Journal of plastic surgery and hand surgery
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J Plast Surg Hand Surg · Jan 2016
Randomized Controlled TrialThe importance of needle gauge for pain during injection of lidocaine.
Local anaesthetics such as lidocaine are used both in minor and major surgical procedures, and can be painful. Different methods have been investigated to reduce the discomfort of the injections. This study investigated if different needle gauges can influence the pain experienced during injection of lidocaine. ⋯ A significant preponderance of respondents stated that there had been less pain using the thinnest needle. Mean VAS responses showed the same trend, but the differences between them were not statistically significant.
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J Plast Surg Hand Surg · Jun 2015
The cost of major complications associated with immediate two-stage expander/implant-based breast reconstruction.
Previous studies assessing the costs associated with two stage expander/implant (E/I) reconstruction rarely include the cost of complications. The purpose of this study is to analyze the complication costs associated with a single institution experience with immediate E/I reconstruction. All immediate two stage E/I reconstructions at a single institution between March 2005-April 2011 were reviewed. ⋯ Unplanned readmissions or unplanned visits to the operative room significantly increased total reconstructive costs (p < 0.001 and p < 0.001, respectively). In conclusion, prosthetic infection and prosthetic exposure significantly increased costs associated with immediate two-stage E/I reconstruction, as did unplanned readmissions and unplanned visits to the operative room. In the current state of the US healthcare system, it is becoming more important for surgeons to be conscious of the economic burden associated with poor reconstructive outcomes.
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J Plast Surg Hand Surg · Jan 2015
Increased anaesthesia duration increases venous thromboembolism risk in plastic surgery: A 6-year analysis of over 19,000 cases using the NSQIP dataset.
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality, particularly in the postoperative setting. Various risk stratification schema exist in the plastic surgery literature, but do not take into account variations in procedure length. The putative risk of VTE conferred by increased length of time under anaesthesia has never been rigorously explored. ⋯ This study validates the long-held view that increased surgical duration confers risk of VTE, as well as benchmarks VTE rates in plastic surgery procedures. While this in itself does not suggest an intervention, surgical time under general anaesthesia would be a useful addition to existing risk models in plastic surgery.
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J Plast Surg Hand Surg · Dec 2014
Case ReportsFunctional reconstruction of bilateral injuries to the dorsum of hand using radial forearm tendocutaneous flaps.
We treated a patient with skin and tendon defects of both hands as a result of injury by a heat press. There have been no reports of bilateral hand injuries being treated using simultaneous bilateral tendocutaneous flaps. In this case, we reconstructed the injured tissue using simultaneous bilateral radial forearm tendocutaneous flaps, with satisfactory results.
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J Plast Surg Hand Surg · Dec 2014
Case ReportsReconstruction of the left thumb with a second toe transfer in a musician's hand.
The free microvascular transfer of toes for reconstruction of the thumb remains to be an area of interest in microsurgery. The goal of reconstruction is to restore the prehensile abilities of the thumb, while achieving acceptable appearance and minimizing morbidity at the donor site. ⋯ The traditional method of playing the Saz is to pluck the strings with the fingers of the right hand and pick the strings with the thumb and fingers of the left hand. Three months after the operation, he was playing the saz again, proving that he had sufficient strength in opposition, adduction, and flexion force in the transferred toe.