Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2001
Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain.
The differential diagnosis of groin pain must consider problems of the ilioinguinal and/or genitofemoral nerve. These nerves may become injured during hernia surgery or lower quadrant surgical procedures. To treat injury to these nerves, it is critical to understand their anatomic variability. ⋯ Additionally, the ilioinguinal nerve innervates the mons pubis and inguinal crease together with a very anteroproximal part of the root of the penis or labia majora (7.8 percent). The described patterns of innervation were bilaterally symmetric in 40.6 percent of the cadavers. The anatomic variability of both nerves has implications for all surgeons operating in the groin region and for those caring for the patient with groin pain.
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Plast. Reconstr. Surg. · Nov 2001
Case ReportsHyponatremia in the postoperative craniofacial pediatric patient population: a connection to cerebral salt wasting syndrome and management of the disorder.
Hyponatremia after cranial vault remodeling has been noted in a pediatric patient population. If left untreated, the patients may develop a clinical hypoosmotic condition that can lead to cerebral edema, increased intracranial pressure, and eventually, to central nervous system and circulatory compromise. The hyponatremia has traditionally been attributed to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH); however, in our patients the treatment has been resuscitation with normal saline as opposed to fluid restriction (the accepted treatment of SIADH), thus placing the diagnosis of SIADH in question. ⋯ All of the patients studied required normal saline resuscitation, a treatment approach that is contrary to the usual management of SIADH. These findings should dictate a change in the postoperative care for these patients. After cranial vault remodeling, patients should prophylactically receive normal saline, rather than a more hypotonic solution, to avoid sodium balance problems.
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Plast. Reconstr. Surg. · Oct 2001
Standardizing digital photography: it's not all in the eye of the beholder.
Advances in digital photography have made it an efficient and economically appealing alternative to conventional photography. Nevertheless, as objective observers and clinical photographers, we must realize that all digital cameras are not created equal. Different digital cameras frequently used in plastic surgery practices (Olympus 600DL, Olympus 2500, Sony DSC-D700, Nikon Coolpix 950, and Nikon D1) were evaluated, using a subject photographed with each camera in the identical lighting conditions, to determine inherent differences in quality, color, and contrast of the resultant photographs. ⋯ With the increasing use of digital photography in plastic surgery journals and presentations, it must be recognized that digital cameras do not all display photographs of similar quality, especially when used to evaluate skin appearance. To standardize digital photography, the surgeon must realize that switching digital cameras is akin to switching film types. Standardization of digital photographs should include image resolution between 1.5 and 2.7 million pixels, ISO default setting, color balancing with an 18 percent gray card and software, consistency in focal distance, JPEG compression of medium-to-high quality, and backgrounds of medium blue or 18 percent gray.
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Plast. Reconstr. Surg. · Sep 2001
The concept of fillet flaps: classification, indications, and analysis of their clinical value.
Tissue of amputated or nonsalvageable limbs may be used for reconstruction of complex defects resulting from tumor and trauma. This is the "spare parts" concept. By definition, fillet flaps are axial-pattern flaps that can function as composite-tissue transfers. ⋯ On the basis of these data, a classification was developed that facilitates multicenter comparison of procedures and their clinical success. Fillet flaps facilitate reconstruction in difficult and complex cases. The spare part concept should be integrated into each trauma algorithm to avoid additional donor-site morbidity and facilitate stump-length preservation or limb salvage.