Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Mar 2009
Comparative StudyFinal results of grafting versus neurolysis in obstetrical brachial plexus palsy.
The authors previously showed that neurolysis in obstetrical brachial plexus palsy resulted in improved function in some patients at 1 year's follow-up. In this study, the hypothesis that the long-term outcome of neuroma-in-continuity resection and nerve grafting yields better results than neurolysis was tested. ⋯ Early improvements in function produced by neurolysis in Erb's palsy were not sustained over time. Neuroma-in-continuity resection and nerve grafting for both Erb's and total palsy produced significant improvements in Active Movement Scores and in the proportion of patients demonstrating functionally useful scores. Neurolysis as a complete surgical treatment for obstetrical brachial plexus palsy should be abandoned in favor of neuroma resection and nerve grafting.
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Plast. Reconstr. Surg. · Mar 2009
Long-term follow-up experience with carbonated calcium phosphate cement (Norian) for cranioplasty in children and adults.
Despite the growing popularity of calcium-based bone cements as a cranioplasty material, the long-term success and complication rates of these materials remain largely controversial. The authors reviewed their extended experience with Norian, a carbonated calcium phosphate bone cement, for cranioplasty. ⋯ Norian is well suited for cranioplasty when used in moderate amounts for onlay applications, as evidenced by acceptable complication rates and contouring ability in this setting. Its use in large amounts as an onlay, inlay full-thickness cranial reconstruction of large defects or areas with potential bacterial contamination should be avoided. Complications or construct failure may occur months or even years after implantation, even under ideal circumstances.
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Plast. Reconstr. Surg. · Feb 2009
ReviewSimulation in plastic surgery training and education: the path forward.
Computer-based training simulators have been used extensively, most notably in flight simulation. Over the past 20 years, surgical simulators have been developed, initially for training of minimally invasive surgery and more recently for open surgical simulation. ⋯ The authors believe that a similar training plan should be mandated for plastic surgery, to take advantage of the use of computers, virtual reality, and simulation in the training of plastic surgery residents and to explore the value of this technology for continuing medical education and maintenance of certification. This article gives a brief background and history of surgical simulation and its technology, followed by a detailed description of the three phases of the American College of Surgeons' plan and how the authors propose that each phase be implemented, with modifications as applicable for trainees in plastic surgery.