Annals of plastic surgery
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Annals of plastic surgery · Sep 2012
Postoperative pain assessment for upper lid blepharoplasty in Asians.
This study was undertaken to investigate the pain intensity, time to peak of pain, bruise, swelling, itching, life limitation, blurred vision, and duration of pain after upper lid blepharoplasty using a survey of pain scale, and to provide objective evidence to aid in education and preoperative counseling of our patients. After upper lid blepharoplasty under local anesthesia, patients were asked to rate their pain on a standardized 11-point pain scale (0-10). After pain assessment of the immediate postoperative period, the evaluation was repeated after 2 to 4 hours, 24 hours, 2 days, 3 days, 7 days, and 1 month. ⋯ Most severe pain was observed during the immediate postoperative period and up to 2 to 4 hours after surgery. Pain after upper lid blepharoplasty was mostly mild to moderate and did not exceed a score of 4, which would require reevaluation, and could remain persistent for up to 7 days after surgery. Specific pain-targeted assessment and treatment based on these results are warranted.
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Annals of plastic surgery · Sep 2012
Clinical application of human adipose tissue-derived mesenchymal stem cells in progressive hemifacial atrophy (Parry-Romberg disease) with microfat grafting techniques using 3-dimensional computed tomography and 3-dimensional camera.
Parry-Romberg disease is a rare condition that results in progressive hemifacial atrophy, involving the skin, dermis, subcutaneous fat, muscle, and, finally, cartilage and bone. Patients have been treated with dermofat or fat grafts or by microvascular free flap transfer. We hypothesized that adipose-derived stem cells (ASCs) may improve the results of microfat grafting through enhancing angiogenesis. We evaluated the utility of ASC in microfat grafting of patients with Parry-Romberg disease by measuring the change in the hemifacial volumes after injection of ASCs with microfat grafts or microfat grafts alone. ⋯ Adipose-derived stem cells enhance the survival of fat grafted into the face. A microfat graft with simultaneous ASC injection may be used to treat Parry-Romberg disease without the need for microvascular free flap transfer.
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Annals of plastic surgery · Sep 2012
Graphic aids for calculation of fluid resuscitation requirements in pediatric burns.
The Parkland formula is currently the most widely used protocol to guide fluid resuscitation of acute burns and has been adapted for pediatric use. We describe 3 novel graphic devices (a nomogram, slide rule, and disc calculator) based on this formula, which have significant advantages over existing graphic and electronic devices. The robust low-cost graphic devices would be particularly suited to developing countries and difficult locations, but could be used as the primary means of calculation in any environment. If a computer or calculator is used as the primary means of calculation, the graphic devices provide a simple and rapid means of checking and preventing errors that may arise because of inadvertent mis-keying of data or incorrect application of the pediatric Parkland formula.
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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.
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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.