Annals of plastic surgery
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Annals of plastic surgery · Oct 2013
Comparative StudyIncisional negative-pressure wound therapy versus conventional dressings following abdominal wall reconstruction: a comparative study.
Improvements in surgical techniques have allowed us to achieve primary closure in a high percentage of large abdominal hernia repairs. However, postoperative wound complications remain common. The benefits of negative-pressure wound therapy (NPWT) in the management of open abdominal wounds are well described in the literature. Our study investigates the effects of incisional NPWT after primary closure of the abdominal wall. ⋯ This study suggests that incisional NPWT following abdominal wall reconstruction significantly improves rates of wound complication and skin dehiscence when compared with conventional dressings. Prospective, randomized, controlled studies are needed to further characterize the potential benefits of this therapy on wound healing after abdominal wall reconstruction.
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Annals of plastic surgery · Oct 2013
Multicenter StudyPredictors of readmission after breast reconstruction: a multi-institutional analysis of 5012 patients.
Recent health care legislation institutes penalties for surgical readmissions secondary to complications. There is a paucity of evidence describing risk factors for readmission after breast reconstruction procedures. ⋯ This is the first study of readmission rates after breast reconstruction. Knowledge of specific risk factors for readmission may improve patient outcomes, steer strategies for optimizing reconstructive outcomes, and minimize readmissions.
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Annals of plastic surgery · Oct 2013
Case ReportsModified superficial circumflex iliac artery perforator flap and supermicrosurgery technique for lower extremity reconstruction: a new approach for moderate-sized defects.
The superficial circumflex iliac artery perforator (SCIP) flap is an evolved form of groin flap. It overcomes the inherent disadvantages of the groin flap by preserving the deep fascia but still requires challenging skills because of short pedicles and small caliber of vessels. The use of SCIP flap was evaluated for lower extremity use. ⋯ With the modification of elevating the flap on the superficial fascia, we can harvest a thin flap without additional debulking and avoid complications such as lymphorrhea. Furthermore, with the perforator to perforator or perforator to small distal vessel approach, we can apply this flap on all regions of the lower extremity overcoming the difficulties with short pedicle and small vessel caliber. In our hands, the modified SCIP flap is the flap of choice for small to moderate size defects in the lower extremity.
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Annals of plastic surgery · Oct 2013
Case ReportsPeripheral nerve surgery for the treatment of postherpetic neuralgia.
Postherpetic neuralgia is a chronic pain condition that develops in some patients after the resolution of herpes zoster, and has no medical cure. Medications used to treat chronic pain do not hasten resolution of the disorder and may impair function. ⋯ Of the 3 treated patients, all had resolution of chronic pain after surgery. It is concluded that peripheral nerve surgery offers a promising option to improve pain and quality of life in postherpetic neuralgia patients, without affecting systemic functioning.
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Annals of plastic surgery · Oct 2013
International plastic surgery missions: a framework for resident education using the CanMEDS competencies.
Residency education has shifted over the past decade in an attempt to graduate well-rounded physicians. There is a recognition that a physician's abilities must extend beyond medical knowledge. The Royal College of Physicians and Surgeons of Canada introduced the CanMEDS physician competency framework in 2005. ⋯ Through these trips, residents gain surgical experience, see a variety and volume of clinical cases, and have the opportunity to travel to a foreign country and experience different cultures. We believe that international plastic surgery surgical missions also provide an exceptional micro environment for the teaching of CanMEDS roles. Using examples from residents' personal experiences on international plastic surgery missions to China, Mali, and Cambodia, we describe the benefits of these missions in transferring the CanMEDS competencies to resident training.