Articles
  • Original Article

    Hypospadias: an algorithm for repair with the aid of the microscope in 102 patients

    Mohamed Maher , Maria Chasapi , Milind Dalal
    Aim: To demonstrate an algorithmic approach to hypospadias repair with the aid of the surgical microscope as a teaching aid, as well as an ergonomic tool. Methods: One hundred and two patients were operated on between 2009 and 2013, all by the senior surgeon (M Dalal). This is a retrospective review of results in the case series. The procedures used were one stage repair with no incision of the urethral plate, or the two stage Bracka repair. Results: Fifty-six patients underwent the one stage procedure and 46 patients underwent the two stage Bracka repair. Early complication rate was 4.9%...
    Published on: 27 Apr 2017
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  • Case Report

    Resolution of 2nd, 3rd or 4th interdigital space incomplete, simple syndactyly using a random vascularity flap

    Heriberto Garza de la Llave , Yusef Jiménez Murat , Alejandro Ángel Corona Figueroa
    Syndactyly consists of a variable fusion of soft tissue or of bone in adjacent fingers. This has important aesthetic and functional impacts on the development of the child due to the abnormal appearance of the hand. When the 1st web space is affected, it compromises grasp and development of the clamp function. Affliction of the 2nd, 3rd or 4th webspaces hinder the independent movement of the fingers adjacent to it. Current syndactyly release techniques have inherent disadvantages such as the use of skin from both the interdigital halves of the syndactylized fingers, the need to skin graft...
    Published on: 27 Apr 2017
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  • Original Article

    The experience performing extended abdominoplasty in massive weight loss patients

    Maria A. Bocchiotti , Elisabetta Adelaide Baglioni , Stefano Bruschi , Luca Spaziante , Erind Ruka
    Aim: The post-bariatric patients who undergo torsoplasty often incur postoperative complications that dilate their recovery time. The authors propose the technique of extended abdominoplasty, described in 2012 for aesthetic torso remodeling, in post-bariatric patients in order to reduce complications and hospitalization time. Methods: The authors performed 21 extended abdominoplasties and compared them with 21 torsoplasties in post-bariatric patients during a 1-year period. Data studied was age, gender, duration of the procedure, blood loss, complications and hospitalization duration....
    Published on: 21 Apr 2017
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  • Letter to Editor

    Management of complications of Medpor® implants in rhinoplasty

    Kapil Agrawal , Raghav Shrotriya
    Published on: 30 Mar 2017
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  • Review

    Multipotency and secretome: the mechanisms behind the regenerative potential of adipose-derived stem cells

    Doruk Orgun , Hiroshi Mizuno
    The use of stem cells for regenerating damaged organs and tissues which are unable to heal on their own is a widely studied field in plastic and reconstructive surgery as well as medicine in general. Among various stem cell types, adipose-derived stem cells (ASCs) are especially considered to be an ideal stem cell population for several clinical situations. These cells could be harvested from fat with relatively less invasive methods with high yield rates. ASCs have proved to be worthy of more research to understand the mechanisms behind their regenerative abilities. However, it remains...
    Published on: 22 Mar 2017
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  • Original Article

    Pressures secondary to circumferential digital dressings in clay models

    Han Joon Kim , Kun Hwang
    Aim: With little manipulation, compression bandages placed circumferentially around the digit can be rolled up the digit, creating a tourniquet effect. The aim of this study was to elucidate the pressures induced by self-adherent bandages applied circumferentially around the fingers. Methods: After fabricating various clay finger models using the live finger as a model, the pressure of each self-adherent bandage was measured at the level of the proximal phalanx. Two different self-adherent bandages were applied with variables of different levels of tightness, number of wraps, and whether...
    Published on: 22 Mar 2017
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  • Case Report

    Unilateral rhinophyma: report of a case and review

    Scott Walter , Steven Krueger , Jonathan Ho , Kavitha K. Reddy
    Rhinophyma is a less-common subtype of rosacea that presents as thickened skin with enlarged sebaceous glands that may progress to large bulbous growths with dilated pores on the nose. Rhinophyma can lead to morbidity aesthetically and sometimes functionally. The prevalence of rosacea ranges from 1% to 20%. The exact pathogenesis is not known, but potential factors include altered circulation, changes in microorganisms and/or alterations in immunity. Here the authors present a unique case where a patient presented with unilateral rhinophyma: a presentation warranting work up to rule out...
    Published on: 22 Mar 2017
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  • Original Article

    A study of correlation between prosthetic breast reconstruction, antibiotic prophylaxis and surgical wound drains

    Emanuele Rampino Cordaro , Nicola Zerbinati , Alice Garzitto , Daria Almesberger , Michela Francescon , Raffaele Rauso , Mario Cherubino , Pier Camillo Parodi
    Aim: The primary aim of this investigation into the correlation between prosthetic breast reconstruction, antibiotic prophylaxis and surgical drains was to determine whether the short-term prophylaxis recommended in the current guidelines is in fact able to sterilize the peri-prosthetic pocket in patients undergoing prosthetic breast reconstruction via tissue expansion, permanent implant placement, or Becker implants, as well as augmentation to correct symmetry. Methods: A total of 96 women who had undergone prosthetic breast reconstruction surgery were considered. Patients were recruited...
    Published on: 28 Feb 2017
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  • Editorial

    Portraits of two innovative plastic surgeons in the National Portrait Gallery

    Kun Hwang
    Published on: 22 Feb 2017
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  • Original Article

    Early muscle reinnervation by means of end-to-side neurorrhaphy in an experimental model

    Araceli Pérez , Rafael Reynoso , Rosa M. Romero , Angélica González , Jorge Ochoa , Dulce H. Gutiérrez , Damián Palafox
    Aim: The aim of the study was to provide early muscular reinnervation to avoid muscle atrophy and functional loss in an experimental model. Methods: Fifty rats were divided into five groups. In group 0 (control group) only nerve dissection was performed. Total peroneal nerve section was performed in the remaining groups. Immediate end-to-end neurorrhaphy (EEN) was made in group 1. In group 2, an end-to-side neurorrhaphy (ESN) was performed from the tibial nerve to the peroneal nerve. In group 3, a direct EEN, plus an ESN, were used as a nerve graft as a bridge from the donor nerve (tibial);...
    Published on: 22 Feb 2017
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  • Letter to Editor

    Five “Ds” of plastic surgery

    Preethitha Babu , Ravi Kumar Chittoria , Sudhanva Hemanth Kumar , Senthil Kumaran Marimuthu , Elan Kumar Subbarayan , Konda Sireesha Reddy , Vinayak Chavan , Devi Prasad Mohapatra , Meethale Thiruvoth Friji , Dinesh Kumar Sivakumar
    Published on: 19 Jan 2017
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  • Original Article

    Thermal distribution and response in Q-switched ruby laser treatment for oculodermal melanosis (Nevus of Ota)

    David Cheong Chon Fok , Cheng-Jen Chang , Yun-Liang Su , Shu-Ying Chang , Yen-Chang Hsiao , Kuen Ting , Wen-Shiung Lin , Kuen-Tasnn Chen , Shih-Feng Chen
    Aim: A clinically useful treatment laser must generate stable and precise energy of low diffusivity. This study assessed the photothermal response of a Q-switched ruby laser (QSRL) in the treatment of oculodermal melanosis (Nevus of Ota). Methods: A two-year retrospective review of 40 patients with oculodermal melanosis treated with a QSRL (λ = 694 nm, pulse duration = 25 ns, 3 mm spot size, energy density 6-10 J/cm2) was performed. Demographics included an age range of 18-54 years (mean 28) and a gender distribution of 25 females and 15 males. The values recorded from real-time infrared...
    Published on: 19 Jan 2017
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  • Case Report

    In vivo degradation of poly L-lactic D-lactic acid and tri-methylene carbonate sheets in orbital reconstruction

    Kun Hwang , Hyung Mook Kim
    This study was conducted to evaluate changes in the composition of a poly-L-lactic D-lactic acid and trimethylene carbonate (PLDLA-TMC) sheet after insertion into the human body. A 35-year-old woman had an orbital fracture that was reconstructed using a PLDLA-TMC sheet. During iliac bone grafting for enophthalmos 190 days after the insertion, the sheet was removed and analyzed using gel permeation chromatography and Fourier transform infrared spectroscopy. The weight average molecular weight decreased (from 151,000 Da to 10,000 Da), as did the number average molecular weight (from 15,600 Da...
    Published on: 19 Jan 2017
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  • Original Article

    Improvements in the cervical angle and anthropometric distances using elasticum suspension

    Seong Kee Kim , Kun Hwang , Hun Kim , Young Rok Kim , Yeop Na
    Aim: This study aims to characterize the effects of elastic facelifts using the elasticum suspension technique on the cervical angle and anthropometric distances. Methods: Forty-six patients underwent surgery. Two 4-5 mm incisions a few centimetres apart were made at sideburn. Through blunt dissection, the deep temporal fascia was approached. An elastic thread (Elasticum®) was anchored to this fascia. A 1.0 cm incision was made just in front of the earlobe. The elastic thread was anchored to the tympanoparotid fascia. Jano needle was passed under the skin surface, as determined by the depth...
    Published on: 23 Dec 2016
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  • Topic: Advanced Wound Management and Prospects

    Preliminary evidence using negative pressure wound therapy to achieve limb salvage for the ischemic diabetic foot

    Joe Chi-Cheng Fang , Yu-Tsung Chen , Yin-Shuo Chang , Jen-Hsiang Shen , Min-Ling Chen , Chang-Cheng Chang
    Aim: Negative pressure wound therapy (NPWT) in diabetic foot ulcers (DFU) has been discussed in several studies, but without a focus on peripheral arterial disease (PAD), which is a common comorbidity. This study aims to investigate the feasibility of NPWT in the treatment of DFU with PAD in regards to limb salvage and the clinical course. Methods: The authors retrospectively collected patients with DFU and PAD diagnosed with either Doppler ultrasound or angiography as the PAD study group. Patients with DFU but no PAD were enrolled as the non-PAD comparison group. NPWT was applied to both...
    Published on: 20 Dec 2016
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  • Topic: Advanced Wound Management and Prospects

    Clinical pathway for an efficient wound care center

    Yu-Tsung Chen , Chang-Cheng Chang
    Published on: 20 Dec 2016
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  • Original Article

    Non-invasive focused ultrasound for abdominal circumference reduction: does it really work?

    Eric Barel , Abraham Amir , Asaf Olshinka , Dean Ad-El
    Aim: Non-invasive body contouring is a promising modality. However, due to a lack of good evidence-based data, the mechanism by which contouring occurs remains unclear. The purpose of this study was to evaluate the effect of treatment with the Contour I™ ultrasound system (Ultrashape®, Syneron®, Israel) on abdominal circumference and to compare 2 power levels for efficacy and safety. Methods: A prospective, self-controlled double-blind design was used. Thirty-six women, aged 30-45 years, were randomized to receive treatment with the Contour I at high or low acoustic outputs in 3 successive...
    Published on: 14 Dec 2016
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  • Original Article

    Full retroauricular skin and fascia expansion in microtia reconstruction: a single center experience of 166 cases

    Ji-Hua Wang , Ting Tang , Yong-Jing He , Ying-Jia Zhang , Yun Yang
    Aim: Ear reconstruction is a challenge for plastic and reconstructive surgeons. The ear requires sufficient skin coverage and a three-dimensional (3D) cartilage framework. In this paper, the authors present their 10-year experience in microtia reconstruction using tissue expansion and an autogenous rib cartilage framework. Methods: Ear reconstruction was performed in 3 operative stages. During the first procedure, a 50-80 mL kidney or cylinder-shaped expander was implanted deep to the subcutaneous fascia of the retroauricular mastoid region. Over a period of 3-5 months, the expander was...
    Published on: 30 Nov 2016
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  • Original Article

    The extended running W-plasty: an additional tool for simultaneous reduction of the hypertrophied labia minora and redundant clitoral hood

    Hamdy A. Elkhatib
    Aim: The extended running W-plasty technique using the W-plasty principle is a modification of the conventional technique. The use of this technique was utilized for simultaneous reduction of the protuberant labia minora and the redundant clitoris. Methods: Twenty-three patients presented to the plastic surgery clinic between 2008 and 2015 with the complaints of protuberant and enlarged labia minora in conjunction with a hypertrophied clitorial hood. The extended running W-plasty was performed in all patients. Surgery was performed under general anesthesia as an outpatient procedure with a...
    Published on: 22 Nov 2016
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  • Original Article

    Development and assessment of a cutaneous tissue stretch device as a novel scar therapy

    Jonathan Kanevsky , Joshua Vorstenbosch , Julian Diaz-Abele , Tyler Safran , Markus Prinz , Youssef Tahiri , Mirko Gilardino , Satya Prakash
    Aim: Scar prevention and reduction is an area of therapeutic opportunity and unmet medical need. With no current effective scar therapy, patients are often disappointed in their appearance post surgery and re-present to surgeons, only to be turned away. The purpose of this study was to develop and test a device that produces intermittent parallel stretch on new scars and to analyze its potential to reduce scarring. Methods: Mice were randomized into 5 scar stretch treatment groups: 1 control, 1 sham, and 3 stretch models (0.5×, 1×, or 2× device strength) and treated for 10 days. Scars were...
    Published on: 15 Nov 2016
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  • Case Report

    Epidermoid and dermoid cysts of the head and neck region

    Samrat S. Sabhalok , Lakshmi S. Shetty , Pallavi H. Sarve , Sneha V. Setiya , Swati R. Bharadwaj
    Epidermoid cysts, dermoid cysts and teratoid cysts are cystic malformations lined with squamous epithelium. They present as soft nodular lesions with a sessile base. Their prevalence is 7% in head and neck patients and 1.6% within the oral cavity. The authors present a case series of 21 patients with dermoid and epidermoid cysts who underwent surgical removal. One year of follow-up was carried out without evidence of recurrence. The removal of these cysts is of great concern as it can cause serious social stigma, aesthetic and functional impairment, dysphagia and dysphonia.
    Published on: 4 Nov 2016
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  • Original Article

    The temporal endoscopic midface lift - centrofacial rejuvenation without facial scars

    Thomas Haffner
    Aim: The author describes a new endoscopic midface lifting technique using solely temporal access and evaluates its advantages and perspectives. Methods: This is a single-surgeon case study. Through a short temporal incision, dissection is performed along a single plane connecting the superficial surfaces of both the facial and temporal superficial musculoaponeurotic system (SMAS) layers. Subsequent midface dissection divides the malar fat pad into the deeper and superficial parts. A new concept of a combination high malar SMAS lift and internal skin flap anchorage that provides long-term...
    Published on: 31 Oct 2016
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  • Original Article

    Topical rapamycin for angiofibromas in patients with tuberous sclerosis: how does it work in clinical practice?

    Maria Palmetun Ekbäck , Desiree Wiegleb Edström
    Aim: Topical rapamycin for angiofibromas has been reported to be a new promising treatment. This study aims to report the outcome in clinical practice. Methods: A retrospective clinical follow-up on twenty-three patients who had been prescribed an oral solution of 0.1% rapamycin, to be applied on facial lesions once a day. Results: Seventeen of 23 patients continued the treatment. Papules and nodules were improved in 8 patients (47%) and erythema in 12 (70%). Side effects, such as stinging and redness were reported in 35% of patients. Blood samples were taken from 5 patients and no...
    Published on: 25 Oct 2016
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  • Case Report

    Morel-Lavallee lesion - radiological spectrum

    Bharat Bhushan Sharma , Sandeep Sharma , Priya Ramchandran , Narendar Kumar Magu , Mir Rizwan Aziz , Shilpa Singh
    Morel-Lavallee lesion (MLL) entity represents as a haemolymph mass as a result of closed degloving injury following focal trauma. The swelling can be mistaken as a tumor or simple hematoma formation, and it can be of concern as it gradually increases in size. It is important to diagnose the entity promptly as proper management can avoid skin necrosis and further complications. We present a 20-year-old female nursing student who fell down from a scooter and developed painful massive right thigh swelling over a 3-week course following trauma. She underwent plain radiography which was...
    Published on: 25 Oct 2016
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  • Original Article

    Proliferation and adipogenic differentiation of human adipose-derived stem cells isolated from middle-aged patients with prominent orbital fat in the lower eyelids

    Guang-Peng Liu , Cai-He Liao , Yi-Pin Xu
    Aim: To evaluate the age-related effects on the adipogenic differentiation and proliferation potentials of human orbital adipose-derived stem cells (OASCs). Methods: Orbital adipose samples were harvested from the central fat compartment in the lower eyelids of 10 young and middle-aged patients during routine blepharoplasty surgery. After assessment of the morphological changes of adipocytes with aging, OASCs were isolated from the fat samples and expanded in vitro. Differences in the stem cell colony number (fibroblast colony-forming unit), growth rate and phenotype characterization (flow...
    Published on: 25 Oct 2016
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  • Original Article

    Soft tissue reconstruction after lower extremity limb-sparing pediatric sarcoma resection

    Kevin Shultz , Nicholas Webster , Miguel A. Soto-Miranda , Anas Eid , Jon P. Ver Halen
    Aim: Limb salvage is the treatment of choice for lower extremity bone sarcomas in children. To date, peers have not described algorithms for soft tissue reconstruction of these defects. This paper is to report a large single center series of lower extremity salvage after sarcoma treatment, with algorithm. Methods: The authors performed a retrospective review of patients undergoing resection of lower extremity bone sarcomas at a single center over 12 years. Results: In total, 65 children (29 girls, 36 boys) with a mean age of 13 years (range 2.9-23.3 years) underwent resection of a lower leg...
    Published on: 30 Sep 2016
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  • Commentary

    Comment on “Breast cancer-related lymphedema: quality of life after lymph node transfer”

    Azra Ashraf
    Published on: 30 Sep 2016
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  • Original Article

    Photometric analysis of absorbable barbed suture for periareolar closure in mastopexy

    Allen D. Rosen , Alanna M. Guzman , Teresa Hartman
    Aim: The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex® suture. This study is designed to compare the degree of areolar widening and safety profile of using absorbable barbed sutures for periareolar closure versus permanent smooth suture. Methods: A retrospective chart review was conducted of all patients whose periareolar closures were performed using...
    Published on: 20 Sep 2016
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  • Original Article

    Medially based de-epithelialized flap for nasal base narrowing and nostril sill augmentation in a cleft lip nasal deformity

    Kun Hwang , Jong Hwan Choi , Hun Kim , Dae Joong Kim
    Aim: The authors observed the nostril floor in a gross cadaver specimen histologically and innovated a medially based de-epithelialized flap for nasal base narrowing and nostril sill augmentation. Methods: In cadaver, fully thick section was taken from the nostril sill at the midpoint of the columella base and ala base, and stained with Masson-Trichrome. In eight patients, circumferential incision along the nostril sill and alar base freed the alar base from the upper lip. At the columellar base, fresh epithelium was shaved on the medial side of the incision line. The widened scar on the...
    Published on: 20 Sep 2016
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  • Case Report

    Total nasal septal reconstruction using costal cartilage in difficult cases of secondary septoplasty

    Kapil S. Agrawal , Raghav Shrotriya
    Rhinoplasty and septal reconstruction often require the use of cartilage grafts. Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deformed post traumatic noses. Usually in these cases the septal cartilage or bone is insufficient for septal reconstruction. The authors hereby describe a new technique of complete septal reconstruction by using the 7th rib (costal) cartilage combined with author’s ingenious technique to prevent warping.
    Published on: 20 Sep 2016
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  • Case Report

    Non-odontogenic hard palate cysts with special reference to globulomaxillary cyst

    Bharat Bhushan Sharma , Shweta Sharma , Arvind Jha , Kamal Deep Sharma , Jai Deep Sharma , Chattur Bhuj Sharma
    Palatal cysts are always confusing by defining their exact nomenclature or conclusive diagnosis. One of these presentations is globulomaxillary cyst which requires to be categorized under appropriate head for the management point of view. Though this entity appears to be of odontogenic in origin but because of its anatomical relation and histo-pathological background this is placed in non odontogenic group. Though the mechanism of its formation remains the same but this cyst cannot be mixed up with nasopalatine cyst as per their location. Globulomaxillary cyst appears as inverted pear...
    Published on: 20 Sep 2016
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  • Original Article

    A mammometric comparison of modified Robertson versus Wise pattern inferior pedicle reduction mammoplasty

    Victor Z. Zhu , Ajul Shah , Rachel Lentz , Tracy Sturrock , Alexander F. Au , Stephanie L. Kwei
    Aim: The advent of 3D photoimaging and mammometrics has allowed for quantitative, volumetric breast analyses. This study uses 3D photoimaging and mammometrics to compare the postoperative morphometric outcomes of the modified Robertson technique to the more traditional Wise pattern inferior pedicle technique. Methods: Inferior pedicle reduction mammoplasty was performed using either a Wise pattern or modified Robertson skin incision. 3D photography and analysis were done at 1-3 months and 6-12 months postoperatively. Results: There were 14 breasts in the modified Robertson group (ROB) and...
    Published on: 20 Sep 2016
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  • Editorial

    Body contouring: “less is more and don’t throw anything away”

    Raffaele Rauso
    Published on: 12 Aug 2016
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  • Original Article

    Peno-scrotal soft tissue loss: a need for multidisciplinary and multimodal integration

    Pradeoth Korambayil Mukundan , Prashanth Varkey Ambookan , Ragu Angappan , Vinoth Kumar Dilliraj
    Aim: Scrotal soft tissue loss is a part of the challenging conditions for plastic surgeon. The non-availability of adequate nearby healthy soft tissue and its probability of frequent contamination by excretory substances make the issue of reconstruction complicated. The authors present their experience with penoscrotal soft tissue loss with hyperbaric oxygen therapy as an adjunct. Methods: This retrospective study was undertaken in the department of plastic surgery, over a period of 2 years. Nine patients with scrotal or penile injury and infection were enrolled in the study. Age of the...
    Published on: 12 Aug 2016
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  • Letter to Editor

    Medicine and new social media: the good and the bad of taking a “selfie” for skin problems

    Anna Zampetti , Dennis Linder
    Published on: 12 Aug 2016
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  • Case Report

    A case of 25-year-old giant neurofibromatosis

    Marcos Sforza , Renato Zaccheddu , Bruno Lopes Cancado , Deborah Sforza
    In this paper, the authors presented a case report of a 39-year-old man taken to the Emergency Unit with a 25-year-old giant neurofibromatosis. Moreover, the treatment applied for this case and the physiopathology of the neurofibromatosis disease are also discussed.
    Published on: 12 Aug 2016
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  • Original Article

    A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

    James D. Goggin , Stacy Wong , Jessica E. Pruszynski , Jon P. Ver Halen
    Aim: Reduction mammaplasty is a commonly performed procedure for the treatment of symptomatic macromastia and is increasingly desired by the obese population. With the increasing prevalence obesity in the population, it is imperative to understand its effect on postoperative outcomes. The purpose of this study is to evaluate obesity as an independent risk factor for postoperative complications in breast reduction surgery using 1:1 patient matching through propensity scores between obese patients and non-obese controls. Methods: Between 2005 and 2013, the National Surgical Quality...
    Published on: 28 Jul 2016
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  • Letter to Editor

    Two-millimeter dermoscopically detected excision margins in the treatment of basal cell carcinoma: an assessment of radicality and recurrence

    Pierfranco Simone , Carlo Carusi , Riccardo Iannuzzi , Paolo Persichetti
    Published on: 28 Jul 2016
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  • Review

    How we do it: the Running-X suture technique

    Nathaniel L. Villanueva , Kyle Sanniec , Ronald Mancini
    There are a myriad of suture techniques available to close incisions of the brow and forehead, each with their own advantages and disadvantages. The ideal suture technique would provide excellent cosmetic results, offer expedient wound closure, optimize skin eversion and wound edge apposition, and provide excellent cosmetic results. The authors describe a new suture technique, the Running-X suture, a running horizontal mattress suture that has successfully been used by the senior author for many years to re-approximate surgical wounds of the brow and forehead in an expeditious and aesthetic...
    Published on: 14 Jul 2016
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  • Original Article

    Use of negative pressure wound therapy in pediatric oncology patients: a single-center review of 66 patients

    Stacy Wong , Anas Eid , Warren Southerland , Jon P. Ver Halen
    Aim: Negative pressure wound therapy (NPWT) has been studied extensively in adult patients, but less is known about pediatric patients. This study assesses the efficacy and safety of vacuum-assisted closure® usage in pediatric oncology patients. Methods: Retrospective data on all patients treated with NPWT at a single pediatric oncology hospital were collected between April 2005 and September 2013. Details on pre-treatment factors, treatment course, and post-treatment events were collected. No control group was available for comparison. Results: Sixty-six patients were identified, with a...
    Published on: 14 Jul 2016
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  • Brief Communication

    Meshed acellular dermal matrix: technique and application in implant based breast reconstruction

    Dino Zammit , Jonathan Kanevsky , Fan-Yi Meng , Tassos Dionisopoulos
    Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic surgeons. However, while the overall surgical outcome of breast reconstruction using alloderm has been a success, the economic burden on the health care system makes it a subject of frequent re-evaluations in cost-effectiveness. Prompted by the high price of $3,700 USD for a 6 cm × 16 cm area, our group proposes the meshing of AlloDerm to decrease the total amount needed for breast reconstruction, while achieving comparable surgical outcomes as using unmeshed alloderm.
    Published on: 14 Jul 2016
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  • Letter to Editor

    The most compatible position of operator for mandibular right posterior teeth extraction

    Ramesh Kumaresan , Sivakumar Pendyala , Jawahar Dhanavel
    Published on: 14 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Breast amyloidosis: a case report

    Giulia Boscaini , Marco Pignatti , Giovanni Tazzioli , Giorgio De Santis
    Amyloidosis is an uncommon disorder characterized by extracellular deposition of abnormal proteins. Breast involvement has rarely been reported and can clinically be misdiagnosed as breast cancer. A 60-year-old woman presented with a 3-mm diameter mass in the right breast close to a silicon implant positioned 20 years before. A core biopsy, performed to rule out breast cancer, showed amyloid deposit. Further exams confirmed a systemic amyloid light chain amyloidosis. After few months the mass increased causing breast volume and shape distortion. Since breast cancer may be the cause of...
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Application of regenerative medicine in treatment of acne scars

    Mauro Barone , Stefania Tenna , Annalisa Cogliandro , Vincenzo Panasiti , Carolina Nobile , Paolo Persichetti
    Aim: The aim of this study is to evaluate the efficacy of the protocol of nanofat and platelet-rich plasma (PRP) infiltration and fractional CO2 laser resurfacing for face atrophic scars by acne and to analyse patient’s satisfaction with the original questionnaire. Methods: From March 2014 to June 2015, 30 patients with acne scarsonthe cheeks were selected for this pilot study. Patients were evaluated pre- and postoperatively by a physical examination, photographs and ultrasound scan with a 22 MHz probe to measure subcutaneous tissue thickness. All patients were treated by infiltration of...
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Closed rhinoplasty: effects and changes on voice - a preliminary report

    Giuseppe Guarro , Romano Maffia , Barbara Rasile , Carmine Alfano
    Aim: Effects of rhinoplasty were already studied from many points of view: otherwise poor is scientific production focused on changes of voice after rhinoplasty. This preliminary study analyzed objectively and subjectively these potential effects on 19 patients who underwent exclusively closed rhinoplasty. Methods: This preliminary evaluation was conducted from September 2012 to May 2013 and 19 patients have undergone primary rhinoplasty with exclusively closed approach (7 males, 12 females). All patients were evaluated before and 6 months after surgery. Each of them answered to a...
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Twenty years of experience with the rabbit model, a versatile model for tracheal transplantation research

    Margot Den Hondt , Bart M. Vanaudenaerde , Pierre Delaere , Jan J. Vranckx
    Pathologies comprising more than half the length of the trachea are a challenge to the reconstructive surgeon. Innovative tracheal transplantation techniques aim to offer the patient a curative solution with a sustained improvement in quality of life. This review summarizes the authors’ experience with the rabbit as a versatile model for research regarding tracheal transplantation. Because of the segmental blood supply of the trachea, it is not feasible to transplant the organ together with a well-defined vascular pedicle. As such, the key element of successful tracheal transplantation is...
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Incredible surgery in India

    Giovanna Spinzo
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Report on the European Residents in Plastic Surgery Meeting 2015

    Carlo Melloni
    Published on: 7 Jul 2016
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  • Topic: EuRePS Meeting 2015: best five papers

    Preface to special issue on “EuRePS Meeting”

    Francesca Toia
    Published on: 7 Jul 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    Current role in facial allograft transplantation: what have we learned?

    Pedro Infante-Cossio , Fernando Barrera-Pulido , Tomas Gomez-Cia , Domingo Sicilia-Castro , Alberto Garcia-Perla-Garcia , Purificacion Gacto-Sanchez , Jose-Maria Hernandez-Guisado , Araceli Lagares-Borrego , Rocio Narros-Gimenez , Juan-David Gonzalez-Padilla
    Face transplant (FT) has evolved enormously in the last 10 years since the successful completion of the first facial transplant. This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces. The authors review the literature and discuss the main surgical, immunological, and ethical aspects as well as the results described in patients undergoing FT. To date there have been more than thirty FT worldwide. The main indication was post-traumatic deformity. In all cases a standard immunosuppression was...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    Current prognosis and quality of life following surgical treatment for head and neck squamous cell carcinoma

    Cristina Hernández-Vila
    Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world with a close relation with some risk factor like, tobacco, alcohol consumption and more recently, with human papilloma virus infection. A review of the literature about actual prognosis and quality of life in HNSCC has been done analysing the results of surgical treatment and their impact on the quality of life of patients. Despite the elevated incidence of HNSCC, the survival rate has increased considerably over the last years thanks to the development of new surgical techniques, such as,...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The reliability of the "Iberic graft" for covering of the radial forearm free flap donor site

    Manuel Moreno-Sánchez , Raúl González-García
    Aim: Traditional donor site closure from radial forearm free flap (RFFF) has been associated with esthetic and functional morbidity. To avoid complications, such as color mismatch and secondary donor site morbidity, a new technique named "Iberic graft" for covering the RFFF donor site was described previously by our team. Methods: A study of patients who underwent reconstruction of head and neck defects using a RFFF was conducted to assess postoperative complications of the RFFF donor site and also to evaluate the morbidity in terms of aesthetics and function following the use of the...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The role of salvage surgery in oral squamous cell carcinoma

    Raúl González-García
    Aim: To select and analyze the most representative papers published in the literature concerning oral squamous cell carcinoma (OSCC), specifically dealing with salvage surgery following primary treatment by surgery with or without by postoperative radiotherapy, specifically focusing in the oral cavity and oropharynx locations. Methods: A bibliography search on MEDLINE and EMBASE databases for studies published from March 2000 to March 2016 was conducted. The authors only included studies published in the English language and those dealing with “squamous cell carcinoma of the oral cavity...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    Contralateral neck dissection in oral squamous cell carcinoma: when it should be done?

    Laura Villanueva-Alcojol
    Oral cavity squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes bilaterally because of the rich lymphatics in the submucosal plexus, which freely communicate across the midline. The presence of contralateral pathologic lymph nodes has been reported previously as a critical factor influencing the survival of patients. There are a few reports in the literature with regard to the rates of contralateral neck disease and the factors that may be involved in the risk with them. An elective ipsilateral neck treatment is generally recommended...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    Elective neck dissection in oral squamous cell carcinoma of the upper maxilla: necessary?

    Manuel Moreno-Sánchez
    Aim: Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma (SCC) of the upper jaw is controversial. The purpose of this systematic review was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected. Methods: An electronic literature search was conducted in several databases, including MEDLINE, EMBASE, and Cochrane Central databases, for articles written in English. Results: Twenty-eight articles were included in the review. The overall cervical metastases rate was 33% and the...
    Published on: 24 Jun 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    Elective neck dissection in early oral squamous cell carcinoma: necessary?

    Carlos Moreno-García
    Aim: The indication of neck dissection in oral squamous cell carcinoma (OSCC) is a problem of risk-benefit evaluation between probability of neck metastases, the problem of complications associated with neck dissection and the prognostic influence of delayed diagnosis of metastasis during follow-up. There is no consensus on the elective treatment of the neck in early oral cancer patients with a clinically N0 (cN0) neck. Methods: The author performed a search of PubMed articles with the words "elective neck dissection vs. observation", "node negative neck" and "early stage oral squamous cell...
    Published on: 25 May 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The role of radiotherapy in the treatment of oral cavity cancer

    Joaquín J. Cabrera-Rodríguez
    Radiotherapy plays a critical role in the treatment of oral cavity squamous cell carcinoma as monotherapy in early stage cancer or combined with surgery and/or chemotherapy in advances ones. Recent developments in the imaging of cancer and radiation technology have allowed developing more precise delivery of treatment with recent data demonstrating improvement in survival and lessening of adverse toxics effects of radiation. This review will focus in the recent advances and current state-of-the-art in radiation oncology both external beam radiotherapy and brachytherapy. As complexity of...
    Published on: 25 May 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The tissue shrinkage phenomenon on surgical margins in oral and oropharyngeal squamous cell carcinoma

    David González-Ballester
    Aim: One of the most important factors associated with recurrence rate and overall survival is the status of surgical margin of resection free of disease. However, sometimes, the margins measured intra-operatively at the time of surgery differ of those measured by the pathologist in the histopathologic analysis. Faced with this dilemma, a literature review of the best available evidence was conducted in an attempt to determine how the phenomenon of tissue shrinkage may influence on the surgical margin of resection in patients undergoing oral and oropharyngeal squamous cell carcinoma (SCC)....
    Published on: 25 May 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The role of sentinel node biopsy in oral squamous cell carcinoma

    Justo Serrano-Vicente
    Aim: The purpose of this study was to conduct a systematic review of the published literature to assess the state of the art of this procedure. Sentinel node biopsy (SNB) in oral squamous cell cancer (OSCC) is a novel and proven useful technique alternative to the neck dissection (ND) in the management of OSCC. Methods: The authors searched PubMed for literature in English published for the last five years, addressing this topic. Prospective studies articles were selected with at least thirty patients studied. Results: Of 235 studies found, 14 studies met the exclusion and inclusion...
    Published on: 25 May 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    The role of human papillomavirus in oral squamous cell carcinoma

    Francisco A. Ramírez-Pérez
    Aim: The causative role of human papillomavirus (HPV) has been established into the aetiology of oral squamous cell carcinoma (OSCC). Some authors believe that HPV can determinate the prognosis and module treatment response from this kind of malignancies. Methods: Articles published in the last 10 years, focusing on the role of HPV in the development, molecular biology, prognosis and treatment of OSCC were reviewed. Results: Thirty-nine articles from 252 were selected, highlighting 4 meta-analysis, 3 prospective and 2 retrospective studies. According to its role in the development of...
    Published on: 25 May 2016
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  • Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

    State of the art in the management of oral squamous cell carcinoma

    Raúl González-García
    The present editorial is an introductory paper to a special issue composed of eleven manuscripts focusing on particular aspects about the state of the art in OSCC under the light of current knowledge. While strict criteria for systematic reviewing concerning Cochrane database recommendations have not been followed due to the heterogeneity of the revised series, an effort has been made to selectively approach particular aspects of OSCC management, while selecting the most prominent series within the last 15 years. Some of the incoming works have made a special effort in trying to include and...
    Published on: 25 May 2016
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  • Original Article

    Treatment of chronic recurrent dislocation of temporomandibular joint by autologus blood injection

    Syed Sayeed Ahmed , Md. Kalim Ansari
    Aim: The aim of this study was to evaluate the efficacy of autologus blood injection in the management of recurrent temporomandibular joint (TMJ) dislocation. Methods: A total of 11 patients, 4 males, 7 females, mean age of 58.6 years and suffering from recurrent dislocation of TMJ, were included in the study. In all the patients the procedure included anesthesia- local or sedation, arthrocentesis which was followed by autologous blood injection in the upper joint cavity. The peri-articular tissues were also infiltrated with autologous blood. Post procedure advice included restricted mouth...
    Published on: 25 Apr 2016
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  • Original Article

    The forehead flap: a valuable option in resource depleted environment

    Rowland Agbara , Benjamin Fomete , Athanasius Chukwudi Obiadazie , Kelvin Uchenna Omeje , Olushola Ibiyinka Amole
    Aim: Reconstruction of orofacial soft tissue defect is often challenging and this is more difficult in resource challenged environment. This retrospective study highlights our experience with the use of forehead flap to overcome some of the challenges of orofacial reconstruction in a resource depleted environment. Methods: A 23-year retrospective analysis of all patients who had orofacial defect reconstruction using forehead flap in our department was undertaken. Information was sourced from patient’s case notes and operating theatre records. Data was analyzed using Statistical Package for...
    Published on: 25 Apr 2016
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  • Original Article

    Self-esteem and rhinoplasty: a case-control study

    Mohsen Naraghi , Mohammad Atari
    Aim: Self-esteem is one’s attitude towards oneself. It is one of the most important psychological aspects of rhinoplasty, a common aesthetic operation. Prior studies have indicated an improvement in patients’ self-esteem after this operation. The aim of current study was to preoperatively compare self-esteem in patients seeking aesthetic rhinoplasty with that of functional rhinoplasty patients. Methods: A total of 42 patients completed the validated Rosenberg Self-Esteem Scale preoperatively (21 aesthetic surgery patients and 21 functional surgery patients). Those with both aesthetic and...
    Published on: 25 Apr 2016
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  • Original Article

    Blood lipid profiles following nonfocused ultrasonic treatment for noninvasive body contouring

    Takashi Honda , Katsuhiro Kure , Hiroyuki Goto , Takuya Suzuki , Mariko Mogami , Tsukasa Isago
    Aim: Blood lipid profiles changed following nonfocused ultrasound treatments for body contouring. The present study elucidates clinical effects of these devices on adipose tissue. Methods: Ultrasound treatments for 5 males and 5 females in a supine position, ages 37-67 years, were applied at 20 KHz and 3.0 W/cm2 in modulated emission. Whole abdomen was treated by an ultrasound handpiece for 30 min followed by a 6-min lymphatic drainage. Waist circumferences at the level of the umbilicus and body weight were measured before and immediately after treatment. Blood lipid profiles including...
    Published on: 25 Apr 2016
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  • Case Report

    Angioleiomyoma: a rare diagnosis of a painful subcutaneous nodule in the hand

    Sandeep Bhogesha , Satyaswarup Tripathy , Jerry R. John , Debajyoti Chatterjee
    Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity. It arises from smooth muscle of the blood vessels and the most common symptom is pain. Imaging with magnetic resonance imaging shows characteristic features like a hypodense peripheral capsule with linear or branching internal hyperdensities on T2-weighted images, and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion. Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells surrounding vascular lumina, lined by...
    Published on: 25 Apr 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    Collagen membrane for reconstruction of soft tissue defects after surgery of oral cancer and precancer: a brief review

    Ankita Vastani , Nishant Chourasia , Vedant Pahlajani , Suryakant Choubey
    There are some surgeries after which a temporary cover for raw wounds is required to ensure healing. Some of those circumstances are loss of tissue due to burns, trauma, amputation, chronic ulcer, leprosy, and skin graft sites. Although the body initiates regeneration mechanisms, however the time taken for complete healing of wounds is unpredictable. Also, there is a tendency for long standing wounds to undergo infection and scarring. Oral mucosa is no exception to scarring and infection of wounds and there has always been a search for new materials that can be used for coverage of oral...
    Published on: 23 Mar 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    An update review on recent skin fillers

    Li-Ying Cheng , Xiao-Ming Sun , Meng-Yao Tang , Rong Jin , Wen-Guo Cui , Yu-Guang Zhang
    Facial rejuvenation has changed over the last decade, evolving from the rhytidectomy to an approach that focuses on revolumization, due to a more complete understanding of the changes to bone and soft tissue that occur with the aging face. Soft tissue augmentation using various injectable filler agents has gained popularity due to their nonsurgical, non-invasive procedures, instant cosmetic outcomes and limited recovery time. The skin filler market is booming and the variety of available skin fillers is increasing, providing the plastic surgeons many choices. Nonpermenant, biodegradable,...
    Published on: 23 Mar 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    Materials to facilitate orbital reconstruction and soft tissue filling in posttraumatic orbital deformaties

    Ling-Xiao Ye , Xiao-Ming Sun , Yu-Guang Zhang , Ying Zhang
    Posttraumatic orbital reconstruction has been a challenging mission for decades in craniomaxillofacial surgery. Complications like enophthalmos, diplopia and gaze obstacles emerge when orbital trauma occurs, affecting people' s daily life as well as their appearance. Advances in technology and research gained through years of experience has provided us with a greater understanding of the changes following trauma, as well as providing us with a variety of filling materials that we can choose from to handle the deformities. However, the best type of material for repair of orbital deformities...
    Published on: 23 Mar 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    Advances in the research of autologous fibroblast injections for aging skin

    Meng-Yao Tang , Rong Jin , Ying Zhang , Yao-Ming Shi , Bao-Shan Sun , Lu Zhang , Yu-Guang Zhang
    With the development of autologous stem cells transplantation, the application of autologous fibroblast graft has been an important therapy in defect repair. In the past decade, amounts of studies have reported favorable treatment effect and safety about the therapy. The material has the ability to produce human collagen in vivo. This article details recent scientific work of the cases, effect, injection technique, complications and safety of autologous fibroblast injection treatment.
    Published on: 23 Mar 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    Biomaterials for facial aging

    Wen-Guo Cui , Xin Zhao , Yu-Guang Zhang
    Fountain of youth has always been the dream of mortals since the ancient time. Since ages ago, mortals have always been searching for ways to stay and look young. In the new millennia, retaining a youthful appearance is no longer a dream beyond reach. The advancement in medical technology, especially in the dermatological technology, has made the dream of youth possible.
    Published on: 23 Mar 2016
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  • Topic: Biomaterials for Plastic and Aesthetic Surgery

    Intradermal fillers for minimally invasive treatment of facial aging

    Zhi Yuan (William) Lin , Vishva Shah , Arvind Dhinakar , Lara Yildirimer , Wen-Guo Cui , Xin Zhao
    The ever-increasing interest in retaining a youthful physical appearance has facilitated the development of various minimally invasive dermatological techniques. The use of intradermal fillers can be incorporated into dermatological practices with minimal overhead costs. This strategy addresses facial volume loss and dynamic lines, which are the main features of facial aging. Moreover, intradermal fillers provide an array of flexible treatment options for a balanced and holistic result to dermatological practitioners. This paper reviews the different intradermal fillers categorized by...
    Published on: 23 Mar 2016
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  • Original Article

    Penoscrotal defect: a functional, esthetic, and psychological challenge

    Durga Karki , Pankaj Kumar Patel , Ravi Prakash Narayan
    Aim: Penoscrotal defects may be caused by a variety of events. Reconstruction of the penoscrotal region is required not only for aesthetic appearance but also for functional and psychological reasons. Numerous techniques have been described for penoscrotal reconstruction reflecting the challenge and complexity of the region involved. This suggests that no single method is satisfactory for all types and degrees of tissue defects. This prospective study was conducted in a tertiary care hospital in India, over a period of 5 years. Methods: Eighteen patients with penoscrotal defects of varying...
    Published on: 29 Feb 2016
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  • Original Article

    Hyperbaric oxygen therapy improves outcome of snake envenomation: tertiary center experience

    Pradeoth Korambayil Mukundan , Prashanth Varkey Ambookan , Ragu Angappan
    Aim: Snakebite injuries of the extremities are common in tropical India among those involved in farming and outdoor activities. These injuries often complicated by cellulitis, gangrene, regional lymphadenopathy, compartment syndrome, bleeding abnormalities, septicemia, hypotension, and disseminated intravascular coagulation, resulting in significant morbidity and mortality. The purpose of the study is to share our experience of hyperbaric oxygen (HBO) therapy in the management of snakebite injuries. Methods: All patients who were treated for snakebite injuries in our department between...
    Published on: 29 Feb 2016
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  • Original Article

    Utility of multi-detector row computed tomography angiography versus Doppler in localization of perforators of anterolateral thigh flaps

    Chandan N. Jadhav , Surinder Singh Makkar , Gautam Biswas , Niranjan Khandelwal
    Aim: Anterolateral thigh (ALT) flap is widely used in reconstruction of various defects. Preoperative imaging facilitates perforator mapping, overcoming intraoperative uncertainty. The purpose of this study was to investigate the utility of multi-detector row computed tomography angiography (MDCTA) and a handheld Doppler in locating ALT perforators. Methods: Twenty patients were randomized into two groups. Group 1 patients received MDCTA and Doppler studies whereas Group 2 received only a Doppler study. The number, location, course, and source of all cutaneous and sizable perforators were...
    Published on: 29 Feb 2016
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  • Original Article

    Reconstruction of the anterior skull base with radial forearm free tissue transfer: case series and literature review

    Windy A. Olaya , Lauren T. Daly , Emily G. Clark , Thomas Scholz , Vincent Laurence , Keyianoosh Z. Paydar , Garrett A. Wirth , Gregory R. D. Evans
    Aim: Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained. We propose the use of the radial forearm free flaps (RFFF) as a superb method of re-establishing integrity in anterior skull base defects. Methods: Literature review and retrospective analysis of 4 single-institution cases of anterior skull base defects reconstructed with a RFFF. Data were collected on successful and unsuccessful defect repairs, complication rates, and length of hospitalization. Results:...
    Published on: 29 Feb 2016
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  • Original Article

    Modulation of Wnt/β-catenin signaling affects the directional differentiation of hair follicle stem cells

    Bin Yang , Xiao-Ying Wu , Jian Ni , Bing-Hang Li , Li-Huan Deng , Meng-Juan Xiang
    Aim: The differentiation of hair follicle stem cells (HFSCs) into hair follicle cells has potential clinical applications for cutaneous burns. However, the mechanisms regulating the differentiation of HFSCs into hair follicular papilla or epidermal cells are currently not clear. This study investigated the role of the Wnt/β-catenin pathway and its crosstalk with other signaling components during this differentiation process. Methods: Lithium chloride (LiCl, 10 mmol/L) and keratinocyte growth factor (KGF, 10 µg/L) were used to induce HFSC differentiation, validated by immunofluorescence...
    Published on: 29 Feb 2016
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  • Letter to Editor

    Painful scar neuropathy: principles of diagnosis and treatment

    Andrea Lisa , Matteo Murolo , Luca Maione , Valeriano Vinci , Valeria Bandi , Francesco Klinger , Marco Klinger
    Published on: 29 Feb 2016
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  • Topic: Aesthetic Surgery of the Breast

    Cleavage classification: categorizing a vital feminine aesthetic landmark

    Muhammad Adil Abbas Khan , Ammar Asrar Javed , Nigel Mercer
    Breast cleavage is defined by the International Federation of Associations of Anatomists (IFAA), as the space present between a woman’s breasts. The width of the inter-mammary cleft is defined by the distance between the points of attachment of the breast tissue to the periosteal tissue.
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    Pathogenesis, presentation and classification of late autoinflation of the breasts: case report and literature search

    Umar Daraz Khan
    Aim: Autoinflation of the breast following mammoplasty using breast implants can be divided into early and late. Early autoinflation of the breast is commonly due to haematoma. Late autoinflation of the breast is an uncommon complication and its true incidence is not known due to the paucity of its reporting. Methods: A retrospective review was performed of the available charts for 2,772 consecutive bilateral primary, secondary augmentation mammoplasties and mastopexy with augmentation mammoplasties by the author between April 1999 and February 2015. Each breast was taken as a single unit...
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    Augmentation mastopexy and augmentation mammoplasty: an analysis of 1,406 consecutive cases

    Umar Daraz Khan
    Aim: Simultaneous augmentation mastopexy is a challenging operation for esthetic plastic surgeons. Complication and revision rates following augmentation mammoplasty or mastopexy are less commonly seen when these two procedures are performed separately. However, when the two procedures are combined, the complication rate is reported exponentially higher when compared with its individual component carried out separately. The current retrospective chart review is a comparative analysis of the two procedures performed by a single surgeon. Methods: Retrospective data were collected using...
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    A long term review of augmentation mastopexy in muscle splitting biplane

    Umar Daraz Khan
    Aim: Simultaneous or single stage mastopexy with augmentation is challenging, unique and commonly performed by a plastic surgeon. In this procedure pocket for implant placement, marking for envelope reduction and type of implants used can affect the outcome of the procedure. Muscle splitting pocket for mastopexy is a plane described by the author for implant placement with a short term follow up. The use and outcome of the technique is presented with a larger series and a long term follows up to evaluate the efficacy of the procedure. Methods: Retrospective data was collected. Augmentation...
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    Bi-plane breast augmentation: a case series supporting its use and benefits

    Matthew Stodell , Gordon McArthur , Mathew James
    Aim: Breast augmentation has traditionally been performed in either the subglandular or submuscular plane. Dual plane augmentation has been described before and captures the advantages of both of these techniques but reduces the trade-offs. The biplane muscle splitting technique adopts the similar advantages seen with the dual plane method without the need for extensive costal muscle fibre release at the infra-mammary fold. Methods: Thirty-five patients underwent bilateral breast augmentation using the biplanar technique from November 2007 to December 2008. All operations were performed by...
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    Commentary

    Francesco M. Egro , Chibueze A. Nwaiwu , Vu T. Nguyen
    The association between body mass index (BMI) and surgical complications has been of great interest in recent years given the rise of obesity worldwide. Current evidence shows that there is a strong correlation between obesity and the rate of complications following breast reconstruction, such as wound dehiscence, superficial wound infection, and graft or flap loss. Although malnutrition has been identified as a risk factor for poor wound healing and the effects of reconstruction, no articles have examined the impact of low BMI on the outcomes of breast reconstruction.

    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    An analysis of underweight status on 30-day outcomes after breast reconstruction

    Anas Eid , Jon P. Ver Halen
    Aim: To examine the impact of underweight body mass index (BMI) values on breast reconstruction outcomes. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively reviewed for all patients who underwent breast reconstruction between 2006 and 2011. Patients were first stratified by breast reconstruction modality into prosthetic or autologous cohorts, and second by BMI values into underweight (BMI < 18.5), normal to overweight (reference, BMI 18.5-29.99), moderate obesity (BMI 30-34.99), severe obesity (BMI 35-39.99),...
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    Internal bra: a unifying solution for reconstructive and aesthetic breast surgery issues

    Richard A. Baxter
    The internal bra is a concept utilizing implantable materials for long term maintenance of support and shape of the breast with mastopexy and in revision breast surgery. This article reviews the various materials used for the internal bra including Acellular Dermal Matrices, non-absorbable meshes, and newer bio-inductive products such as Seri silk scaffold and Galaflex.
    Published on: 15 Jan 2016
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  • Topic: Aesthetic Surgery of the Breast

    An overview of aesthetic surgery of the breast

    Umar Daraz Khan
    Aesthetic surgery for the breast is one of the common procedure performed by an aesthetic plastic surgeon today. The surgery is frequently performed for aesthetic as well reconstructive reasons. Breast itself is a uniquely important part of the female body and as such embodies in itself anatomical, physiological and aesthetic role. A proportionately developed breast is an important feminine feature, a sign for fertility and sexuality. It is not surprising that breasts are extremely important for women’s self-confidence especially when their role in society has expanded immensely.
    Published on: 15 Jan 2016
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  • Original Article

    Transfer of upper trapezius with clavicular segment for restoration of shoulder movements following injury to the brachial plexus

    Neeraj Kant Agrawal
    Aim: Most brachial plexus palsies occur following high-velocity trauma. The shoulder joint is a large proximal joint which influences the motion of the hand. Transfer of the trapezius muscle is an effective alternative for palsy of the deltoid and supraspinatus muscles. Methods: Between 2009 and 2014, 32 patients were treated with modified trapezius muscle transfer in which only the descending fibers along with their attachment to the lateral third of clavicle were used. The clavicle was fixed to the anterolateral surface of the humerus by cancellous screws. The arm was immobilized for 6...
    Published on: 12 Nov 2015
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  • Original Article

    Tissue engineering using mesenchymal stem cells with periosteal wrap for bone defect repair in rabbits

    Trung-Hau Lê Thua , Dang-Nhat Pham , Khanh-Linh Lê , Minh-Tuan Lê , Quang-Ton-Quyen Nguyen , Phan-Huy Nguyen , Ngoc-Vu Tran , Ngoc-Luong Nguyen , Willy Boeckx , Albert Demey
    Aim: Mesenchymal stem cells (MSCs) are an excellent potential source of cells for bone tissue engineering due to their excellent renewal ability and osteogenic differentiation capabilities. This study was designed to evaluate the bone formation properties of a demineralized cancellous bone scaffold seeded with MSCs, with or without periosteum, in a critical size bone defect model in rabbits. Methods: Rabbit culture‑expanded bone marrow (BM)‑MSCs were seeded onto a human demineralized cancellous bone (HDCB) scaffold. Bone defects measuring 15 mm in length were created in each radius. A total...
    Published on: 12 Nov 2015
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  • Original Article

    Synergistic effect of hyperbaric oxygen preconditioning and hydrogen-rich saline in ameliorating rat flap ischemia/reperfusion injury

    Yi-Ding Xiao , Yun-Qi Liu , Ming-Zi Zhang , You-Bin Wang , Yi-Fang Liu , Xue-Mei Ma
    Hyperbaric oxygen (HBO) treatment has been widely used in clinical work, while, hydrogen-rich saline (HRS) has also been shown its protective effect of ameliorating ischemia/reperfusion (IR) injury. What will we obtain if these two approaches combined together? In this study, we set five independent groups (Sham, IR, HBO, HRS and HBO+HRS) of rat abdominal skin flap IR model with different interferences. In conclusion, the synergistic application of HBO and HRS showed a higher flap survival rate, which could be a combined treatment to improve skin flap survival against IR injury.
    Published on: 12 Nov 2015
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  • Editorial

    Peripheral nerve injuries

    Katerina Anesti , Paul Caine
    Published on: 12 Nov 2015
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  • Review

    Nasal dorsal aesthetic lines and rhinoplasty technical tricks

    Alexander Kutubidze
    Rhinoplasty surgery remains one of the most difficult operations of the face. Improving aesthetic appearance and maintaining nasal function are inseparable goals in rhinoplasty surgery, and failure to achieve either of these objectives can be devastating for the patient. After evaluating a variety of rhinoplasty complications, increased attention was devoted to the surgical technique for reconstruction of the dorsal aesthetic lines and nasal tip projection in the patient with a prominent dorsal hump. Based on the modern concept of cartilage conservation, the autospreader flap rotation...
    Published on: 12 Nov 2015
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  • Original Article

    First-year experience of a new skin bank in Brazil

    Alysson Rogerio Matioski , Clóvis Rodrigo Guimarães Braz Pereira da Silva , Diogo Rodrigues da Silva-Cunha , Luiz Henrique Auerswald Calomeno , Flávia Thaiana Bonato , Marcelus Vinícios Araujo Nigro
    Aim: To report the 1st year experience of the skin bank opened at the Evangelical University Hospital of Curitiba (HUEC), Brazil in June 2013. Methods: A retrospective statistical and epidemiological study was conducted from data obtained from the activities of the HUEC skin bank from June 2013 to August 2014. Results: The HUEC skin bank harvested tissue from 45 cadaveric donors (46.6% female and 53.3% male), with an average age of 36.42. The white skin‑colored donors represented 91% of donations. Most causes of death were of neurological origin (55.6%). Eighty‑one batches were harvested....
    Published on: 12 Nov 2015
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  • Case Report

    Lacrimal sac rhinosporidiosis

    Laxmi Kanta Mishra , Sanjeev Gupta , Surya Kanta Pradhan , Manas R. Baisakh
    Rhinosporidiosis is caused by the organism Rhinosporidium seeberi. It is a rare aquatic protistan parasite. Though more prevalent in Asiatic regions, cases have also been reported in European countries. In India, it mostly affects the southern part. Rhinosporidium seeberi most commonly affects the mucous membranes, but can also affect other structures including the larynx, trachea, skin, genitalia, lungs and rectum. The typical presentation is that of a pinkish mass which bleeds profusely. Isolated lacrimal sac rhinosporidiosis is very rare. Computed tomography scans and magnetic resonance...
    Published on: 12 Nov 2015
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  • Editorial

    Lift of cheek and neck: technical notes

    Maurice Yves Mommaerts
    Published on: 12 Nov 2015
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  • Review

    Free deep inferior epigastric perforator flap after abdominal liposuction: reconsidering a contraindication

    Peter James Mankowski , Jonathan Kanevsky , Anne-Sophie Lessard , Teanoosh Zadeh
    Autologous breast reconstruction with perforators has been previously avoided in tissues that have undergone liposuction. We present a case series and literature review of breast reconstruction with deep inferior epigastric perforator (DIEP) flaps after abdominal wall liposuction. An MEDLINE search was performed for all relevant articles describing breast reconstruction with DIEP flap technique following the abdominal wall liposuction. Key search words used included “DIEP”, “DIEAP”, “deep inferior epigastric perforator”, “liposuction” and “free flap”. All published data on the topic from...
    Published on: 12 Nov 2015
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  • Original Article

    Cost-effectiveness of one-stage versus two-stage breast reconstruction in the United Kingdom

    Isabel Teo , Iman A. Azmy
    Aim: Permanent expanders allow for breast reconstruction as a single stage. These prostheses are more expensive than conventional tissue expanders, but this excess cost is markedly offset as only one operation is required. However, if the revision rate is sufficiently high, then this effect is negated. We aim to compare costs of one-stage vs. two-stage reconstruction at a single center, taking into account explantation and unexpected admissions following complications. Methods: A retrospective review was carried out on all patients who underwent one‑stage and two‑stage reconstruction over a...
    Published on: 12 Nov 2015
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  • Case Report

    High pressure paint gun injury of the index finger: a case report

    Memet Yazar , Zeliha Gül , Ali Can Günenç , Sevgi Kurt Yazar , Erol Kozanoğlu
    Injuries to the hand secondary to high pressure paint guns are considered to be true hand emergencies. These rare injuries may have serious outcomes, and a critical step in their management is extensive debridement performed within the first six hours following injury. For this reason, their diagnosis should not be delayed, and the hand surgeon should be informed immediately to initiate appropriate treatment. In this report, the authors describe a patient who was injured with a chemical paint gun, and whose injury was not diagnosed in the emergency department. The patient subsequently...
    Published on: 12 Nov 2015
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  • Topic: Current Concepts in Wound Healing

    Corticosteroid - an uncertainty in management of sepsis

    Kanica Yashi
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Acellular micronized extracellular matrix and occlusive dressings for open fingertip injuries

    Stephanie E. Dreifuss , Ronit Wollstein , Stephen F. Badylak , Peter J. Rubin
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Role of jet force technology in wound management

    Vijayaraghavan Nandhagopal , Ravi Kumar Chittoria , Devi Prasad Mohapatra , Friji Meethale Thiruvoth , Dinesh Kumar Shivakumar , Arjun Ashokan
    Aim: The aim was to study the role of jet force technology (JFT) in wound management. Methods: This is a retrospective analysis of 18 cases of chronic nonhealing wounds in which JFT was used. Chronic wounds which had already undergone surgical debridement but which were not ready for reconstruction (skin graft/flap) secondary to a persistent bacterial load or infection (tissue culture positive) were included in the study. Patients were divided into two groups. Group 1 included those patients who were poor candidates for anesthesia or who refused for reconstruction and were managed with JFT...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Histopathological study of chronic wounds modulated by intermittent negative pressure therapy under limited access dressing

    Thittamaranahalli Muguregowda Honnegowda , Pramod Kumar , Rekha Singh , Swarna Shivakumar , Pragna Rao , Hemanth K. Prasad , Sudesh Kumar , Udaya Kumar , Echalasara Govindarama Padmanabha Udupa
    Aim: Negative pressure wound therapy (NPWT) has achieved widespread success in the treatment of chronic wounds. However, its effects have been only partially explored, and investigations have generally concentrated on the wound-dressing interface; a detailed histopathological description of the evolution of wounds under NPWT is still lacking. The present study was performed to investigate the effect of a limited access dressing (LAD) which exerts intermittent NPWT in a moist environment on chronic wounds. Methods: A total of 140 patients were randomized into 2 groups: LAD group (n = 64) and...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    A comparative study to evaluate the effect of limited access dressing on diabetic ulcers

    Thittamaranahalli Muguregowda Honnegowda , Pramod Kumar , Krishnananda Prabhu , Ashwini Kumar , Pragna Rao , E. G. Padmanabha Udupa , Shobha Kamath , Antony Sylvan D’ Souza , Krishna Kishore Mahato
    Aim: Emerging evidence favors the important role of antioxidants, matrix metalloproteinases (MMPs), and nitric oxide (NO) in the healing of diabetic wounds. There is a lack of substantial evidence regarding the effects of negative pressure on antioxidants, MMPs and NO in chronic wounds associated with diabetes. Methods: A total of 55 type 2 diabetic patients with leg ulcers were divided into 2 groups: a limited access dressing (LAD) group (n = 27) and a conventional dressing group (n = 28). Levels of hydroxyproline, total protein, MMP‑2 and MMP‑9, NO and antioxidants including reduced...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Computer assessment of the composition of a generic wound by image processing

    Rohit Nayak , Pramod Kumar , Ramesh R. Galigekere
    Aim: This paper addresses the assessment of the composition of a general wound, in terms of all identifiable categories of tissue and pigmentation in an attempt to improve accuracy in assessing and monitoring wound health. Materials and Methods: A knowledgebase of clusters was built into the hue, saturation and intensity (HSI) color space and then used for assessing wound composition. Based on the observation that the clusters are fairly distinct, two different algorithms, that is, Mahalanobis distance (MD) based and the rotated coordinate system (RCS) method, were used for classification....
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Effect of limited access dressing on surface pH of chronic wounds

    Pramod Kumar , Thittamaranahalli Muguregowda Honnegowda
    Aim: Changes in the pH of chronic wounds can inhibit the optimal activity of various enzymes in the wound environment, thereby delaying wound healing. The aim of the present study is to monitor the effect of limited access dressing (LAD) on the pH on the surface of chronic wounds. Methods: A total of 140 patients with chronic wounds of more than 4 weeks duration were divided into two groups by simple randomization: a LAD group (n = 64) and a conventional dressing group (n = 76). Fifty‑six participants (22 in the LAD group and 34 in the conventional dressing group) were lost to follow‑up or...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Current concepts in the physiology of adult wound healing

    Friji Meethale Thiruvoth , Devi Prasad Mohapatra , Dinesh Kumar Sivakumar , Ravi Kumar Chittoria , Vijayaraghavan Nandhagopal
    Wound healing requires a complex interaction and coordination of different cells and molecules. Any alteration in these highly coordinated events can lead to either delayed or excessive healing. This review provides an overview of adult wound healing physiology. A review of the literature focused on wound healing physiology and current advances in wound healing was conducted using the online MEDLINE/PubMed database. The aim of this review was to inspire further investigation into wound healing physiology that will ultimately translate into improved patient care.
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Role of angiogenesis and angiogenic factors in acute and chronic wound healing

    Thittamaranahalli Muguregowda Honnegowda , Pramod Kumar , Echalasara Govindarama Padmanabha Udupa , Sudesh Kumar , Udaya Kumar , Pragna Rao
    Angiogenesis plays a crucial role in wound healing by forming new blood vessels from preexisting vessels by invading the wound clot and organizing into a microvascular network throughout the granulation tissue. This dynamic process is highly regulated by signals from both serum and the surrounding extracellular matrix environment. Vascular endothelial growth factor, angiopoietin, fibroblast growth factor and transforming growth factor-beta are among the potent angiogenic cytokines in wound angiogenesis. Specific endothelial cell ECM receptors are critical for morphogenetic changes in blood...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Assessment of the histological state of the healing wound

    Akriti Gupta , Pramod Kumar
    The dynamic process of wound healing has various phases, and the knowledge of which is essential for identification of the pathology involved in a chronic intractable wound. Various instruments for the assessment of wound healing have been described, primarily for clinical assessment of the wound. However, very few instruments are currently available for histological grading of the wound. The aim of this article is to review all available literature from 1993 to 2014 on the objective histological scoring of the state of wound healing. This review article emphasizes the importance of...
    Published on: 15 Sep 2015
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  • Case Report

    A massive dentigerous cyst of the mandible in a young patient: a case report

    Gururaj Arakeri , Kirthi Kumar Rai , Hosadurga Rudraswami Shivakumar , Shahanavaj I. Khaji
    Cysts of the jaw present as swellings of jaws and midface. Of the different varieties, the dentigerous cyst is the most common type of noninflammatory odontogenic cyst and the frequent cause of a lytic lesion associated with an impacted tooth. The cyst develops from epithelial remnants of the tooth forming organ. The obstruction of venous flow due to compression of tooth follicle by developing tooth causes fluid accumulation between the follicular epithelium and the crown of the developing or unerupted tooth resulting in a cyst. Most small dentigerous cysts manifest in early age, usually as...
    Published on: 15 Sep 2015
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  • Topic: Current Concepts in Wound Healing

    Limited access dressing and wound infection

    Pramod Kumar
    Published on: 15 Sep 2015
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  • Original Article

    Morphometry of subcutaneous fat lobules of the abdomen and its implication in obesity

    Arvind K. Pandey , Pramod Kumar , Kodavoor Shrinivas Aithal , Rama Kotian Sushma , Antony Sylvan D’Souza
    Aim: The subcutaneous fat in the lower abdomen (LA) is more resistant to resorption as compared to the upper abdomen (UA). Males and females have variability in fat deposition and resorption in the abdominal region. Hence, there could be a difference in morphology of fat cells of these regions. The present study aims to identify the differences in morphology of subcutaneous fat lobules of upper and LA. Methods: Subcutaneous fat samples were collected from upper and LA of 40 cadavers (33 males and 7 females). The shape, the arrangement, and the color of superficial and deep subcutaneous fat...
    Published on: 15 Sep 2015
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  • Case Report

    Ectrodactyly-ectodermal dysplasia-cleft lip/palate syndrome: a rare entity

    Samrat Sabhlok , Sobhan Mishra , Ramanupam Tripathy , Deepthi Mony
    Ectrodactyly-ectodermic dysplasia-cleft lip/palate (EEC) syndrome is a rare congenital anomaly of inherited origin and varying clinical features. This syndrome has three main symptoms, which display variable expression and penetrance. The management of this syndrome is challenging, with few reports in the medical literature. We present a case of a 22-year-old boy with EEC syndrome and offer insight into current knowledge about this syndrome.
    Published on: 15 Sep 2015
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  • Letter to Editor

    A simple postoperative oral physiotherapy aid for edentulous patients with oral submucous fibrosis

    Ankita Vastani , Anisha Maria , Nishant Chourasia , Ambika Shrivastava Gupta
    Published on: 15 Sep 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Nerve regeneration in vascularized composite allotransplantation: current strategies and future directions

    Anirudh Arun , Nicholas B. Abt , Sami Tuffaha , Gerald Brandacher , Angelo A. Leto Barone
    Vascularized composite allotransplantation (VCA) has emerged as a viable treatment option for limb and face reconstruction of severe tissue defects. Functional recovery after VCA requires not only effective immunosuppression, but also consideration of peripheral nerve regeneration to facilitate motor and sensory reinnervation of donor tissue. At the time of transplantation, the donor and recipient nerves are typically coapted in an end‑to‑end fashion. Following transplantation, there are no therapies available to enhance nerve regeneration and graft reinnervation, and functional outcomes...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Endoscopic telemicrosurgery or minimally invasive robotically-assisted microsurgery for peripheral nerve repair

    Satoshi Ichihara , Sybille Facca , Frédéric Bodin , Sarah Hendriks , André Gay , Philippe Liverneaux
    Microsurgery comprises a variety of surgical procedures such as neurovascular anastomoses, performed under optical magnification and with fine instrumentation. While refinements have been made since its advent in the 1960s, robotics offers the potential for major technological advancement. Endoscopic telemicrosurgery is minimally invasive, robotically-assisted microsurgery. This technique removes some limitations of conventional microsurgery and enhances visual and manual dexterity. Vision is enhanced through greater magnification, three‑dimensionality, and functionalization, all through an...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Tissue-engineered constructs for peripheral nerve repair: current research concepts and future perspectives

    Alba C. de Luca , Wassim Raffoul , Francesco Giacalone , Maddalena Bertolini , Pietro G. di Summa
    Traumatic injuries resulting in peripheral nerve lesions lead to important morbidity with devastating social and economic consequences. When the lesioned nerve cannot be sutured directly, a nerve graft is generally required to bridge the gap. Although autologous nerve grafting is still the first choice for reconstruction, it has the severe disadvantage of the sacrifice of a functional nerve. Research in tissue engineering and nerve regeneration may have a dramatic impact on clinical and surgical treatment of such nerve lesions. The authors review the latest concepts in tissue engineering...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    “Babysitting” procedures in proximal nerve trunk injuries: two case reports and a review

    Michele R. Colonna , Antonio Russo , Mariarosaria Galeano , Gabriele Delia , Giorgio E. Pajardi , Francesco Stagno d’Alcontres
    One of the most important goals in treating proximal nerve injuries is to maintain the function of distal effectors during axonal regeneration. “Babysitting”, that is, connecting the injured nerve to a healthy trunk provides a bypass for distal neural regeneration or reactivation. It avoids degeneration of sensory and motor terminations, with minimal donor nerve damage. We present a technique where a nerve graft is used between ulnar and median nerve through two end‑to‑side sutures in the distal third of the forearm, in two different cases of proximal ulnar nerve injury. Both patients were...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Sensory protection to enhance functional recovery following proximal nerve injuries: current trends

    Boa Tram Nghiem , Ian C. Sando , Yaxi Hu , Melanie G. Urbanchek , Paul S. Cederna
    Proximal nerve injury can lead to devastating functional impairment. Because axonal regeneration is slow, timely reinnervation of denervated muscle does not occur. These denervated muscles atrophy and lose function. Sensory protection is a surgical technique thought to prevent denervated muscle impairment using local sensory nerves to provide trophic support to the muscle until motor nerves can regenerate, and neuromuscular junctions are reestablished. We performed a comprehensive literature search using multiple databases to find primary articles reporting on the outcomes and treatment of...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Nerve transfers of the forearm and hand: a review of current indications

    Paolo Sassu , Katleen Libberecht , Anders Nilsson
    Nerve transfer surgery, also referred to neurotization, developed in the mid 1800s with the use of animal models, and was later applied in the treatment of brachial plexus injuries. Neurotization is based on the concept that following a proximal nerve lesion with a poor prognosis, expendable motor or sensory nerves can be re-directed in proximity of a specific target, whether a muscle or skin territory, in order to obtain faster re-innervation. Thanks to the contribution of several authors including Oberlin, MacKinnon and many others, the field of nerve transfer surgery has expanded in...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Vascularized nerve “grafts”: just a graft or a worthwhile procedure?

    Salvatore D’Arpa , Karel Etienne Yvonne Claes , Filip Stillaert , Britt Colebunders , Stan Monstrey , Phillip Blondeel
    The aim of this review is to extrapolate evidence regarding the use of vascularized nerve grafts (VNGs) in peripheral nerve reconstruction and summarize available data on their indications, if any, and clinical applications. A review of the literature via the PubMed database was performed with analysis of ninety-five articles on the experimental and clinical studies of VNGs. Eight relevant questions were selected to be answered about VNGs. VNGs allow faster nerve regeneration and convey a functional advantage under certain clinical conditions such as large nerves, proximal lesions, and...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Recalcitrant cubital tunnel syndrome

    Adolfo Vigasio , Ignazio Marcoccio , Eleonora Morandini
    Ulnar nerve neuropathy at the elbow represents the second most frequent compression neuropathy of the upper extremity. Of the five different anatomical areas responsible for ulnar nerve compression at the elbow region, the epitrochlear-olecranon channel and Osborne’s arcade are the most common. An additional cause of nerve damage is a dynamic process in which the ulnar nerve dislocates anteriorly at the epitrochlear-olecranon level during elbow flexion, partially or completely, causing nerve friction and constriction leading to chronic neuropathic pain. Failure after primary surgery is...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Neuropathic pain after bilateral sagittal split osteotomy: management and prevention

    Jimoh Olubanwo Agbaje , Ivo Lambrichts , Reinhilde Jacobs , Constantinus Politis
    Neuropathic pain is characterized by spontaneous and provoked pain and other signs reflecting neural damage. Aberrant regeneration following peripheral nerve lesions leaves neurons unusually sensitive and prone to spontaneous pathological activity, abnormal excitability and heightened sensitivity to stimuli. This review covers the current understanding of neuropathic pain after bilateral sagittal split osteotomy (BSSO) of the lower jaw. The reported incidence of neuropathic pain after mandibular osteotomies is less than 1%, while the incidence in patients with iatrogenic inferior alveolar...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    The management of neuropathic pain from neuromas in the upper limb: surgical techniques and future directions

    Tereze Laing , Aftab Siddiqui , Manu Sood
    Neuropathic pain of the upper limb results from damage or disease of the upper limb somatosensory system caused by wide range of pathologies including peripheral neuromas. Treatment strategies depend on making an accurate diagnosis, recognizing co-existing pathologies, and formulating an individualized treatment plan that commonly involves multiple modalities. A long list of nonsurgical and surgical methods acting peripherally (neuromodulation, nerve blocks, surgical manipulation of the nerve) and centrally (medications, spinal cord, and deep brain stimulation) has been described and it is...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Painful scar neuropathy: principles of diagnosis and treatment

    Pierluigi Tos , Alessandro Crosio , Pierfrancesco Pugliese , Roberto Adani , Francesca Toia , Stefano Artiaco
    Nerve-tissue interactions are critical. Peripheral nerve injuries may involve intraneural and extraneural scar formation and affect nerve gliding planes, sometimes leading to complex clinical presentations. All of these pathological entities involve pain as the main clinical symptom and can be subsumed under the term “painful scar neuropathy”. The authors review the literature on treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis‑associated procedures and propose a simple classification and a therapeutic approach to scar neuropathy. The search retrieved...
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Clinical neurophysiology and imaging of nerve injuries: preoperative diagnostic work-up and postoperative monitoring

    Andrea Gagliardo , Francesca Toia , Francesco Maggì , Alessio Vincenzo Mariolo , Michele Cillino , Francesco Moschella
    Peripheral nerve injuries are a heterogeneous group of lesions that may occurs secondary to various causes. Several different classifications have been used to describe the pathophysiological mechanisms leading to the clinical deficit, from simple and reversible compression-induced demyelination, to complete transection of nerve axons. Neurophysiological data localize, quantify, and qualify (demyelination vs. axonal loss) the clinical and subclinical deficits. High-resolution ultrasound can demonstrate the morphological extent of nerve damage, fascicular echotexture (epineurium vs....
    Published on: 15 Jul 2015
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  • Topic: Peripheral Nerve Repair and Regeneration

    Preface to special issue on "Peripheral Nerve Repair and Regeneration"

    Francesca Toia
    Published on: 15 Jul 2015
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  • Original Article

    Hyperbaric oxygen therapy and surgical delay improve flap survival of reverse pedicle flaps for lower third leg and foot reconstruction

    Pradeoth Mukundan Korambayil , Prashanth Varkey Ambookan
    Aim: The purpose of the study is to present a management protocol for various types of soft tissue defects of the distal third region of leg and foot treated with pedicle flaps, by including hyperbaricoxygen (HBO) therapy in the treatment regimen with flap delay. Methods: We present a prospective study of 23 patients with various types of soft tissue defects of the foot, and lower third of leg managed in our institution from December 2012 to December 2013. All soft tissue defects were treated by a reverse pedicle flap. Twelve patients were managed with flap delay with HBO therapy and 11...
    Published on: 15 May 2015
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  • Original Article

    A guiding oblique osteotomy cut to prevent bad split in sagittal split ramus osteotomy: a technical note

    Gururaj Arakeri , Peter A. Brennan
    Aim: To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems. Methods: The medial osteotomy cut is modified in the posterior half at an angle of 15°‑20° following novel landmarks. Results: The proposed cut exclusively directs the splitting forces downwards to create a favorable lingual fracture, preventing the possibility of an upwards split which would cause a coronoid or condylar fracture. Conclusion: This modification has proven to be successful to date without...
    Published on: 15 May 2015
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  • Original Article

    Use of the multiplane internal mastopexy for ptosis correction revision-augmentation mammoplasty

    Umar Daraz Khan , Muhammad Riaz
    Aim: Augmentation mammoplasty is a commonly performed procedure with a high satisfaction rate. Multiplane pocket was described for simultaneous internal mastopexy and augmentation using inframammary crease incision for selected primary and secondary mammoplasties. The use of the technique is presented with a larger experience for correction of ptosis in a patient presenting for revision surgery following subglandular augmentation mammoplasty. Methods: A retrospectively collected data were analyzed using the Excel Spread Sheet. A total of 25 patients had multiplane augmentation with the...
    Published on: 15 May 2015
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  • Case Report

    Use of tensor fascia lata flap for reconstruction of the defect created following inguinal block dissection in a case of carcinoma penis: a case report and brief review of literature

    Amitabh Jena , Banoth Manilal , Sriharsha Haranadh , Rashmi Patnayak
    Tensor fascia lata (TFL) flap is a versatile myofasciocutaneous flap. It has varied usages as both free and pedicled flap. As a pedicled flap, it is a good option for reconstructing soft tissue defects after tumor ablation. The TFL perforator flap is a good alternative for anterolateral thigh (ALT) flap. The advantages of TFL flap are that dissection can be made through the same incision, without impairment of other donor sites. The reconstructive plan remains same as that of ALT flap. TFL flap offers a good volume of skin and can be made thin removing variable portions of muscle. The...
    Published on: 15 May 2015
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  • Original Article

    Fat injection to correct contour deformities of the reconstructed breast: a single surgeon experience

    Youssef Tahiri , Jonathan Kanevsky , Joshua Vorstenbosch , James Lee , Karl Schwarz
    Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in breast reconstruction. The purpose of this study was to share our clinical experience using autologous fat injection to correct contour deformities during breast reconstruction. Methods: A single surgeon, prospectively maintained database of patients who underwent autologous fat injection during breast reconstruction from January 2008 to November 2013 at McGill University Health Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume of fat injected,...
    Published on: 15 May 2015
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  • Case Report

    Aesthetic rehabilitation of a patient with an anterior maxillectomy defect, using an innovative single-step, single unit, plastic-based hollow obturator

    Vishwas Bhatia , Garima Bhatia
    What could be better than improving the comfort and quality of life of a patient with a life-threatening disease? Maxillectomy, the partial or total removal of the maxilla in patients suffering from benign or malignant neoplasms, creates a challenging defect for the maxillofacial prosthodontist when attempting to provide an effective obturator. Although previous methods have been described for rehabilitation of such patients, our goal should be to devise one stage techniques that will allow the patient an improved quality of life as soon as possible. The present report describes the...
    Published on: 15 May 2015
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  • Editorial

    Hemifacial microsomia: management of the vertical ramus compartment

    Maurice Yves Mommaerts
    Hemifacial microsomia and Goldenhar syndrome pose unique challenges to the craniofacial surgeon. The O.M.E.N.S. classification provides a description of the craniofacial features. For the “M” of O.M.E.N.S. (the mandible), the Pruzansky-Kaban classification provides therapeutic guidelines for joint and face reconstruction. A sequence of standard procedures, including temporomandibular joint reconstruction, facial rotation surgery, gluteal fat grafting, and patient-specific titanium implantation, each have their intricacies. The author provides his expert opinion, acquired over thirty years...
    Published on: 15 May 2015
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  • Review

    Neurovascular plexus theory for “escape pain phenomenon” in lower third molar surgery

    Gururaj Arakeri , Mandeep Gill Sagoo , Peter A. Brennan
    Pain during extraction of impacted mandibular third molars which can occur despite adequate local anesthesia is termed as “escape pain phenomenon”. Recently, it was described during elevation of a mesioangular impacted mandibular third molar and also while curetting an extracted third molar socket. This phenomenon has been overlooked, as it was previously considered secondary to pressure effect on the inferior alveolar neurovascular bundle (IANB). However, it is unlikely that the pain impulses originate from direct pressure on the IANB, as the nerve is blocked more proximally at its entry...
    Published on: 15 May 2015
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  • Original Article

    Role of topical heparin in the management of burns: experience in a district government hospital of Karnataka in South India

    Ashish Gupta , Thangam J. Verghese , Priyanka Gupta , Ashok K. Gupta
    Aim: Heparin is a multifaceted compound with uses not only as an anticoagulant, but also as an anti-inflammatory, anti-allergenic, anti-histaminic, anti-serotonin, anti-proteolytic and neoangiogenic agent. The aim of the study was to study the effect of topical heparin in the management of second-degree burns. Methods: Between December 2005 and January 2007, 60 consecutive patients, aged 10-60 years, with first‑and second‑degree thermal injuries ranging from 10% to 60%, were randomly enrolled in the study divided into a control group (C) and a heparin group (H) of 30 patients each. Results:...
    Published on: 15 May 2015
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  • Case Report

    Rupture of the flexor carpi radialis tendon secondary to trauma: case report and literature review

    Jonathan Kanevsky , Dino Zammit , Jean-Paul Brutus
    The flexor carpi radialis (FCR) is one of the long flexors, which is important in flexing and abducting the hand at the wrist. It originates at the medial epicondyle of the humerus and attaches at the base of the second metacarpal. Closed rupture of the long flexors of the finger is well-described, especially in association with rheumatoid hands. However, rupture of the FCR is rare; only 11 cases reported in the literature, most of them associated with scaphotrapezial‑trapezoidal osteoarthritis. We describe 1 case of complete FCR rupture secondary to trauma, showing that long‑term...
    Published on: 15 May 2015
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  • Case Report

    Straight line closure for correction of congenital isolated bilateral macrostomia

    Narendra S Mashalkar , Naren Shetty
    Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see cases of isolated bilateral macrostomia. Although the creation of a symmetric neocommissure is imperative, this presents a technical challenge. A review of the literature for surgical solutions revealed various techniques, but no cases in which a bilateral straight line repair was described and adopted. This report presents the case of a 3-month-old boy with isolated bilateral macrostomia for whom straight line closure was performed on both sides. At 1 year follow-up, the oral commissures...
    Published on: 13 Mar 2015
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  • Case Report

    Reconstruction of palate with buccal fat pad secondary to resection of desmoplastic ameloblastoma

    Bhimappa Mallappa Rudagi , Manjunatha Reddy Bandral , Reshma Hammannawar , Pritish Harish Padgavankar
    Desmoplastic ameloblastoma (DA) is an unusual variant of ameloblastoma exhibiting important differences in the anatomical distribution, radiographic features and histologic appearance compared with the classic type of ameloblastoma. The purpose of this paper is to report a case of DA in the anterior left maxilla and to describe a simple method of reconstruction with the use of buccal fat pad (BFP). BFP is an excellent choice for reconstruction of small to medium sized defects. It should be manipulated gently and hemostasis should be achieved meticulously during this surgery. It should not...
    Published on: 13 Mar 2015
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  • Case Report

    Pseudoangiomatous squamous cell carcinoma: a challenge for pathologists and plastic surgeons

    Dimitrios Kanakopoulos , Evgenios Evgeniou , Panayiotis A Dimitriadis , Mahendra Kulkarni
    Pseudo-angiosarcomatous or pseudovascular squamous cell carcinoma (SCC) of the skin is an unusual variant form of acantholytic SCC that mimics the histopathological appearance of angiosarcoma. We describe a case of pseudovascular SCC in a 77-year-old lady to highlight the frequent recurrence and aggressiveness, as well as the clinicopathological features of this rare form of cutaneous SCC, and demonstrate the difficulties in establishing the correct diagnosis. Plastic surgeons involved in the care of patients with cutaneous malignancies should be aware of this variant of SCC and its...
    Published on: 13 Mar 2015
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  • Case Report

    Isolated tibial nerve injury: a rare presentation

    Rahul Krishnarao Patil , Prashant Verkey , Harshal Patil , Deepesh Manoharan
    Tibial nerve injury is rare and is always associated with other injuries due to its close association with the other structures. We present a rare case of isolated injury to the tibial nerve where the nerve was avulsed from the middle third of the leg, but all other structures were intact. The nerve was reconstructed with sural nerve grafts. The patient recovered sensation of the sole 12 months following the reconstruction and was able to maintain a normal gait and is living normal life. The results of nerve repairs in lower limbs in general have been poor. The treatment options for such an...
    Published on: 13 Mar 2015
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  • Original Article

    Soft tissue defects of eyelid and malar region: an experience with the McGregor flap

    Pradeoth Korambayil Mukundan , Prashanth Varkey Ambookan , Vinoth Kumar Dilliraj
    Aim: Reconstruction of defects of the eyelids and malar region following trauma may result in considerable distortion of the adjacent tissue. A clinical study was undertaken to demonstrate the ability to utilize a modified McGregor flap for reliable soft tissue coverage. Methods: Nine patients with eyelids and malar soft tissue defects were treated over a period of 12 months from July 2013 to June 2014. In this prospective study, a McGregor flap was used for the closure of defects in 9 patients (7 men and 2 women), aged 20-36 years (mean age: 27 years). Three sessions of hyperbaric oxygen...
    Published on: 13 Mar 2015
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  • Case Report

    Inferior dermoglandular flap for autologous breast remodeling following explantation of breast implants in ptotic breasts: a case report and literature search

    Umar Daraz Khan
    Explantation following aesthetic mammoplasty without implant replacement is quite uncommon and often leaves the patient worse off than prior to mammoplasty. A case is presented here in which patient's own tissue was used as an inferior dermoglandular flap for autologous breast remodeling. Inferior dermal flap has been described for breast reconstruction and simultaneous augmentation mammoplasty with mastopexy for prosthesis cover in the lower pole of the breast, but its use following explantation without implant replacement has not been described for breast remodeling and volume conservation.
    Published on: 13 Mar 2015
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  • Original Article

    Simultaneous expander and deep inferior epigastric perforator reconstruction: indications and alloderm sling technique for protecting the anastomosis

    Elizabeth Stirling Craig , Ajul Shah , Sarah Persing , Jeffrey Salomon , Stefano Fusi
    Aim: Autologous tissue is considered the "gold standard" for breast reconstruction today. However, little is known about deep inferior epigastric perforator (DIEP) flap reconstruction in combination with tissue expander (TE)/implant. The authors describe a series of combined DIEP flap/TE reconstruction, including its indications and technique to ensure protection of the pedicle during the expansion process. Methods: Between January 2009 and December 2012, patients undergoing immediate DIEP with TE reconstruction were retrospectively reviewed. Oncologic, comorbid conditions, intraoperative,...
    Published on: 13 Mar 2015
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  • Case Report

    A rare case of bilateral absence of distal ulnar artery

    Jung Ho Lee , Rock Kuen Ju , Young Joon Jun , Young Jin Kim
    It is fairly common to find anatomic variations and anomalies in the arterial pattern of the upper extremities. However, a complete absence of the distal ulnar artery bilaterally is extremely rare. During preoperative assessment for a radial forearm free flap, we accidentally discovered bilateral distal ulnar artery agenesis. In this article, the clinical implications of this variation are discussed, along with a review of the literature.
    Published on: 13 Mar 2015
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  • Original Article

    Heel pad avulsion injury: an approach with hyperbaric oxygen therapy

    Pradeoth Korambayil Mukundan , Prashanth Varkey Ambookan
    Aim: Crush injuries of the foot are often associated with partial or complete degloving of the heel pad. The purpose of this study is to present an algorithm for the management of various types of heel pad avulsion injuries, including hyperbaric oxygen (HBO) therapy in the treatment regimen. Methods: We present a prospective study of 27 patients with various types of heel pad avulsion managed in our institution from December 2012 to June 2013. Heel pad avulsion injuries were classified according to the angiosomal pattern. Partial or complete avulsions were classified and treated...
    Published on: 13 Mar 2015
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  • Case Report

    A novel approach to achieve breast symmetry in a single-stage procedure

    Benedetto Longo , Rosaria Laporta , Marco Pagnoni , Fabio Santanelli di Pompeo
    Preservation of the skin envelope and the inframammary fold is the main factor in achieving breast symmetry in unilateral reconstruction. Skin sparing mastectomy (SSM) type-IV followed by immediate autologous reconstruction and contralateral symmetrization permits realizing this goal in large, ptotic breasted patients, and tumor superficially located in the inferior quadrants. If the tumor is superficially located in the superior or inferior quadrants with a previous lumpectomy or quadrantectomy scar in the superior quadrants, modified radical mastectomy and a staged procedure are...
    Published on: 13 Mar 2015
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  • Review

    Surgical treatment of synovial-collagen disorders of the hand

    H Kirk Watson , Purnell Traverso , Lois Carlson , Daniel Mastella , Ronit Wollstein
    Critical relationships between collagen and synovium exist and affect the function of the hand. Understanding these relationships enhances the ability to perform surgery including procedures addressing soft tissue and joint pathology. We present a series of surgical procedures based on this principle.
    Published on: 13 Mar 2015
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  • Original Article

    A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

    Rahul Datta , Yasmin Grewal , Jaspreet Singh Batth , Amandeep Singh
    Aim: This study was conducted to determine the preferred analgesic and anti-inflammatory drugs prescribed by oral implantologists in India. Methods: A structured questionnaire was distributed to 332 dentists to gather information regarding their prescription habits for analgesics and anti-inflammatory drugs. Frequency distributions were computed by type of drug being prescribed and the protocol followed. Results: Analysis of data showed that majority of dentists (85.8%, n = 285) prescribed conventional non-steroidal anti-inflammatory drugs (NSAIDs) for implant surgery. The most common...
    Published on: 13 Mar 2015
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  • Case Report

    Aneurysmal bone cyst of the maxilla rare presentation with radiological and pathological correlation

    Bharat Bhushan Sharma , Priya Ramchandran , Sandeep Sharma , Shweta Sharma
    The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed for a long period prior to becoming symptomatic. This may cause associated issues secondary to compression by extending to the surrounding vital anatomical areas. An aggressive course can lead to bony destruction with intracranial extension. We present a case of a 23-year-old man who presented with bilateral exorbitism with nasal obstruction.
    Published on: 13 Mar 2015
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  • Original Article

    Composite augmentation phalloplasty: personal experience after 275 patients

    Juan Monreal
    Aim: To report the author's experience in augmentation phalloplasty by studying a retrospective series of patients who underwent fat grafting for girth enhancement or a composite technique based on suspensory ligament release plus fat grafting performed simultaneously. Methods: The author analyzed retrospectively the outcomes of 275 augmentation phalloplasty procedures performed in 259 patients until November 2013. Of these, 127 correspond to girth augmentation with fat grafting and 148 to composite augmentation phalloplasty (girth augmentation with fat grafting and length improvement by...
    Published on: 15 Jan 2015
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  • Original Article

    Primary contraction of skin grafts: a porcine preliminary study

    Alexander Bogdanov Berezovsky , Vasileios A Pagkalos , Eldad Silberstein , Yaron Shoham , Lior Rosenberg , Yuval Krieger
    Aim: Skin grafting is a common clinical practice for plastic surgeons, yet primary contraction of these grafts is a neglected topic. This study was designed to investigate primary contraction and introduce the shape of skin graft as a possible factor that modifies primary contraction behavior, using porcine models. Methods: In the first series, full-thickness skin grafts (FTSGs) and split-thickness skin grafts (STSGs) were compared. In a second series, how the shape of the skin graft affected the degree of contraction was examined. Results: The mean percentage of FTSG shrinkage was 12.04%,...
    Published on: 15 Jan 2015
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  • Case Report

    Temporary ectopic hand implantation

    Xu Zhang , Hong-Wei Zhu
    Severe crushing injuries to the distal forearm can preclude immediate hand replantation, with temporary ectopic implantation as a practicable option under special circumstances. This report describes a case of temporary ectopic hand implantation for a crush injury extending from the wrist to the middle third of the forearm, using the left foot as the recipient site. The hand was replanted onto the left forearm 3 months after the ectopic implantation, with functional gains seen by 18 months. Satisfactory ambulation was retained, with no reported foot pain. Temporary ectopic implantation is a...
    Published on: 15 Jan 2015
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  • Original Article

    Effect of neoadjuvant chemotherapy on skin-sparing mastectomy and breast reconstruction modalities in 409 patients

    Sameh Goubran , Jon Ver Halen
    Aim: While skin-sparing mastectomy (SSM) can be performed in patients with stage II-III breast cancer, the impact of neoadjuvant chemotherapy (NAC) on SSM rates and reconstructive modalities in these patients is not known. Methods: Between January 2007 and December 2009, 409 immediate breast reconstructions (IBRs) were performed in patients with Stage II-III breast cancer. Data were collected on preoperative, operative, and postoperative factors. Results: There was a statistically significant relationship between clinical stage of disease and the utilization of SSM or non-SSM (P<0.0001)....
    Published on: 15 Jan 2015
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  • Case Report

    Diode and Nd:YAG laser in a case of refractory acne keloidalis nuchae

    Ravi Kumar Chittoria , Devi Prasad Mohapatra , Friji Meethale Thiruvoth , Dinesh Kumar , Arjun Asokan , Vijayaraghavan Nandhagopal
    Acne keloidalis nuchae (AKN) is a disease of unclear etiology that mainly affects males. Medical treatment of AKN is difficult, with refractory cases often requiring ablation by laser or surgical resection. We report herein, a 23-year-old male with refractory AKN treated successfully with combined laser ablation, using an 810-nm diode laser and a 1064-nm Nd:YAG laser.
    Published on: 15 Jan 2015
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  • Original Article

    Patient-centric dose equivalency pilot study of incobotulinumtoxin a (xeomin) vs. abobotulinumtoxin a (dysport) in the treatment of glabellar frown lines

    Jonathan Bank , Nicole A Phillips , Laurie A Casas
    Aim: Incobotulinumtoxin A (xeomin) has been proposed as an alternative to abobotulinumtoxin A (dysport) and onabotulinumtoxin A (Botox) in the treatment of glabellar frown lines. A recent study is comparing abobotulinumtoxin A and onabotulinumtoxin A revealed equivalent efficacy with a dose conversion ratio of 2.5:1. We sought to establish effectiveness and dosing equivalency of incobotulinumtoxin A vs. abobotulinumtoxin A. Methods: Inclusion criteria for this pilot study included patients of a single surgeon (LAC) who had previously received a constant dose of abobotulinumtoxin A over at...
    Published on: 15 Jan 2015
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  • Case Report

    Primary repair of ear laceration with wedge resection

    Bhupinder Singla , Inderjit Chawla , Prasant Gautam , Anupam Goyal , Jalaj Rathi
    Although major contributions have been made in the field of reconstructive surgery, reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons. Here, we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear. Primary repair of the ear laceration after wedge resection of the avulsed part was done. The cosmesis achieved by this technique is discussed.
    Published on: 15 Jan 2015
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  • Review

    Liposuction for chronic medical diseases and noncosmetic conditions: review of the literature

    Hamdy Abuelhassan El-Khatib
    The purpose of this systematic literature review was to evaluate the safety of liposuction techniques and to identify the cosmetic and noncosmetic application of liposuction. Liposuction can be used to improve the quality-of-life in patients with disabling medical conditions in addition to its use for cosmetic rejuvenation. An online search of the Cochrane Library, MEDLINE, Embase, and SciELO were conducted. Forty-seven original articles reported from 1982 to February 2014 were included in this review. The articles reported on the use as well as the limitations of liposuction for treatment...
    Published on: 15 Jan 2015
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  • Original Article

    Surgical pitfalls with custom-made porous hydroxyapatite cranial implants

    Bruno Zanotti , Angela Verlicchi , Roberto Stefini , Attilio Carlo Salgarelli , Nicola Zingaretti , Pier Camillo Parodi , Casadei Matteo , Massimo Robiony
    Aim: Cranioplasty implants are used primarily in cases of surgical cranial decompression following pathological elevations of intracranial pressure. Available bone substitutes include porous hydroxyapatite (HA) and polymethylmethacrylate. Whichever material is used, however, prosthetic cranial implants are susceptible to intra- and postsurgical complications and even failure. The aim of this study was to investigate such occurrences in HA cranioplasty implants, seeking not only to determine the likely causes (whether correlated or not with the device itself) but also, where possible, to...
    Published on: 15 Jan 2015
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  • Case Report

    Preliminary stages before nasal reconstruction using forehead flap: restoring perinasal subunits and nostril patency

    Victor Diniz de Pochat , Fernando César Câmara de Oliveira , Felipe Simões da Rocha Mata , Marcelo Sacramento Cunha , Nivaldo Alonso , José Valber Lima Meneses
    Due to the complex three-dimensional structure of the nose, the repair of the nasal defect requires reconstruction of three different layers: skin envelope, osteocartilaginous framework and nasal lining. Before nasal reconstruction can be accomplished, the nose must rest on a stable platform to avoid late nasal obstructions, and septal deviations resulting from scar contraction. We present three cases of nasal reconstruction using a forehead flap in which we performed a preliminary stage to increase reliability of outcomes.
    Published on: 15 Jan 2015
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  • Original Article

    Differential fat harvesting

    Sebastian Torres Farr , Angelo Trivisonno
    Aim: Volume replacement with fillers is regularly performed with the use of diverse volumetric materials to correct different structures around the face, depending on the volume enhancement required and the thickness of the soft tissue envelope. Differential fat harvesting and posterior grafting is performed to place the correct fat parcel size for each target area, expanding the potential applications of fat. Methods: Sixty patients consecutively recruited on a first come basis undergone a facial fat grafting procedure, in private practice setting between March 2012 and October 2013. Fat...
    Published on: 29 Oct 2014
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  • Original Article

    The influence of national guidelines on soft tissue sarcoma patient outcome: a single center experience

    Annu Nummi , Taina A Partanen , Ylermi Soini , Leena Berg , Leena Setala , Paula Mustonen
    Aim: The aim was to study the impact of nationwide clinical practice guidelines for soft tissue sarcomas (STS), introduced in 1994 and again in 2005 in North Savo, Finland. Methods: We retrospectively reviewed all the patients whose sarcoma was treated by a multidisciplinary team between the years 2000 and 2009 with mean follow-up time of 68 months. The patients were divided into 2 groups according to years: Group A (2000-2005, 72 patients) and Group B (2006-2009, 64 patients). Primary outcomes were local recurrence, metastases, and overall survival. Results: Fifty-five percent were men...
    Published on: 29 Oct 2014
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  • Original Article

    Autologous bone graft harvested during implant site preparation: histological study

    Mario Santagata , Umberto Tozzi , Rosario V.E. Prisco , Gianpaolo Tartaro , Salvatore D'Amato
    Aim: The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement. Methods: A simple surgical procedure was described in which autogenous bone was harvested from the drills during the preparation of implant sites. Eleven samples were obtained from bone drilling during fixture installation in 11 patients (5 men and 6 women) with an average age of 57 years. These samples were subjected to histological preparation, in order to evaluate for the presence of viable osteoblasts. Results: Histological evaluation...
    Published on: 29 Oct 2014
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  • Case Report

    Lipoma causing Guyon's canal syndrome: a case report and review

    Narayanathu Chellappantilla Sreekumar , Panambur Laxminarayan Bhandari , Lalitha Sreedharan Sreelesh , Krishnankutty Rajamma Thushara
    Compression of the ulnar nerve in Guyon's canal leads to Guyon's canal syndrome. Lipoma is a rare cause of such compressions with only 12 cases reported previously. We report a 55-year-old man who presented with swelling in the left hand with decreased sensation in the ring and little fingers. Magnetic resonance imaging revealed high signals in T1-weighted and T2-weighted images with suppression of the short T1 inversion recovery signal, suggestive of lipoma. On exploration a well-encapsulated, dumbbell-shaped, fatty tumor was seen in the hypothenar space and Guyon's canal. The tumor was...
    Published on: 29 Oct 2014
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  • Original Article

    Superiorly based perforator plus flap for inguinal defects

    Pradeoth Mukundan Korambayil , Prashanth Varkey Ambookan , Vinoth Kumar Dilliraj
    Aim: Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma are always associated with soft tissue loss over the groin region. A clinical study was undertaken to demonstrate the ability to utilize a superiorly-based perforator flap with reliable vascularity and less donor site morbidity to cover defects in the inguinal region. Methods: A prospective study was performed on 7 patients with inguinal soft tissue defects managed in our institution from January 2013 to September 2013. During the study period, a "superiorly-based perforator plus flap" was used...
    Published on: 29 Oct 2014
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  • Case Report

    Isolated sporadic bilateral split hand malformation: a case report and review of the literature

    Manjit Singh , Sukhminder Jit Singh Bajwa , Harsimarjit Kaur , Ravinder Singh
    Typical cleft hand is a rare disorder usually inherited in an autosomal-dominant manner. We report a case of bilateral typical cleft hand in a 6-year-old male. There was no positive family history of such presentation, and no systemic manifestations were associated with this entity. Preanesthetic evaluation revealed no systemic or airway challenges and parents were counseled for routine surgical and anesthetic risks. The hands underwent successful surgical reconstruction with no peri-operative complications. To the best of our knowledge, this is the first report of an operated case of an...
    Published on: 29 Oct 2014
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  • Letters to Editor

    A unique late complication with the use of calcium hydroxylapatite filler in facial lipoatrophy rehabilitation

    Raffaele Rauso
    Published on: 29 Oct 2014
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  • Original Article

    Anatomic variability of the vascularized composite osteomyocutaneous flap from the medial femoral condyle: an anatomical study

    Trung-Hau Le Thua , Duc-Phu Bui , Dang-Nhat Pham , Vu-Bao Le , Albert DeMey , Willy Boeckx
    Aim: The anatomical study and clinical application for the vascularized corticoperiosteal flap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous flap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA) was found in 33 of 40 cases (82.5%). The...
    Published on: 29 Oct 2014
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  • Case Report

    Craniofacial abnormalities in goldenhar syndrome: a case report with review of the literature

    Ramesh Kumaresan , Balamanikanda Srinivasan , Mohan Narayanan , Navaneetha Cugati , Priyadarshini Karthikeyan
    Goldenhar syndrome (oculo-auriculo-vertebral spectrum) is a rare congenital anomaly of unclear etiology and characterized by craniofacial anomalies such as hemifacial microsomia, auricular, ocular and vertebral anomalies. In many cases, this syndrome goes unnoticed due to a lack of knowledge about its features and because of its associated wide range of overlapping anomalies. Herewith, we present a case of Goldenhar syndrome in a 21-year-old male, who presented all the classical signs of this rare condition. This article also summarizes the characteristic features of patients with Goldenhar...
    Published on: 29 Oct 2014
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  • Letters to Editor

    Unburied K-wire induced injuries: taking the edge off

    Ravi Kumar Chittoria , Devi Prasad Mohapatra , Friji Meethale Thiruvoth , Dinesh Kumar , Arjun Asokan , Nandhagopal Vijayaraghavan
    Published on: 29 Oct 2014
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  • Original Article

    Allogeneic epidermal substitutes in the treatment of chronic diabetic leg and foot ulcers

    Andrea Marchesi , Marco Brioschi , Pier Camillo Parodi , Matteo Marchesi , Roberto Brambilla , Luca Vaienti
    Aim: Diabetic foot ulcers are the most common cause of nontraumatic lower extremity amputations in the industrialized world. Tissue-engineering products offer a lower extremity salvage strategy when healing does not proceed according to the standard of care. New allogeneic sheets are available for the management of diabetic leg and foot ulcers. Methods: The endpoints of this case series study regard preliminary outcomes of the application of allogeneic keratinocytes composed of benzyl ester of hyaluronic acid to 16 diabetic foot and leg ulcers in 11 patients with type 2 diabetes mellitus....
    Published on: 28 Aug 2014
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  • Original Article

    The keystone-design perforator-based flap for leg defects: a synthesis of philosophies

    Jerry R John , Jyoshid R Balan , Satyaswarup Tripathy , Ramesh Kumar Sharma , Chandan Jadhav
    Aim: The classical keystone-design flap, although elegantly employed for various trunk defects, has limited movement on the leg. This study aims to modify the keystone-design flaps for leg defects. Methods: A keystone-design flap, in which perforators are identified and dissected, is described specifically for elliptical defects overlying the tibia. Results: It retains the unique advantages of both the perforator island flap concept as well as the keystone-design philosophy. Conclusion: The technique as well as the possibilities of raising such flaps over various areas of the leg is outlined.
    Published on: 28 Aug 2014
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  • Original Article

    Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

    Shwetha Suryanarayan , Leelavathy Budamakuntla , Syed Iqbalulla Sha Khadri , Sacchidanand Sarvajnamurthy
    Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of chronic nonhealing ulcers. Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume) was assessed. Results: The mean age of the patients was 42.5 years (standard deviation [SD] 12.48). Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to...
    Published on: 28 Aug 2014
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  • Original Article

    Hyaluronic acid in calves defects correction

    Lorenzo Rosset , Mario Goisis
    Aim: Since the advent of fillers, new techniques are continuously developed for different uses. In this study, we evaluated the use of hyaluronic acid for calf augmentation. Methods: A total of 42 patients were enrolled in this study. All of them underwent augmentation procedure in our centers under local anesthesia, the operations were completed within 1 h with a prompt correction of the defects. Results: Thirty-nine patients were satisfied with the treatment (93%), while three had complications, local infection, and lumps, that were resolved quickly (7%). Conclusion: Macrofillers can be...
    Published on: 28 Aug 2014
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  • Original Article

    Perceived aesthetic impact of malocclusion in 16-24 year-old adults in the rural areas of India

    Charu M Marya , Amit Rekhi , Ruchi Nagpal , Sukhvinder S Oberoi , Chandan Dhingra
    Aim: The purpose of this study was to assess the self-perception of patients toward their dental appearance using the aesthetic component (AC) of index of orthodontic treatment need (IOTN) index and whether age and gender had any influence on it. Methods: A cross-sectional study was carried out to assess the perceived esthetic impact of malocclusion in 16-24 year-old subjects selected from the rural population of Faridabad, Haryana, India. The sample was divided into two groups, older adolescents and younger adults, and the AC of the IOTN index was applied. Results: The results showed that...
    Published on: 28 Aug 2014
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  • Original Article

    Comperative analysis of unilateral cleft lip closure using absorbable and nonabsorbable sutures: a randomised clinical study

    Abhay Nilkanth Datarkar , Darshan Rewanwar , Anshul Rai
    Aim: Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members. Young patients often require sedation or general anesthesia (GA) for suture removal on a sensitive area to prevent disruption of the repair. In this study, we compared absorbable and nonabsorbable sutures for primary cleft lip repair. Methods: Patients with cleft lip who presented to Smile Train Unit, Child Hospital and Research Institute, Nagpur, India, were randomly assigned to two groups and underwent surgical repair using either Vicryl...
    Published on: 28 Aug 2014
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  • Review

    Current and future applications of nanotechnology in plastic and reconstructive surgery

    Dana K Petersen , Tate M Naylor , Jon P Ver Halen
    Although nanotechnology is a relatively young field, there are countless biomedical applications in use or under investigation. Many specialties have benefitted from nanoscale refinements of diagnostic and therapeutic techniques. Plastic and reconstructive surgery is an incredibly diverse specialty, encompassing craniofacial and hand surgery; trauma, oncologic and congenital reconstruction; burn care, and aesthetic surgery. Advances in nanotechnology have significantly impacted wound management, topical skin care, implant and prosthetic design, tissue engineering, and drug delivery systems....
    Published on: 28 Aug 2014
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  • Original Article

    Management of isolated zygomaticomaxillary complex fractures with an individualized approach: a retrospective study

    Rahul Datta , Kanwar Harit , Yasmin Grewal
    Aim: Fractures of the zygomatico maxillary complex (ZMC) are commonly seen after traumatic injuries to the facial skeleton. The aim of the study was to review the outcome of individualized treatment approach in the management of isolated ZMC fractures. Methods: A retrospective analysis of 25 patients was conducted to assess the outcomes of isolated ZMC (iZMC) fracture treatment at a multi specialty hospital (Punjab, India) over a 3-year period. Results: Out of the 25 patients reviewed, 4 patients required no surgical intervention and 21 patients underwent surgical reduction via the buccal...
    Published on: 28 Aug 2014
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  • Commentary

    Commentary

    Dina Gofstein , Jonathan Bank
    Published on: 28 Aug 2014
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  • Case Report

    Supermicrosurgical reconstruction of knee defect using superior medial genicular perforator as a recipient vessel

    Hoon Kim
    A 24-year-old male presented after being involved in a motorcycle accident and was found to have soft tissue defects of the knee with exposure of patella. Due to the severe injury from the popliteal fossa to the posterior aspects of the lower leg, repair with a free flap from anterolateral thigh perforator was planned instead of local calf muscle flap. Preoperative angiography was performed, and it showed that superior medial genicular perforator was patent compared with unreliable filling of the superior lateral genicular perforator. The soft tissue defect was repaired using the superior...
    Published on: 28 Aug 2014
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  • Original Article

    Internal derangement of temporomandibular joint: role of arthocentesis with steriod

    Altaf Hussain Malik
    Aim: The aim of this study was to compare the efficacy of arthrocentesis with arthrocentesis plus steroid in the treatment of temporomandibular joint (TMJ) internal derangements. Methods: Nine males and 11 females aged 17-39 years were enrolled in the study. The patients were complaining of limited mouth opening and TMJ pain. Arthrocentesis was performed under aseptic conditions. All patients were clinically evaluated before the procedure, and 1 week and 6 months after the procedure. Intensity of TMJ pain and maximal mouth opening was recorded at each follow-up visit. Results: Both groups...
    Published on: 27 Jun 2014
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  • Original Article

    Comparison between four treatment modalities for active myofascial triggers point

    Atef Fouda
    Aim: The study aimed at the painful trigger points (TrPs) for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The...
    Published on: 27 Jun 2014
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  • Editorial

    In consideration of a career in research

    Gaurav Goyal
    Published on: 27 Jun 2014
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  • Original Article

    A modified bilobed flap design for nasal tip defects

    Zhi-Guo Wang , Xiu-Juan Chen , Zhen-Yu Chen
    Aim: The correction of nasal tip defects presents many challenges. Zitelli's bilobed flap has been widely used for such repairing defects, but may be complicated by interrupted scars on the nasal dorsum. Our study evaluates the design principles, results, and advantages of a modified bilobed flap for repairing nasal tip defects. Methods: The primary lobe was located between the defect and the cheek, and the second lobe was located in the cheek. The width of the primary lobe was equal to that of the primary defect. The length of the primary lobe was 10% longer than the distance of the distal...
    Published on: 27 Jun 2014
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  • Case Report

    Options for thumb revascularization: our experience and literature review

    Pradeoth Mukundan Korambayil , Prashanth Varkey Ambookan , Vinoth Kumar Dilliraj
    Traumatic injuries to the thumb resulting in segmental loss of a digital artery are not uncommon. To bridge the gap and repair a transacted digital artery, the superficial palmar arch or the radial digital artery of the index finger can be used to reconstruct the ulnar digital artery of thumb for revascularization. Revascularization following segmental loss resulting from a crushed ulnar digital artery of the thumb can be performed based on the superficial palmar arch or the radial digital artery of the index finger, avoiding anastomosis at two sites and hence providing better results. The...
    Published on: 27 Jun 2014
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  • Review

    Nanotechnology applications in osteodistraction

    Adam E. Singleton , Jon P. Ver Halen
    Most current strategies for bone regeneration have relatively satisfactory results. However, there are drawbacks and limitations associated with their use and availability, and even controversial reports about their efficacy and cost-effectiveness. The induction of new bone formation through distraction osteogenesis (DO) is widespread clinical application in the treatment of bone defects, limb deformities, and fracture nonunions. However, a lengthy period of external fixation is usually needed to allow the new bone to consolidate, and complications such as refracture at the distraction gap...
    Published on: 27 Jun 2014
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  • Original Article

    Auricular seroma: A new concept in management

    Monika Shamrao Malgonde , Manoj Kumar
    Aim: Auricular seroma is a cystic swelling with a collection of serous fluid between the perichondrium and cartilage. The successful treatment of auricular seromas remains a challenge because this disease has a high propensity for recurrence. Methods: A total of 20 patients with auricular seromas were treated by remodeling a corrugated rubber drain. Results: All patients tolerated the procedure well. No patient had any collection of fluid after the removal of the splint. No patient experienced pain, fever, or edema after treatment. The seroma disappeared without disfigurement. There were no...
    Published on: 27 Jun 2014
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  • Case Report

    Management of extensive intraparotid vascular malformation: a case report

    Katerina Anesti , Zachary Moaveni , Heng-Yi Wu
    Treatment of large soft tissue vascular lesions remains one of the greatest challenges in modern plastic surgery. The extent of the disease and the involved structures, but also the expectations of the patients are important in determining the way of treatment. The effective management of hemangiomas and vascular malformations of the head and neck requires a team approach, in order to understand the biologic behavior of the lesion, complete the diagnostic studies necessary to define the area of involvement, and understand the benefits and limitations of interventional radiologic and...
    Published on: 27 Jun 2014
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  • Letter to Editor

    Progressive drain withdrawal without suture removal: a technical note

    Zaher Jandali , Charles Yuen Yung Loh , Athanassopoulos Thanassi
    Published on: 27 Jun 2014
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  • Editorial

    Fifty-six years of plastic surgery

    Thomas M. Biggs
    Published on: 27 Jun 2014
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