Latissimus dorsi flap is the gold standard for pedicled breast reconstruction but is limited by donor site scarring that is difficult to conceal, and a high rate of post-operative seroma. We investigated the anatomic characteristics and feasibility of using a subcostal artery perforator (SCAP) flap, taken from the flank area, and vascularised via a perforator artery through a subcostal pedicle, for a breast reconstruction.
Background GLI3 encodes a transcription factor in the sonic hedgehog signaling pathway, which is essential in regulating the human limb bud development, especially on the anteroposterior axis. Mutations in GLI3 have been confirmed to be associated with various human congenital malformations, including Greig cephalopolysyndactyly syndrome, Pallister-Hall syndrome, and isolated polydactyly. A robust gene-phenotype relationship between GLI3 and Greig cephalopolysyndactyly syndrome and Pallister-Hall...
Background Today, plastic surgeons have largely transitioned to digital photography. This shift has introduced new risks to daily workflows, notably data theft and Health Insurance Portability and Accountability Act (HIPAA) violations. Methods We performed a national survey of digital photograph management patterns among members of the American Society of Plastic Surgery and trainees in Accreditation Council for Graduate Medical Education–accredited plastic surgery programs. Results Our...
Background In patients with diabetic foot ulcers requiring flap reconstruction, the choice of local flaps is limited by the lack of adequate tissue available. Free flaps are often bulky, presenting footwear difficulty due to poor contouring. Here, we present our experience of using the proximal lateral leg perforator flap in the reconstruction of thin diabetic foot ulcers. Methods This is a retrospective study of 17 patients with diabetic foot ulcers reconstructed with the proximal lateral...
Background Surgical site infections (SSIs) following body-contouring plastic surgery pose a significant burden on patients and caregivers, possibly leading to undesired surgical outcomes. Surgical site infection incidence following body-contouring plastic surgery ranges from 2% to 7%, but is estimated much higher among postbariatric massive weight loss (MWL) patients. Objective The aim of this study was to evaluate SSI rate, risk and protective factors among postbariatric MWL patients following...
No abstract available
Introduction and Objectives The literature reports many variations of Poland syndrome, which is a congenital disorder and a rare condition. The associated features are extremely variable, including alterations in the ipsilateral thorax and upper extremity and other malformations. This is used to designate the condition as Poland sequence (PS) because a sequence is a primary defect with a secondary cascade of structural changes. It is generally accepted that it is characterized as pathognomonic...
Background Skin and soft tissue defect of the ankle usually mandates flap reconstruction; however, bulky flap and difficulty ambulance have been the major disadvantages after flap reconstruction of this area. We used the concept of full-thickness skin graft as a 1-stage method of secondary debulking procedure to achieve both aesthetic and functional results. Methods Since January of 2004 to June of 2016, 22 one-stage secondary debulking procedures were performed on 22 patients who had received...
Background On June 27, 2015, a colored powder explosion occurred in Taiwan. As a result, 499 people were injured, and over 200 people were in critical condition because of severe burns. Forty-nine casualties were transported to the Chang Gung Memorial Hospital. Methods We undertook a single-center retrospective observational study using clinical data for 37 patients with major burns with more than 20% total burn surface area (TBSA). We describe the experience of managing patients with acute...
Purpose Intraosseous ganglion cyst (IGC) is a rare disease, particularly in lunate. The objective of this study was to summarize current knowledge on the treatment of IGC of the lunate, through a literature review, to provide a therapeutic strategy for this rare disease. Methods The PubMed, ISI Web of Science, Cochrane Library, EMBASE, Science Direct database were searched with a set of predefined inclusion and exclusion criteria. Manual searches for references were performed to find potential...
Purpose Volar plate injuries of the proximal interphalangeal joint (PIPJ) of a finger are common, often occurring in sporting or workplace incidents. Treatment of a stable dorsal dislocation entails a conservative approach, directed at preventing hyperextension and allowing the ligament to heal in position that does not negatively impact on healing. Current treatment regimens include dorsal block splinting (DBS) in 30° of flexion, which maintains the PIPJ in flexion in order to prevent any strain...
No abstract available
Flexor Tendon Reconstruction: Active Range of Motion After the First Stage of Silicone Rod Insertion
Purpose In the first stage of flexor tendon reconstruction, a silicon rod is fixed distally to the remnant of the flexor tendon at the distal phalanx. The proximal end of the rod is left free (unsutured) in the distal forearm. Hence, the rod insertion is not expected to result in any active flexion of the finger. The author reports on a case series in which adhesions have occurred between the rod and the adjacent flexor tendons in the distal forearm. Methods A retrospective study of 110 patients...
Background Soft tissue defects with dead space in the ankle and foot remain a challenge for surgeons. The aim of the study was to evaluate the surgical technique and clinical significance of posterior tibial artery perforator flaps carrying partial gastrocnemius muscle for patients with soft tissue defects with dead space in the ankle area. Methods Between August 2015 and August 2017, 14 patients (2 women and 12 men) between 20 and 58 years old (median age, 42 years) were hospitalized in...
Background Recently, skin-redraping medial epicanthoplasty has emerged as an extremely effective way to minimize the resultant scar. We found that the novel skin-redraping medial epicanthoplasty technique, which has been applied to aesthetic surgery, could also be suitable for the correction of congenital epicanthus and telecanthus. Methods We retrospectively identified patients who had an epicanthoplasty from December 2007 to August 2017. Among 47 patients, we identified 19 cases with congenital...
Objective The aim of this study was to establish the anatomic basis for functional upper and lower lip reconstruction with locoregional flaps. Design, Setting, and Participants This article is an anatomic fresh cadaver study. Results For lower lip reconstruction, the modified Bernard-Webster and Karapandzic flaps preserve the modiolus, buccinator, zygomaticus major muscle, and buccal branches of the facial nerve. The Bernard-Webster flap allowed for a larger oral aperture despite a larger...
Background Helical rim reconstruction is relatively difficult because of the unique anatomical structure of the ear. The aesthetic and functional characteristics of the ear make such reconstruction even more important. This article presents the newly defined chondrocutaneous hatchet flap-Z plasty (HFZP) method in helical rim defects and evaluates the results. Methods This study retrospectively evaluates 14 patients who were operated on using the chondrocutaneous HFZP method after a tumor...
Until, sometime ago, microsurgery meant mainly covering a defect or replanting severed parts back to where they belong. Now, restoration of original function and aesthetic consideration is a must in planning reconstructive procedure. Hand transplant combines hand surgery and microsurgery with complex multidisciplinary care. At the anniversary of our first cadaveric bilateral proximal forearm transplantation done in the country's government institute, we would like to share our experience in performing...
The deep inferior epigastric artery perforator (DIEP) flap is one of the most used free flaps for the reconstruction of the breast after a mastectomy. Despite careful selection of the patients and preoperative imaging, difficulties in vascularization of the flap can occur in some cases. Although multiple vascular connections (bipedicled, turbocharged, or stacked) can be made in selected cases, there can still be venous congestion before the flap is transferred. Between 2016 and 2018, 4 cases in...
Facial expressions play a fundamental role in interpersonal communication and interaction; consequently, facial palsy has profound effects on the quality of life of patients. Reanimation of lower lip depressors is rarely addressed during facial reanimation but is as important as treating the eye sphincter and the lip levators. Depressors of lower lip are vital for full denture smile and the expression of facial emotions. Static and dynamic techniques are used to reanimate the lower lip depressors....
Purpose We investigated the histological characteristics of the tissues in the intrinsic hand muscles of patients with compressive ulnar neuropathy (CUN) to determine how the compromised nerve influences the target muscle. Methods In total, 83 patients underwent surgery for CUN in our institution between March 2015 and August 2017. Of these, 45 patients who met our inclusion/exclusion criteria were initially included in this study. Basic demographic data including age, sex, hand dominance,...
No abstract available
Abstract Purpose Platelet-rich plasma (PRP) is an autologous prepared plasma enriched with platelets and obtained after a centrifugal separation and aggregation procedure. However, the optimized preparation protocol for PRP is still controversial and there are no standardized preparation protocols. The aim of this study is to show the effect of time and force of the centrifugation on the concentrations of platelets and to optimize the...
Abstract Background The development of fillers for wrinkle prevention is growing to meet rising demands to reduce the aging of skin. Objective In this experiment, we confirmed the effects of human collagen and hyaluronic acid filler biodegradation for wrinkle reduction using a photo-aging mouse model. ...
Abstract Patients undergoing secondary female hairline correction surgery present with dissatisfaction of various causes that require specific solutions. Satisfactory results following secondary revision surgery are achieved only after consideration of the reasons for the patient's dissatisfaction as well as specific factors regarding the state of the hairline, height and width of the forehead, and overall facial type; all of these must be considered when...
Publication date: Available online 13 April 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Andrew R. McKean, Michael Gallagher, Katherine Elworthy, Peter Macneal, Shakeel Rahman, Isabel Jones
Orbital compartment syndrome poses a significant risk for vision loss if not promptly treated. The authors report a patient with neuropsychiatric systemic lupus erythematosus presenting with bilateral orbital compartment syndrome and rapid decompensation leading to uncal and tonsillar herniation. While extremely rare, bilateral orbital compartment syndrome should prompt consideration of systemic etiologies including neuropsychiatric systemic lupus erythematosus. Accepted for publication January...
Abstract Background Facial asymmetry combined with a prominent mandibular angle is common in the population. Its treatment involves two or three stages of surgeries. Generally, orthognathic surgery is a top priority. However, some patients with no severe occlusion disorders focus on the appearance and could not accept complex therapeutic procedures. This study evaluated the surgical effect of en bloc mandibular angle–body–chin curved ostectomy...
Publication date: Available online 11 April 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Ryckie G. Wade, Justin C.R. Wormald, Andrea Figus
Publication date: Available online 11 April 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Yingfang Fan, Tae-Hyun Choi, Jee-Hyeok Chung, Yoon-Kyung Jeon, Sukwha KimSummaryCompared to pure hyaluronic acid filler, crosslinked hyaluronic acid (HAc) exhibits superior biocompatibility and longevity as a dermal filler. We previously developed composite HAc-hydroxyapatite (HAp) fillers. Herein, we systematically compared the protein-level increase and gene expression between...
Publication date: Available online 11 April 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): J. Stallard, D. Aaron, P. Muthayya
Publication date: Available online 11 April 2019Source: Journal of Plastic, Reconstructive & Aesthetic SurgeryAuthor(s): Christine S Quinlan, Michael Capra, Marlese DempseyAbstractIntroductionMalignant melanoma is increasing in frequency worldwide however this disease is rare in childhood. As large-scale studies into paediatric melanoma are lacking management is currently often based upon understanding of the disease process in adults. The aim of this study was to characterise cases of paediatric...
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