Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Nov 2020
The early response of plastic and reconstructive surgery services to the COVID-19 pandemic: A systematic review.
The World Health Organisation characterised the spread of coronavirus disease-19 (COVID-19) as a pandemic in March 2020, signalling medical governance and professional organisations worldwide to make urgent changes in their service. We have performed a systematic review of the literature to identify all published literature on plastic surgery and COVID-19, in an effort to summarise the evidence for future reference. Our search identified 1207 articles from electronic databases and 17 from manual search, out of which 20 were included in the final data synthesis. ⋯ Strategies described to limit the spread and impact of the virus could be divided into nine distinct categories, including the suspension of non-essential services, use of telemedicine, use of personal protective equipment, screening patients for COVID-19, restructuring the healthcare team, adapting standard management practices, using distance-learning for trainees, promoting public education and initiatives, and minimising intra-hospital viral transmission. The ever-changing nature of the COVID-19 may prompt plastic surgeons to adapt special strategies as pandemic progresses and subsequently declines. The findings of this review can prove beneficial to other plastic surgery departments in informing their response strategies to the pandemic and in a second wave of the disease.
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J Plast Reconstr Aesthet Surg · Jul 2020
Meta Analysis Comparative StudyAllograft Alone vs. Allograft with Intramedullary Vascularized Fibular Graft for Lower Extremity Bone Cancer: A Systematic Review and Meta-Analysis.
Limb salvage surgery has become a first-line treatment in the setting of lower extremity cancer. Despite a multitude of techniques, the most effective modality for osseous reconstruction has not been described. We aim to examine outcomes of allograft reconstruction alone compared to an allograft combined with a vascularized fibula graft (VFG) (Capanna Technique) through a meta-analysis of the literature. ⋯ Allograft reconstruction with a supplementary inlay VFG decreases the risk of nonunion and explantation compared to allograft alone reconstruction in the setting of oncological resection of the osseous lower extremity. This technique warrants increased consideration in the operative planning of lower limb reconstruction following tumor extirpation.
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J Plast Reconstr Aesthet Surg · Jun 2019
Meta AnalysisFibrin tissue sealant and minor skin grafts in burn surgery: A systematic review and meta-analysis.
The indications for use of fibrin glue in skin grafting burn patients remains understudied. The purpose of this study is to review the efficacy of fibrin tissue sealant in skin graft adherence, establish guidelines for use of fibrin tissue sealant, and review the cost effectiveness of fibrin glue. ⋯ Fibrin glue is as effective as staples for adhering skin grafts, and trends towards lower rates of hematoma/seroma. In topographically complex regions, fibrin glue may be a better choice for adherence of skin grafts.
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J Plast Reconstr Aesthet Surg · Oct 2018
Meta AnalysisEfficacy of autologous fat transfer for the correction of contour deformities in the breast: A systematic review and meta-analysis.
Autologous fat transfer (AFT), also known as fat grafting or lipofilling, has already become a part of clinical practice for treating contour deformities of the breast, even though evidence regarding its efficacy is still lacking. This is the first meta-analysis on this subject, aimed to facilitate intuitive interpretation of the available data by clinicians, guideline committees and policy makers. ⋯ AFT seems to be an effective procedure in breast reconstruction, reflected by the high patient and surgeon satisfaction and low incidence of clinical and radiological complications. Future research should focus on evaluating the technical and patient factors influencing the rate of fat resorption as well as its oncological safety.
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J Plast Reconstr Aesthet Surg · Sep 2018
Review Historical ArticleHistorical review of Dakin's solution applications.
Dakin's solution and the Carrel-Dakin method were developed and integrated into clinical practice in the early 20th century, which were found to aid in effective wound healing and infection. This historical review briefly outlines highlights with regard to the history of infection management, wartime amputation, and wound treatment dating back to Galen through the early 20th century. ⋯ Additionally, we discuss the history of wound care with the emphasis on the Carrel-Dakin method. Finally, this review discusses and presents contemporary application and utilization of Dakin's solution in two large tertiary care centers.