Background Chylous leak is an uncommon complication after head and neck surgery and typically results from a lesion of the thoracic duct (TD). Beside conservative treatment, different minimally invasive and surgical procedures exist, of which almost all lead to a total closure of the TD. Methods We report on a rare case of microsurgical lymphovenous anastomosis to treat a TD lesion. An additional systematic review on surgical procedures to treat TD lesions with special attention to lymphovenous...
Tue Mar 10, 2020 23:57
Introduction This study investigates the utility of common surgical dyes under direct visualization and infrared laser angiography. Methods Pigments affecting light within the visual (λ = 400–700 nm) and infrared (λ = 700–1000 nm) spectra were placed on subjects spanning the Fitzpatrick scale. Photometric properties of these pigments were assessed under direct visualization and infrared laser angiography. Results Among patients of various Fitzpatrick classifications, black ink pigment...
Tue Mar 10, 2020 23:57
Introduction Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging issue facing the medical community. Government organizations such as the US Food and Drug Administration and specialty groups including the American Society of Plastic Surgeons have published online resources about BIA-ALCL for patients. Given the complexity of the diagnosis, it is important that patients can easily read these resources. In this study, we examined the readability levels of online BIA-ALCL...
Tue Mar 10, 2020 23:57
Background The need for preoperative imaging as well as anastomotic technique (ie, end-to-side [ETS] vs end-to-end [ETE]) are areas of controversy in microsurgical lower-extremity reconstruction. The objective of this study was to (1) investigate whether preoperative imaging is mandatory and (2) to elicit if the type of anastomosis impacts clinical outcomes. Methods A retrospective review of all patients who underwent microvascular lower-extremity reconstruction between 2007 and 2015 by a...
Tue Mar 10, 2020 23:57
Background Artificial Intelligent Virtual Assistants (AIVA) is a segment of artificial intelligence that is rapidly developing. However, its utilization to address patients' frequently asked questions remains unexplored. Methods We developed an AIVA to answer questions related to 10 frequent topics asked by plastic surgery patients in our institution. Between July 27, 2018, and August 10 of 2018, we recruited subjects with administrative positions at our health care institution to chat with...
Tue Mar 10, 2020 23:57
No abstract available
Tue Mar 10, 2020 23:57
No abstract available
Tue Mar 10, 2020 23:57
Introduction Head and neck free flap (HNFF) reconstructions have historically utilized a multidisciplinary approach between otolaryngology head and neck surgery (OHNS) and plastic surgery (PS). However, there seems to be a trend toward both the extirpative and reconstructive portions being performed by OHNS. We aimed to elucidate the volume trend in HNFF reconstruction over the last decade. Methods Data were collected by 3 modalities: electronic medical record search of patients who underwent...
Tue Mar 10, 2020 23:57
Background Blepharoptosis is a common and challenging clinical problem for oculoplastic surgeons, and various surgical techniques have been used to correct ptosis. The aims of this study were to present the clinical results of a modified technique using levator aponeurosis–Müller muscle–reinforced plication for blepharoptosis correction and to demonstrate its advantages over conventional advancement or plication methods. Methods This study was conducted in the Plastic Surgery Department of...
Tue Mar 10, 2020 23:57
Background Hidradenitis suppurativa (HS) is a chronic debilitating condition. Treatment of HS depends on disease stage, goals of care, access to care, and frequency of symptoms. We present our experience with surgical treatment for patients with HS. Methods Patients were followed longitudinally for at least 2 years postsurgical intervention. Demographic data, participation in a multidisciplinary program, type of surgery, healing rates, and potential factors contributing to wound healing were...
Tue Mar 10, 2020 23:57
Background Abdominoplasty is becoming increasingly more common, with seroma being the most frequent complication. Suction drains are used very often as a method to prevent seroma formation, and it has been suggested that techniques using Scarpa fascia preservation and closed-suction drains have lower seroma rates than other approaches. However few studies have addressed parameters that may affect drain efficiency. A prospective comparative study was conducted to determine if applying 2 or 3 closed-suction...
Tue Mar 10, 2020 23:57
Background Recently, it has been shown that panniculectomy concurrent to living donor renal transplantation is a safe option for management of renal transplant recipients with a large focal pannus. This combined management requires precise coordination of teams. We describe the technique, timing, and sequence for combined renal transplantation and panniculectomy. Methods We conducted a retrospective chart review of adult patients (≥18 years old) who underwent simultaneous living donor renal...
Tue Mar 10, 2020 23:57
Background Single-stage direct-to-implant (DTI) breast reconstruction can offer several potential benefits. Subpectoral DTI reconstruction can present with animation deformity and pectoralis muscle spasm. To potentially avoid these complications, surgeons have attempted prepectoral placement for DTI; however, the benefits of this approach are mostly unknown. We evaluated the outcomes of DTI between prepectoral and subpectoral placement. Methods This was a retrospective review of patients...
Tue Mar 10, 2020 23:57
The Food and Drug Administration Bans Biocell Textured Breast Implants: Lessons for Plastic Surgeons
No abstract available
Tue Mar 10, 2020 23:57
Background Nipple-areola complex–sparing mastectomy (NSM) represents, when a mastectomy is unavoidable, the best treatment possible that can be offered to attenuate the negative impact of surgery on patients' quality of life. Unfortunately, NSM can be used only in selected patients with small and nonptotic breasts. In order to save the nipple-areola complex (NAC) also in patients with large and ptotic breast, otherwise subjected to a skin-sparing mastectomy with the sacrifice of the NAC, we described...
Tue Mar 10, 2020 23:57
Introduction Maxillary cancer is relatively rare but devastating for those affected with the disease. For patients who require suprastructural or total maxillectomy for oncologic resection, the resection of the orbital floor can be challenging to reconstruct. The serratus-rib flap is a well-known and useful method of head and neck reconstruction, albeit infrequently used. However, the serratus-rib flap has not previously been described for reconstruction of the orbital floor and has the potential...
Tue Mar 10, 2020 23:57
Background Burned patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have exceedingly high mortality rates of 73% to 100%. Since January 2011, we have been adopting an early RRT approach in managing burned patients with AKI. Our hypothesis was that early initiation of RRT leads to improved outcome and survival among burned patients with AKI. Methodology We conducted a retrospective analysis of Burns Database in Singapore General Hospital from January 2011 to...
Tue Mar 10, 2020 23:57
Background The use of medial sural vessels (MSVs) as recipient vessels to repair wounds in the lower limbs has been previously reported. However, there is controversy regarding the methods used to expose MSVs and the repairable area of the wound. Methods Eight fresh cadavers were used to determine the shape, outer diameter, and length of the MSVs arising from the popliteal vessels. Lower extremity wounds were repaired in 7 patients using free latissimus dorsi flaps with the MSVs as recipient...
Tue Mar 10, 2020 23:57
Background Histological differentiation between hypertrophic scars (HSs) and keloids has been considered difficult. In this study, we analyzed differences in the 3-dimensional tissue architecture between HSs and keloids using focused ion beam/scanning electron microscopy (FIB/SEM). Methods Five specimens each of normal skin, normotrophic scars (NSs), HSs, and keloids were investigated. Three sites in each specimen were observed by FIB/SEM tomography, resulting in an observation of 15 sites...
Tue Mar 10, 2020 23:57
Inguinal hernia repair is one of the most commonly performed surgical procedures. Postoperative neuropathic groin pain is a potentially disabling complication and can be due to a neuroma of the ilioinguinal, iliohypogastric, and/or genitofemoral nerves. In this article, we present our operative technique—a retroperitoneal approach to the ipsilateral ilioinguinal, iliohypogastric, and genitofemoral nerves with neurectomy and proximal transposition of these nerves—for management of neuropathic pain....
Tue Mar 10, 2020 23:57
Introduction Expanding surgical capacity is very difficult in resource-constrained countries. Financial input and additional physical operating room space are needed. The surgical patient volume exists, but the lack of operating room time causes postponement of cases. Hand surgery is particularly important as it improves patient function and allows for a timely return to the workforce after injury. Some hand surgery cases may be performed under local anesthesia with a very basic instrument set...
Tue Mar 10, 2020 23:57
Background Cutaneous mold infections occur infrequently but can be life-threatening in immunocompromised children. The literature regarding its surgical management is limited. This study aims to describe the surgical management and outcomes of cutaneous mold infections in immunocompromised children. Methods Hospitalized patients receiving a skin biopsy at a single pediatric hospital in 2003 to 2017 were identified. Inclusion criteria were immunocompromised status, younger than 21 years, and...
Tue Mar 10, 2020 23:57
This article aims to present a new method for correcting bony deformity in racquet thumb. Methods We operated on 37 thumbs of 32 patients (age, 17–52 years) with racquet thumb using a procedure that included narrowing the nail bed, recreating the lateral nail fold, making a bone defect in the widened proximal base, and exposing more proximal nail bed. The ratio of the length to the width of the nail was calculated. Results The ratio of the length to the width of the nail increased from...
Tue Mar 10, 2020 23:57
Background Plastic surgeons in the United States are trained under 2 residency training models: integrated and independent. This study analyzes the variability of craniofacial surgery cases performed both between and within training models. Methods Case volume data from national data reports of 5 plastic surgery resident cohorts were analyzed (2011–2015). Craniofacial surgery case volumes across 4 major categories and 23 subcategories were compared between training models via t tests. Differences...
Tue Mar 10, 2020 23:57
Background The anterior aspect of the auricle is a complex 3-dimensional structure. Each anatomical component in this region has an essential role in the aesthetic appearance of the ear and face. The reconstruction of defects in this region is challenging because of the lack of mobile, excess skin for primary closure, and the inability to skin graft overexposed cartilage. Objective The aim of the study was to present the planning and surgical technique of a simple, reproducible, 1-stage flap,...
Tue Mar 10, 2020 23:57
Background The reverse sural artery flap (RSAF) is a popular option for patients with distal lower extremity defects who are not ideal candidates for free flap reconstruction. This is the first systematic review and pooled analysis of surgical characteristics, risk factors, and outcomes of the RSAF. Methods A systematic literature review was conducted. All studies reporting on patients undergoing RSAF reconstruction and their outcomes were included. Outcomes were pooled and analyzed using...
Tue Mar 10, 2020 23:57
Background Impaired brow function in adult patients with arteriovenous malformation is a serious disability that can even influence the field of vision. Brow reanimation techniques are used to recover a more natural appearance and brow function. Many static procedures have been set to augment brow elevation, but only dynamic procedures can lead to better functional results. In this study, the experience of a single surgeon addressing the challenge of brow restoration with dynamic procedures is...
Tue Mar 10, 2020 23:57
No abstract available
Tue Mar 10, 2020 23:57
During transcatheter aortic valve replacements (TAVR), there is a risk of cerebrovascular events due to embolic debris breaking off from vessel walls and migrating to the brain. While microembolization during the procedure is a universal phenomenon, the majority of patients experience no symptoms. However, a clinically-evident stroke is a serious and feared complication. Protembis is developing a solution that will hopefully reduce the incidence of post-TAVR cerebrovascular events. The...
Tue Mar 10, 2020 22:11
Mountain View-based NeuroPace today announced it has received FDA approval for MRI labeling for its RNS System, a closed-loop brain-responsive neurostimulation system designed to prevent seizures in adults refractory to antiseizure medications. The approval applies specifically to the RNS-320 model of the RNS neurostimulator. Because MRI scans are often used to monitor patients with brain anomalies that may contribute to seizures, incompatibility with the imaging modality may have...
Tue Mar 10, 2020 21:41
LivaNova announced today that Symmetry, a device for vagus nerve stimulation (VNS) therapy, has received CE Mark approval for difficult-to-treat depression. Symmetry is a small device that stimulates the vagus nerve to improve symptoms of depression and quality of life. After surgical implantation, the device regularly sends mild electric pulses to the vagus nerve, which is connected to areas of the brain that control mood. While previous devices for VNS therapy have received CE Mark...
Tue Mar 10, 2020 19:15
Existing prosthetic hands have to rely on weak electrical nerve signals in order to know when to activate their motors. That’s because electrodes are typically placed on the skin over the area where the nerves end at the stump and the skin doesn’t transmit electricity that well. Implantable electrodes that make contact with the nerves tend to form scar tissue that ends up ruining signal fidelity and brain-computer interfaces are simply too invasive for most applications. Now, researchers at...
Tue Mar 10, 2020 17:03
Dysphagia, or difficulty swallowing, can dramatically decrease a person’s quality of life and lead to poor nutritional intake. Neurological oropharyngeal dysphagia is due to damage to the nerves that control the muscles related to swallowing, often caused by strokes or other neurological conditions. The Phagenyx System is a neurostimulation device that helps to restore neurological swallowing control through electrical stimulation. The device delivers small amounts of electrical stimulation...
Tue Mar 10, 2020 14:46
High Altitude Medicine &Biology, Ahead of Print.
Mon Mar 09, 2020 09:00
Abstract Participation in cancer clinical trials (CCTs) is critical to improving cancer treatments and quality of care. However, rates of patient participation remain low. Research has shown that a trusted physician recommendation is an important influence on patients’ decisions to enroll in a CCT. Improving primary care providers’ (PCPs’) knowledge, attitudes, and beliefs about CCTs is a promising potential path for improving CCT participation. The aim of this pilot study was...
Tue Mar 10, 2020 02:00
Abstract Objectives The objective of this study was to explore potential relationships between neonatal line (NNL) width and early life history variables such as maternal health, gestation, the birth process, and perinatal health. Materials and methods Histological thin sections of deciduous canines were studied from 71 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). The width of the NNL was measured in three locations on the tooth crown using spatial...
Tue Mar 10, 2020 23:18
Abstract Objectives Macroscopic entheseal forms show two main features: predominant signs of bony formation or resorption. To understand the development of these forms, we investigated microarchitectural differences between the macroscopic proliferative and resorptive forms of the gluteus maximus enthesis. Materials and Methods The macromorphological analysis of entheseal changes (EC) was based on the Villotte, visual scoring system for fibrous entheses. Gluteal tuberosity specimens...
Tue Mar 10, 2020 17:09
Abstract Objectives The island of New Guinea was settled by modern human over 50,000 years ago, and is currently characterized by a complex landscape and contains one‐seventh of the world's languages. The Eastern Highlands of New Guinea were also the home to the devastating prion disease called kuru that primarily affected Fore‐speaking populations, with some 68% of cases involving adult females. We characterized the mitochondrial DNA (mtDNA) diversity of highlanders from Papua New Guinea...
Tue Mar 10, 2020 11:01
One of the most feared complications after arthroplasty is infection due to its significant impact on patient morbidity. Infection may transfer to the joint at the time of surgery or be seeded, haematologically, to the prosthetic joint from another infection source. In this case, a 72-year-old female presented with symptoms of septic arthritis seven years after her original arthroplasty surgery. At presentation, she denied trauma and any comorbidity which would predispose her to infection. Culturing...
Tue Mar 10, 2020 12:05
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