Annals of plastic surgery
-
Annals of plastic surgery · Jun 2015
Multicenter StudyCraniofacial fracture patterns in all terrain vehicle injuries.
A multicenter, retrospective study was conducted to determine the frequency and distribution of craniofacial fractures sustained from all terrain vehicle (ATV) accidents. ⋯ The most common craniofacial fractures experienced in ATV injuries are naso-orbital fractures. The correlation of nonuse of safety equipment and associated traumatic brain injuries displays the importance of using helmets when operating ATVs. Future studies can be conducted examining ATV-related upper extremity injuries, among others.
-
Annals of plastic surgery · Jun 2015
Comparative StudyEffects of immediate reconstruction on adjuvant chemotherapy in breast cancer patients.
Recent studies have shown that patients undergoing immediate breast reconstruction after mastectomy have a higher rate of complications relative to patients undergoing mastectomy alone. Conflicting data exist on how these complications impact adjuvant treatment. We sought to quantify the additional risk associated with immediate breast reconstruction after mastectomy and determine how these risks influence adjuvant chemotherapy. ⋯ Immediate reconstruction after mastectomy does not delay additional cancer treatment. Overall, when complications do occur, adjuvant therapy is significantly delayed, though the median delay was only 6 days.
-
Annals of plastic surgery · Jun 2015
Patient perception of postoperative pain after administration of liposomal bupivacaine in plastic surgery.
Since obtaining FDA approval for postsurgical pain management in 2011, a number of well-designed studies have reported favorably on the safety and efficacy of liposomal bupivacaine (LB). However, the literature lacks adequate reports of patient perception of postoperative pain and subjective satisfaction. ⋯ Patient perception of efficacy after the injection of LB correlates with previous clinical findings. Our experience with LB injections for cosmetic and reconstructive breast procedures indicates that patients experienced low postoperative pain scores with high overall patient satisfaction. Additional studies comparing the use of LB to standard narcotic regimens and its use in multimodality pain management are warranted.
-
Annals of plastic surgery · Jun 2015
Scaphoid fracture nonunion treated with pronator quadratus pedicled vascularized bone graft and headless compression screw.
The purpose of our retrospective study was to evaluate the outcomes of scaphoid fracture nonunion treated with a pronator quadratus pedicled vascularized bone graft and a headless compression screw with regard to early wrist and thumb mobilization. From January 2008 to June 2011, 27 patients (20 men and 7 women; mean age, 24 years; age range, 15-32 years) with scaphoid fracture nonunion were treated with a pronator quadratus pedicled vascularized bone graft and a headless compression screw, and who met our inclusion criteria, including symptomatic scaphoid waist fracture nonunion with or without compromised vascularity and carpal instability. We evaluated radiologic assessment (correction of carpal instability and union rate). ⋯ The final average range of motion was as follows: wrist flexion, 73 degrees (range, 65-85 degrees); extension, 69 degrees (range, 60-80 degrees); ulnar deviation, 36 degrees (range, 15-50 degrees); and radial deviation, 22 degrees (range, 10-35 degrees). The average postoperative modified Mayo wrist score and disabilities of the arm, shoulder and hand score were 92 points (range, 78-100 points) and 11 points (range, 0-32 points), respectively. Our results suggest that a pronator quadratus pedicled vascularized bone graft and internal fixation with a headless compression screw can yield satisfactory functional and radiographic outcomes in the treatment of scaphoid fracture nonunion.
-
Annals of plastic surgery · Jun 2015
Clinical TrialPatient access in plastic surgery: an operational and financial analysis of service-based interventions to improve ambulatory throughput in an academic surgery practice.
Inefficient patient throughput in a surgery practice can result in extended new patient backlogs, excessively long cycle times in the outpatient clinics, poor patient satisfaction, decreased physician productivity, and loss of potential revenue. This project assesses the efficacy of multiple throughput interventions in an academic, plastic surgery practice at a public university. ⋯ Implementation of a PAcE initiative, focusing on outpatient clinic throughput, yields significant improvements in access to care, patient satisfaction as measured by complaints, physician productivity, and financial performance. An academic, university-based, plastic surgery practice can use throughput interventions to deliver timely care and to enhance financial viability.