Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2010
Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes.
Autologous fat transplantation is a well-established technique in surgery. Moreover, the use of preadipocytes in soft-tissue engineering is currently being intensely investigated. Current efforts focus on identifying maneuvers that may minimize resorption and provide predictable late results. The aim of this study was to investigate the influence of different local anesthetics frequently used in clinical practice on the viability of preadipocytes and their ability to differentiate into adipocytes. ⋯ The authors' results show that there is a marked influence of local anesthetics not only on the quantity but also on the quality of viable preadipocytes as determined by their ability to differentiate into mature adipocytes. Therefore, these results should be considered in the context of autologous fat transfer and soft-tissue engineering.
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Plast. Reconstr. Surg. · Nov 2010
The prevalence of cervical spine injury, head injury, or both with isolated and multiple craniomaxillofacial fractures.
Several studies have reported the relationship among craniomaxillofacial fractures, cervical spine injuries, and head injuries with varying results. Life-threatening injuries to the head and cervical spine with devastating consequences cannot be missed by reconstructive surgeons during evaluation of facial trauma. The purpose of this study was to establish the prevalence of cervical spine injuries and/or head injuries with isolated and multiple craniomaxillofacial fractures at trauma centers across the United States. ⋯ This article represents the most accurate description of the prevalence of cervical spine and/or head injury with craniomaxillofacial fracture at trauma centers in the United States.
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Plast. Reconstr. Surg. · Nov 2010
Painless abdominoplasty: the efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery time.
Reducing postoperative pain following abdominoplasty is essential for shortening the length of recovery time, reducing the use of narcotics, promoting quicker return to normal activities, and maximizing overall patient satisfaction. The extended use of narcotics and pain pumps is often unacceptable because of nausea, restriction of normal activities, and inconvenience. When the recovery process is not too lengthy and debilitating for the patients, they are more likely to refer the procedure to others and to return for additional elective procedures. ⋯ This is the first study showing successful long-term relief of pain associated with abdominoplasty using a combination of intercostal, ilioinguinal, iliohypogastric, and pararectus blocks. This pain-block procedure significantly reduces the recovery time and allows the patient to return to normal activities and work much sooner.
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Plast. Reconstr. Surg. · Oct 2010
Institutional review board-based recommendations for medical institutions pursuing protocol approval for facial transplantation.
Preliminary outcomes from the previous nine face transplants performed since 2005 have been encouraging and have therefore led to a rise in the number of medical centers interested in establishing face transplant programs worldwide. However, until now, very little literature has been published providing surgeons the necessary insight on how to (1) prepare a protocol for institutional review board approval and (2) establish a face transplant program. ⋯ Every surgical department hoping to establish a face transplant program must realize that this endeavor requires both tremendous financial and long-term commitments by its medical institution. These transplants should be performed only within university-based medical centers capable of orchestrating a specialized, talented, multidisciplinary team. More importantly, facial composite tissue allotransplantation possesses an unmatched level of complexity and therefore requires most centers to prepare a carefully detailed protocol using these institutional review board-based guidelines.