Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2012
ReviewPatient safety in the operating room: II. Intraoperative and postoperative.
The perioperative environment can be hazardous to patients and providers alike. Although many risks are best addressed preoperatively, some hazards require constant attention by the surgeon, anesthesiologist, and staff in the operating room. In a previous article, the authors discussed preoperative aspects of patient safety. In this article, the authors review intraoperative and postoperative risks and techniques to decrease these risks. ⋯ In this article covering intraoperative and postoperative hazards, the authors build upon a previous article addressing preoperative risks to patients during inpatient plastic surgery. Although neither article covers an exhaustive list of potential risks, the goal is to provide the modern plastic surgeon with the means to prevent common adverse events, as well as the tools to research new hazards.
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Plast. Reconstr. Surg. · Nov 2012
ReviewAcellular dermal matrices in abdominal wall reconstruction: a systematic review of the current evidence.
Reconstruction of the anterior abdominal wall is a complex procedure that can be complicated by contamination, loss of domain, previous scarring or radiotherapy, and reduced availability of local tissues. With the introduction of acellular dermal matrices to clinical use, it was hoped that many of the problems associated with previous synthetic materials could be overcome. With their enhanced biocompatibility, acellular dermal matrices are believed to integrate with surrounding tissues while demonstrating resistance to infection, extrusion, erosion, and adhesion formation. ⋯ High-quality data derived from level I, II, and III studies are necessary to determine the indications for acellular dermal matrix use and the optimal surgical techniques to maximize outcomes in abdominal wall reconstruction.
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Plast. Reconstr. Surg. · Nov 2012
ReviewComplications of acellular dermal matrices in abdominal wall reconstruction.
Acellular dermal matrices have been increasingly used in abdominal wall reconstruction. Unique characteristics of these grafts have allowed surgeons to reconstruct increasingly complex abdominal wall defects. This has resulted in a myriad of complications related to the acellular dermal matrix with unique management strategies as compared with synthetic mesh. ⋯ Complications are frequent in abdominal wall reconstruction. Many acellular dermal matrices have properties that allow for conservative management and maintenance of reconstruction when complications occur. With traditional synthetic mesh reconstruction, complications likely result in mesh explantation and prolonged morbidity. With acellular dermal matrix reconstruction, however, more conservative treatment strategies will allow for mesh salvage.
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Plast. Reconstr. Surg. · Jul 2012
ReviewMeasuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures.
Incomplete recovery from facial nerve damage has functional deficits and significant social and psychological consequences. To evaluate the success of surgical and nonsurgical interventions in facial paralysis patients, patient satisfaction and impact on quality of life should be considered. The objective of this study is to identify existing patient-reported outcome instruments that measure quality-of-life outcomes in the facial paralysis population. ⋯ Although instruments are available for measuring outcomes with respect to facial function, there are few instruments developed to specifically evaluate the impact of facial paralysis on quality of life. To quantify treatment outcomes of facial paralysis patients, future research to develop and validate a new patient-reported outcome instrument is needed.
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Plast. Reconstr. Surg. · Dec 2011
ReviewAn update on facial transplantation cases performed between 2005 and 2010.
Since 2005, 13 facial allotransplantation cases have been performed worldwide. The major indications for these facial allotransplantations were neurofibromatosis and trauma injuries, including animal bites, burns, falls, and shotgun blasts. ⋯ This report provides a useful overview of the technical aspects of face transplantation; however, the reports on long-term functional and aesthetic outcomes will help to define the future of face transplantation.