Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Dec 2014
Airway compromise following palatoplasty in Robin sequence: improving safety and predictability.
Prior studies report a high incidence of airway complications in patients with Robin sequence following palatoplasty. The authors' institution uses polysomnography to assess risk of airway compromise before palatoplasty in Robin sequence. This study compares airway complications in Robin sequence to cleft palate only using this screening airway protocol and identifies risk factors for airway complications after palatoplasty. ⋯ Screening polysomnography can control airway complications following palatoplasty in Robin sequence patients to a rate that is comparable to that of patients with cleft palate only.
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Plast. Reconstr. Surg. · Dec 2014
Latissimus dorsi breast reconstruction: how much nerve resection is necessary to prevent postoperative muscle twitching?
The latissimus dorsi muscle flap represents a valuable option in breast reconstruction but can result in postoperative twitching and retraction, discomfort, arm movement limitations, and breast deformation. These complications can be avoided by denervation of the thoracodorsal nerve; however, the optimal method of nerve management is unknown. This study presents the authors' experience with the outcomes of latissimus dorsi flaps for breast reconstruction in the light of thoracodorsal nerve management strategies. ⋯ Denervation of the latissimus dorsi is a safe and reliable procedure that should be performed at the time of breast reconstruction and should include more than 4 cm to achieve a nontwitching breast with a stable volume and shape.
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Plast. Reconstr. Surg. · Dec 2014
Randomized Controlled TrialPostoperative analgesia by infusion of local anesthetic into the surgical wound after modified radical mastectomy: a randomized clinical trial.
There is no consensus on the efficacy of postoperative infusion of local anesthetics after radical mastectomy. ⋯ Continuous infusion of local anesthetic reduces pain and analgesic consumption, with high satisfaction, but does not affect rates of nausea and vomiting.