Annals of plastic surgery
-
Annals of plastic surgery · Oct 2012
Comparative StudyThe impact of fiberwire, fiberloop, and locking suture configuration on flexor tendon repairs.
Suture technique, suture material, and the number of strands all play critical roles in achieving optimal strength of flexor tendon repairs. We evaluated the contribution to the tensile strength of flexor tendon repair using the strongest suture material, Fiberwire, and the best surgical technique (locking configuration) using 2- and 4-strand core repair to see what factor played the most important role in tendon repair. ⋯ The suture strand configuration rather than the strict number of strands or the strength of the suture material yielded the maximum tensile strength with reduced gapping at the repair site.
-
Annals of plastic surgery · Oct 2012
Comparative StudyComparison of native porcine skin and a dermal substitute using tensiometry and digital image speckle correlation.
Dermal substitutes are currently used in plastic surgery to cover various soft tissue defects caused by trauma, burns, or ablative cancer surgery. Little information is available on the biomechanical properties of these dermal substitutes after adequate incorporation as compared to normal skin. Determining parameters such as tensile strength in these skin substitutes will help us further understand their wound healing properties and potential in developing artificial tissue constructs. ⋯ Using 2 different methods of analysis, we have shown a dermal substitute does not display similar biomechanical properties after adequate incorporation. These major tensile strength differences are shown between normal, grafted, and Integra constructs under physiological conditions. These properties will lead to further understanding of artificial tissue and engineered constructs in laboratory and clinical applications.
-
Annals of plastic surgery · Oct 2012
Indications and outcomes following complex abdominal reconstruction with component separation combined with porcine acellular dermal matrix reinforcement.
Component separation (CS) is an effective technique for complex abdominal wall reconstruction (AWR). Reinforcement of the repair with mesh can add durability. The purpose of this study was to evaluate the indications and outcomes following CS combined with a porcine acellular dermal matrix (PADM) for reinforcement. ⋯ Strattice is an effective adjunct to AWR when used as reinforcement during CS for a wide variety of indications. Complication rates remain low in complex patients. In addition, Strattice appears to add durability to midline reconstructions with no recurrences during the follow-up period.
-
Annals of plastic surgery · Oct 2012
Nurse training with simulation: an innovative approach to teach complex microsurgery patient care.
Simulation has become an integral part of education at all levels within the medical field. The ability to allow personnel to practice and learn in a safe and controlled environment makes it a valuable tool for initial training and continued competence verification. An area of specific interest to the reconstructive microsurgeon is assurance that the nursing staff has adequate training and experience to provide optimum care for microsurgery patients. ⋯ Simulation provides a safe, reproducible, and controlled clinical experience. Our results show that simulation is a highly rated and effective way to teach nurses microsurgery patient care. Simulated patient care training should be considered to augment the clinical experience in hospitals where microsurgery is performed.
-
Annals of plastic surgery · Oct 2012
The impact of residency and fellowship training on the practice of microsurgery by members of the american society for surgery of the hand.
The purpose of this study was to assess the microsurgical training background of current members of the American Society for Surgery of the Hand (ASSH) and then determine the impact that prior training had on current microsurgical practice. ⋯ Training backgrounds have a substantial impact on current microsurgical practice, with residency having the most significant effect. Specifically, hand surgeons trained in plastic surgery residency programs are more likely to perform replantations, free tissue transfer, and general microvascular surgery than those who completed orthopedic residencies. Fellowship training background does not significantly affect microsurgical practice.