Annals of plastic surgery
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Annals of plastic surgery · Mar 2013
Intraoperative esophageal Doppler hemodynamic monitoring in free perforator flap surgery.
Goal-directed fluid therapy optimizes cardiac output and flap perfusion during anesthesia. Intraoperative esophageal Doppler (ED) monitoring has been reported as more accurate and reliable, demonstrating improved surgical outcomes compared with central venous pressure and arterial catheter monitoring. A prospective study of patients undergoing free perforator (deep inferior epigastric artery perforator/anterolateral thigh) flap surgery with intraoperative ED monitoring (51 patients) or central venous pressure monitoring (53 patients) was undertaken. ⋯ Fluid output was greater in the ED group (P = 0.008). The ED group showed less fluid balance (P = 0.023), less anesthetic time (P = 0.001), less hospital stay (mean 1.9 days; P = 0.147), less monitoring and flap complications (P = 0.062). ED monitoring demonstrated no monitoring complications, provides a favorable postoperative fluid balance, and may reduce flap complications and hospital stay.
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Annals of plastic surgery · Mar 2013
Experimental model of degloving injury in rats: effect of allopurinol and pentoxifylline in improving viability of avulsed flaps.
Degloving injuries may be a challenge when it comes to deciding the surgical approach to be used. Repositioning of the flap and suturing are faster and more straightforward, but often these procedures often lead to total or partial loss of the avulsed flap. Pharmacological agents with vascular properties that enhance the viability of the reattached flap could be beneficial to patients with degloving injuries. Experimental models with which to test this hypothesis are scarce. An experimental model reproducing a degloving injury of the hind limb of rats was developed in our department, and the effects of pentoxifylline (Ptx) and allopurinol (Alp) were assessed. ⋯ The areas of necrosis observed in the degloved flaps of the rats' hind limbs were smaller in the pentoxifylline and allopurinol groups. Although allopurinol seems to be more efficient, the difference was not significant.
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Annals of plastic surgery · Feb 2013
Randomized Controlled Trial Comparative StudyA comparison of levobupivacaine and levobupivacaine-tramadol combination in bilateral infraorbital nerve block for postoperative analgesia after nasal surgery.
Our aim in this study was to investigate the effect of levobupivacaine and a levobupivacaine + tramadol combination on postoperative analgesia in intraoperative nerve block under standard general anesthetic. ⋯ Bilateral infraorbital nerve block with 0.25% levobupivacaine is an effective, reliable, and simple technique in the treatment of postoperative pain in nasal surgery. In addition, the addition of tramadol as an adjuvant to local anesthetics in this technique is safe.
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Annals of plastic surgery · Feb 2013
National representation in the plastic and reconstructive surgery literature: a bibliometric analysis of highly cited journals.
In recent years, significant growth has been observed in the field of plastic and reconstructive surgery. However, the national productivity to the field of plastic and reconstructive surgery remains unknown. We therefore intended to reveal national contributions in the field of plastic and reconstructive surgery. ⋯ USA is the most productive country in the field of plastic and reconstructive surgery. When normalized to population size, some European countries might be more productive.
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Annals of plastic surgery · Jan 2013
Current trends in breast reconstruction: survey of American Society of Plastic Surgeons 2010.
We conducted a retrospective survey of American Society of Plastic Surgeons to ascertain the current trends in breast reconstruction (BR). ⋯ The survey provides an insight to the current trends in BR practice with respect to surgeon and practice setting characteristics. Although not necessarily the correct best practices, the survey does demonstrate a likely portrayal of what is being practiced in the United States in the area of BR.