Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · May 2010
Case ReportsHemifacial resurfacing with prefabricated induced expanded supraclavicular skin flap.
Severe facial burn sequelae present a great challenge and maximally test the principles of reconstructive surgery. Three of these basic principles--free tissue transfer, flap prefabrication, and tissue expansion--are combined to achieve superior reconstructive outcomes. This approach evolved into the prefabricated induced expanded flap, which refers to the staged transfer of expanded supraclavicular skin with an antebrachial fascial free flap used as the carrier. ⋯ The supraclavicular prefabricated induced expanded flap can provide ample amounts of vascularized, thin, and desirable skin with perfect color match for resurfacing major facial defects. The aesthetic and functional results were encouraging and progressively improved during follow-up.
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Plast. Reconstr. Surg. · May 2010
Anatomy of the auriculotemporal nerve: variations in its relationship to the superficial temporal artery and implications for the treatment of migraine headaches.
Clinical experience with surgical decompression of specific peripheral nerves in the head and neck for the relief of migraine headache symptoms has proven to be effective in most patients. Some patients, however, continue to have residual symptoms after these procedures. In an effort to better understand potential etiologies for failure of treatment, an investigation was performed to determine whether or not vascular-mediated peripheral trigger points exist that have heretofore been undescribed that may be contributing to persistent symptomatology. One such potential trigger point is the superficial temporal artery's interaction with the auriculotemporal nerve. A cadaveric investigation was performed to advance this anatomical understanding of this relationship. ⋯ There are variations in the relationship between the auriculotemporal nerve and the superficial temporal artery. These variations may serve as an anatomical explanation for this point as a source of migraine headaches in some patients. A topographical map of the relationship between these two structures may serve as a guide for surgeons interested in decompressing the nerve from the artery when indicated.
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Plast. Reconstr. Surg. · May 2010
Comparative StudyDermal substitution in acute burns and reconstructive surgery: a 12-year follow-up.
Application of dermal substitutes has been reported to improve the outcome of burns. However, the long-term effectiveness of dermal substitutes has not been investigated objectively. The aim of this study was to evaluate long-term effectiveness of a collagen-elastin dermal substitute in acute and reconstructive burn surgery. ⋯ In this first long-term and objective follow-up of dermal substitution, the authors found improved scar parameters in both acute and reconstructive wounds treated with the substitute, indicating a long-lasting effect on scar quality.
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Plast. Reconstr. Surg. · May 2010
The patient-reported impact of scars measure: development and validation.
Skin scars have a unique impact on patients' lives. Quantification with disease-specific patient-reported outcome measures is essential for assessing disease severity. This study aimed to develop and validate the first scar-specific patient-reported outcome measure. ⋯ The Patient-Reported Impact of Scars Measure is the first scientifically rigorous, scar-specific, patient-reported outcome measure. It has two unidimensional scales with good psychometric and scaling properties. It is well accepted by patients and easy to use, and should prove valuable for assessing scar disease severity in clinical trials and in general and specialty clinics.