Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · May 2011
Randomized Controlled Trial Multicenter Study Comparative StudyEfficacy of skin stretching for burn scar excision: a multicenter randomized controlled trial.
Burn survivors are frequently faced with disfiguring scars. Various techniques exist to improve scar appearance, such as laser treatment and dermabrasion. Next to that, surgical reconstruction, such as scar excision is an option. This randomized controlled trial investigates whether a larger burn scar can be excised using a skin-stretching device for wound closure, thereby optimizing use of adjacent healthy skin. This technique may allow scar excision in a one-step procedure instead of two or more steps, which is necessary for serial excision and tissue expansion. ⋯ In burn scar reconstructions, a significantly larger reduction in scar area can be achieved using a skin-stretching device compared with scar excision with no additional techniques, without an increased risk of complications. It was shown that skin stretching is of added value for scars that cannot be excised in a one-step procedure.
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Plast. Reconstr. Surg. · May 2011
ReviewAdult peripheral nerve disorders: nerve entrapment, repair, transfer, and brachial plexus disorders.
After reading this article, the participant should be able to: 1. Describe the pathophysiologic bases for nerve injury and how they apply to patient evaluation and management. 2. Recognize the wide variety of injury patterns and associated patient complaints and physical findings associated with peripheral nerve pathology. 3. Evaluate and recommend further tests to aid in defining the diagnosis. 4. Specify treatment options and potential risks and benefits. ⋯ Peripheral nerve disorders comprise a gamut of problems, ranging from entrapment neuropathy to direct open traumatic injury and closed brachial plexus injury. The pathophysiology of injury defines the patient's symptoms, examination findings, and treatment options and is critical to accurate diagnosis and treatment. The goals of treatment include management of the often associated pain and improvement of sensory and motor function. Understanding peripheral nerve anatomy is critical to adopting novel nerve transfer procedures, which may provide superior options for a variety of injury patterns.
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Plast. Reconstr. Surg. · May 2011
Comparative StudyAdherence to practice guidelines based on American Board of Plastic Surgery Maintenance of Certification data.
The American Board of Plastic Surgery Maintenance of Certification program includes the submission of 10 consecutive cases in one of 20 tracer modules for Performance in Practice evaluation. This has resulted in a wealth of data on the practice patterns of Board diplomates. The specific aim of this project was to examine these data to determine whether diplomates are adhering to evidence-based practice guidelines. ⋯ This study revealed that there were few guidelines with which to compare diplomate performance. Steps should be taken to increase the number of evidence-based practice guidelines for plastic surgery procedures.
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Plast. Reconstr. Surg. · Apr 2011
Early escharectomy and concurrent composite skin grafting over human acellular dermal matrix scaffold for covering deep facial burns.
Although escharectomy and full-thickness skin autografting have been widely used to treat deep facial burns, the clinical outcomes remain unacceptable. Composite razor-thin skin grafting over acellular dermal matrix scaffold has been used successfully in repairing burns of the trunk and limbs, but its use in covering deep facial burns has rarely been reported. In this study, the authors investigated the clinical outcomes of early escharectomy and concurrent composite razor-thin skin autografting and acellular dermal matrix scaffold for treating deep facial burns. ⋯ Early escharectomy and concurrent composite razor-thin skin autografting on top of acellular dermal matrix scaffold constitute an effective and favorable option for covering deep facial burns, especially for patients with limited donor sites.