Annals of plastic surgery
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Annals of plastic surgery · Apr 2011
ReviewIschemic optic neuropathy and implications for plastic surgeons: report of a new case and review of the literature.
Postoperative visual loss is a rare and devastating complication after nonocular as well as ocular surgery. A case of such a complication arising as a consequence of nonocular surgery prompted a review of the literature, and an appraisal of current theories on etiology, risk factors, and potential treatment options, as well as implications for informed consent. It is clear from our review that all patients undergoing both reconstructive and cosmetic surgery are at risk. ⋯ Ischemic optic neuropathy can be a devastating complication of surgery. Plastic surgeons need to be aware of the risks, as well as the signs and symptoms, and counsel at-risk patients accordingly because of the potentially devastating nature of this complication. There are significant implications in relation to informed consent, underscored by the legal case of Rogers v Whitaker, 67 ALJR 47 (Aust 1992), which highlights the importance within the consent process of complications threatening sight, no matter how small.
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Annals of plastic surgery · Mar 2011
ReviewApproach to venous thromboembolism prophylaxis: are we evolving fast enough in plastic surgery?
Venous thromboembolism has become a target for research by the American Society of Plastic Surgery. The current article reviews the steps that plastic surgeons and the American Society of Plastic Surgery have taken for creating guidelines in our field. We summarized the current reported incidences of venous thromboembolism in various plastic surgical procedures, and reviewed the current efforts that the society is taking to address the burden of this deadly preventable disease.
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Annals of plastic surgery · Jan 2011
ReviewOrthoplastic classification systems: the good, the bad, and the ungainly.
Over the last few decades, there have been many important advances in the treatment of severe lower limb injuries. This article looks at a few of the more widely used classification systems and Injury Severity Scores to examine their utility in a practical setting. Gustilo and Anderson formulated their landmark classification system in 1976 (J Bone Joint Surg Am. 1976;58:453-458). ⋯ This included index bacteriology, and was weighted heavily toward the presence of vascular injury. Nerve Injury, Ischemia, Soft-Tissue Injury, Skeletal Injury, Shock, and Age of Patient Score attempted to address criticized weaknesses of the Mangled Extremity Severity Score. These scores can be useful tools in the decision-making process when used cautiously, but should not be used as the principal means for reaching difficult decisions.
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Annals of plastic surgery · Aug 2010
ReviewSepsis in burns: a review of current practice and future therapies.
Sepsis is a major cause of death worldwide and remains the subject of much research and debate within the critical care community. Despite advances in burn prevention, treatment, and rehabilitation, sepsis remains a common cause of death in patients who have sustained a severe burn injury. ⋯ This article describes current issues in the prevention, diagnosis, and treatment of sepsis in burns with a review of the associated literature. In addition, we discuss possible future therapies for managing this condition.
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Annals of plastic surgery · Nov 2009
Review Case ReportsThe world's experience with facial transplantation: what have we learned thus far?
The objective of this review article is to summarize the published details and media citations for all seven face transplants performed to date to point out deficiencies in those reports so as to provide the basis for examining where the field of face transplantation stands, and to act as a stimulus to enhance the quality of future reports and functional outcomes. Overall long-term function of facial alloflaps has been reported satisfactorily in all seven cases. ⋯ The risks and benefits of facial composite tissue allotransplantation, which involves mandatory lifelong immunosuppression analogous to kidney transplants, should be deliberated by each institution's multidisciplinary face transplant team. Face transplantation has been shown thus far to be a viable option in some patients suffering severe facial deficits which are not amenable to modern-day reconstructive technique.