Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2019
Algorithm for Free Perforator Flap Selection in Lower Extremity Reconstruction Based on 563 Cases.
Microsurgical lower extremity reconstruction remains a challenge. The use of perforator flaps in lower extremity reconstruction is expanding. The authors present an algorithm to guide in the selection of the ideal free perforator flap that can be tailored to each lower extremity defect. ⋯ Therapeutic, IV.
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Plast. Reconstr. Surg. · Nov 2019
Outcomes in Patients Receiving Neoadjuvant Chemotherapy Undergoing Immediate Breast Reconstruction: Effect of Timing, Postoperative Complications, and Delay to Radiation Therapy.
Neoadjuvant chemotherapy is offered to many patients with breast cancer. In patients undergoing mastectomy and immediate breast reconstruction, there is concern that this treatment could increase postoperative complications. The authors characterize which patients are at a higher risk of experiencing a postoperative complication, and assess the impact of postoperative complications on timing of radiation treatment. ⋯ Risk, III.
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Plast. Reconstr. Surg. · Sep 2019
Prophylactic Regenerative Peripheral Nerve Interfaces to Prevent Postamputation Pain.
Postamputation pain affects a large number of individuals living with major limb loss. Regenerative peripheral nerve interfaces are constructs composed of a transected peripheral nerve implanted into an autologous free muscle graft. The authors have previously shown that regenerative peripheral nerve interfaces can be used to treat symptomatic end neuromas that develop after major limb amputation. In this study, they investigated the potential of prophylactic interfaces to prevent the formation of symptomatic neuromas and mitigate phantom limb pain. ⋯ Therapeutic, III.
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Plast. Reconstr. Surg. · Sep 2019
Comparative StudyCell-Enriched Fat Grafting Improves Graft Retention in a Porcine Model: A Dose-Response Study of Adipose-Derived Stem Cells versus Stromal Vascular Fraction.
Cell-enrichment of fat grafts has produced encouraging results, but the optimal concentrations and types of added cells are unknown. The authors investigated the effects of enrichment with various concentrations of ex vivo-expanded adipose-derived stem/stromal cells and stromal vascular fraction on graft retention in a porcine model. ⋯ Cell-enriched fat grafting improved graft retention and was feasible in this porcine model. No significant differences in graft retention were observed among the various adipose-derived stem/stromal cell concentrations or between adipose-derived stem/stromal cell and stromal vascular fraction enrichment. Future studies using this model can help improve understanding of the role of adipose-derived stem/stromal cells in cell-enriched fat grafting.
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Plast. Reconstr. Surg. · Sep 2019
ReviewLocal Anesthetic Systemic Toxicity: A Narrative Literature Review and Clinical Update on Prevention, Diagnosis, and Management.
The objective of this narrative review of local anesthetic systemic toxicity is to provide an update on its prevention, diagnosis, and management. ⋯ All physicians who administer local anesthetics should be educated regarding the nature of systemic toxicity and contemporary management algorithms that include lipid emulsion therapy.