Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Aug 2010
Comparative StudyOptimizing closed reduction of nasal and zygomatic arch fractures with a mobile fluoroscan.
Although closed reductions of nasal fractures and zygomatic arch fractures are considered minor procedures, improper reductions are not uncommon. Objectively evaluating reduction adequacy with imaging assistance during surgery is crucial. The authors used mobile Fluoroscan intraoperatively to assess the adequacy of closed reduction for nasal fractures and zygomatic arch fractures. ⋯ The mobile Fluoroscan provides direct visualization of the fracture site and instruments and improves the outcomes of closed reduction.
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Plast. Reconstr. Surg. · Aug 2010
Comparative StudyPlastic surgery chief resident clinics: the current state of affairs.
One of the goals of plastic surgery residency programs is to provide effective training in aesthetic surgery. Recently, programs have adopted the idea of chief clinics to provide senior residents with the opportunity to perform cosmetic surgery with an increased level of autonomy. The goal of this article is to characterize chief clinics currently in place and their usefulness in providing effective training in plastic surgery under the precepts set forth by the Accreditation Council for Graduate Medical Education. ⋯ A majority of plastic surgery training programs use the chief clinic model to enhance resident education. These clinics vary in makeup and case distribution but serve as an effective way of teaching autonomy, surgical maturity, and the six Accreditation Council for Graduate Medical Education core competencies.
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Plast. Reconstr. Surg. · Aug 2010
The zygomaticotemporal branch of the trigeminal nerve: Part II. Anatomical variations.
Musculofascial and vascular entrapments of peripheral branches of the trigeminal nerve have been thought to be trigger points for migraine headaches. Surgical decompression of these sites has led to complete resolution in some patients. The zygomaticotemporal branch of the trigeminal nerve has been shown clinically to have sites of entrapment within the temporalis. A cadaveric study was undertaken to elucidate and delineate the location of this nerve's foramen and intramuscular course. ⋯ The zygomaticotemporal branch of the trigeminal nerve is a site for migraine genesis; surgical decompression or chemodenervation of the surrounding temporalis can aid in alleviating migraine headache symptoms. Advances in the understanding of the anatomy of this branch of the trigeminal nerve will aid in more effective surgical decompression.
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Plast. Reconstr. Surg. · Jul 2010
Comparative StudyIrradiated autologous breast reconstructions: effects of patient factors and treatment variables.
Postmastectomy irradiation often negatively impacts breast reconstruction outcomes. Further investigation is necessary to recognize factors contributing to adverse results. The purpose of this study was to (1) accurately assess the impact of radiation on autologous breast reconstruction and (2) identify patient and treatment factors affecting reconstructive outcomes. ⋯ Patient-specific factors, including diabetes mellitus and smoking, increase the risk of postirradiation parenchymal changes, and neoadjuvant chemotherapy is associated with a greater than twofold increase in skin complications. Breast reconstruction followed by irradiation can be successful, but patients with specific risks should be aware of increased complication rates.