Plastic and reconstructive surgery
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After studying this article, the participant should be able to: (1) Determine the need for operative treatment of metacarpal fractures. (2) Describe the position of immobilization for nonoperative treatment of fifth metacarpal fractures. (3) Assess the differences between intramedullary pinning and transverse pinning of displaced metacarpal fractures. (4) Compare the advantages of plating and pinning for treatment of displaced metacarpal fractures. (5) Recognize appropriate timing and treatment of open metacarpal fractures. ⋯ The body of evidence regarding the treatment of metacarpal fractures continues to grow. Conservative management, closed reduction with percutaneous Kirschner wire fixation, intramedullary fixation, and open reduction and internal fixation with plates and/or screws are all accepted treatment modalities. The goal of this review is to highlight the most recent literature and the best evidence available for the management of metacarpal fractures.
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Plast. Reconstr. Surg. · May 2014
Randomized Controlled TrialEffects of hypotensive anesthesia on blood transfusion rates in craniosynostosis corrections.
Hypotensive anesthesia is routinely used during craniosynostosis corrections to reduce blood loss. Noting that cerebral oxygenation levels often fell below recommended levels, the authors sought to measure the effects of hypotensive versus standard anesthesia on blood transfusion rates. ⋯ Therapeutic, II.
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Plast. Reconstr. Surg. · May 2014
Clinical TrialPerineal perforator-based island flaps: the next frontier in perineal reconstruction.
Perineal reconstruction is a challenging prospect. Conventional flap reconstruction often involves the sacrifice of a source artery and muscle, resulting in significant donor morbidity. Perforator flaps sought to overcome this but required tedious dissection. In this article, the authors introduce a new concept in perineal reconstruction using perforator-based island flaps. ⋯ Therapeutic, IV.
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Plast. Reconstr. Surg. · May 2014
Competency-based medical education for plastic surgery: where do we begin?
North American surgical education is beginning to shift toward competency-based medical education, in which trainees complete their training only when competence has been demonstrated through objective milestones. Pressure is mounting to embrace competency-based medical education because of the perception that it provides more transparent standards and increased public accountability. In response to calls for reform from leading bodies in medical education, competency-based medical education is rapidly becoming the standard in training of physicians. ⋯ The ideal curriculum should provide exposure to core principles of plastic surgery while demonstrating competence through performance of index procedures that are most likely to benefit graduating residents when entering independent practice and span all domains of plastic surgery. The authors advocate that exploring the role and potential benefits of competency-based medical education in plastic surgery residency training is timely.
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Plast. Reconstr. Surg. · May 2014
Surgical treatment of nipple malposition in nipple-sparing mastectomy device-based reconstruction.
This article discusses the senior author's (M.T.) experience with nipple-areola complex malposition following nipple-sparing mastectomy, surgical options for treatment, and an analysis of risk factors. ⋯ Risk, III.