Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 2005
Comparative StudyQuality of life and affective distress in women seeking immediate versus delayed breast reconstruction after mastectomy for breast cancer.
This study compared the presurgical psychosocial and functional status of 238 women seeking breast reconstruction, either at the time of their mastectomy (immediate) (n = 151) or after prior mastectomy (delayed) (n = 87). Delayed subjects were further categorized in groups of time-since-mastectomy to examine the effects of time on postmastectomy psychosocial adjustment. ⋯ Women seeking immediate reconstruction at the time of mastectomy show a relatively higher incidence of psychosocial impairment and functional disability. Women who undergo mastectomy demonstrate early restoration of psychosocial health within the first year after surgery. Patient preoperative psychosocial distress may have important implications for clinical decision-making and surgical outcome for women seeking combined mastectomy and breast reconstruction.
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Plast. Reconstr. Surg. · Sep 2005
Case ReportsAnatomy of Y-shaped configurations in the subscapular arterial system and clinical application to harvesting flow-through flaps.
A flow-through flap is useful in cases where the recipient artery must not be sacrificed. The aim of this study was to investigate Y-shaped configurations in the subscapular arterial system that can safely be used in harvesting a flow-through flap from the scapular region. ⋯ The results of our study are available for determining preoperatively and intraoperatively which Y-shaped configuration to use in harvesting a flow-through flap from the scapular region.
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Plast. Reconstr. Surg. · Sep 2005
Quality-of-life and outcome predictors following massive burn injury.
Quality of life is a major criterion when decisions regarding resuscitation, reconstruction, and rehabilitation of patients with massive burn injuries are being considered. There has been little research focusing on quality of life following burn injuries involving more than 50 percent total body surface area in the adult population. The authors' goals were to describe quality of life and identify specific clinical and functional indices that predict good quality of life following massive burn injuries. ⋯ Survivors of massive burn injury reported a good quality of life in most Short Form-36 domains. The authors identified the size of the total full-thickness injury and the age of the patient as factors available at the time of injury that predict quality of life. The addition of hand function and the patient's perceived level of social support at the time of follow-up improved prediction of quality of life. Accordingly, this information on quality of life after massive burn injury could aid in decision making at the time of resuscitation, reconstruction, and rehabilitation.
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Plast. Reconstr. Surg. · Sep 2005
Establishing a composite auricle allotransplantation model in rats: introduction to transplantation of facial subunits.
Allografts from cadaveric sources may be an alternative for replacing the missing auricle. In this report, the technical aspects of orthotopic composite auricle allotransplantation and an effective short-term immunosuppression protocol in a rat model are described. ⋯ It is feasible to elevate and transplant the composite auricle in rats as a single neurosensorial facial subunit. A tapered dose of cyclosporine A from 16 mg/kg to 8 mg/kg allows maintaining allograft survival for 30 days across a strong major histocompatibility complex barrier. This model is reliable and reproducible and has the potential to be used for future immunologic studies to prevent or to induce transplantation tolerance.