Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jun 2009
ReviewCurrent scales for assessing human scarring: a review.
Patients can have wide-ranging problems related to scars, in terms of cosmesis, function, symptoms, psychological problems and overall quality of life issues. A range of treatments have been recommended for problematic scarring, however it has been acknowledged that the evidence base for most of the recommendations for scar therapy is limited, with few studies using validated measures of scar assessment in generating data. This review critically evaluates the subjective scar assessment scales developed to date and provides an insight into developments required in this area for the future. The principles of psychometric theory are discussed as a means of developing reliable and valid outcome measures and these are also applicable for measuring outcomes in other fields of plastic surgery research.
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J Plast Reconstr Aesthet Surg · Apr 2009
Review Case ReportsAn unusual case of galactorrhea in a postmenopausal woman complicating breast reduction.
Galactorrhea is a relatively common condition, but has rarely been seen following breast reduction surgery. To date there are only seven cases reported in the literature, all in premenopausal women. Postsurgical galactorrhea is a diagnosis of exclusion and differential diagnosis is extensive. ⋯ She was on long-term hormonal replacement therapy. Because of suspected nerve-related pain in her right breast she was commenced on amitriptyline. We hypothesise that galactorrhea may have been caused by underlying neuroma or irritation of the anterior branch of the T4 intercostal nerve or hormonal replacement therapy or a combination of both.
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J Plast Reconstr Aesthet Surg · Jan 2009
Review Meta AnalysisThe effectiveness of pressure garment therapy for the prevention of abnormal scarring after burn injury: a meta-analysis.
This study had three objectives. First, to conduct a systematic review to identify the available evidence for the use of pressure garment therapy (PGT); second, to assess the quality of the available evidence; and third, to conduct a meta-analysis to quantify the effectiveness of PGT for the prevention of abnormal scarring after burn injury. ⋯ PGT does not appear to alter global scar scores. It does appear to improve scar height, although this difference is small and of questionable clinical importance. The beneficial effects of PGT remain unproven, while the potential morbidity and cost are not insignificant. Given current evidence, additional research is required to examine the effectiveness, risks and costs of PGT.
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J Plast Reconstr Aesthet Surg · Jan 2008
ReviewComposite tissue allotransplantation: a review of relevant immunological issues for plastic surgeons.
Composite tissue allotransplantation of hand, facial and other tissues is now a clinical reality. The terminology, treatment principles, drug combinations, dosage schedules and mechanisms of the immunosuppression medications on which contemporary transplant surgery is based are unfamiliar to plastic surgeons and most healthcare providers outside the field of transplantation medicine. With this in mind, the purpose of this manuscript is to provide plastic surgeons with a comprehensive and understandable review of key immunological principles relevant to composite tissue allotransplantation. ⋯ Today, as transplant and reconstructive surgeons join forces to move hand and facial tissue allotransplantation into the clinical arena, it is important that plastic surgeons have an understanding of the major immunological principles upon which this new treatment is based.
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This is a review of 249 patients who have suffered ear trauma and who have presented for reconstruction over the last eighteen years. All were born with normal ears and had lost one or both ears or a major segment of the ear. Congenital ear problems including microtia are not included.