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Showing 1201 - 1400 of 2281 Journals sorted alphabetically
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.33, h-index: 29)
J. of Earth Science     Hybrid Journal   (Followers: 6, SJR: 0.299, h-index: 11)
J. of Earth System Science     Open Access   (Followers: 16, SJR: 0.466, h-index: 27)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.669, h-index: 15)
J. of Echocardiography     Hybrid Journal   (Followers: 3, SJR: 0.136, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 25, SJR: 5.251, h-index: 54)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.231, h-index: 11)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.463, h-index: 20)
J. of Economics and Finance     Hybrid Journal   (Followers: 7, SJR: 0.238, h-index: 15)
J. of Educational Change     Hybrid Journal   (Followers: 6, SJR: 0.694, h-index: 14)
J. of Elasticity     Hybrid Journal   (Followers: 4, SJR: 0.821, h-index: 38)
J. of Electroceramics     Hybrid Journal   (SJR: 0.566, h-index: 49)
J. of Electronic Materials     Hybrid Journal   (Followers: 2, SJR: 0.752, h-index: 68)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.241, h-index: 24)
J. of Electronics (China)     Hybrid Journal   (Followers: 3, SJR: 0.127, h-index: 7)
J. of Elementary Science Education     Hybrid Journal   (Followers: 7)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (SJR: 0.294, h-index: 7)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.484, h-index: 21)
J. of Evolution Equations     Hybrid Journal   (SJR: 1.312, h-index: 22)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.127, h-index: 9)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.878, h-index: 42)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 2, SJR: 0.565, h-index: 34)
J. of Experimental Criminology     Hybrid Journal   (Followers: 23, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (SJR: 0.256, h-index: 12)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.532, h-index: 27)
J. of Family Violence     Hybrid Journal   (Followers: 15, SJR: 0.552, h-index: 45)
J. of Financial Services Research     Hybrid Journal   (Followers: 14, SJR: 1.196, h-index: 29)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.467, h-index: 10)
J. of Fluorescence     Hybrid Journal   (Followers: 4, SJR: 0.553, h-index: 47)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.104, h-index: 1)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.839, h-index: 21)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.578, h-index: 22)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.271, h-index: 10)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.248, h-index: 36)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.263, h-index: 6)
J. of Fusion Energy     Hybrid Journal   (Followers: 2, SJR: 0.389, h-index: 16)
J. of Gambling Studies     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 50)
J. of Gastroenterology     Hybrid Journal   (Followers: 13, SJR: 1.724, h-index: 73)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.371, h-index: 36)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.632, h-index: 87)
J. of General Internal Medicine     Hybrid Journal   (Followers: 12, SJR: 2.379, h-index: 115)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.357, h-index: 17)
J. of Genetic Counseling     Hybrid Journal   (Followers: 3, SJR: 0.535, h-index: 32)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.42, h-index: 24)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 4.049, h-index: 48)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.58, h-index: 14)
J. of Geographical Systems     Hybrid Journal   (Followers: 2, SJR: 0.839, h-index: 32)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.496, h-index: 23)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.349, h-index: 13)
J. of Global Optimization     Hybrid Journal   (Followers: 2, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 7)
J. of Grid Computing     Hybrid Journal   (SJR: 0.727, h-index: 32)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 14, SJR: 0.785, h-index: 30)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.194, h-index: 11)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.718, h-index: 43)
J. of High Energy Physics     Hybrid Journal   (Followers: 4, SJR: 1.027, h-index: 139)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.102, h-index: 1)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.553, h-index: 21)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.317, h-index: 15)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.28, h-index: 7)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.573, h-index: 29)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.459, h-index: 41)
J. of Indian Philosophy     Hybrid Journal   (Followers: 10, SJR: 0.179, h-index: 7)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.165, h-index: 5)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 10, SJR: 1.064, h-index: 68)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 7, SJR: 0.411, h-index: 11)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.65, h-index: 39)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 0.902, h-index: 31)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.182, h-index: 66)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 6, SJR: 0.316, h-index: 27)
J. of Insect Behavior     Hybrid Journal   (Followers: 8, SJR: 0.537, h-index: 36)
J. of Insect Conservation     Hybrid Journal   (Followers: 9, SJR: 0.775, h-index: 36)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.501, h-index: 36)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.427, h-index: 39)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.095, h-index: 44)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 1.073, h-index: 38)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 16)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.385, h-index: 9)
J. of Labor Research     Hybrid Journal   (Followers: 14, SJR: 0.228, h-index: 21)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 5, SJR: 0.63, h-index: 20)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 1, SJR: 0.773, h-index: 48)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 1, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 4, SJR: 1.845, h-index: 32)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 3.22, h-index: 73)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.383, h-index: 26)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.134, h-index: 4)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.343, h-index: 8)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.317, h-index: 22)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.19, h-index: 5)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 2, SJR: 0.392, h-index: 16)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.666, h-index: 31)
J. of Materials Science     Hybrid Journal   (Followers: 18, SJR: 1.006, h-index: 101)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3, SJR: 0.697, h-index: 48)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4, SJR: 0.926, h-index: 77)
J. of Mathematical Biology     Hybrid Journal   (Followers: 13, SJR: 1.183, h-index: 61)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.407, h-index: 41)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.709, h-index: 17)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 1.25, h-index: 44)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.358, h-index: 19)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.32, h-index: 20)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 12, SJR: 1.042, h-index: 14)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 1)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 2, SJR: 0.589, h-index: 20)
J. of Medical and Biological Engineering     Hybrid Journal   (SJR: 0.434, h-index: 13)
J. of Medical Humanities     Hybrid Journal   (Followers: 17, SJR: 0.251, h-index: 13)
J. of Medical Systems     Hybrid Journal   (Followers: 2, SJR: 0.604, h-index: 32)
J. of Medical Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.765, h-index: 21)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.209, h-index: 11)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.971, h-index: 75)
J. of Micro-Bio Robotics     Hybrid Journal  
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.641, h-index: 35)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.296, h-index: 11)
J. of Molecular Evolution     Hybrid Journal   (Followers: 11, SJR: 1.07, h-index: 99)
J. of Molecular Histology     Hybrid Journal   (Followers: 1, SJR: 0.791, h-index: 43)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.452, h-index: 100)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.55, h-index: 42)
J. of Molecular Neuroscience     Partially Free   (Followers: 8, SJR: 1.242, h-index: 61)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 11)
J. of Muscle Research and Cell Motility     Hybrid Journal   (SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 2, SJR: 0.777, h-index: 66)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.586, h-index: 22)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.857, h-index: 48)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.331, h-index: 23)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.302, h-index: 77)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.342, h-index: 80)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.239, h-index: 36)
J. of Neurology     Hybrid Journal   (Followers: 12, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (SJR: 1.367, h-index: 63)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 7, SJR: 0.452, h-index: 22)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.772, h-index: 36)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 38)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.456, h-index: 60)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 16, SJR: 0.886, h-index: 50)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.174, h-index: 3)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 11, SJR: 1.166, h-index: 43)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (SJR: 0.144, h-index: 8)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 1.031, h-index: 46)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.228, h-index: 8)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 2, SJR: 0.831, h-index: 2)
J. of Optics     Hybrid Journal   (Followers: 4)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 20)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthop√§die     Hybrid Journal   (SJR: 0.667, h-index: 27)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.684, h-index: 42)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 1.284, h-index: 58)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.272, h-index: 5)
J. of Pediatric Neuropsychology     Hybrid Journal  
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.002, h-index: 21)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 7, SJR: 0.617, h-index: 14)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.16, h-index: 2)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 22, SJR: 0.567, h-index: 41)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.367, h-index: 31)
J. of Philosophical Logic     Hybrid Journal   (Followers: 7, SJR: 0.94, h-index: 20)
J. of Physiology and Biochemistry     Hybrid Journal   (Followers: 3, SJR: 0.741, h-index: 30)
J. of Plant Biochemistry and Biotechnology     Hybrid Journal   (Followers: 5, SJR: 0.257, h-index: 17)
J. of Plant Biology     Hybrid Journal   (Followers: 9, SJR: 0.52, h-index: 16)
J. of Plant Growth Regulation     Hybrid Journal   (Followers: 1, SJR: 0.761, h-index: 47)
J. of Plant Research     Hybrid Journal   (Followers: 4, SJR: 1.055, h-index: 43)
J. of Police and Criminal Psychology     Hybrid Journal   (Followers: 412, SJR: 0.328, h-index: 10)
J. of Polymer Research     Hybrid Journal   (Followers: 6, SJR: 0.649, h-index: 27)
J. of Polymers and the Environment     Hybrid Journal   (Followers: 1, SJR: 0.618, h-index: 39)
J. of Population Ageing     Hybrid Journal   (Followers: 4, SJR: 0.357, h-index: 3)
J. of Population Economics     Hybrid Journal   (Followers: 16, SJR: 2.455, h-index: 42)
J. of Population Research     Hybrid Journal   (Followers: 1, SJR: 0.404, h-index: 10)
J. of Porous Materials     Hybrid Journal   (Followers: 3, SJR: 0.523, h-index: 34)
J. of Primary Prevention     Hybrid Journal   (Followers: 6, SJR: 0.816, h-index: 30)
J. of Productivity Analysis     Hybrid Journal   (Followers: 2, SJR: 0.825, h-index: 48)
J. of Pseudo-Differential Operators and Applications     Hybrid Journal   (SJR: 1.275, h-index: 5)
J. of Psycholinguistic Research     Hybrid Journal   (Followers: 9, SJR: 0.445, h-index: 37)
J. of Psychology and Judaism     Hybrid Journal   (Followers: 2)
J. of Psychopathology and Behavioral Assessment     Hybrid Journal   (Followers: 1, SJR: 0.949, h-index: 39)
J. of Psychosocial Rehabilitation and Mental Health     Hybrid Journal   (Followers: 2)
J. of Public Health     Hybrid Journal   (Followers: 23, SJR: 0.262, h-index: 17)
J. of Quantitative Criminology     Hybrid Journal   (Followers: 6, SJR: 2.481, h-index: 44)
J. of Racial and Ethnic Health Disparities     Hybrid Journal   (Followers: 1)
J. of Radiation Oncology     Hybrid Journal   (Followers: 1)
J. of Radioanalytical and Nuclear Chemistry     Hybrid Journal   (Followers: 4, SJR: 0.515, h-index: 44)
J. of Radiosurgery     Hybrid Journal   (Followers: 2)
J. of Rational-Emotive & Cognitive-Behavior Therapy     Hybrid Journal   (Followers: 1, SJR: 0.394, h-index: 19)
J. of Real-Time Image Processing     Hybrid Journal   (Followers: 6, SJR: 0.356, h-index: 16)
J. of Regulatory Economics     Hybrid Journal   (Followers: 7, SJR: 1.081, h-index: 35)
J. of Religion and Health     Hybrid Journal   (Followers: 10, SJR: 0.483, h-index: 18)
J. of Religious Education     Hybrid Journal   (Followers: 3)
J. of Risk and Uncertainty     Hybrid Journal   (Followers: 19, SJR: 2.34, h-index: 46)
J. of Robotic Surgery     Hybrid Journal   (SJR: 0.227, h-index: 11)
J. of Russian Laser Research     Hybrid Journal   (SJR: 0.326, h-index: 18)
J. of Scheduling     Hybrid Journal   (Followers: 2, SJR: 1.417, h-index: 38)
J. of Science Education and Technology     Hybrid Journal   (Followers: 16, SJR: 0.754, h-index: 30)
J. of Science Teacher Education     Hybrid Journal   (Followers: 15, SJR: 1.128, h-index: 22)
J. of Scientific Computing     Hybrid Journal   (Followers: 18, SJR: 1.771, h-index: 42)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.171]   [H-I: 14]   [5 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1435-0130 - ISSN (Online) 0930-343X
   Published by Springer-Verlag Homepage  [2281 journals]
  • The use of a single local analgesics infusion in operation cavity
           following mastectomy and its effect on postoperative pain—a
           retrospective cohort study
    • Abstract: Background Pain following mastectomy often require use of opioids, drugs associated with a significant number of side effects. This study investigated the effect of a single perioperative infusion of bupivacaine in the mastectomy cavity on the postoperative outcomes: use of opioids, pain score, and nausea. Methods This retrospective cohort included 244 women undergoing mastectomies at the Odense University Hospital, Denmark. Thirty-five patients received bupivacaine in the mastectomy cavity and were compared to 209 controls who had no local analgesic. Results A reduction in the postoperative use of 6.1 “oral morphine equivalents” (OMEQs) was observed in the infusion group in the first 24 h after mastectomy compared to a control group not receiving infusion. This corresponds to a reduction of 6.1 mg of orally administered morphine, equivalent to a 52 % reduction. This was, however, not statistically significant (p = 0.1208). No statistically significant differences between the two groups were found in visual analogue scale (VAS) scores for pain and nausea or in the use of other nonopioid analgesics. Conclusions A single perioperative infusion of bupivacaine may have a morphine-sparing effect in the first 24 h after mastectomy. Our results were however not statistically significant when tested on these low-pain surgical procedures. Infusion of analgesics in surgical cavities is simple, fast, and low cost. It might prevent the often seen vicious cycle of nausea and impaired coping with postsurgical pain when patients are introduced to opioids. Level of Evidence: Level III, therapeutic study.
      PubDate: 2016-04-30
  • Computer-assisted analysis contour lines of aesthetic unit for the
           assessment of lip augmentation
    • Abstract: Background Lip augmentation and changing contour lines have become more popular ways of improving the appearance. However, validated measures of lip fullness for quantification of outcomes are needed; ethnic background and personal goals can optimise outcomes while tailoring lip enhancement treatment to each individual’s anatomy. The aim of this study is to analyse the morphological features of the lip in detail and to clarify the objective parameters in related with the subjective ones regarding the lip augmentation and lip reconstruction. Methods Standard photographs of the lips of 200 young Anatolian adults were calculated with linear and angular components. The features of the lower third of the face were analysed with the software program. Linear analyses (heights of the upper lip, the upper vermilion, the lower lip height, the lower vermillion and the chin height) and angular analyses (the upper lip, the lower lip, the apex and Cupid’s bow angles) were measured as reference points. The lip shape was classified into five groups: thin, very thin, medium, full and very full. Results The lower third of the face was divided into three segments (Sn–Sto, Sm–Me and Sto–Sm), and the largest portion of the lower face was occupied by the chin and the smallest by the lower lip height in both genders. The upper vermilion height was 8.07 ± 1.8 mm in males and 7.08 ± 1.5 mm in females. The lower vermilion height was 10.1 ± 2.4 mm in males and 9.7 ± 1.9 mm in females. The upper lip angle was calculated as 30.3 ± 9.6° in males and 24.2 ± 6.2°mm in females. The lower lip angle was calculated as 38.3 ± 9.7° in males and 36.5 ± 6.4° in females. Meanwhile, the angular measurements of Cupid’s bow (i.e., the apex and the central angle of Cupid’s bow) were smaller in men than in women. When the lip was analyzed, the medium and full types in upper and lower lips accounted for substantial fractions in men, whereas medium and thin types were predominant also in women. Conclusions With the help of certain software, this research has made possible to define the best cosmetical redesign solution of lip construction and augmentation with a natural appearance for the patient. Level of Evidence: Level III, diagnostic study.
      PubDate: 2016-04-15
  • Bowtie technique—a novel approach to correct the widened ventral
           labia majora after male-to-female gender reassignment surgery
    • Abstract: Abstract Male-to-female gender reassignment surgery is a procedure that has evolved significantly since its inception. To create an aesthetic and functional vagina is the primary focus. Despite its evolutions, second stage revisions are frequently utilised to correct labial and clitoral hood defects (e.g. loss of clitoral hood, widening of the ventral labia major and exposure of the anterior commissure). Our objective is to present a simple and effective surgical step in the male-to-female gender reassignment operation in order to reduce the need for second stage interventions. The Bowtie technique is performed as the last step to the male-to-female gender reassignment procedure and aims to emphasise the clitoral hood, reduce the space of the ventral labia major and diminish the exposure of the anterior commissure. Having been performed by the senior author since 1992, outcomes have been satisfactory with no need for secondary procedures in those patients for the described defects. The Bowtie technique is a beneficial addition in male-to-female reconstructive surgery, which allows for the procedure to be performed in one stage without the need to correct common post-operative aesthetic defects. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-11
  • Novel microvascular anastomosis between a single vessel and two downstream
    • Abstract: Abstract Microsurgeons rarely encounter a situation that includes multiple downstream arteries requiring reperfusion with only one feeding artery being available. To cope with the difficulty of such a case, a unique microvascular anastomosis is described. This surgical technique is based on the assumption of the presence of a single large outflowing vessel and two small downstream vessels. The axial incisions were made on the cut end of the two small vessels. The ends of the two small vessels were sutured side-to-side and remodeled as one vessel. The partially coalesced small vessels were then anastomosed with the outflowing large vessel in an end-to-end fashion. Case presentation: a crush injury of the foot required reconstruction of the blood flow. The first dorsal metatarsal artery (FDMA) was damaged and occluded by thrombosis. The first and second toes had no blood supply. The original plan was simply to remove the damaged area of the FDMA and replace it with a straight vein graft, as the bifurcation to the two digital arteries appeared to be intact. At the time of microvascular anastomosis, however, the FDMA was found to still be damaged, and it required additional debridement. As a suboptimal method, the vein graft and the two digital arteries were anastomosed by the above-described atypical method. The digits all survived, and the patient subsequently returned to work, with no complications as of 10 months postoperatively. This atypical microvascular anastomosis is not an established method, but it has potential utility in similar situations. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-11
  • Lipofilling may induce nerve regeneration after previous traumatic injury:
           a clinical case with remarkable outcome
    • Abstract: Abstract Despite the fast amount of techniques, which promote nerve regeneration, the outcomes of high ulnar nerve injuries are still poor. This case report illuminates the usability of lipofilling in peripheral nerve regeneration. In the case described, we encountered a successful regeneration with return of sensibility and motor function. We believe that the rationale for this technique is the presence of adipose-derived stem cells (ADSCs). We speculate that this improvement depends on tissue regeneration induced by these ADSCs. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-08
  • Ventral hernia repair with lateral component separation and onlay
           Biodesign graft
    • Abstract: Background Ventral hernia is common, complicating up to 20 % of laparotomies. Plication of the rectus sheath with lateral component separation (LCS) provides a durable repair with acceptable functional outcomes. Additional support to the anterior abdominal wall may be provided by synthetic or biological mesh. Biological grafts invoke local tissue remodeling and result in strong fibrocollagenous tissue able to support the dynamic stressor of the anterior abdominal wall. Biodesign graft is a new graft derived from porcine small-intestine submucosa. We aim to review the use of Biodesign mesh for repair of ventral hernia with LCS. Methods Patients underwent ventral hernia repair completed with plication of the rectus sheath, LCS, and use of an onlay Biodesign graft. Data was collected retrospectively. Key outcome measures included post-operative complications and recurrence. Results Twelve patients were included for analysis. Mean age was 51.2 years, with 50 % males and a median weight of 87 kg (65–111 kg). Median operative time was 210 min (147 to 278 min) and median length of stay was 4 days. At a mean follow-up of 14.0 months, 8/12 (66 %) developed seroma, 1/12 (8 %) developed abdominal wall abscess, and 1/12 (8 %) suffered flap failure requiring vacuum dressings for closure. No patients were complicated by ventral hernia recurrence. Conclusions Our results describe an early Australian experience of onlay Biodesign graft in the context of rectus sheath plication with LCS. We report acceptable rates of post-operative complications and recurrence. Level of evidence: IV, therapeutic study.
      PubDate: 2016-04-05
  • Sunitinib related osteonecrosis of the jaw (SURONJ): a rare
    • PubDate: 2016-04-01
  • Retrospective analysis of acute hand injuries in an academic tertiary
           hospital that need plastic surgeon consultation
    • Abstract: Background Hand surgery covers a major area of plastic surgery practice. To our knowledge, there is no publication directly investigating the characteristics of hand injuries that plastic surgery consultation was requested, which could be an essential information to guide the plastic surgery education programs. This study determined the features of the hand injuries presented to the plastic surgery department during a year from an academic trauma hospital in Turkey. Methods Epidemiological information of the patients with hand injuries who were admitted to the emergency department of an academic tertiary hospital and needed plastic surgery consultation was evaluated. Patients were analyzed retrospectively in terms of gender, distribution of age, occupation, mechanism of injury, cause of injury, injured soft tissue structures, and duration of hospitalization. Results One thousand and forty-three (83.7 %) of the 1246 patients included in the study were male and 203 (16.3 %) were female. The mean age of patients was 32. The most common injured structure were the tendons with a rate of 41.2 %. The tendons were followed by fractures, tissue defects, nail injuries, nerve injuries, and vascular injuries with a rate of 18.8, 16.6, 10, 8.3, and 5.3 %, respectively. The most frequent mechanism of injury was crush type (38.6 %) followed by blunt cut (26.9 %), sharp cut (25.9 %), combined (4.8 %), and avulsion injuries (3.8 %). 7.8 % of the patients with hand injuries had amputations. Conclusions Despite the limitations, our study can reflect emergency hand injuries that a plastic surgeon may be faced within a tertiary care center. By our work, a plastic surgeon will be aware of demographic features of a patient with a hand injury presented by the emergency department. Level of Evidence: Level IV, risk/prognostic.
      PubDate: 2016-04-01
  • Vancomycin-related partial necrosis of congenital hemangioma
    • Abstract: Abstract The term hemangioma refers to the common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. Infantile hemangiomas are benign vascular neoplasms that develop from the dermal capillary network. Vancomycin is a bactericidal antibiotic agent commonly used in the treatment of infections caused by Gram-positive organisms. The most common adverse effect of intravenously administered vancomycin is “red man syndrome” (RMS), which is associated with the rapid infusion of large doses of vancomycin. This reaction is secondary to mast cell degranulation and is characterized by erythema, pruritus, flushing of the upper torso, and, in severe cases, angioedema and (rarely) cardiovascular complications. We present the case of a 3.5-month-old girl who developed partial hemangioma necrosis secondarily to RMS following intravenous administration of vancomycin for the treatment of Gram-positive bacteremia. Level of Evidence: Level V, prognostic / risk study.
      PubDate: 2016-04-01
  • Dual-incision approach for excision of postauricular sinus
    • PubDate: 2016-04-01
  • Modification of the anterolateral thigh free flap design for
           reconstruction after laryngo-pharyngoesophagectomy
    • Abstract: Abstract The anterolateral thigh free flap (ALTFF) has become the favourable fasciocutaneous flap for reconstruction of laryngo-pharyngoesophagectomy (LPO) defects. Reconstruction of these defects can be challenging. We report our experience with a new flap design based on the traditional ALTFF template for single-stage reconstruction of circumferential LPO defects with anterior neck skin deficits in previously irradiated patients. The design uses the traditional tubed skin island to create the neopharynx and also utilises the natural dog-ears from the thigh as a second vascularised skin island that can be used to fill dead space or externalised to resurface the neck. This addresses the issues of monitoring the internal skin paddle and also of replacing anterior neck skin deficits with a single flap. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-01
  • Late spontaneous rupture of extensor pollicis longus tendon after blunt
           trauma with no residual fracture
    • Abstract: Abstract Spontaneous rupture of extensor pollicis longus tendon was first reported by Dupley in 1876. This rupture has been reported after distal radius fracture (Colles fracture), rheumatoid arthritis, steroid injections or systemic steroid treatment, and occupational tenosynovitis. The main etiologies of this rupture are the fracture of the tendon over the irregular bone surface following the fracture or inflammatory processes as in rheumatoid arthritis. Most ruptures are usually found at Lister’s tubercle. Some authors suggested ischemic etiology in the cases following wrist trauma with no residual fracture. We describe a case of rupture of the extensor pollicis longus tendon 1 month after a blunt wrist trauma with no residual fracture. The rupture was at the myotendinous junction (MTJ). To highlight on this rupture, we believed it was caused from both vascular and mechanical factors. The mechanical factor was the position of the myotendinous junction under the extensor retinaculum. The vascular factor was the nature of the myotendinous junction being the most sensitive to ischemia. Level of Evidence: Level V, diagnostic study.
      PubDate: 2016-04-01
  • A prospective cohort pilot study to assess the safety and efficacy of
           combining autologous platelet-rich plasma (PRP) with autologous dermal
           fibroblast for skin augmentation
    • Abstract: Background There is a renewed interest in autologous fillers for facial rejuvenation. We used PRP combined with cultured fibroblasts as an attractive alternative to synthetic fillers. Methods Twenty adults (17 women and 3 men: mean age 45 years: range 36–65 years) participated in a clinical trial to improve the fold in the skin of the nasolabial folds by having 1 ml of platelet-rich plasma (PRP) combined with cultured fibroblasts injected into each side. Results Sixteen patients had an 80 % increase in thickness of the skin adjacent to the nasolabial fold at the 9-month follow-up. Fifteen patients also showed an increase in dermal density, and in 7, there was an increase in the hydration of the facial skin. In 16 patients, the sebum quality of the skin either improved on one side or both sides of the cheek (adjacent to the nasolabial fold). Wrinkle depth on either one or both sides of the nasolabial fold was reduced in 15 patients. Seventeen patients (85 %) were satisfied with the result and would undergo the procedure again. In standardised photography, the contour of the nasolabial fold was improved in 15 patients. Conclusions This technique softens the nasolabial folds as well as improves the condition of the adjacent skin. This improvement was present after 9 months and did not appear to diminish with time. PRP when combined with cultured fibroblasts can act as an effective autologous filler. Level of Evidence: Level IV, therapeutic study
      PubDate: 2016-04-01
  • A rare case of eccrine spiradenoma—treatment and management
    • Abstract: Abstract A young male patient presented with multiple swellings on his chest and the nape of his neck. Physical examination revealed multiple small papulonodular swellings measuring 0.5 × 0.5 cm to 2 × 2 cm, that were soft without discharge with no surrounding skin changes or induration. Skin biopsy samples were diagnosed as benign adnexal neoplasm consistent with eccrine spiradenoma, trichoepithelioma, and cylindroma, i.e., Brooke–Spiegler syndrome. Having confirmed this to be a case of eccrine spiradenoma, surgical excision was performed and the raw area was covered with a split thickness skin graft taken from the right thigh and sutured over the raw area. The sternal lesion was circumferentially excised and the wound was primarily closed by Z-plasty. Surgical excision is considered the gold standard for the treatment of these cases, with low rates of recurrence. Around 50 such cases have been reported in the literature to date. Although eccrine spiradenomas are usually solitary and small, the findings in our case underscore the fact that a variety of presentations are possible. With strict clinical suspicion and histological criteria, the correct diagnosis can be achieved, especially when combined with pertinent clinical information and laboratory studies. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-01
  • The management of acute peripheral arterial bleeding in emergencies: a
           plastic surgeon’s perspective
    • PubDate: 2016-04-01
  • A comparison of fasciotomy wound closure methods following extremity
           compartment syndrome at a regional trauma centre
    • Abstract: Background Extremity fasciotomy wound closure following acute compartment syndrome is often prohibited by residual swelling, producing wounds that significantly contribute to patient morbidity. The aim of this study was to assess patient and fasciotomy wound outcomes associated with dynamic closure (DYN), delayed primary closure (DPS) and split skin grafting (SSG) techniques. Methods A retrospective review of all trauma-related compartment syndrome patients managed between January 2000 and March 2010 was conducted, and a comprehensive patient and wound outcomes analysis was performed. Results DYN was employed in 109 wounds, DPS in 66 wounds and SSG in 7 wounds. DPS wounds achieved closure in a significantly shorter timescale than other methods (p = <0.05). DYN and SSG group wound closure times were comparable; however, SSG techniques were employed later post-fasciotomy. SSG patients had longer hospital stays (p = <0.05) and the lowest wound complication rate (0 %). Wound complication rates were significantly higher in the DYN (55 %) and DPS groups (15 %) (p = <0.05), and these wounds required a higher number of further surgical procedures. The need for repeated wound debridements was higher in the DYN group than any other (p = <0.05). Conclusions DPS provided the fastest method of fasciotomy wound closure and the shortest inpatient stay. DYN techniques were associated with higher wound complication rates and the need for further surgical procedures. SSG techniques were associated with low complication rates and fewer surgical procedures and, if applied earlier, could result in shorter inpatient stay. Level of evidence IV, therapeutic study.
      PubDate: 2016-04-01
  • The use of dermal regeneration template (Pelnac®) in acute
           full-thickness wound closure: A case series
    • Abstract: Background Dermal regeneration template (DRT) has been well implicated in the reconstruction of full-thickness burn injury. This case series specifically presents our experience and our clinical application of Pelnac® to achieve wound closure with complex acute full-thickness defect. Methods A retrospective review of patients treated with Pelnac for complex wound defects from 2008 to 2014 at Concord Burns Unit was carried out. Variables such as wound aetiology, wound size and complications were considered. Results Five patients (four females and one male with a mean age 54 ± 20) all had full-thickness defects (mean defect size 4.3 ± 2.0 % TBSA), some with exposed tendon and bone. The wounds were treated with Pelnac®; the silicone layer was removed at postoperative day 14 and a split-thickness skin graft (0.2 to 0.3 mm) was applied. Clinically, the reconstructed areas demonstrated good granulation tissue at 14 days with good take of the skin graft. There were no major acute graft loss, rejection or associated infection. However, there were small areas of graft loss which did not require re-grafting. Conclusions DRT provides a safe and efficacious alternative when dealing with acute contaminated full-thickness wounds. Pelnac® seems versatile in obtaining wound coverage in difficult complex wounds, especially in critically ill patients where free or pedicle flap reconstruction would be problematic. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-01
  • Anteriorly based pudendal thigh flap for scrotal reconstruction based on
           the deep external pudendal artery (DEPA) flap
    • Abstract: Background Major scrotal skin loss represents a significant challenge for reconstructive surgeons. Although many therapeutic methods have been established for the treatment of such defects, each technique has its own advantages and disadvantages. A posteriorly based pudendal thigh fasciocutaneous flap at the perianal region has been described for reconstruction of genital organs, but an anteriorly based pudendal thigh fasciocutaneous flap has not been described for scrotal reconstruction. Aim The aim of this study was to introduce and evaluate the use of an anteriorly based pudendal thigh flap for scrotal reconstruction. Methods Twenty flaps in 15 patients with major scrotal defects were subjected to reconstruction using this flap. The etiology of scrotal loss was Fournier gangrene in all cases. Five patients each underwent bilateral and ten patient unilateral reconstructions, by the anteriorly based pudendal thigh flap, based on the deep external pudendal artery (DEPA). Results All 20 flaps survived completely. Additionally, the donor site was closed directly, and the scar was hidden in the perineal crease. The donor site healed uneventfully, as one patient required a secondary procedure for healing. Conclusion An anteriorly based pudendal thigh flap is highly reliable for coverage of major scrotal defects. This flap allows adequate coverage with excellent aesthetic appearance of the scrotum. Level of Evidence: Level II, therapeutic study.
      PubDate: 2016-04-01
  • DIEP flap salvage by cannula venesection of the superficial inferior
           epigastric vein
    • Abstract: Abstract The deep inferior epigastric perforator (DIEP) flap is a technique of autologous breast reconstruction that is gaining popularity. The main advantage of the DIEP flap over the traditional transverse rectus abdominis myocutaneous (TRAM) flap is that there is a lower incidence of abdominal wall donor-site morbidity with the DIEP flap. However, venous congestion is the most dreaded complication of DIEP flap surgery which requires prompt intervention. In this case report, we present a simple but effective procedure to salvage the congested DIEP flap. A 55-year-old female underwent left breast reconstruction with DIEP flap and developed venous congestion during surgery. Cannula venesection of the superficial inferior epigastric vein (SIEV) was performed intraoperatively followed by intermittent aspiration of blood for 3 days. A satisfactory aesthetic result was achieved with no evidence of fat necrosis. This procedure eliminated the need for performing an additional microvascular anastomosis, required less operative time, and allowed augmentation of the venous drainage of the congested flap. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-04-01
  • Fat grafting for the prevention of pressure ulcers: a case series
    • Abstract: Background Pressure sores tend to recur and become chronic, especially in high-risk groups such as paraplegics, who may present multiple wounds and have long life expectancies. Here, we assess the outcomes achieved with fat grafting as a new preventive strategy for pressure sores. Methods From 2010 to 2013, seven paraplegic patients presenting stage I or stage II pressure ulcers were treated with the injection of 115 to 620 cm3 of fat that was previously filtered and washed with saline solution. Patients were followed up at 2 and 4 weeks and at 3, 6, and 12 months after surgery. Results Our experience was encouraging. There was an increase in the thickness of the subcutaneous fat layer and in the degree of padding of the underlying bony protrusions, as a type of natural cushion, which restored the physiological sliding on the underlying fascial planes. A general improvement in the skin characteristics was noted, which reduced the risk of new recurrences. In addition, the fat allowed for satisfactory restoration of the anatomical profile. There were no major complications. Only two cases required new lipofilling due to partial resorption of the graft. Conclusions Fat grafting may prevent the evolution of lesions and reduce the risk of recurrence. This strategy may avoid the necessity of using assisted scarring devices or more aggressive surgical approaches. Level of Evidence: Level IV, therapeutic study
      PubDate: 2016-04-01
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