Although the rise in lawsuits involving plastic surgeries is sensed across Brazilian tribunals, little is known about litigations considered by the trial courts and nothing regarding those judged by the appellate instance.
Tue Feb 04, 2020 02:00
Microneurovascular free muscle transfer is the gold-standard surgical procedure for the reanimation of established facial paralysis. However, the innervation of the transferred muscle by the contralateral facial nerve is usually insufficient to produce a stable smile. Besides, the corner of the mouth sometimes moves unnaturally as if it were being pulled up because of the single-direction movement. Thus, we propose one-stage facial reanimation using free latissimus dorsi (LD)-serratus anterior (SA)...
Fri Jan 31, 2020 02:00
Abdominoplasty is a popular aesthetic operation. Complication rates vary from 4-80%. To date, there is a lack of evidence for complication-reducing techniques. The aim of this meta-analysis was to summarise and quantify the effects of these techniques on complication rates and determine the safest combination.
Fri Jan 31, 2020 02:00
Robotic-Assisted Latissimus Dorsi Muscle Flap for Autologous Chest Reconstruction in Poland Syndrome
Since chest reconstructions in Poland syndrome are performed for patients at young ages, patients are generally concerned about conspicuous scars. Meanwhile, a robotic-assisted latissimus dorsi (LD) muscle harvest with inconspicuous scars has been performed for autologous breast reconstruction. As our experience with robotic-assisted LD flap harvest has increased over the years, we have made improvements in surgical techniques to optimize the results. The purpose of this study was to introduce and...
Fri Jan 31, 2020 02:00
We would like to thank M. Felix Freshwater for their article titled, ‘R.I.P. the “Re:” Letter to the Editor’, which we found to be thought provoking and as medical students at King's College London we offer our contribution to the discussion.1
Thu Jan 30, 2020 02:00
We appreciate the comments and questions from Harborough et al. and welcome the opportunity to respond. First, we would like to clarify that the cases we presented were all pedicled muscle sparing latissimus dorsi flaps (MSLD). All cases presented in our letter had interruption of the dominant thoracodorsal artery (TDA) blood supply, just proximal to the muscular branch to the latissimus dorsi (LD) muscle. In all cases, the serratus branch was either clipped or absent (Figure 1A of the initial letter).
Wed Jan 29, 2020 02:00
Traumatic neuroma caused by injuries or surgery can result in neuropathic pain, functional impairment and psychological distress, which has an impact on quality of life. The aim of this study was to identify the factors related to successful treatment of symptomatic lower extremity symptomatic neuromas using patient-reported outcome measures.
Thu Jan 23, 2020 02:00
Superficial circumflex iliac artery perforator (SCIP) flap is commonly used but only limited data on the anatomical distribution of superficial veins in these flaps are available. Therefore, we sought to determine the anatomic distribution and characteristics of additional superficial veins and also describe our clinical experience.
Thu Jan 23, 2020 02:00
Pelnac Gplus®, Integra® and Terudermis® are approved artificial dermis products in Japan. Previously, we proved that Pelnac Gplus® was able to sustain basic fibroblast growth factor (bFGF) and accelerated wound healing by releasing impregnated bFGF. In this study, we impregnated Pelnac Gplus®, Integra® and Terudermis® with bFGF and compared the binding activity and wound healing process. We applied bFGF to each material and compared the bFGF concentrations in the surrounding area after 24-h incubation.
Thu Jan 23, 2020 02:00
In most breast reduction techniques the pedicle of the nipple-areola-complex (NAC) is de-epithelialized to preserve the subdermal plexus, thereby decreasing the risk of NAC necrosis. However, deskinning the pedicle is faster and makes it more pliable, which potentially improves the aesthetic outcome. There is no scientific evidence regarding the beneficial effects of de-epithelialization. In this study, we present data from patients undergoing breast reduction with deskinning of a superomedial pedicle.
Thu Jan 23, 2020 02:00
The aim of a nerve block is to infiltrate around the nerve without damaging the nearby structures and the nerve itself.1 Thus, a sound knowledge of the regional anatomy of the digital nerves is essential to conduct a safe and effective ring block. Studies on the digital nerves of the toe and its applied anatomy in surgical practice are sparse, and there are no clinically utilizable standard anatomical landmarks available to locate digital nerves of toes to date. Therefore, the objective of the study...
Thu Jan 23, 2020 02:00
The question to what extent perfusion in Deep-inferior-epigastric-perforator (DIEP) flaps depends on specific perforator characteristics has been raised. Anatomical studies and previous clinical trials focusing on DIEP flap perfusion resulted in discrepancies. This prospective study investigates how perforator row, number and diameter affect DIEP flap microperfusion via Indocyanine-Green fluorescence angiography.
Thu Jan 23, 2020 02:00
Numerous techniques have been proposed for the plastic surgical treatment of hypertrophic breasts. Challenges of the procedure include the preservation of vascular supply and sensitivity of the nipple areola complex (NAC), breast feeding, and an aesthetically pleasing result.
Wed Jan 22, 2020 02:00
Immediate Post Mastectomy Alloplastic Breast Reconstruction (IPMABR) traditionally requires a post-operative overnight stay. Recent initiatives have identified same day discharge as a safe option.
Wed Jan 22, 2020 02:00
Lymphedema surgery has made tremendous advances and is quickly becoming the standard of care for patients suffering from lymphedema.1,2 A lymphovenous anastomosis (LVA) creates a shunt allowing lymphatic fluid to drain into the systemic circulation. Numerous studies have demonstrated successful outcomes using this approach, and in experienced, skilled hands, is reproducible, predictable, and effective in improving patients’ lymphedema but remains technically challenging and is dependent on specialized...
Wed Jan 22, 2020 02:00
Simultaneous contralateral augmentation in direct-to-implant (DTI) breast reconstruction may increase the risk of skin flap necrosis on the reconstruction side due to increased tension on the skin flap when implants are larger than the original breast size. The purpose of this study was to evaluate whether the contralateral augmentation procedure affects complications in unilateral DTI breast reconstruction.
Wed Jan 22, 2020 02:00
The flap necrosis rate remains high despite the advancement of technology in daily practices. Several randomized trials of topical Nitroglycerin (NTG) have shown promise in reducing flap necrosis. We aim to evaluate the efficacy and safety of topical NTG in preventing flap failure based on existing databases.
Wed Jan 22, 2020 02:00
The distinctive features of Oriental eyes are narrow palpebral aperture and up-slanting lower eyelid margin, which are not in accordance with modern appreciation of the beauty. Although many ophthalmic plastic procedures have been designed to change the characteristic appearance, the methods to enlarge the palpebral aperture by lowering the lower eyelid are limited.
Tue Jan 21, 2020 02:00
The success of microsurgical reconstruction is dependent on the availability of recipient vessels for restoration of flow within the transferred tissues. Vessels located within or adjacent to the defect to be reconstructed are the ideal choice.1 However, certain conditions such as in extensive traumatic tissue injury or vascular disease adjacent to the defect, preclude the use of these vessels and require more distant vascular access.2 Under such circumstances, vein grafts may be required to bridge...
Tue Jan 21, 2020 02:00
Osteosynthesis is the first step in digital replantation and of paramount importance for re-vascularisation in the context of open fractures. 1 Multiple techniques have been described to achieve this: plates and screws, Kirschner wires, intraosseous wires and combinations of these.2,3 K-wire fixation is the most commonly used, as it is fast and readily available in most Hand Surgery units. Insertion of two K-wires can be sufficient to stabilize most fractures and control rotation, allowing microsurgical...
Tue Jan 21, 2020 02:00
Manicures are an increasingly popular treatment. Ultraviolet(UV) nail lamps which primarily emit UVA with no detectable UVB or UVC are frequently used to set the varnish.
Tue Jan 21, 2020 02:00
: Sometimes, injecting ICG or isotope at distal limbs is insufficient especially in the cases with low lymphatic function. The purpose of this study was to elucidate the usefulness of multi-lymphosome injection ICG lymphography.
Tue Jan 21, 2020 02:00
Lengthening temporalis myoplasty, described by Daniel Labbe in 1997, is a facial reanimation procedure for the treatment of facial nerve palsy. It involves mobilization of the temporalis muscle antero-inferiorly, and insertion of its tendon at the nasolabial fold-oral commissure region. Knowledge of the temporalis muscle is crucial in performing this procedure; however, previous anatomical studies are limited. This study on cadavers, aimed to describe the anatomical location of the temporalis muscle...
Tue Jan 21, 2020 02:00
The deep temporal fascia is known to separate into two layers that descend to attach to the zygomatic arch. When surgeons reduce an isolated fracture of the zygomatic arch via a temporal approach, the temporal incision site needs be superior to the split line of the deep temporal fascia.
Tue Jan 21, 2020 02:00
The nasal columella is often described as being one of the most difficult nasal subunits to reconstruct. There are a wide range of indications for columella reconstruction, with defects resulting from ischemic injuries, trauma, tumour resection, vascular malformations and congenital agenesis/dysgenesis of nasal anatomy. There is a variety of columella reconstruction techniques reported in the literature, giving reconstructive surgeons options when approaching different columella defects. Each technique...
Tue Jan 21, 2020 02:00
In recent years the undergraduate medical curriculum in the United Kingdom has undergone significant reshaping to reflect the primary and holistic care needs of today's society. Subspecialty interests; such as burns care and reconstruction, are now infrequently represented in the formal teaching programme1–4. We aimed to further explore medical students’ self-reported confidence in initial burns management to give an indication whether more emphasis on teaching this subject at an undergraduate level...
Tue Jan 21, 2020 02:00
The inguinal area is often involved in oncologic debulking surgeries, lymphadenectomies and vascular procedures that can jeopardise blood flow and compromise wound healing. Radiotherapy and venous insufficiency can further aggravate the clinical picture. among principal etiologies of wound healing failure at the inguinal region we can consider wide soft tissues defects with dead space, bacterial contamination, lymphatic leaks, iterative procedures and general comorbidities such as diabetes, cachexia...
Tue Jan 21, 2020 02:00
Breast cancer is the most commonly diagnosed invasive cancer in women worldwide. The physical and psychological consequences of breast cancer can be somewhat mitigated with reconstruction, making it an integral part of the treatment approach in women requiring mastectomy.1 With improvements in surgical management, increasing amounts of the native breast skin can be spared with oncologic safety. This skin sparing approach has improved aesthetic outcomes, but it does not affect the loss of sensation...
Tue Jan 21, 2020 02:00
To systematically evaluate the effect of bone morphogenetic protein-2 (BMP-2) and iliac cancellous bone graft (ICBG) on alveolar cleft bone grafting (ACBG) in cleft lip and palate.
Tue Jan 21, 2020 02:00
The pedicled transverse rectus abdominis myocutaneous flap (TRAM) remains an effective and widely-used method for breast reconstruction despite well-documented donor-site morbidity. We present the island-type pedicled TRAM flap as a way to obtain better and more reliable outcomes in breast reconstruction.
Tue Jan 21, 2020 02:00
First reported by Dellon et al. in 1992, nerve decompression by dissecting the deep transversal intermetatarsal ligament through a dorsal incision appears to be an reliable method for treating Morton's neuroma by addressing its underlying pathomechanism, since it should rather be considered a Morton entrapment. As there are no current studies dealing with Dellon's surgical technique, we carried out a retrospective analysis with the aim of showing that nerve decompression is an effective method to...
Tue Jan 21, 2020 02:00
With the move towards increased simulation based microsurgical training and emphasis on the declining usage of animal models, there is a need for an objective method to evaluate the microvascular anastomoses in a non-living, simulated microsurgical training environment. Our aim was to create a validated assessment tool to evaluate the intimal surface of the end product to measure skills acquisition.The intimal surface of 200 anastomoses from 23 candidates and 2 experts were assessed using ImageJ...
Tue Jan 21, 2020 02:00
Telecanthus results from medial canthal tendon (MCT) disruption, which can result from traumatic nasoorbitoethmoid (NOE) fractures. Several methods, using different anchoring materials, incision approaches, or fixation positions, have been proposed for MCT reconstruction. Herein, we report our experience in treating MCT disruption using ipsilateral transnasal medial canthopexy with a Y-V approach.
Tue Jan 21, 2020 02:00
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