and the lymphatic microvasculature to identify first-echelon nodes draining a given malignancy. Although initially considered difficult and unreliable in the head and neck, experience with the technique has improved and evolved significantly over the last 3 decades. It is now recognized to be accurate and reliable for regional nodal staging and detection of occult nodal metastasis in the head and neck. Although initially described for nodal staging of melanoma, the usefulness of sentinel lymph node biopsy continues to expand and i...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Ahmad FI, Su SY, Gross ND Tags: Facial Plast Surg Clin North Am Source Type: research

Adjuvant and Neoadjuvant Treatment of Skin Cancer.
Abstract Skin cancer represents a broad classification of malignancies, which can be further refined by histology, including basal cell carcinoma, squamous cell carcinoma and melanoma. As these three cancers are distinct entities, we review each one separately, with a focus on their epidemiology, etiology including relevant genomic data, and the current evidence-based recommendations for adjuvant and neoadjuvant therapy. We also discuss future directions and opportunities for continued therapeutic advances. PMID: 30420067 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Sacco AG, Daniels GA Tags: Facial Plast Surg Clin North Am Source Type: research

Mohs Micrographic Surgery.
Abstract Mohs micrographic surgery (MMS) is the gold standard for treating various cutaneous tumors. MMS has evolved into a single-day, outpatient procedure. The tumor is excised, mapped, and processed with frozen, horizontal sections for immediate histologic evaluation. The process is repeated as necessary until the tumor is completely removed, with maximal conservation of normal tissue. Evaluation of 100% of the surgical margin allows for exceptional cure rates. The Mohs surgeon is trained in tumor excision, histopathology interpretation, and surgical reconstruction. The use of MMS is often part of a multidiscip...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Wong E, Axibal E, Brown M Tags: Facial Plast Surg Clin North Am Source Type: research

Health Outcome Studies in Skin Cancer Surgery.
Abstract As cutaneous cancers are the most common malignancies affecting US citizens, they represent a significant public health problem and health care cost burden. There are a variety of treatment options available to manage cutaneous malignancies, but limited data are available regarding outcomes, including quality of life, recurrence, and mortality. Here, we examine outcomes of skin cancer surgery as they relate to sociodemographic data and treatment factors. PMID: 30420070 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Olds CE, Pepper JP Tags: Facial Plast Surg Clin North Am Source Type: research

Reconstruction of the Nose.
Abstract Nasal reconstructive techniques have advanced significantly over the past 50 years. Modern techniques in nasal reconstruction are based on the nasal aesthetic subunits. In order to achieve ideal outcomes, reconstructive surgeons must consider differences in tissue qualities across the nasal aesthetic subunits and formulate reconstructive plans based on these differences. Local flaps, skin grafts, and several types of interpolated flaps comprise the most commonly used techniques for nasal reconstruction. Defects that involve structural or internal lining defects require reconstruction of significantly...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Joseph AW, Truesdale C, Baker SR Tags: Facial Plast Surg Clin North Am Source Type: research

Reconstruction of the Cheek.
Abstract The goal of cheek reconstruction is to restore an illusion of "normal." Attention must be directed toward the contralateral cheek skin color, texture, thickness, and contour, because this serves a template for reconstruction. The cheek is a peripheral facial subunit and largely frames the more central subunits (eyelids, nose, lips). As such, avoiding distortion or disfigurement of the central subunits is of paramount importance. The cheek possesses significant tissue laxity, elasticity, and mobility, thus allowing for the vast majority of cheek defects to be addressed with primary closure, local...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Cass ND, Terella AM Tags: Facial Plast Surg Clin North Am Source Type: research

Reconstruction of Defects Involving the Lip and Chin.
This article focuses on local reconstructive options for defects of the lip and chin. PMID: 30420074 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Geelan-Hansen K, Clark JM, Shockley WW Tags: Facial Plast Surg Clin North Am Source Type: research

Reconstruction of the Forehead and Scalp.
Abstract Tissue inelasticity and the hair-bearing nature of the scalp and forehead pose unique challenges during reconstruction. A thorough understanding of the surgical anatomy of the scalp and forehead is paramount for optimal reconstructive outcomes. Primary wound closure is usually preferred over secondary intention healing and skin grafting. Use of dermal alternatives and tissue expansion are adjunctive therapies to facilitate scalp wound closure. Local skin and soft tissue flaps are commonly used for most small to medium defects; however, microsurgical free tissue transfer can be considered for large full-th...
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Bradford BD, Lee JW Tags: Facial Plast Surg Clin North Am Source Type: research

Reconstruction of the Ear.
This article reviews the relevant anatomy of the ear, defines the goals of reconstruction, outlines the assessment of defects based on location, and describes specific surgical techniques useful in auricular reconstruction. PMID: 30420076 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 14, 2018 Category: Surgery Authors: Smith RM, Byrne PJ Tags: Facial Plast Surg Clin North Am Source Type: research

Overview of Enhanced Recovery After Surgery: The Evolution and Adoption of Enhanced Recovery After Surgery in North America.
Abstract Enhanced Recovery is broadly defined as the application of evidence based perioperative care elements for improved surgical outcomes. Demonstration of decreasing surgical stress with innovation of surgical technique, in combination with pressure to drive down health care costs, have coalesced into a unique version of perioperative medicine in the United States. The US government has failed to show interest; there are no performance metrics, no participation requirements, and certainly no monetary incentives for implementation of best perioperative practices. When considering the term, Enhanced Recovery is...
Source: The Surgical Clinics of North America - November 7, 2018 Category: Surgery Authors: Thacker J Tags: Surg Clin North Am Source Type: research

Enhanced Recovery After Surgery and Effects on Quality Metrics.
Abstract Enhanced recovery after surgery (ERAS) is an evidence-based protocol that aims to decrease the physiologic stress response to surgery and maintain postoperative physiologic function. This best practice bundle plays a significant role in improving surgical quality by impacting important quality metrics such as length of stay, hospital-acquired infections, readmissions, and patient experience. Adherence to ERAS as a collective bundle is more important than individual components in improving quality metrics, and this can only be achieved with data-driven information through auditing and interdisciplinary col...
Source: The Surgical Clinics of North America - November 7, 2018 Category: Surgery Authors: Liu JY, Wick EC Tags: Surg Clin North Am Source Type: research

Enhanced Recovery After Surgery and Its Effects on Patient Reported Outcomes.
Abstract Enhanced recovery programs were developed as a means for improving patient recovery after surgery with a multifaceted approach including several interventions in the perioperative period. There is now sufficient evidence in the literature that enhanced recovery programs have actually shortened hospital length of stay after colorectal surgery. Nonetheless, the impact of these successful programs on patient-reported outcomes like functional recovery and return to baseline quality of life is not known. PMID: 30390847 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 7, 2018 Category: Surgery Authors: Bikhchandani J Tags: Surg Clin North Am Source Type: research

Enhanced Recovery After Surgery: Economic Impact and Value.
Abstract Value in health care is defined as the best outcome that matters to the patient at the lowest cost. Therefore, a valuable intervention is one that either results in better outcomes at the same cost, the same outcomes at lower cost, or in the best-case scenario, better outcomes at lower cost. Enhanced recovery pathways (ERPs) increase value by improving clinical outcomes without increasing costs. ERPs do not increase overall costs, even when implementation and maintenance costs are considered. More research on patient-reported outcomes and other downstream effects of ERPs is required to fully characterize ...
Source: The Surgical Clinics of North America - November 7, 2018 Category: Surgery Authors: Lee L, Feldman LS Tags: Surg Clin North Am Source Type: research