Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jan 2011
Case ReportsSecondary refinements of free perforator flaps for lower extremity reconstruction.
The aim of lower extremity reconstruction has focused on early wound coverage and functional recovery but rarely aesthetics. Free muscle flaps provide durable coverage; however, they require skin graft coverage and result in muscle atrophy limiting future revisions. Perforator-based flap reconstructions can be easily elevated to allow for both orthopedic and contouring procedures. The authors reviewed the role of secondary procedures in achieving improved functional and aesthetic results following perforator flap reconstruction of lower extremity defects. ⋯ Limb salvage remains the primary goal of lower extremity reconstruction. Following convalescence and functional recovery, however, appearance becomes increasingly important with regard to quality of life. Initial flap selection with free perforator flaps, meticulous inset, and secondary refinements provide superior functional and aesthetic outcomes.
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Plast. Reconstr. Surg. · Jan 2011
Comparative StudyComparison of single versus double nerve transfers for elbow flexion after brachial plexus injury.
Restoration of elbow flexion is commonly achieved with nerve transfer to the musculocutaneous nerve branches after upper trunk brachial plexus injury. It is unknown if double nerve transfer to the biceps and brachialis nerve branches results in greater strength than single nerve transfer to the biceps branch alone. ⋯ Outcomes are similar between the two groups for elbow flexion and supination strength. Postoperative Disabilities of the Arm, Shoulder, and Hand scores are similar in single and double nerve transfer patients.
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Plast. Reconstr. Surg. · Jan 2011
Reconstruction of high maxillectomy defects with the fibula osteomyocutaneous flap in combination with titanium mesh or a zygomatic implant.
This retrospective review examined the authors' patients who underwent reconstruction of high maxillectomy defects with fibula osteomyocutaneous flaps in combination with titanium mesh or a zygomatic implant. Outcome assessments included aesthetic, speech, and masticatory function. ⋯ Reconstruction of high maxillectomy defects with the fibula osteomyocutaneous flap in combination with titanium mesh or a zygomatic implant is a feasible and acceptable option with a high success rate, a low complication rate, excellent postoperative cosmesis, and well-accepted function.
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Surgeons use eponymous instruments daily, yet the stories behind these instruments are often lost in history. The authors have selected eponymous instruments commonly used in plastic surgery and provide a brief biography of the surgeons who invented them. This list represents more than two centuries of surgical history, and the physicians come from a number of disciplines, including general surgery, plastic surgery, ophthalmic surgery, and rural medicine. Remembering the life stories of surgeon inventors enriches our understanding of the history of our profession and allows us to appreciate our instruments instead of taking them for granted.