Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Aug 2012
Case ReportsEating out of the hand, maggots--friend or foe?
The presence of maggots (fly larvae) in an open wound is a repelling sight to many and documented cases of myiasis in the literature are scant due to the rarity of such infestation in live patients. A unique case of such a presentation is elaborated in a patient who sustained a crush injury to the hand. This case serves to highlight the unique challenges faced in treating such injuries and to raise the profile of maggots and their untapped potential use in biodebridement and management of open wounds in modern day wound care practices.
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J Plast Reconstr Aesthet Surg · Jul 2012
Comparative StudyImmediate 1-stage vs. tissue expander postmastectomy implant breast reconstructions: a retrospective real-world comparison over 18 months.
Postmastectomy implant breast reconstruction is typically accomplished in a two-stage process involving a tissue expander that is later exchanged for a permanent implant. Adoption of an immediate one stage reconstruction (1-stage) approach, where feasible, has been slowed by surgeon perception that this method is less likely to achieve acceptable results. ⋯ The results show that surgeons in the United States achieved substantially similar results in immediate postmastectomy implant breast reconstructions with 1-stage and TE approaches in terms of patient complications and returns for reconstruction-related services over 18 months. As evolving mastectomy techniques make 1-stage implant reconstructions more attractive, we hope these findings will motivate researchers to compare the approaches in more strictly controlled clinical studies.
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J Plast Reconstr Aesthet Surg · Jun 2012
Comparative StudyMedial sural perforator plus island flap: a modification of the medial sural perforator island flap for the reconstruction of postburn knee flexion contractures using burned calf skin.
The medial sural perforator island flap may be suitable for the reconstruction of postburn knee flexion contractures. However, postburn knee flexion contractures are usually associated with burns of the calf, which is the donor site of the medial sural perforator flap. Thus, there are concerns regarding the safety of raising medial sural perforator flaps from burned calves. ⋯ Although this series is not large, the authors are convinced that some reliable medial sural perforators are usually present under second-degree burned calf skin that healed by secondary intention, and that the medial sural perforator island flap or the medial sural perforator plus island flap can be safely used even though the skin may not be as pliable as normal skin.
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J Plast Reconstr Aesthet Surg · Jun 2012
Comparative StudyThe PIP mammary prosthesis: a product recall study.
Concerns about the durability of silicone breast implants manufactured by Poly Implant Prothèse (PIP) have been expressed for several years prior to their formal withdrawal from the market in March 2010. Although precise details of what elements were at fault remain unclear, concerns have been raised about both the elastomer and the filler gel. Media speculation has focussed on device safety, longevity and, recently, a possible association with lymphoma, specifically anaplastic large cell lymphoma (ALCL). There is however, no actual data concerning these implants with which to guide and inform when concerned patients seek advice. ⋯ Long-term studies such as this are difficult to undertake for a number of reasons as they place a significant additional burden of resources on a practice. They are, however, essential from an industry perspective both for the provision of information and supporting audit and professional standing. Being only a single-handed practice, this initial study is the tip of an iceberg that may affect 40,000 women in the UK with PIP implants, but it does provide some hard data with which to guide our patients. It is also believed to be the first independent product recall study in aesthetic breast surgery.