Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Dec 2016
Replantation or revascularization for the treatment of hand degloving injuries.
The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. ⋯ Midlateral incision to reduce the secondary damage to the capillaries, repair of more vessels for circulation, application of full-thickness skin grafts to enlarge the survival area, and use of anticoagulation protocols during and postsurgery may be beneficial to improve the replantation survival of the degloved skin.
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J Plast Reconstr Aesthet Surg · Dec 2016
The pre-expanded subclavicular island flap: A new tool for facial reconstruction.
The anterior chest is an excellent donor site for cervicofacial reconstruction. Studies of chest flaps began as early as 1988 at our institution. We identified a new branch of the supraclavicular artery that nourishes the anterior chest, and on the basis of this finding, we created a new flap called the subclavicular flap. Unlike the supraclavicular flap, which is pedicled by the deltoid branch, this flap is primarily pedicled by the thoracic branch, and it shares similar vascular territory with the deltopectoral flap. In China, this flap has been widely used for neck reconstruction since our first publications on it in 1993. However, reports of its application are limited. To popularize the use of this flap, we present our experiences with pre-expanded subclavicular island flaps for the repair of facial scars. ⋯ Pre-expanded subclavicular island flaps have similar benefits to supraclavicular and deltopectoral flaps, and they may emerge as one of the best choices for cervicofacial reconstruction globally.
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J Plast Reconstr Aesthet Surg · Dec 2016
Endoscopy-assisted subfascial anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome.
Many techniques have been described to relieve the compression and reduce subluxation of the ulnar nerve following surgery. The subfascial anterior transposition of the ulnar nerve (SfATUN) is one described technique, but involves a long scar, risk of injury to the medial antebrachial cutaneous nerve, and possible nerve ischemia from anterior transposition. We assessed a more refined approach of endoscopy-assisted SfATUN for the treatment of cubital tunnel syndrome. ⋯ A combination of endoscopy-assisted SfATUN allows for decompression transposition and reduced strain on the ulnar nerve through a small scar. This is now our standard approach for cubital tunnel syndrome and the "unstable" nerve.
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J Plast Reconstr Aesthet Surg · Oct 2016
Can the American College of Surgeons NSQIP surgical risk calculator identify patients at risk of complications following microsurgical breast reconstruction?
The American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator is an open access online tool that estimates the risk of adverse post-operative events for a wide range of surgical procedures. This study evaluates the predictive value of the ACS NSQIP calculator in patients undergoing microvascular breast reconstruction. ⋯ This study demonstrates that while the ACS NSQIP Universal risk calculator can predict the proportion of patients that will develop complications it cannot effectively discriminate between patients who are at risk of complications and those who are not.
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J Plast Reconstr Aesthet Surg · Oct 2016
Three-dimensional autologous cartilage framework fabrication assisted by new additive manufactured ear-shaped templates for microtia reconstruction.
During microtia reconstruction, the intraoperative design of the cartilage framework is important for the appearance and symmetry of the bilateral auricles. Templates (traditionally, the X-ray film template) are usually utilized to complete the task, which can provide cues regarding size, cranioauricular angle and positioning to the surgeons. With a combination of three-dimensional (3D) scanning and additive manufacturing (AM) techniques, we utilized two different ear-shaped templates (sheet moulding and 3D templates) during the fabrication of 3D-customized autologous cartilage frameworks for auricle reconstruction. ⋯ The new sheet-moulding template is much more accurate than the traditional X-ray film template. Framework fabrication assisted by accurate 3D and informative AM templates contributed to individualized cartilage framework fabrication and satisfactory results.