Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 2007
Randomized Controlled TrialIntraoperative Sensorcaine significantly improves postoperative pain management in outpatient reduction mammaplasty.
Breast reduction is one of the most frequently performed plastic surgical procedures in the United States; more than 160,500 patients underwent the procedure in 2005. Many outpatient reduction mammaplasty patients report the greatest postoperative discomfort in the first 48 hours. The authors' investigated the effect of intraoperative topical application of the long-acting local anesthetic agent bupivacaine (Sensorcaine or Marcaine) on postoperative pain, time to postanesthesia care unit discharge, and postoperative use of narcotic medication. ⋯ This prospective, randomized, single-blind study demonstrates that a single dose of intraoperative Sensorcaine provides a safe, inexpensive, and efficacious way to significantly shorten the length of postanesthesia care unit stay and significantly decrease postoperative opioid analgesic use in patients undergoing ambulatory reduction mammaplasty.
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Plast. Reconstr. Surg. · Sep 2007
ReviewMeasuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments.
Patient-reported outcomes in cosmetic and reconstructive breast surgery are increasingly important for clinical research endeavors. Traditional surgical outcomes, centered on morbidity and mortality, remain important but are no longer sufficient on their own. Quality of life has become a crucial research topic augmenting traditional concerns focused on complications and survival. Given this, reliable and valid patient questionnaires are essential for aesthetic and reconstructive breast surgeons. ⋯ Valid, reliable, and responsive instruments to measure patient-reported outcomes in cosmetic and reconstructive breast surgery are lacking. To demonstrate the benefits of aesthetic and reconstructive breast surgery, future research to rigorously develop and validate new cosmetic and reconstructive breast surgery-specific instruments is needed.
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Plast. Reconstr. Surg. · Sep 2007
Free tissue transfer to the lower extremity distal to the zone of injury: indications and outcomes over a 25-year experience.
Microvascular free flap anastomoses performed for lower extremity reconstruction are traditionally proximal to the zone of injury. The authors assessed the feasibility and outcomes of microvascular free flaps with anastomoses performed distal to the zone of injury. ⋯ The authors' extensive 25-year experience with lower extremity reconstruction demonstrates that in appropriately selected patients, free tissue transfer to recipient vessels distal to the zone of injury is reliable and in certain cases preferable.
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Plast. Reconstr. Surg. · Sep 2007
Dorsal intercostal artery perforator flap: anatomical study and clinical applications.
The posterior intercostal arteries form the largest angiosome in the torso by means of their many perforators to the skin, the arteries of which are proposed to be the vascular pedicle of an island flap. Using these perforators, the authors developed a new flap, the dorsal intercostal artery perforator flap, harvested in the back. ⋯ Flap extendibility and less invasiveness without sacrifice of the underlying muscles have proved that the dorsal intercostal artery perforator flap is a new reconstructive option in the back, where suitable flaps are often proposed.