Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2010
The anatomy of the greater occipital nerve: Part II. Compression point topography.
Advances in the understanding of migraine trigger points have pointed to entrapment of peripheral nerves in the head and neck as a cause of this debilitating condition. An anatomical study was undertaken to develop a greater understanding of the potential entrapment sites along the course of this nerve. ⋯ There are six compression points along the greater occipital nerve. These can be located using the data from this study, serving as a guide for surgeons interested in treating patients with migraine headaches originating in these areas. Long-term relief from migraine headaches has been demonstrated clinically by using both noninvasive and surgical decompression of these points.
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Plast. Reconstr. Surg. · Nov 2010
Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes.
Autologous fat transplantation is a well-established technique in surgery. Moreover, the use of preadipocytes in soft-tissue engineering is currently being intensely investigated. Current efforts focus on identifying maneuvers that may minimize resorption and provide predictable late results. The aim of this study was to investigate the influence of different local anesthetics frequently used in clinical practice on the viability of preadipocytes and their ability to differentiate into adipocytes. ⋯ The authors' results show that there is a marked influence of local anesthetics not only on the quantity but also on the quality of viable preadipocytes as determined by their ability to differentiate into mature adipocytes. Therefore, these results should be considered in the context of autologous fat transfer and soft-tissue engineering.
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Plast. Reconstr. Surg. · Nov 2010
The prevalence of cervical spine injury, head injury, or both with isolated and multiple craniomaxillofacial fractures.
Several studies have reported the relationship among craniomaxillofacial fractures, cervical spine injuries, and head injuries with varying results. Life-threatening injuries to the head and cervical spine with devastating consequences cannot be missed by reconstructive surgeons during evaluation of facial trauma. The purpose of this study was to establish the prevalence of cervical spine injuries and/or head injuries with isolated and multiple craniomaxillofacial fractures at trauma centers across the United States. ⋯ This article represents the most accurate description of the prevalence of cervical spine and/or head injury with craniomaxillofacial fracture at trauma centers in the United States.
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Plast. Reconstr. Surg. · Nov 2010
Painless abdominoplasty: the efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery time.
Reducing postoperative pain following abdominoplasty is essential for shortening the length of recovery time, reducing the use of narcotics, promoting quicker return to normal activities, and maximizing overall patient satisfaction. The extended use of narcotics and pain pumps is often unacceptable because of nausea, restriction of normal activities, and inconvenience. When the recovery process is not too lengthy and debilitating for the patients, they are more likely to refer the procedure to others and to return for additional elective procedures. ⋯ This is the first study showing successful long-term relief of pain associated with abdominoplasty using a combination of intercostal, ilioinguinal, iliohypogastric, and pararectus blocks. This pain-block procedure significantly reduces the recovery time and allows the patient to return to normal activities and work much sooner.