Eplasty最新文献

{"title":"Treatment of a Congenital Melocytic Giant Naevi at Age 39 Using Split-Thickness Skin Graft Over an Artificial Dermal Scaffold Through 2-Step Operation: A Novel Technique and Literature Review.","authors":"Merve Akin, Ali Emre Akgün, Huriye Bilge Tuncer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Congenital melanocytic nevus is a benign proliferation seen from birth. However, malignant transformation can be observed in later ages, so the removal of especially large and giant nevi is recommended during childhood. Nevertheless, there are no cases reported in the literature regarding excision of giant congenital melanocytic nevi in advanced age. This article presents the first case of a 39-year-old patient with a giant congenital melanocytic nevus covering 10% of the total body surface area, who underwent treatment with a 2-step operation. The nevus was located on the back, covering 10% of the total body surface area. The patient underwent en-bloc excision. A bilayer dermal matrix was applied over the fascia. Subsequently, a split-thickness skin graft was applied to the entire area. Full re-epithelialization was achieved within a total of 35 days. Thanks to the applied dermal scaffold, the area became pliable.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Effective, Simple, and Reliable Intraoperative Breast Sizer for Selecting Implant Volume in Breast Reconstruction With Double-Drape, Double-Donut: Standard Lap Pad.","authors":"Ryan A Cantrell, Alexander L Mostovych, Carter Prewitt, Claire Fell, Sierra M Shockley, Bradon J Wilhelmi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA21"},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bilobed Flap - Critical Analysis and New Mathematically Precise Design.","authors":"Imran Pathan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A bilobed flap is a workhorse flap to reconstruct the lower third of the nasal defect. It has been described as a double transposition flap. Various changes have been proposed to reduce the drawbacks of this flap. Most of the modifications pay attention to flap width and length without emphasizing the pivot point. In this article, the classic Zitelli design is tested for its mathematical precision, and the key role of the pivot point is discussed.</p><p><strong>Method: </strong>The bilobed flap was designed with accurate mathematical measurement on simple drawing software. Its design and flap movement were studied and critically analyzed. The biogeometry of the flap was investigated with multiple diagrams and various mathematical principles.</p><p><strong>Results: </strong>The classic description carries some mathematical errors. The author describes a new design that is more precise mathematically. A proper pivot point location is vital for accurate design and flaps movement. Putting the pivot point at a distance 2.6 times the radius of the defect makes the movement of the flaps precise. In a proper design, the extension of secondary flap length is an optional step, and the dog-ear so formed can be tackled separately. This new design of the bilobed flap only needs rotation advancement movement.</p><p><strong>Conclusions: </strong>The bilobed flap is one of the major tools for lower third nasal reconstruction. A perfectly designed bilobed flap is primarily a rotation flap. A slight modification of classic design by putting the pivot point at a distance 2.6 times of the radius of the defect makes it more perfect mathematically.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Trapezius Myocutaenous Flap for Shoulder Reconstruction.","authors":"Tyler Firlik, Olivia Means, Matthew Fahrenkopf","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA20"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Complications Following Reduction Mammaplasty in Relation to Patient Body Mass Index.","authors":"Jessica Suber, Grace Berry, Philip Janszen, Rachel Haddad, Steven Janszen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Reduction mammaplasty is a common procedure that is performed for both aesthetic reasons and quality-of-life improvement. It is performed largely to help the patient achieve a proportionate breast size for their individual body type, with the goal of restoring anatomical proportionality and psychological wellness while reducing chronic neck, back, and shoulder pain. The common risks of breast reduction include bleeding, scarring, infection, poor wound healing, fat necrosis, nipple necrosis, and/or seroma. This study is designed to show that patients with a body mass index (BMI) of >30.0 kg/m² are at higher risks for all complications.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records of 236 patients who underwent breast reduction mammaplasty from January 2015 to February 2022 by a single surgeon at a single institution. Patients were divided into 2 groups based on their BMI: the non-obese group with a BMI ≤29.9 kg/m² and the obese group with a BMI ≥30.0 kg/m² and above. This study compares postsurgical outcomes and complications in relation to patient BMI.</p><p><strong>Results: </strong>Of 236 total patients, 104 (44%) had complications specified by predetermined criteria. Of those 104 patients with complications, 94 (90.38%) had a BMI ≥30.0 kg/m². Predetermined complications were as follows: 24 patients (23.08%) experienced wound dehiscence, 23 of whom had a BMI ≥30.0 kg/m²; 9 patients (8.65%) experienced hematomas, all of whom had a BMI ≥30.0 kg/m²; 37 patients (35.58%) were found to have superficial wounds, 32 of whom had a BMI ≥30.0 kg/m²; 39 (37.5%) were found to have a seroma, 35 of whom patients were found to have a BMI ≥30.0 kg/m²; 25 patients (24.04%) experienced fat necrosis, 24 of whom had a BMI ≥30.0 kg/m²; 3 patients (2.88%) experienced nipple necrosis, all of whom had a BMI ≥30.0 kg/m²; 20 patients (19.23%) experienced infection, 19 of whom had a BMI ≥30.0 kg/m².</p><p><strong>Conclusions: </strong>On the basis of data gathered and the statistics performed, patients with a BMI ≥30.0 kg/m² were 4.86 times more likely to have postsurgical complications than those with a BMI <30.0 kg/m².</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis Comparing Outcomes of Two Different Closed Incision Negative Pressure Systems in Breast Surgery and Implications to Cost of Care.","authors":"Devinder P Singh, Allen Gabriel, Ronald Silverman, Christine Bongards, Leah Griffin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Surgical site complication (SSC) rates in breast surgery have been reported between 2.25% and 53%. Use of incision management may help reduce the risk of SSCs. The potential of 2 closed incision negative pressure therapy (ciNPT) systems to mitigate surgical site complications (SSC) and surgical site infections (SSI) in breast surgery were assessed.</p><p><strong>Methods: </strong>A systematic literature review for breast surgery studies was conducted comparing ciNPT use against standard of care (SOC). SSC, SSI, and dehiscence rates were examined. SSCs were defined as all surgical site complications including SSI, dehiscence, seroma, hematoma, and necrosis. Risk ratios and random effects models were used to assess the effect of ciNPT with multilayer absorbent dressing (ciNPT-MLA) and ciNPT with foam dressing (ciNPT-F) compared with SOC.</p><p><strong>Results: </strong>Eight articles were included in the meta-analysis. No significant differences in SSC rates (<i>P</i> = .307) or SSI rates (<i>P</i> = .453) between ciNPT-MLA and SOC were observed. ciNPT-MLA use was associated with a reduction in dehiscence compared with SOC (RR = 0.499, 95% CI = 0.303, 0.822; <i>P</i> = .006). A significant reduction in SSC rates (RR = 0.498, 95% CI = 0.271, 0.917; <i>P</i> = .025) was observed with ciNPT-F use. Similarly, dehiscence rate reduction was associated with ciNPT-F use (RR = 0.349, 95% CI= 0.168, 0.725; <i>P</i> = .005). A trend towards reduction of SSI rates with ciNPT-F use compared with SOC was also noted (<i>P</i> = .053).</p><p><strong>Conclusions: </strong>Compared with SOC, ciNPT-MLA significantly reduced rates of dehiscence, while ciNPT-F use resulted in significantly reduced SSC and dehiscence rates with a trend toward reducing SSI.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e40"},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique Transligamentous Variant of the Recurrent Motor Branch of the Median Nerve.","authors":"Reed Wulbrecht, Michael Doarn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case report presents a 72-year-old female with a unique anatomical variation of the median nerve recurrent motor branch that has not been described in the literature. During her open carpal tunnel release, the recurrent motor branch was found to divide from the median nerve within the carpal tunnel, pierce the proximal aspect of the transverse carpal ligament in a transligamentous fashion, and then immediately divide into one branch that pierced the thenar muscles and another branch that traveled superficial to the transverse carpal ligament before piercing the thenar muscles more distal. This variation in anatomy stresses the importance of thoughtful incision design and direct visualization of all structures during carpal tunnel release.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e39"},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antihelical Defect Closure By Secondary Intention: Revisiting an Old Paradigm.","authors":"Dieter Brummund, Angela Chang, Christopher Salgado","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA19"},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of Complex Upper Extremity Wounds With Novosorb Biodegradable Temporizing Matrix Versus Integra Collagen-Chondroitin Silicone: A Cost Analysis.","authors":"Christopher Jou, Kyle J Chepla","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of upper extremity wounds with dermal matrices can reduce the length of hospitalization and surgical complexity without compromising functional outcomes. We aimed to compare costs between Novosorb biodegradable temporizing matrix (BTM) and Integra collagen-chondroitin silicone (CCS) bilayer.</p><p><strong>Methods: </strong>A chart review was performed for patients with isolated upper extremity traumatic wounds who underwent reconstruction with either BTM or CCS between January 2017 and May 2022. Demographic data, surgical procedures, outcomes, and costs were collected for analysis.</p><p><strong>Results: </strong>Twenty-seven patients were included: 18 BTM and 9 CCS. There were no differences in age, sex, wound size, or dermal template size. Skin grafting was required less frequently in BTM compared with CCS (44.4% vs 55.6%, <i>P</i> = .013). Time to skin graft was longer in the BTM group (43.4 days vs 21.4 days, <i>P</i> = .002). The BTM group experienced fewer complications (33.3% vs 55.6%, <i>P</i> = .002). The mean number of secondary procedures required after template placement was 0.67 in BTM compared with 1.56 in CCS, <i>P</i> = .049. When factoring in the cost of product, the cost of reconstruction with BTM was significantly lower than CCS ($1361.92 vs $3185.71, <i>P</i> = .049).</p><p><strong>Conclusions: </strong>Novosorb BTM is a more cost-effective option when compared with CCS for reconstruction of upper extremity soft tissue defects.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e38"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Flap Abdominal Wall Reconstruction: A Review.","authors":"Abraham Zavala, María I Vargas, Walter Ayala, Miguel A Chávez, Jesús López, Ricardo Delgado","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA18"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}