Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 2011
Review Meta AnalysisRisk factors for complications of tissue expansion: a 20-year systematic review and meta-analysis.
Tissue expansion is a widespread and accepted concept in plastic and reconstructive surgery and burn treatment but is also associated with a variety of complications. Most research does not reveal the risk factors for multiple complications of tissue expansion. To determine the risk factors for tissue expansion complications and to evaluate average complication rates, the authors performed a systematic review and meta-analysis of observational studies exploring risk factors for complications of tissue expansion. ⋯ Risk, II.
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Plast. Reconstr. Surg. · Sep 2011
ReviewAnaplastic large T-cell lymphoma and breast implants: a review of the literature.
Anecdotal reports and one case-control study suggested an association, without evidence of causation, between breast implants and anaplastic lymphoma kinase-negative anaplastic large T-cell lymphoma (ALCL), a rare non-Hodgkin's lymphoma. This review summarizes the published evidence, including case reports and epidemiologic studies. ⋯ Risk, V.
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Plast. Reconstr. Surg. · Sep 2011
Volunteers in plastic surgery guidelines for providing surgical care for children in the less developed world: part II. Ethical considerations.
Many international volunteer groups provide free reconstructive plastic surgery for the poor and underserved in developing countries. An essential issue in providing this care is that it meets consistent guidelines for both quality and safety-a topic that has been addressed previously. An equally important consideration is how to provide that care in an ethical manner. No literature presently addresses the various issues involved in making those decisions. ⋯ Any group seeking to undertake an international mission trip in plastic surgery should be able to go to one source to find a detailed discussion of the perceived needs in providing ethical humanitarian care. This document was created to satisfy that need and is a companion to our original guidelines addressing safety and quality.
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Plast. Reconstr. Surg. · Sep 2011
Long head of the triceps branch transfer to axillary nerve in C5, C6 brachial plexus injuries: anterior approach.
Shoulder abduction is a very complex movement and quite important for upper limb function, as more distal functions depend on a stable shoulder, especially in C5, C6 brachial plexus injuries. Various studies in the literature have emphasized the importance of improved functional outcome and shoulder reanimation with concomitant neurotization of suprascapular nerve and axillary nerve in C5, C6 brachial plexus injuries. A number of approaches to axillary nerve transfer in brachial plexus injuries have been reported. The author describes an innovative anterior deltopectoral approach for axillary nerve transfers in five patients with C5, C6 brachial plexus injuries. The spinal accessory nerve was neurotized with the suprascapular nerve through a transverse supraclavicular incision. The axillary nerve and the long head of the triceps branch were identified through the anterior deltopectoral approach and neurotized at the posterior cord level. This approach gives easy access to other donors such as the medial pectoral, thoracodorsal, and median and ulnar nerves. Oberlin's transfer was also performed for elbow flexion by extending the deltopectoral incision. The regained shoulder active abduction (M5) averaged 120 degrees and active external rotation averaged 65 degrees at the final follow-up of 26 months (average). This anterior deltopectoral approach is an excellent alternative for axillary nerve transfer in brachial plexus injuries and produces results comparable with those of other approaches. All brachial plexus surgeons must understand the anatomy and the relationship of the axillary nerve to the surrounding structures. ⋯ Therapeutic, V.