Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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Pretibial lacerations remain one of the commonest yet most neglected conditions facing emergency departments and plastic surgeons alike. Furthermore, these injuries afflict the most vulnerable groups of adults - the elderly and the infirm. It is essential therefore to have an approach to pretibial lacerations based on best available evidence, in order to optimize wound outcomes, but perhaps more importantly, to safeguard the general health of the vulnerable individual. We present an evidence-based approach to the tertiary management of these injuries and propose a treatment algorithm that we have utilized in our unit to successfully manage 40% of tertiary referrals of pretibial lacerations in a conservative manner.
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J Plast Reconstr Aesthet Surg · Sep 2012
Comparative StudyA comparative study of finger pulp reconstruction using arterialised venous sensate flap and insensate flap from forearm.
The aim of this study was to investigate the feasibility of finger pulp reconstruction using arterialised venous flaps from forearm and compare the outcomes of arterialised venous sensate flap and insensate flap. ⋯ The arterialised venous sensate flap from forearm is a practical alternative for finger pulp reconstruction with satisfactory functional and aesthetic outcomes. The forearm region can be an acceptable donor site for arterialised venous sensate flap in the reconstruction of larger finger pulp defect.
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J Plast Reconstr Aesthet Surg · Sep 2012
Comparative StudySecond free flaps in head and neck reconstruction.
Ablative surgery for head and neck cancer often results in defects that require free flap reconstruction. Improved survival after refined oncologic and adjuvant techniques has led to an increase in the number of patients undergoing a second free flap reconstruction. The objective of this study was to assess outcomes following a second free flap in head and neck reconstruction. ⋯ A second free flap may be required for reconstruction of head and neck defects following complications of the initial reconstruction, presence of a second primary or tumour recurrence. Success rates for second free flap reconstructions were significantly lower in those patients with initial free flap failure.
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J Plast Reconstr Aesthet Surg · Sep 2012
Comparative StudyThe anatomy of the pectoral nerves and its significance in breast augmentation, axillary dissection and pectoral muscle flaps.
In many plastic surgeries, a detailed understanding of the pectoral nerve anatomy is often required. However, the information available on the anatomy of pectoral nerves is sparse and unclear. The purpose of this study is to provide detailed anatomical information on the pectoral nerves to allow for their easy intra-operative localisation and to improve the understanding of the pectoral muscle innervation. ⋯ Knowing the pectoral nerves' origins, courses and connections, in addition to understanding the functional consequences of iatrogenically severing these nerves, leads to a better understanding of the pectoral muscle's innervation. Precise anatomical data on the pectoral nerve allow for its easy localisation during axillary breast augmentation, axillary dissection, removal of the pectoralis minor muscle and harvesting the pectoralis major muscle island flap.
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J Plast Reconstr Aesthet Surg · Sep 2012
Comparative StudyEffects of hyperbaric oxygen therapy on rapid tissue expansion in rabbits.
Tissue expansion has been widely used to provide additional soft tissue for clinical reconstruction. Rapid expansion requires a much shorter clinical period than conventional expansion; however, less natural skin growth occurs resulting in a larger stretch-back ratio and insufficient extra soft tissue for clinical use. In this study, hyperbaric oxygen therapy (HBOT) was used in the inflation phase of rapid expansion to increase natural skin growth. ⋯ The use of HBOT in the inflation phase of rapid expansion can effectively promote blood flow in the expanded skin, increase its natural skin growth and reduce the instant stretch-back ratio and tension of expanded skin.