Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Mar 2014
Meta AnalysisComplications following body contouring surgery after massive weight loss: a meta-analysis.
Bariatric surgery is a way to achieve lasting weight loss in the obese. Body contouring surgery seeks to alleviate some of the discomfort caused by the excessive loose skin following massive weight loss. Higher complication rates are described in this type of surgery when done post-bariatric. The purpose of this article is to compare complication rates of body contouring surgery when performed on patients with weight loss due to bariatric surgery compared to patients who lost weight due to dietary changes and/or exercise. ⋯ The analysis shows a 60-87% increased risk of complications in the post-bariatric group compared to the non-bariatric group with statistical significance.
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J Plast Reconstr Aesthet Surg · Feb 2014
Randomized Controlled Trial Comparative StudyComparative analysis between minimal access versus traditional accesses in carpal tunnel syndrome: a perspective randomised study.
Carpal tunnel decompression with division of the transverse carpal ligament has been a highly successful procedure for the treatment of carpal tunnel syndrome. The standard longitudinal incision technique, with a long curvilinear incision, has been the optimal treatment procedure for surgical decompression of the median nerve, for many surgeons. The aim of this study was to compare the traditional open carpal tunnel release (TOCTR) technique with the minimal-access carpal tunnel release (MACTR) technique for the treatment of carpal tunnel syndrome (CTS), presenting our experience. ⋯ In our perspective randomised study, MACTR showed statistically significant improvement compared to TOCTR. The patient tolerance is reasonably high and the procedure is compatible with the current minimal invasive trend in surgery.
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J Plast Reconstr Aesthet Surg · Feb 2014
Outcome analysis after helmet therapy using 3D photogrammetry in patients with deformational plagiocephaly: the role of root mean square.
Deformational plagiocephaly (DP) is a multifactorial non-synostotic cranial deformity with a reported incidence as high as 1 in 7 infants in North America. Treatment options have focused on non-operative interventions including head repositioning and the use of an orthotic helmet device. Previous studies have used linear and two dimensional outcome measures to assess changes in cranial symmetry after helmet therapy. ⋯ Furthermore, when the sample of infants was divided into two treatment subgroups, a statistically significant correlation was found between the age at the beginning of treatment and the change in the RMS value. When helmet therapy was started before 7 months of age a greater improvement in symmetry was seen. This work represents application of the technique of RMS analysis to demonstrate the efficacy of treatment of deformational plagiocephaly with a cranial molding helmet.
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J Plast Reconstr Aesthet Surg · Jan 2014
Disordered conditioned pain modulation system in patients with posttraumatic cold intolerance.
Conditioned pain modulation (CPM) is a phenomenon of 'pain inhibiting pain' that is important for understanding idiopathic pain syndromes. Because the pathophysiology of posttraumatic cold intolerance is still unknown but it could involve similar mechanisms as idiopathic pain syndromes, we evaluated the functioning of the CPM system in patients with posttraumatic cold intolerance compared to healthy controls. ⋯ In this study, we found a CPM effect after a cold stimulus in both controls and patients. A significant weaker CPM effect compared to the controls was found, as in other chronic pain conditions. The CPM system within patients with cold intolerance is altered.
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Pedicled perforator flaps in the trunk such as the DIEAP or the IMAP-flap have increasingly been used for reconstructive purposes. However, perforator flaps of the upper abdominal wall derived from the SEA and DIEA have not been widely reported in literature. The aim of this study was to investigate the vascular basis of perforator flaps of the upper abdominal wall based on the epigastric vascular axis and to describe the location and size of the individual flaps. ⋯ Through selective injection of perforators, a reliable anatomy of SEAP- and DIEAP-flaps of the upper abdominal wall could be demonstrated. From a clinical point of view, subcostal SEAP-flaps are of special interest. These flaps may be rotated cranially for lower chest wall or breast reconstruction or deflected caudally for abdominal wall reconstructive purposes. The harvest site can be closed directly or via a reverse abdominoplasty procedure.