Clinics in plastic surgery
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Advances in medicine have enabled more craniopagus twins to survive separation, but the ultimate goal, to have both twins emerge from their separation with full neurologic function and a chance at leading independent and productive lives, remains elusive. The authors were contacted to evaluate craniopagus conjoined male infant twins for separation. ⋯ To the authors' knowledge, this is the first such outcome in such a case. This article reviews the pertinent literature and discusses the authors' rationale and methodology.
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Mandibular distraction osteogenesis can be a safe and effective way to avoid tracheostomy placement in selected neonates with Pierre Robin sequence,with or without other associated syndromes. In non-syndromic Pierre Robin sequence syndromes, this procedure, in the current author's experience, has provided definitive correction of both airway obstruction and micrognathia. ⋯ A support team of pediatric anesthesia, pulmonary, and otolaryngology specialists is required for the safe and successful selection and treatment of this group of patients with Pierre Robin sequence using mandibular distraction. The author's investigation of this group is ongoing.
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Regenerative medicine is evolving toward a powerful new paradigm of functional restoration. With the ethical use of gene therapy or through the manipulation of autologous tissues, improved tissue replacements may soon be available. The promise of engineered whole organs, although fraught with technical hurdles, remains on the horizon. As these advances occur, physicians and surgeons of the twenty-first century will possess ever more powerful tools to restore form and function.
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No single scientific field can generate the ideal method of engineering bone. However, through collaboration and expansion of programs in bone tissue engineering, the right combination of materials, cells, growth factors, and methodology will come together for each clinical situation such that harvesting bone grafts will become obsolete. This article reviews the need for engineered bone and provides a historical perspective of bone engineering research, current research efforts, and the future direction of this work.
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Advances in the field of peripheral nerve surgery have increased our understanding of the complex cellular and molecular events involved in nerve injury and repair. Application of these important discoveries has led to important developments in the techniques of nerve repair, nerve grafting, nerve allografts, end-to-side repairs, and nerve-to-nerve transfers. As our understanding of this dynamic field increases, further improvement in functional outcomes after nerve injury and repair can be expected.