Annals of plastic surgery
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Annals of plastic surgery · Oct 2009
Comparative StudyThe sensate medial dorsal intercostal artery perforator flap for closure of cervicothoracic midline defects after spinal surgery: an anatomic study and case reports.
Complex cervicothoracic midline defects after spinal surgery are traditionally treated with the use of muscle and myocutaneous flaps. The authors introduce the sensate medial dorsal intercostal artery perforator flap as an alternative treatment for these defects. ⋯ It can provide enough volume to obliterate dead space. Inclusion of the cutaneous nerve gives protective sensibility to the reconstructed area.
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Annals of plastic surgery · Oct 2009
Comparative StudyTextured and smooth breast implants: is there a difference in the chemical structure of silicone?: an analysis with fourier transformation infrared and attenuated total reflectance spectroscopy.
Scientific controversy concerning silicone and its biocompatibility has been ongoing for the last 10 years. This study on textured and smooth silicone breast implant shells using fourier transformation infrared spectroscopy associated with attenuated total reflectance cells aimed to identify eventual chemical modifications of silicone induced by texturization. The surfaces of 8 new implants produced by 2 well-known manufactures have been taken into consideration. ⋯ Infrared spectra were then recorded, evaluated, and compared with the reference spectrum of pure silicone. Potentially reactive groups, known as silanols, were identified, in all shells, intensity increasing in textured implants (P < 0.05), whereas no silanols were detected in the spectrum of pure silicone. These results suggest that polar groups, present in manipulated silicone might influence capsula formation.
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Annals of plastic surgery · Aug 2009
Randomized Controlled Trial Comparative StudyTemporomandibular joint dislocation reduction technique: a new external method vs. the traditional.
The traditional intraoral approach for temporomandibular joint dislocations reduction, although effective, has some disadvantages. Here, a new extraoral approach is described. This study was performed to evaluate this new method's success rate. ⋯ Among 29 attempts with the conventional method, 25 were successful (86.2%; 95% confidence interval: 73-100) and among 29 attempts with the external method, 16 were successful (55.2%; 95% confidence interval: 39-79). This difference was statistically significant. Because of the benefits of the external approach, such as avoiding hand bites and disease transfer, it can be a reasonable choice to reduce a dislocated temporomandibular joint.
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Annals of plastic surgery · Aug 2009
Case ReportsTreatment of recalcitrant air leaks: the combined latissimus dorsi-serratus anterior flap.
Pleural space problems after lung resection and persistent air leaks are among the commonest challenges posed to thoracic surgeons. Surgical repair of air leaks are indicated when conventional tube thoracostomy has failed to solve the problem. We would like to propose the novel application of the combined latissimus dorsi-serratus anterior transposition flap for selected cases of air leaks that are recalcitrant to conventional treatment. ⋯ The muscle bulk of the latissimus dorsi fills the pleural dead space and the serratus anterior muscle seals the axilla preventing subcutaneous emphysema. There was minimal morbidity associated with the use of this dual muscle flap technique. This technique is an effective treatment option for recalcitrant air leaks.
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Annals of plastic surgery · Aug 2009
Breast augmentation by autologous fat injection grafting: management and clinical analysis of complications.
Autologous fat is an excellent soft-tissue filler, given its abundance and ease of harvest. Nevertheless, the technique is accompanied by postoperative complications such as fat necrosis, calcification, and sclerotic nodules. These problems directly influence surgical efficacy. ⋯ Intramammary autologous fat injection should only be used with caution. Selecting suitable indications and correct surgical techniques make autologous fat grafting an ideal method for breast augmentation. Strictly controlling the injection volume and injecting diffusely in multiple layers to allow fat granules to distribute evenly within the breast, are effective methods to reduce postoperative complications.