Annals of plastic surgery
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Annals of plastic surgery · May 2007
Case ReportsThe use of reinforced adhesive tape in supporting pendulous upper eyelid lesions.
Prolonged interference in the conjugate vision of an infant by monocular occlusion of the visual axis produces a significant risk of the development of stimulus deprivation amblyopia. Any clinician dealing with a large number of children's vascular lesions in the periorbital region will encounter cases where vision is threatened in this way. We have used a simple technique to help avoid interference with the visual axis while awaiting responses to conventional treatments of vascular lesions including laser and more rarely systemic steroid therapy. This involves the use of a reinforced adhesive tape.
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Annals of plastic surgery · May 2007
Freestyle perforator-based V-Y advancement flap for reconstruction of soft tissue defects at various anatomic regions.
Perforator flap surgery has gained great popularity in the last decade because surgeons can prepare freestyle flaps in anywhere on the body if they find a perforator supplied to the flap. One of the basic principles of reconstructive surgery is that superior results can be obtained for color and texture match if immediately adjacent soft tissue is used to repair a defect. V-Y advancement flaps are used successfully based on this principle, but the degree of mobility of a V-Y advancement flap is dependent on the laxity of the underlying subcutaneous tissue. This is an important disadvantage of traditional V-Y advancement flap and limits its use. ⋯ Perforator-based V-Y advancement flaps are safe and very effective for coverage of defects in which closure is impossible with a standard V-Y advancement flap. Dissection of the perforator or perforators offers remarkable excursion to the V-Y flap with minimal donor site morbidity. These axial pattern flaps can be used successfully with good esthetic and functional results at various regions of the body if there is any detectable perforator.
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Annals of plastic surgery · Apr 2007
Persistent pain following postmastectomy breast reconstruction: long-term effects of type and timing of surgery.
This study prospectively examined the long-term effects of type (transverse rectus abdominis musculocutaneous [TRAM] versus implant) and timing (immediate versus delayed) of postmastectomy reconstructive surgery on patient reports of pain at multiple body sites. Women (n = 205) seeking immediate or delayed breast reconstruction, choosing either expander implant or autologous tissue transfer surgical procedures, provided ratings for the presence of bodily, breast, abdominal, and back pain and abdominal tightness prior to surgery and at 2-year follow-up. ⋯ There was a trend for implant subjects to report more frequent problems with breast pain. These results suggest the need for heightened awareness of potential long-term pain morbidity for women undergoing TRAM flap or implant breast reconstruction.
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Annals of plastic surgery · Mar 2007
Case ReportsThe contemporary management of electrical injuries: resuscitation, reconstruction, rehabilitation.
Due to advances in resuscitation of patients with electrical injuries, new challenges in reconstruction and rehabilitation have emerged. This study is a comprehensive institutional review of a prospectively gathered database of patients with electrical injuries, from initial resuscitation through final impairment ratings. ⋯ Electrical injuries can produce significant morbidity despite relatively small burn sizes. Patients require early operative procedures for prevention of further injury. Timely reconstructive surgery may improve final function and return to productivity. Finally, continued reconstruction may ensure improved late outcomes. The plastic surgeon is essential to patients with electrical injuries through all phases of their care.
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Annals of plastic surgery · Mar 2007
Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications.
Eighty-six women underwent modified inferior pedicled reduction mammaplasty. All were grouped according to body mass index (BMI): 14 in the overweight group, 51 in the obese group, and 21 in the morbidly obese group. The mean ages were 34, 35, and 36, respectively, for the 3 groups and were not statistically different. ⋯ Forty-seven percent of this group continued to have limited activity after breast reduction with a mean BMI of 37.8 kg/m2. The mean BMI of all women was 37.41 kg/m2 with a total BMI change of -0.4 kg/m2, suggesting that most women do not lose a significant amount of weight after breast reduction. There was no statistical difference in long-term BMI.