Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jun 2019
Comparative StudyOverlapping Surgery in Plastic Surgery: An Analysis of Patient Safety and Clinical Outcomes.
Overlapping surgery is an important and controversial health care issue. To date, there is minimal evidence on the safety of overlapping surgery in plastic surgery. The purpose of this study was to evaluate and compare outcomes for patients undergoing overlapping surgery versus nonoverlapping surgery in plastic surgery. ⋯ Therapeutic, III.
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Plast. Reconstr. Surg. · Jun 2019
Review Comparative StudyProsthetic Rehabilitation and Vascularized Composite Allotransplantation following Upper Limb Loss.
Upper limb loss is a devastating condition with dramatic physical, psychological, financial, and social consequences. Improvements in the fields of prosthetics and vascularized composite allotransplantation have opened exciting new frontiers for treatment and rehabilitation following upper limb loss. Each modality offers a unique set of advantages and limitations with regard to the restoration of hand function following amputation. ⋯ Few studies have performed a direct comparison between patients undergoing vascularized composite allotransplantation and those undergoing prosthetic rehabilitation. Upper extremity transplantation and prosthetic reconstruction should not be viewed as competing options, but rather as two treatment modalities with different risk-to-benefit profiles and indications.
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Participation in scientific meetings yields multiple benefits, yet participation opportunities may not be equally afforded to men and women. The authors' primary goal was to evaluate the representation of men and women at five major academic plastic surgery meetings in 2017. Secondarily, the authors used bibliometric data to compare academic productivity between male and female physician invited speakers or moderators. ⋯ Although the impact of women's published work was no different than that of men among junior and midcareer faculty, women constitute a minority of invited speakers at academic plastic surgery meetings. Sponsorship is imperative for achieving gender balance within plastic surgery and to ultimately create more diverse and effective teams to improve patient care.
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Plast. Reconstr. Surg. · May 2019
Meta AnalysisIs There a Preferred Incision Location for Nipple-Sparing Mastectomy? A Systematic Review and Meta-Analysis.
The incidence of nipple-sparing mastectomy is rising, but no single incision type has been proven to be superior. This study systematically evaluated the rate and efficacy of various nipple-sparing mastectomy incision locations, focusing on nipple-areola complex necrosis and reconstructive method. ⋯ For nipple-sparing mastectomy, the periareolar incision maintains the highest necrosis rate because of disruption of the nipple-areola complex blood supply. The inframammary fold incision has become the most popular incision, demonstrating an acceptable complication profile.
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Plast. Reconstr. Surg. · May 2019
ReviewCryopreservation and Transplantation of Vascularized Composite Transplants: Unique Challenges and Opportunities.
Vascularized composite allotransplantation is the ultimate reconstructive tool when no other means of reconstruction are available. Despite its immense potential, the applicability of vascularized composite allotransplantation is hampered by high rejection rates and the requirement for high doses of immunosuppressive drugs that are associated with severe adverse effects and death. Because this is a non-life-saving procedure, widespread use of vascularized composite allotransplantation demands methods that will allow the reduction or elimination of immunosuppressive therapy. ⋯ In the current review, the authors discuss how limb cryopreservation can attenuate or eliminate allograft rejection by either enabling better human leukocyte antigen matching or by adaptation of clinical tolerance protocols such as mixed chimerism induction. Also, the authors discuss the possible advantages of cryopreservation in autologous tissue salvage and cryopreservation following trauma. Clinical-grade cryopreservation may revolutionize the field of reconstruction, organ banking, and complex traumatic limb injury management.