Plastic and reconstructive surgery
-
Plast. Reconstr. Surg. · Nov 2016
The Stanford-ReSurge Burn Scar Contracture Scale for Neck: Development and Initial Validation for Burn Scar Contracture.
Burn contractures can cause significant disability, particularly in patients in resource-limited settings. However, a gap exists in our ability to measure outcomes in patients with burn contractures of the neck. The objective of this study was to develop and validate the Stanford-ReSurge Burn Scar Contracture Scale-Neck to longitudinally assess functional status and measure functional improvement following contracture release of the neck. ⋯ The authors have created an outcome tool for measuring functional status following burn contracture release of the neck, which can easily be implemented in resource-limited settings where the burden of burn injuries and morbidities is disproportionately high. Ongoing work includes a multicountry study to evaluate validity and reliability.
-
Plast. Reconstr. Surg. · Nov 2016
Comparative StudyMedical Student Mentorship in Plastic Surgery: The Mentor's Perspective.
The reproducible benefits of mentoring to mentees have been studied extensively. However, insights from the mentor perspective are less well described. This study evaluates mentorship of plastic surgery medical students from the attending surgeon's perspective. A comparison is made with a previous publication evaluating mentorship from the medical student's perspective. ⋯ By comparing the perspectives on mentoring between attending surgeons and medical students, discrepancies and similarities were identified. These findings can be used to increase efficacy and strengthen mentoring efforts for medical students in plastic surgery.
-
Plast. Reconstr. Surg. · Nov 2016
Reinterpretation of Electrodiagnostic Studies and Magnetic Resonance Imaging Scans in Patients with Nontraumatic "Isolated" Anterior Interosseous Nerve Palsy.
Different hypotheses have been proposed for the pathophysiology of anterior interosseous nerve palsy: compression, fascicular constriction, or nerve inflammation (Parsonage-Turner syndrome). The authors hypothesized that critical reinterpretation of electrodiagnostic studies and magnetic resonance imaging scans of patients with a diagnosis of anterior interosseous nerve palsy could provide insight into the pathophysiology and treatment. ⋯ All patients in the authors' series with presumed isolated anterior interosseous nerve palsy had magnetic resonance imaging evidence of a more diffuse muscle involvement pattern, without any radiologic signs of nerve compression of the anterior interosseous nerve branch itself. These data strongly support an inflammatory pathophysiology.
-
Plast. Reconstr. Surg. · Oct 2016
ReviewSystematic Review of Liposomal Bupivacaine (Exparel) for Postoperative Analgesia.
Management of postoperative pain often requires multimodal approaches. Suboptimal dosages of current therapies can leave patients experiencing periods of insufficient analgesia, often requiring rescue therapy. With absence of a validated and standardized approach to pain management, further refinement of treatment protocols and targeted therapeutics is needed. Liposomal bupivacaine (Exparel) is a longer acting form of traditional bupivacaine that delivers the drug by means of a multivesicular liposomal system. The effectiveness of liposomal bupivacaine has not been systematically analyzed relative to conventional treatments in plastic surgery. ⋯ Liposomal bupivacaine is a safe method for postoperative pain control in the setting of plastic surgery and may represent an alternative to more invasive pain management systems such as patient-controlled analgesia, epidurals, peripheral nerve catheters, or intravenous narcotics.
-
Plast. Reconstr. Surg. · Oct 2016
A Retrospective Analysis of Secondary Revisions after Face Transplantation: Assessment of Outcomes, Safety, and Feasibility.
Face transplantation has emerged as a viable option for certain patients in the treatment of devastating facial injuries. However, as with autologous free tissue transfer, the need for secondary revisions in face transplantation also exists. The authors' group has quantified the number of revision operations in their cohort and has assessed the rationale, safety, and outcomes of posttransplantation revisions. ⋯ Therapeutic, V.