Annals of plastic surgery
-
Annals of plastic surgery · Aug 2012
Management of full-thickness abdominal wall defects following tumor resection.
Abdominal wall reconstruction continues to evolve with improvement in technique and technology. This study reviews our experience with challenging full thickness (skin, muscle, and fascia) defects following tumor resections often in high-risk patients. ⋯ Abdominal wall reconstruction after full thickness tumor resection is challenging. It can be performed safely and effectively with attention to surgical technique, patients' risk of infection, and type of mesh. Acellular dermal matrix graft has been a useful addition to minimize morbidity and recurrence in these high-risk patients.
-
Annals of plastic surgery · Aug 2012
Case ReportsTwo-staged tendon reconstruction in flexor tendon ruptures secondary to fracture of the hamate hook.
We report a case of 2-staged reconstruction of flexor tendons ruptured spontaneously by attrition. A 49-year-old man presented with inability to flex the ring and little fingers of his left hand. Preoperative computed tomographic scans revealed fracture of the hamate hook. ⋯ Because the flexor tendon rupture secondary to the fracture of the hamate is extremely rare, and surgical outcomes of previous reports are not satisfactory, a decision was made to perform 2-staged reconstruction of ruptured flexor tendons. The surgical result was excellent with complete restoration of full range of motion. This report describes for the first time to our knowledge, the technique, and rehabilitation of 2-staged tendon reconstruction in a patient with hook of hamate fracture.
-
Annals of plastic surgery · Aug 2012
One-stage immediate breast reconstruction with implants: a new option for immediate reconstruction.
The current standard of care for breast implant reconstruction after mastectomy is 2-stage reconstruction with placement of tissue expanders followed by implants. The immediate use of implants at the time of mastectomy, which eliminates the need for a second operative procedure, has been sparsely reported and is not yet accepted as the standard of care. This study describes a 1-stage immediate implant reconstruction technique and evaluates its risks. ⋯ With complication rates similar to previously reported tissue expander reconstructions, immediate implant reconstruction is a viable alternative to 2-stage expander reconstruction, presenting many advantages over expander reconstruction while offering the same risk profile and eliminating the additional risks, costs, and discomfort of a second procedure. Additionally, aesthetic results were highly satisfactory according to patients themselves and based on evaluation by independent observers.