Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Mar 2007
Comparative StudyEndoscopic versus open tissue-expander placement: is less invasive better?
Skin tissue expansion provides an excellent option for reconstruction of large cutaneous defects. Unfortunately, the complication rate with tissue-expander reconstruction is very high. One potential alternative to reduce these complications and improve recovery time is to place the tissue expanders endoscopically. The authors hypothesize that endoscopic placement of tissue expanders will reduce the complication rate, operative time, and time to full expansion. ⋯ Endoscopic tissue-expander placement significantly reduced operative time for placement of each expander, major complication rate, time to full expansion, and length of hospital stay for this reconstructive technique. The authors conclude that endoscopic placement of tissue expanders is a safe and effective method for tissue-expander reconstructions of large, difficult wounds.
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Plast. Reconstr. Surg. · Feb 2007
Financial impact of hand surgery programs on academic medical centers.
This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. ⋯ While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.
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Conventional fasciocutaneous flaps in reconstructive surgery, especially in the lower extremities, have limited utility. Traditional flaps are essentially random pattern, often require delays, and are limited in mobility and reach. Islanded fasciocutaneous flaps pedicled on perforators can be raised anywhere on the body and have a reliable blood supply and greater freedom of movement. However, venous compromise is a common problem. ⋯ The perforator-plus flap appears to be a versatile and reliable option in lower limb injuries and other diverse indications, in both the emergency and the elective settings.
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Plast. Reconstr. Surg. · Feb 2007
Reliability and validity testing of the Patient and Observer Scar Assessment Scale in evaluating linear scars after breast cancer surgery.
The Patient and Observer Scar Assessment Scale is a promising new method incorporating observer and patient ratings in evaluating burn scars. The authors compared this tool to the Vancouver Scar Scale in a cohort of women with linear scars from breast cancer surgery. ⋯ In surgical scar assessment, the new Patient and Observer Scar Assessment Scale and Vancouver Scar Scale were both associated with acceptable internal consistency and interobserver reliability. The new tool is more comprehensive and has higher correlation with patients' ratings. These findings support the use of the new tool as a reliable, valid, and comprehensive approach to assess linear surgical scars.