Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Oct 2008
Randomized Controlled TrialProspective, randomized, double-blind trial of local anesthetic infusion and intravenous narcotic patient-controlled anesthesia pump for pain management after free TRAM flap breast reconstruction.
: This study assessed the efficacy of a continuous infusion pump system for postoperative pain control at muscle-sparing transverse rectus abdominis musculocutaneous (TRAM) flap donor sites. ⋯ : The continuous infusion pump system appears to be a safe and effective method for postoperative donor-site pain management in TRAM flap breast reconstruction patients and should be considered for postoperative donor-site pain management. However, continuous infusion pump local anesthetic delivery to the muscle-sparing TRAM flap donor site did not eliminate narcotic use for pain control.
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Plast. Reconstr. Surg. · Oct 2008
Review Case ReportsCommunity-acquired methicillin-resistant staphylococcus aureus: diagnosis and treatment update for plastic surgeons.
: After studying this article, the participant should be able to: 1. Identify risk factors associated with community-acquired methicillin-resistant Staphylococcus aureus. 2. Recognize the clinical presentation of patients with community-acquired methicillin-resistant S. aureus. 3. Understand the treatment and indications for decolonization of patients who have community-acquired methicillin-resistant S. aureus infections. ⋯ : Community-acquired methicillin-resistant Staphylococcus aureus has evolved over the past 10 years as a new health threat seen by plastic surgeons and is an increasing cause of soft-tissue infections. This pathogen has several distinct virulence factors and unique antimicrobial susceptibilities that distinguish methicillin-resistant S. aureus from traditional hospital-acquired methicillin-resistant S. aureus. This article reviews the epidemiology, risk factors, clinical presentation, and treatment of community-acquired methicillin-resistant S. aureus.
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Plast. Reconstr. Surg. · Oct 2008
Cranial vault expansion in the management of postshunt craniosynostosis and slit ventricle syndrome.
Slit ventricle syndrome and postshunt craniosynostosis are uncommon complications after shunting procedures for congenital hydrocephalus. Slit ventricle syndrome occurs as a complication in 1 to 5 percent of patients after shunting procedures for hydrocephalus during infancy. These patients usually have had a shunt in place for years, with overdrainage of cerebrospinal fluid resulting in very small ventricles. Excessive intracranial decompression may result in ventricular collapse with the formation of slit-like ventricles and cranial vault collapse with secondary craniosynostosis. ⋯ Cranial vault expansion is a useful approach in the management of the restricted cranium associated with slit ventricle syndrome and postshunt craniosynostosis. This approach resulted in a decreased need for shunt revisions and improvement of neurologic symptoms and cranial vault shape.