Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Feb 2017
ReviewDelay techniques for nipple-sparing mastectomy: A systematic review.
Rare but serious complications of nipple-sparing mastectomy (NSM) include necrosis of the nipple-areolar complex (NAC) and mastectomy skin flaps. NAC and mastectomy flap delay procedures are novel techniques designed to avoid these complications and may be combined with retroareolar biopsy as a first-stage procedure. We performed a systematic review of the literature to evaluate various techniques for NAC and mastectomy flap delay. ⋯ Delay procedures for NSM have a good safety profile and may be considered in patients at risk for NAC or mastectomy flap necrosis, such as patients with pre-existing breast scars, active smoking, prior radiation, or ptosis. These procedures have the added benefit of allowing a retroareolar biopsy to be sent for permanent sections prior to mastectomy, allowing the surgical team to plan for the removal of the NAC at the time of mastectomy if indicated and eliminating the risk of a false-negative result on frozen section analysis.
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J Plast Reconstr Aesthet Surg · Jan 2017
ReviewFree tissue transfer in patients with sickle cell disease: Considerations for multi-disciplinary peri-operative management.
Sickle cell disease (SCD) is an increasingly common condition in the UK. The safety of free tissue transfer in these patients is controversial, and no specific guidelines exist. The aim of this paper is to create recommendations for the plastic surgical multidisciplinary team for use in the assessment and management of SCD patients undergoing free tissue transfer and reconstruction. ⋯ Free tissue transfer theoretically carries a high risk of a crisis, due not only to long anaesthetic times, but the potential requirement for tourniquet use, and the relatively hypoxic state of the transferred tissue. This paper outlines a useful, practical algorithm to optimise the safety of free tissue transfer in patients with SCD.
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J Plast Reconstr Aesthet Surg · Jan 2017
Versatility and "flap efficiency" of pedicled perforator flaps in lower extremity reconstruction.
The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower limb reconstruction. We use computer-aided image analysis to investigate the versatility of pedicled perforator flaps for the reconstruction of lower limb defects. ⋯ Image analysis can be used as a modality to assess the versatility of individual flaps in the reconstruction of lower limb defects.
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J Plast Reconstr Aesthet Surg · Jan 2017
ReviewSurgical anatomy of the first extensor compartment: A systematic review and comparison of normal cadavers vs. De Quervain syndrome patients.
De Quervain syndrome or tenosynovitis is a common wrist pathology caused by stenosing tenosynovitis of the first dorsal compartment. Multiple studies have demonstrated significant anatomic variation within the first extensor compartment. ⋯ Level III.
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J Plast Reconstr Aesthet Surg · Dec 2016
Adipofascial fold-down flaps based on the posterior tibial artery perforator to cover the medial foot and ankle defects.
We report the clinical outcome after coverage for soft-tissue defect on the medial foot and ankle with an adipofascial fold-down flap based on the posterior tibial artery perforator branch proximal to the defect. ⋯ For the medial foot and ankle soft-tissue defect, the fold-down adipofascial flaps based on the posterior tibial artery perforator branch proximal to the defect could be a good option to cover it.