Annals of plastic surgery
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Annals of plastic surgery · Mar 2012
ReviewGrowing trend of China's contribution to the field of plastic and reconstructive surgery: a 10-year study of the literature.
In the past decade, plastic and reconstructive surgery in China has achieved great advances. However, the scientific publications in plastic and reconstructive surgery in the major regions of China-Mainland, Hong Kong, and Taiwan are unknown. We therefore intended to reveal the contribution of articles from Chinese authors to the field of plastic and reconstructive surgery. ⋯ The number of articles published from Chinese authors increased markedly from 2000 to 2009, particularly from Mainland China, since 2004.
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Annals of plastic surgery · Mar 2012
Infrared fluorescence imaging of lymphatic regeneration in nonhuman primate facial vascularized composite allografts.
Clinical vascularized composite allografts (VCA), although performed with good success, have been characterized by rejection episodes and postoperative graft edema. We investigated lymphatic donor-recipient reconstitution and lymphatic regeneration in a nonhuman primate facial VCA model. ⋯ Donor-recipient lymphatic channel regeneration following VCA did not result in resolution of edema. Technical causes of graft edema may be overcome with alternative surgical techniques, allowing for direct investigation of the immunologic relationship between VCA graft edema and rejection responses. Mechanisms and timing of dynamic donor-recipient lymphatic channel relationships can be evaluated using fluorescent imaging systems to better define the immunologic role of lymphatic channels in VCA engraftment and rejection responses, which may have direct clinical implications.
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Annals of plastic surgery · Mar 2012
Immunological demyelination enhances nerve regeneration after acute transection injury in the adult rat sciatic nerve.
Our recent experiments demonstrate that demyelination enhances peripheral nerve regeneration after contusion injury in the adult rat sciatic nerve. The role of demyelination in peripheral nerve regeneration in a sciatic nerve transection model has yet to be elucidated. We hypothesize that (1) axon regeneration within a region of injury increases after experimental, immunologic demyelination, and (2) regenerated axons are partially derived from the proximal motor axons. ⋯ This study demonstrates enhanced histomorphologic nerve regeneration in the rat sciatic nerve after local delivery of experimental, immunologic demyelination following transection injury. It highlights the utility of demyelination in peripheral nerve regeneration. This therapy may be applicable for tissue-engineered constructs, cell-based systems, and nerve transfers to improve outcomes in peripheral nervous system injuries.
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Annals of plastic surgery · Feb 2012
Innovative treatment of peripheral nerve injuries: combined reconstructive concepts.
Although autografts are the gold standard for failed primary nerve repairs, they result in donor-site morbidity. Nerve conduits and decellularized allografts are a novel solution for improved functional outcomes and decreased donor-site morbidity. Unfortunately, previous reconstructive algorithms have not included the use of decellularized allograft nerve segments, either for repair of the primary injury or reconstruction of the autograft donor site. To identify the optimal sequence of techniques and resources, we reviewed our cases of upper extremity peripheral nerve reconstruction. ⋯ To restore maximal target-organ function with minimal donor-site morbidity, we have created an algorithm based on evidence for nerve reconstruction using allograft, conduit, and autologous donor nerve. Based on our clinical outcomes, despite small sample study, the adoption of the proposed algorithm may help provide uniform outcomes for a given technique, with minimal patient morbidity. Individualized reconstructive technique, based not only on nerve gap size but also on functional importance and the anatomical level of the nerve injury are important variables to consider for optimal outcome.
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Owing to the diverse application of the pectoralis major muscle (Pmaj) in reconstructive surgery, with special reference to its safe and functional transfer, a precise knowledge of its nerve supply becomes mandatory. The aim of the present study was to investigate its innervations. ⋯ The muscle is mainly innervated by the lateral pectoral nerve supplemented by the branches of the MPN. The proximal segment, having a separate nerve, allows its functional transfer. Care should be practiced whenever the distal segment is to be harvested, because of having multiple nerves.