Annals of plastic surgery
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Annals of plastic surgery · May 2013
Factors affecting complications in radiated breast reconstruction.
Breast irradiation in combination with breast reconstruction is associated with increased complications. Because of the diminishing threshold for radiotherapy, breast reconstruction irradiation is rising. Our aim was to evaluate factors affecting outcomes in irradiated breast reconstructions. ⋯ Radiation after prosthetic reconstruction may produce an increase in failure rates. The use of ADMs in the face of breast irradiation increases the likelihood of a complication requiring reoperation.
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Annals of plastic surgery · May 2013
Laser-assisted indocyanine green angiography: a critical appraisal.
Laser-assisted indocyanine green angiography (ICG-A) has been promoted to assess perfusion of random skin, pedicled, and free flaps. Few studies address its potential limitations. ⋯ Indocyanine green angiography often confirmed our clinical/radiologic findings in abdominal perforator and fasciocutaneous flaps. It tended to underestimate perfusion in pedicle and skin flaps. When clinical examination was obvious, ICG-A rendered clear-cut findings. When clinical examination was equivocal, ICG-A tended to provide ambiguous findings, demonstrating that a distinct cutoff point does not exists for every patient or flap. Indocyanine green angiography is a promising but expensive technology that would benefit from standardization. Further research is needed before ICG-A can become a reliable tool for surgeons.
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Annals of plastic surgery · May 2013
Case ReportsUse of osteogenesis distractors in cloverleaf skull reconstruction.
Cloverleaf skull deformity (Kleeblattschädel-Syndromen, trilobular skulls) results from synostosis of multiple cranial sutures. The number of sutures involved, the pathogenesis of the synostosis, and the associated anomalies and syndromes are variable. All forms of cloverleaf skull are associated with a high morbidity and mortality. ⋯ Maximal advancement of the forehead/brow at the initial surgery is usually not enough to correct the associated proptosis and a second brow advancement must be done. We present a patient with Apert syndrome and cloverleaf skull deformity that required early (1 month old) cranial vault decompression due to severe proptosis and papilledema. Our management included the placement of osteogenesis distracters on the forehead/brow to gain additional advancement and expand the soft tissue.