Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2009
Reconstruction of extensive composite posterolateral mandibular defects using nonosseous free tissue transfer.
The management of composite oromandibular defects involving the posterolateral mandible and surrounding soft tissue remains a reconstructive challenge. Although bony reconstitution restores continuity of the mandible, osteocutaneous flaps sometimes do not provide adequate soft-tissue coverage of these postablative defects. The purpose of this study was to evaluate the use of soft-tissue flaps for extensive posterolateral oromandibular defects. ⋯ Extensive composite defects of the posterolateral mandibular can be repaired effectively using soft-tissue flaps alone. When reconstructing a defect involving (1) the posterolateral mandible, overlying soft-tissues, and external skin and/or (2) the posterolateral mandible and two or more adjacent soft-tissue zones, the use of a soft-tissue flap alone can maximize success.
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Plast. Reconstr. Surg. · Oct 2009
ReviewEvidence-based patient safety advisory: patient assessment and prevention of pulmonary side effects in surgery. Part 1. Obstructive sleep apnea and obstructive lung disease.
Obstructive sleep apnea and obstructive lung disease may increase a patient's risk of perioperative pulmonary complications. This practice advisory provides an overview of the preoperative steps that should be performed to ensure appropriate patient selection and the safety of patients with these conditions. Also discussed are recommendations for perioperative management and strategies for minimizing complications.
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Plast. Reconstr. Surg. · Oct 2009
ReviewEvidence-based patient safety advisory: patient selection and procedures in ambulatory surgery.
Despite the many benefits of ambulatory surgery, there remain inherent risks associated with any surgical care environment that have the potential to jeopardize patient safety. This practice advisory provides an overview of the preoperative steps that should be completed to ensure appropriate patient selection for ambulatory surgery settings. In conjunction, this advisory identifies several physiologic stresses commonly associated with surgical procedures, in addition to potential postoperative recovery problems, and provides recommendations for how best to minimize these complications.