Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Dec 2011
The effects of topically applied silicone gel and its silver derivative on the prevention of hypertrophic scarring in two rabbit ear-scarring models.
Topically applied silicone gel is an effective treatment in the management of hypertrophic scars. This early study of silicone gel predates other well-controlled scientific studies that demonstrate these findings. Our well-established rabbit ear scarring model creates 7 mm punch wounds down to the bare cartilage, including the removal of the perichondrium. ⋯ Silicone gel silver significantly reduced scar elevation index (p=0.004). The new 10 mm scar model resulted in more hypertrophic scarring than the typical, 7 mm wound scar model (p=0.0001). In conclusion, silicone gel and its silver derivative are effective in preventing hypertrophic scarring and scar models that leave the perichondrium intact causes scars with more hypertrophy.
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J Plast Reconstr Aesthet Surg · Nov 2011
Superficial peroneal and sural nerve transfer to tibial nerve for restoration of plantar sensation after complex injuries of the tibial nerve: cadaver feasibility study.
Nerve reconstruction following lower-extremity nerve injuries usually leads to worse outcomes in comparison with upper-extremity injuries due to the long distances of nerve regeneration. This study was performed to consider the clinical application of distal nerve transfer for the treatment of long gaps of the tibial nerve (TN) and in established compartment syndrome. It aimed to determine the anatomic suitability of transferring the sural nerve (SN) in combination with the superficial peroneal nerve (SPN) to the TN at the level of the tarsal tunnel for restoration of plantar sensation. ⋯ Distal nerve transfer using the SN in combination with the SPN is an anatomically reliable procedure, being a potential alternative to the use of nerve grafts in reconstruction of long gaps of the TN. In addition, selected patients with compartment syndrome may also benefit from this transfer to restore plantar sensation.
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J Plast Reconstr Aesthet Surg · Nov 2011
Cryptotia correction--the post-auricular transposition flap.
Cryptotia is a congenital ear deformity in which the upper pole appears buried beneath mastoid skin. Here we describe our method of cryptotia correction which we have used to good effect with minimal complications. ⋯ The post-auricular flap is a simple technique, retaining the depth of the auriculotemporal sulcus, providing a good skin colour match without the need for skin grafting and without distorting the hair line. Our results are comparable or superior to those seen with other techniques previously described.
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J Plast Reconstr Aesthet Surg · Oct 2011
Meta Analysis Comparative StudyGeneral anaesthesia versus thoracic paravertebral block for breast surgery: a meta-analysis.
Thoracic paravertebral block (TPVB) offers an attractive alternative to general anaesthesia (GA) for ambulatory breast surgery. The aim of this meta-analysis was first to evaluate the safety and efficacy of TPVB for breast surgery, and second to compare TPVB with GA with regard to postoperative pain, nausea and vomiting, opioid consumption and length of hospital stay. ⋯ TPVB provides effective anaesthesia for ambulatory breast surgery and can result in significant benefits over GA. However, further studies are required to determine whether these advantages would still be present if an optimal technique for outpatient GA is employed. Adjunctive ultrasonography may contribute to improve the safety of TPVB in breast surgery and requires further investigation.
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J Plast Reconstr Aesthet Surg · Oct 2011
Case ReportsFoot reanimation via nerve transfer to the peroneal nerve using the nerve branch to the lateral gastrocnemius: case report.
Injury to the peroneal nerve can be devastating to a patient's daily function. By paralyzing the ankle dorsiflexors, peroneal neuropathy results in foot drop. Gait difficulties and other functional limitations impede these patients on a daily basis. ⋯ This 18 year old male underwent foot reanimation via nerve transfer to the peroneal nerve using the branch from the lateral gastrocenus to tibalias anterior muscle branch. The patient was followed and assessed for function during the subsequent two years. This case reports provides a synopsis of this patient's surgical treatment, as well as a glance into the literature surrounding peroneal nerve transfer.