Clinics in plastic surgery
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Aspirated fat contains unnecessary components such as water, oil, and blood cells. For better outcomes, tissue purification and condensation are useful, especially when injection volume to the recipient site is limited. ⋯ Reducing tissue volume by removing some adipocytes or supplementation of stromal vascular fraction or ASCs can increase the ASC/adipocyte ratio in the graft. Clinical results of ASC supplementation remain controversial, but ASC condensation seems to lead to expanding applications of fat grafting into revitalization of stem cell-depleted tissue.
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Treatment of complex hand trauma includes adequate debridement of nonviable tissue, early reconstruction, and careful selection of various available surgical procedures tailored to patients' needs and requests. Debridement of all necrotic tissue is crucial before any attempt at reconstruction. ⋯ For best results reconstruction should be performed early, with proper early postoperative therapy. This article reviews the principles and surgical options in the management of complex hand injuries involving the dorsal and the palmar aspects of the hand, and the different types of tissue in the hand.
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This article provides an update of the current state of motor and sensory nerve transfers for the functional reconstruction of proximal and distal nerve lesions of the upper extremity. General principles, indications, surgical options, and functional outcomes are summarized for conventional transfers used in brachial plexus reconstruction, more recently described distal nerve transfers for isolated nerve injuries in the extremity, and sensory nerve transfers performed both proximally and distally.