Annals of plastic surgery
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Annals of plastic surgery · Sep 2011
ReviewConcomitant face and hand transplantation: perfect solution or perfect storm?
Face and hand composite tissue allotransplantations have evolved into a promising subset of reconstructive transplant surgery due to recent advances in immunotherapy. Concomitant composite tissue allotransplantation, which involves a variable combination of facial (myocutaneous versus osteomyocutaneous) and upper extremity (ie, various levels) composite subtypes, has been performed infrequently at this time. In this review, we will describe many reasons as to why this field remains unexplored. Undoubtedly, future investigation is warranted to investigate the potential advantages and disadvantages of using this approach versus a staged manner for alloreconstruction and to identify the complexities of cortical reorganization and rehabilitation in this setting.
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Annals of plastic surgery · Sep 2011
Prediction of mortality in patients with major burns: clinical and biochemical factors.
The plasma electric charge, in addition to clinical factors, was considered to improve the prediction of mortality in patients with major burns. ⋯ [Na(+)], [HCO(3)(-)] (bicarbonate), and [Cl(-)] are the ions contributing the most to the plasma charge equilibrium in patients with major burns; a loss of 50% of plasma proteins in the first 48 hours is equivalent to the loss of 1 mmol/L of HCO(3)(-). Moreover, the consideration of plasma biochemical parameters in the first 48 hours may improve the mortality predictive equation of mortality for burned victims.
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Annals of plastic surgery · Sep 2011
Nonincisional osteotomy for gradual lengthening by callus distraction in the hand and foot.
Gradual lengthening by distraction osteogenesis is widely used for brachydactyly. The most frequent postoperative complaint of the patients treated with this method is the appearance of the scar caused by the skin incision for the osteotomy, which is an integral technique of distraction osteogenesis. A nonincisional approach to osteotomy would reduce the dorsal scarring. ⋯ Of 14 digits, 13 digits achieved the target length and sufficient bone consolidation and 1 digit showed early consolidation. There was no case in which complications occurred because of the drilling. Nonincisional osteotomy for callus distraction in the hand and foot reduced dorsal longitudinal scarring and achieved good cosmetic results as compared with an ordinary osteotomy involving skin incision.