Annals of plastic surgery
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Annals of plastic surgery · Mar 2017
Case ReportsSimple Skin-Stretching Device in Assisted Tension-Free Wound Closure.
Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. ⋯ The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful.
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Annals of plastic surgery · Mar 2017
Comparative StudyThe Dawn of Transparency: Insights from the Physician Payment Sunshine Act in Plastic Surgery.
The Physician Payments Sunshine Act (PSSA) is a government initiative that requires all biomedical companies to publicly disclose payments to physicians through the Open Payments Program (OPP). The goal of this study was to use the OPP database and evaluate all nonresearch-related financial transactions between plastic surgeons and biomedical companies. ⋯ Plastic surgeons in private practice receive higher payments from industry. Among academic plastic surgeons, higher payments were associated with higher h-indices.
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Annals of plastic surgery · Mar 2017
A New Form of Artificial Skin to Promote Permanent Wound Coverage: A Preliminary Report.
Although tendon-exposed or bone-exposed wounds can be resurfaced with flaps, such surgeries may not be feasible in patients with poor general or local conditions. Biosynthetic artificial skin is an alternative for critical wound coverage. We designed a new artificial skin bilayer to close difficult wounds permanently. ⋯ Both SAPD and Integra are double-layered artificial skin products. Our results demonstrate that APDM and IDM are good templates and show excellent incorporation with autologous FTS graft. The results also demonstrated gradual wound contraction over time, but the contraction rate was not different between SAPD and Integra 6 weeks after grafting in a rat model.
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Annals of plastic surgery · Feb 2017
Preventing Breast Implant Contamination in Breast Reconstruction: A National Survey of Current Practice.
Implant-based breast reconstruction is commonly performed by plastic surgeons worldwide. Bacterial contamination is of paramount concern because of its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination; however, definitive evidence supporting these practices is lacking. ⋯ There is considerable heterogeneity in surgical practices aimed at preventing bacterial contamination in implant-based breast reconstruction. Surgeons may benefit from high-level studies designed to create standardized evidence-based practice guidelines.
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Advances in burn care have accelerated within the last 50 years. The principal modalities of and approaches to burn treatment include dressings, antimicrobials, fluid resuscitation, burn wound excision, skin grafting, and use of skin substitutes. This review presents a historical outline of these approaches, their current status, and prospects for the future of burn care.