Plastic and reconstructive surgery
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Recently, pain infusion pumps for postoperative pain control have gained popularity in many surgical specialties. This investigation was designed to evaluate the efficacy of a local anesthetic pain infusion pump in management of postoperative pain in abdominoplasty patients. ⋯ The postoperative use of pain pumps in abdominoplasty patients does not significantly improve pain management. Further investigation into this application of the pain pump is necessary before recommending their routine use in abdominoplasty patients.
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Plast. Reconstr. Surg. · Feb 2007
Reliability and validity testing of the Patient and Observer Scar Assessment Scale in evaluating linear scars after breast cancer surgery.
The Patient and Observer Scar Assessment Scale is a promising new method incorporating observer and patient ratings in evaluating burn scars. The authors compared this tool to the Vancouver Scar Scale in a cohort of women with linear scars from breast cancer surgery. ⋯ In surgical scar assessment, the new Patient and Observer Scar Assessment Scale and Vancouver Scar Scale were both associated with acceptable internal consistency and interobserver reliability. The new tool is more comprehensive and has higher correlation with patients' ratings. These findings support the use of the new tool as a reliable, valid, and comprehensive approach to assess linear surgical scars.
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Plast. Reconstr. Surg. · Feb 2007
Financial impact of hand surgery programs on academic medical centers.
This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. ⋯ While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.
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Plast. Reconstr. Surg. · Feb 2007
Microvascular reconstruction in burn and electrical burn injuries of the severely traumatized upper extremity.
As the versatility and variability of free flaps have significantly increased during recent years, so have the indications for free tissue transplantation in burn reconstruction expanded. ⋯ The authors' data demonstrate that burn and high-voltage injuries are distinct entities, each requiring custom-tailored reconstructive solutions for limb salvage. Even if the authors' flap failures all occurred during the first 6 weeks, it should not be forgotten that this type of coverage is the only alternative to amputation in selected cases.
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Conventional fasciocutaneous flaps in reconstructive surgery, especially in the lower extremities, have limited utility. Traditional flaps are essentially random pattern, often require delays, and are limited in mobility and reach. Islanded fasciocutaneous flaps pedicled on perforators can be raised anywhere on the body and have a reliable blood supply and greater freedom of movement. However, venous compromise is a common problem. ⋯ The perforator-plus flap appears to be a versatile and reliable option in lower limb injuries and other diverse indications, in both the emergency and the elective settings.