Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Sep 2012
Randomized Controlled TrialStroke volume variation as a guide for fluid resuscitation in patients undergoing large-volume liposuction.
: The potential for fluid overload in large-volume liposuction is a source of serious concern. Fluid management in these patients is controversial and governed by various formulas that have been advanced by many authors. Basically, it is the ratio of what goes into the patient and what comes out. Central venous pressure has been used to monitor fluid therapy. Dynamic parameters, such as stroke volume and pulse pressure variation, are better predictors of volume responsiveness and are superior to static indicators, such as central venous pressure and pulmonary capillary wedge pressure. Stroke volume variation was used in this study to guide fluid resuscitation and compared with one guided by an intraoperative fluid ratio of 1.2 (i.e., Rohrich formula). ⋯ : Therapeutic, II.
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Plast. Reconstr. Surg. · Sep 2012
Randomized Controlled TrialEpinephrine, norepinephrine, dobutamine, and dopexamine effects on free flap skin blood flow.
The optimal sympathomimetic drug to support blood pressure without adverse vasoconstriction of free flap circulation remains unknown. This study examined the effects of four agents (epinephrine, norepinephrine, dobutamine, and dopexamine) on free flaps following resection of head and neck cancer. ⋯ Both dobutamine and norepinephrine had beneficial effects on flap skin blood flow. The maximal improvement in flow occurred with norepinephrine, making it the optimal pressor to use in patients with hypotension after free flap surgery.
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Plast. Reconstr. Surg. · Sep 2012
Nocturnal ultrasound measurements of optic nerve sheath diameter correlate with intracranial pressure in children with craniosynostosis.
Children with craniosynostosis are at risk for increased intracranial pressure, and additional possibilities to screen for increased intracranial pressure are required. The authors' aim was to use ultrasound measurements of the optic nerve sheath to understand and express the variability of intracranial pressure in syndromic craniosynostosis. ⋯ The optic nerve sheath diameter changes during the night and is as dynamic as the intracranial pressure. To the best of their knowledge, the authors are the first to describe a real-time relationship of the optic nerve sheath with increased intracranial pressure in children.
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Plast. Reconstr. Surg. · Sep 2012
Comparative StudyOperating room fires: part II. optimizing safety.
The second part of the authors' study on operating room fires analyzes the construct of the nasal cannula used during facial surgery for patients under conscious sedation with supplemental oxygen. This prospective study compares two common styles of nasal cannulas with a nasopharyngeal system described in their first report. ⋯ This study demonstrates that mass spectrometry oxygen readings around the face are similar to room air when the cut ends of the oxygen cannulas are passed down the nasaopharyngeal tube, whereas readings are significantly higher with the nasal cannulas. The nasopharyngeal system that the authors describe represents a significantly safer means of oxygen delivery during conscious sedation.
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Plast. Reconstr. Surg. · Sep 2012
Misrepresentation of scholarly works by integrated plastic surgery applicants.
Many authors report alarming rates of false or questionable claims of scholarly achievement among residency applicants. The authors sought to further elucidate the authenticity of such inappropriate declarations by simultaneously conducting an investigation of a selected pool of integrated plastic surgery applicants. The authors' hypothesis is that the percentage of citations claimed by many authors to be false was erroneously high because of failure of an adequate search or prolonged time from submission to publication for many journals. ⋯ The majority (93 to 98 percent) of integrated plastic surgery applicants are truthful regarding scholarly achievement. Applicants should be given the benefit of the doubt and the opportunity to confirm their claims when we cannot.