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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.727, h-index: 14)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.921, h-index: 44)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 1.087, h-index: 74)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 4, SJR: 1.126, h-index: 59)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.291, h-index: 19)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.511, h-index: 20)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.068, h-index: 60)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.27, h-index: 13)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.437, h-index: 31)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 7, SJR: 0.151, h-index: 2)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.995, h-index: 78)
J. of Computers in Education     Hybrid Journal   (Followers: 7)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.363, h-index: 21)
J. of Consumer Policy     Hybrid Journal   (Followers: 5, SJR: 0.704, h-index: 30)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.237, h-index: 5)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.197, h-index: 6)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 4, SJR: 0.397, h-index: 23)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.359, h-index: 19)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 7, SJR: 0.231, h-index: 9)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.631, h-index: 29)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.989, h-index: 11)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.443, h-index: 55)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.539, h-index: 29)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.149, h-index: 8)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 7, SJR: 0.114, h-index: 5)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.574, h-index: 29)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.578, h-index: 35)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 7, SJR: 0.154, h-index: 6)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.4, h-index: 26)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.418, h-index: 31)
J. of Earth Science     Hybrid Journal   (Followers: 8, SJR: 0.483, h-index: 16)
J. of Earth System Science     Open Access   (Followers: 40, SJR: 0.448, h-index: 32)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.537, h-index: 20)
J. of Echocardiography     Hybrid Journal   (Followers: 4, SJR: 0.22, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 23, SJR: 3.273, h-index: 63)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.263, h-index: 12)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.418, h-index: 23)
J. of Economics and Finance     Hybrid Journal   (Followers: 6, SJR: 0.272, h-index: 19)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.961, h-index: 21)
J. of Elasticity     Hybrid Journal   (Followers: 5, SJR: 0.851, h-index: 45)
J. of Electroceramics     Hybrid Journal   (SJR: 0.577, h-index: 57)
J. of Electronic Materials     Hybrid Journal   (Followers: 3, SJR: 0.609, h-index: 75)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.372, h-index: 27)
J. of Electronics (China)     Hybrid Journal   (Followers: 4, SJR: 0.112, h-index: 9)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.347, h-index: 37)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.288, h-index: 11)
J. of Engineering Research     Open Access   (SJR: 0.145, h-index: 5)
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.763, h-index: 9)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.609, h-index: 25)
J. of Evolution Equations     Hybrid Journal   (SJR: 0.826, h-index: 26)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.145, h-index: 11)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.492, h-index: 52)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 4, SJR: 0.458, h-index: 39)
J. of Experimental Criminology     Hybrid Journal   (Followers: 31, SJR: 1.445, h-index: 28)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.261, h-index: 15)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.396, h-index: 32)
J. of Family Violence     Hybrid Journal   (Followers: 17, SJR: 0.639, h-index: 56)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.273, h-index: 10)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, SJR: 0.572, h-index: 36)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.644, h-index: 13)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.465, h-index: 56)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.307, h-index: 4)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.441, h-index: 29)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.495, h-index: 27)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.304, h-index: 14)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.18, h-index: 42)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.373, h-index: 7)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.387, h-index: 19)
J. of Gambling Studies     Hybrid Journal   (Followers: 4, SJR: 1.171, h-index: 57)
J. of Gastroenterology     Hybrid Journal   (Followers: 12, SJR: 1.651, h-index: 88)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 39)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.64, h-index: 99)
J. of General Internal Medicine     Hybrid Journal   (Followers: 13, SJR: 1.804, h-index: 134)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.554, h-index: 22)
J. of Genetic Counseling     Hybrid Journal   (Followers: 4, SJR: 0.902, h-index: 39)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.458, h-index: 28)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 2.173, h-index: 56)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.8, h-index: 23)
J. of Geographical Systems     Hybrid Journal   (Followers: 3, SJR: 0.822, h-index: 39)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.491, h-index: 27)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.272, h-index: 15)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 0.992, h-index: 60)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
J. of Grid Computing     Hybrid Journal   (SJR: 1.414, h-index: 37)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 15, SJR: 0.881, h-index: 39)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.2, h-index: 13)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.308, h-index: 50)
J. of High Energy Physics     Hybrid Journal   (Followers: 5, SJR: 1.052, h-index: 153)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.232, h-index: 2)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.648, h-index: 28)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.344, h-index: 19)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.304, h-index: 10)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.759, h-index: 37)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 46)
J. of Indian Philosophy     Hybrid Journal   (Followers: 11, SJR: 0.127, h-index: 12)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.164, h-index: 7)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 12, SJR: 0.966, h-index: 80)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 6, SJR: 0.327, h-index: 15)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.673, h-index: 46)
J. of Information Technology     Hybrid Journal   (Followers: 49, SJR: 1.474, h-index: 55)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 7)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 1.25, h-index: 36)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.389, h-index: 77)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 7, SJR: 0.338, h-index: 33)
J. of Insect Behavior     Hybrid Journal   (Followers: 9, SJR: 0.569, h-index: 39)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, SJR: 0.872, h-index: 43)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.629, h-index: 43)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.691, h-index: 43)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.397, h-index: 54)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 0.93, h-index: 43)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 27, SJR: 4.208, h-index: 130)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.549, h-index: 23)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.308, h-index: 13)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 20, SJR: 0.793, h-index: 22)
J. of Labor Research     Hybrid Journal   (Followers: 15, SJR: 0.394, h-index: 27)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 7, SJR: 0.288, h-index: 25)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 52)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.203, h-index: 7)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.134, h-index: 37)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 2.252, h-index: 83)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.805, h-index: 33)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.605, h-index: 6)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.439, h-index: 11)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.235, h-index: 19)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.228, h-index: 8)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 3)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.449, h-index: 22)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.544, h-index: 40)
J. of Materials Science     Hybrid Journal   (Followers: 19, SJR: 0.836, h-index: 123)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
J. of Mathematical Biology     Hybrid Journal   (Followers: 12, SJR: 1.011, h-index: 71)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 45)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.22, h-index: 22)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 0.901, h-index: 53)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.414, h-index: 23)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.272, h-index: 23)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 13, SJR: 1.062, h-index: 20)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 2)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.589, h-index: 26)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 1, SJR: 0.387, h-index: 18)
J. of Medical Humanities     Hybrid Journal   (Followers: 19, SJR: 0.299, h-index: 18)
J. of Medical Systems     Hybrid Journal   (Followers: 1, SJR: 0.717, h-index: 44)
J. of Medical Toxicology     Hybrid Journal   (Followers: 4, SJR: 0.874, h-index: 28)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.18, h-index: 13)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.738, h-index: 82)
J. of Micro-Bio Robotics     Hybrid Journal   (SJR: 0.28, h-index: 3)
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.741, h-index: 43)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.317, h-index: 16)
J. of Molecular Evolution     Hybrid Journal   (Followers: 9, SJR: 0.952, h-index: 108)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, SJR: 0.755, h-index: 48)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.165, h-index: 113)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.466, h-index: 50)
J. of Molecular Neuroscience     Partially Free   (Followers: 9, SJR: 0.988, h-index: 69)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.418, h-index: 15)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 1.264, h-index: 55)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, SJR: 0.583, h-index: 84)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.602, h-index: 28)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.689, h-index: 55)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.466, h-index: 26)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.034, h-index: 86)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.274, h-index: 90)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.662, h-index: 45)
J. of Neurology     Hybrid Journal   (Followers: 13, SJR: 1.429, h-index: 105)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 0.979, h-index: 69)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 9, SJR: 0.863, h-index: 27)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.887, h-index: 42)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 0.723, h-index: 47)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.024, h-index: 68)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 18, SJR: 0.919, h-index: 60)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.214, h-index: 6)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 12, SJR: 0.811, h-index: 51)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.237, h-index: 11)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 0.796, h-index: 52)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.183, h-index: 11)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 3)
J. of Optics     Hybrid Journal   (Followers: 5, SJR: 0.214, h-index: 8)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 3, SJR: 0.898, h-index: 65)
J. of Ornithology     Hybrid Journal   (Followers: 22)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal   (SJR: 0.574, h-index: 33)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.708, h-index: 48)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 0.984, h-index: 64)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.298, h-index: 9)
J. of Pediatric Neuropsychology     Hybrid Journal   (Followers: 1)
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.341, h-index: 28)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 8, SJR: 0.524, h-index: 17)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 6)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 21, SJR: 0.708, h-index: 46)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.433, h-index: 36)
J. of Philosophical Logic     Hybrid Journal   (Followers: 8, SJR: 0.704, h-index: 26)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.203]   [H-I: 16]   [6 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  [2335 journals]
  • Assessment and planning for oncoplastic and reconstructive breast surgery:
           a review and a proposed chart
    • Authors: Amit Agrawal
      Pages: 321 - 330
      Abstract: Assessment for oncoplastic and reconstructive breast surgery (ORBS) can be time-consuming and subjective with a prolonged learning curve. Further, lack of recognition of options may lead to loss of patient choices whether available locally or not. This article reviews and incorporates essential variables into an author-designed chart with components of clinic consultation (“History” and “Examination”) that classify individual cases into one of the three complexities: high, average and low. Based on these complexities, decision-making processes are discussed in order to achieve, safely and realistically, both subjective and objective (anticipated versus achieved) goals of ORBS. This article by summarising literature around common ORBS variables attempts to streamline decision-making process as well as charts out variables to facilitate audit of decision-making and case selection process. Level of Evidence: Not ratable
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1221-7
      Issue No: Vol. 39, No. 5 (2016)
       
  • Blood supply to the second metatarsophalangeal joint—anatomical
           injection study and clinical correlation for free vascularised joint
           transfer
    • Authors: James Nott; Stephen J. Goldie; Wee Lam
      Pages: 331 - 334
      Abstract: Background Reconstruction of the injured/arthritic metacarpophalangeal joint remains challenging. Free vascularised joint transfer (VJT) using the second metatarsophalangeal joint (MTPJ) remains the gold standard, with an oblique osteotomy is usually performed to correct the natural hyperextended MTPJ during transfer. Surprisingly, few descriptions of the MTPJ arterial supply exist, despite reports of avascular necrosis of the MTP head following VJT. This study provides an up-to-date investigation of the second MTPJ blood supply. Methods The anterior and posterior tibial arteries in three cadaveric feet were injected with an Indian ink-latex mass. The second toe was dissected in its entirety. A modified Spalteholz technique was then used to demonstrate the extraosseus and intraosseus blood supply of the metatarsal head. Results Irrespective of arterial dominance within the first web space, the MT head was observed to receive a constant branch from the first dorsal metatarsal artery (FDMA) at a mean distance of 2.1 cm from the MTPJ. Variable articular branches were also observed to branch from the first/second plantar metatarsal arteries. Conclusions This is the first formal injection study to identify the presence of a constant articular branch from the FDMA. During VJT dissection, better knowledge of the blood supply allows planning of osteotomy without compromising blood supply to the MT head. Level of Evidence: Not ratable.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1215-5
      Issue No: Vol. 39, No. 5 (2016)
       
  • Risk factors of microtia: A systematic review and meta-analysis
    • Authors: Sanjib Tripathee; Jue Zhang; Meng Xiong
      Pages: 335 - 344
      Abstract: Background The pathogenesis of microtia is still unclear. Various risk factors have been studied but they remain inconclusive. We conducted the first ever systematic review and meta-analysis to look for the association between microtia and various environmental risk factors. Methods Relevant case-control studies published between January 2000 to October 2014 were identified through a systematic search in PubMed and EMBASE. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Out of 1706 potential articles, 12 were included in the systematic review and 8 in the meta-analysis. Results Risk factors which showed significant positive association with microtia were: cold-like syndrome during pregnancy (OR = 2.15; 95 % CI = 1.36, 3.41, P = 0.001); multiple gestation (OR = 1.55; 95 % CI = 1.05, 2.29, P = 0.03); and gestational diabetes (OR = 1.48; 95 % CI = 1.04, 2.10, P = 0.03). Risk factors which showed positive association but statistically insignificant were: threatened abortion (OR = 1.22; 95 % CI = 0.69, 2.15, P = 0.50); smoking during pregnancy (OR = 1.05; 95 % CI = 0.63, 1.77, P = 0.84); alcohol during pregnancy (OR = 1.08; 95 % CI = 0.65,1.80 P = 0.77); urinary tract infection (OR = 1.04; 95 % CI = 0.59, 1.84, P = 0.89); essential hypertension (OR = 1.04; 95 % CI = 0.74, 1.47, P = 0.82); maternal diabetes (OR = 3.98; 95 % CI = 0.72, 21.96, P = 0.11); respiratory tract infection (OR = 1.26,95 % CI = 0.84,1.88, P = 0.26); chronic disease during pregnancy (OR = 1.29,95 % CI = 0.99,1.69, P = 0.06); severe nausea/vomiting (OR = 1.16; 95 % CI = 0.66, 2.04, P = 0.61); NSAIDs during pregnancy (OR = 1.17, 95 % CI = 0.61,2.22, P = 0.64); antihypertensives during pregnancy (OR = 1.84,95 % CI = 0.94,3.62, P = 0.08); and illegal drugs during pregnancy (OR = 1.69; 95 % CI = 0.65, 4.39, P = 0.28). Reduced risk for microtia was found with these factors: folic acid (OR = 0.55; 95 % CI = 0.33, 0.92, P = 0.02); advanced maternal age (OR = 0.94; 95 % CI = 0.79, 1.11, P = 0.45); ampicillin during pregnancy (OR = 0.80,95 % CI = 0.50, 1.28, P = 0.35); and metronidazole during pregnancy (OR = 0.77,95 % CI = 0.40, 1.48 P = 0.44). Conclusions Our study indicates cold-like syndrome, multiple gestation, and gestational diabetes as significant risk factors for microtia; whereas folic acid consumption during pregnancy is shown to be a protective factor. Studies on risk factors for microtia are still very limited to establish the definitive risk factors. Further large-scale and multicentre studies are needed to clarify the role of key risk factors for the development of microtia. Level of Evidence: Level II, risk / prognostic study.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1196-4
      Issue No: Vol. 39, No. 5 (2016)
       
  • Surgical stabilization for symptomatic carpometacarpal hypermobility; a
           randomized comparison of a dorsal and a volar technique and a cohort of
           the volar technique
    • Authors: Kim Robin Spekreijse; Guus Maarten Vermeulen; Thybout M. Moojen; Harm P. Slijper; Steven E. R. Hovius; Ruud W. Selles; Reinier Feitz
      Pages: 345 - 352
      Abstract: Background Hypermobility of the first carpometacarpal joint is mostly surgically treated with a volar approached stabilization by Eaton, but recent studies indicate the importance of the dorsoradial and intermetacarpal ligaments (DRL and IML) for carpometacarpal joint stability. The aim of this study was to compare a dorsal and volar technique for primary carpometacarpal hypermobility regarding pain and functional outcome. Methods Patients with non-degenerative, painful carpometacarpal hypermobility were included and were randomly assigned to either the volar technique using the FCR, or a dorsal technique using the ECRL. After premature termination of the trial, we followed all patients treated with the volar approach. Pain, strength, and ADL function using DASH and Michigan Hand Questionnaires (MHQ) were measured at baseline and 3 and 12 months after surgery. Results After including 16 patients, the randomized trial comparing the volar and dorsal technique was terminated because of significant increased pain in the dorsal group. Although none of the other outcome measures were significant in the underpowered comparison, in line with the pain scores, all variables showed a trend towards a worse outcome in the dorsal group. Between 2009 and 2012, 57 thumbs were surgically stabilized. We found significant better pain and MHQ scores, and after 1 year improved grip and key pinch strength. Patients returned to work within 8 (±7) weeks, of which 85 % in their original job. Conclusions Surgical stabilization of the thumb is an effective method for patients suffering from hypermobility regarding pain, daily function, and strength. We recommend a volar approach. Level of Evidence: Level I, therapeutic study
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1212-8
      Issue No: Vol. 39, No. 5 (2016)
       
  • Negative-pressure wound therapy for diabetic ischemic foot wounds in
           hemodialysis patients
    • Authors: Kyoichi Matsuzaki; Kazuo Kishi
      Pages: 353 - 358
      Abstract: Background The evidence-based recommendations in 2011 state that a negative-pressure wound therapy (NPWT) may be considered as an advanced wound care therapy for lower limb ulceration after successful revascularization. Since the grade of recommendation was determined by six articles which did not study patients with similar wound severity to critical limb ischemia (CLI), we investigated the patients with similar one. Methods Of the 169 cases who were surgically treated for lower extremity wounds due to CLI between January 1, 2007, and December 31, 2013, nine cases satisfied the following criteria in our institute. There were patients on hemodialysis due to diabetic nephropathy among patients with CLI, and percutaneous transluminal angioplasty (PTA) was performed. These patients had foot gangrene, underwent debridement, and then underwent second-stage midfoot wound closure. Their wounds were completely healed. After performing debridement until the second-stage wound closure surgery, the localized wound therapy without NPWT in three patients (group 1) before health insurance covered NPWT in 2010 and using NPWT in six patients (group 2) thereafter. Results The mean period until wound closure surgery after debridement was 55.7 ± 11.2 days in group 1 and 31.3 ± 6.6 in group 2. Significant difference in the number of days was observed between the two groups (p = 0.002). Conclusions Period of time from debridement to the time of wound closure surgery was significantly shortened with NPWT after revascularization by means of PTA in CLI patients. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1182-x
      Issue No: Vol. 39, No. 5 (2016)
       
  • Interest in cosmetic surgery among Iranian women: the role of self-esteem,
           narcissism, and self-perceived attractiveness
    • Authors: Abdoljalil Kalantar-Hormozi; Ramin Jamali; Mohammad Atari
      Pages: 359 - 364
      Abstract: Background Examining psychological aspects of cosmetic surgery has gained considerable attention in the research literature, particularly among women. The present study aimed to examine the role of three self-worth variables including self-esteem, narcissism, and self-perceived attractiveness on interest in cosmetic surgery among Iranian women. Methods Three hundred women were selected and completed a set of measures including Rosenberg Self-Esteem Scale, Single-Item Narcissism Scale, and self-perceived attractiveness. Pearson correlation coefficients and hierarchical multiple regression analyses were used in statistical analyses. Results The results showed that participants were moderately interested in cosmetic surgery. Moreover, self-esteem and self-perceived attractiveness could significantly predict interest in cosmetic surgery. On the other hand, narcissism was not significantly correlated with interest in undergoing cosmetic surgery. Conclusions Findings support the notion that self-worth variables have a significant relationship with interest in cosmetic surgery. The present results are discussed in relation to previous evidence investigating the variables which are associated with interest in cosmetic surgery. Level of Evidence: Level III, risk study
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1185-7
      Issue No: Vol. 39, No. 5 (2016)
       
  • Levels of evidence in plastic surgery—bibliometric trends and comparison
           with five other surgical specialties
    • Authors: Riaz A. Agha; Mariana Devesa; Katharine Whitehurst; Alexander J. Fowler; Robert Coe; Georgina Wellstead; Dennis P. Orgill; Peter McCulloch
      Pages: 365 - 370
      Abstract: Background Categorising research by level of evidence (LOE) is an important evidence-based medicine initiative. Our objective was to assess the change in LOEs in plastic surgery from 2003 to 2013 and compared this with five other surgical specialties. Methods A search for all research articles published in the top three general plastic surgery journals (ranked by impact factor) was conducted for 2003 and 2013. Articles were then labelled as LOE 1–5 and compared to other specialties. Results Mean LOE for plastic surgery improved by 4.1 % from 3.86 (95 % confidence interval 3.81–3.91) to 3.70 (95 % confidence interval 3.64–3.74) from 2003 to 2013 respectively. All six surgical specialties improved their mean LOE (range 3.7 to 10.9 %). By mean LOE, plastic surgery continues to rank five out of six. Conclusions Plastic surgery is tending towards higher levels of evidence at a slow pace. The specialty must continue to drive towards higher levels of evidence. Level of Evidence: Not ratable.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1219-1
      Issue No: Vol. 39, No. 5 (2016)
       
  • Novel microvascular anastomosis between a single vessel and two downstream
           vessels
    • Authors: Tetsushi Aizawa; Mitsuru Sekido
      Pages: 371 - 374
      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: 2016-10-01
      DOI: 10.1007/s00238-016-1192-8
      Issue No: Vol. 39, No. 5 (2016)
       
  • The horseshoe flap. An “emergency” oncoplastic breast surgery
           technique
    • Authors: Guido Torresini; Maurizio Brucchi; Emanuele Garreffa; Antonella Sozio
      Pages: 375 - 382
      Abstract: Since 2003, oncoplastic breast surgery was introduced combining breast cancer resection and reconstruction. The goal of OBS is to achieve an oncologically safe surgery with the best possible cosmetic result. This type of procedure must be carefully planned preoperatively by taking into account several factors. However, sometimes this does not happen, and as a response to this factors’ neglect, we developed a technique to correct the defect from an upper quadrant breast cancer lumpectomy, which resulted to be wider than expected. This technique is called the horseshoe flap. Data were collected retrospectively from the Teramo Breast Unit database from June 2013 to December 2014. Both preoperative and postoperative data were recorded. The horseshoe flap was used in resections of 20 % or more of the breast volume and consisted in the dissection of the remaining breast tissue from the overlying skin flap, and the mobilization of the remaining part of the upper pole from the pectoralis muscle. The two upper extremities were folded to cover the substance loss in the lumpectomy. A total of five patients underwent a horseshoe flap to correct their defect resulting for an upper quadrant cancer excision. Average resection volume was 131 cc, and no poor or bad cosmetic results were observed. During the follow-up, no cancer recurrences were observed. Sometimes breast surgeons need to perform resections larger than expected, and we are challenged with the correction of the defect without the possibility of a preoperative planning. In this pilot work, we present a valid solution for this situation in case cancers are located in the upper quadrants of the breast. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1186-6
      Issue No: Vol. 39, No. 5 (2016)
       
  • Lipofilling may induce nerve regeneration after previous traumatic injury:
           a clinical case with remarkable outcome
    • Authors: Geraldine L. Nanninga; Tim H. Nijhuis; Rutger M. Schols; Sjoerd B. Paulusma; J. Henk Coert; Jean Bart Jaquet
      Pages: 383 - 386
      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: 2016-10-01
      DOI: 10.1007/s00238-016-1193-7
      Issue No: Vol. 39, No. 5 (2016)
       
  • Post-traumatic onset of secondary progression of gynecomastia
    • Authors: Yordan P. Yordanov; Aylin Shef; Radka Hristoskova; Albena Fakirova
      Pages: 387 - 390
      Abstract: Gynecomastia is a benign enlargement of the male breast which can be a source of significant anxiety and embarrassment for the patients. A great variety of etiologic factors have been investigated and discussed. However, only few studies in the literature have accentuated on the possible role of the chronic tissue trauma for the de novo development of gynecomastia. Nevertheless, the exact mechanism of its onset in such cases remains unclear. The authors report on a case of posttraumatic unilateral progression of preexisting stable gynecomastia. The possible role of a single episode of acute trauma as a trigger mechanism for the new onset of the breast enlargement is discussed. Level of Evidence: Level V, risk/prognostic study.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1199-1
      Issue No: Vol. 39, No. 5 (2016)
       
  • The fully rotated tensor fasciae latae perforator propeller flap in
           reconstruction of trochanteric pressure sores
    • Authors: Paul Liebmann; Maria Deutinger; Ali A. Saalabian
      Pages: 391 - 394
      Abstract: Reconstruction of trochanteric pressure sores continues to challenge reconstructive surgeons because recurrence is not uncommon and patients typically have undergone previous surgery. We herein report on the use of a large adipocutaneous TFLPP rotated for 180° facilitating reconstruction of a recurring trochanteric decubital ulcer in a 37-year-old male morbidly obese patient with diabetes mellitus. The postoperative period showed no adverse events, and no recurrence was observed to date. The TFLPP is a valuable option because skin grafts are usually not needed for donor-site closure, the muscle is spared, and minimal donor-site morbidity as well as a less bulky appearance is observed. Level of evidence: Level V, therapeutic study.
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1209-3
      Issue No: Vol. 39, No. 5 (2016)
       
  • Comparison of long-term changes in breast surface measurements after
           augmentation mammaplasty: silicone versus saline implants
    • Authors: Katherine H. Carruthers; Ergun Kocak; James D. McMahan
      Pages: 395 - 396
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-016-1198-2
      Issue No: Vol. 39, No. 5 (2016)
       
  • Combined anterolateral chest and medial arm flap for treatment of
           degloving injuries of four digits
    • Authors: Hysni M Arifi; Hasan R Ahmeti; Shkelzen B Duci; Violeta K Zatriqi; Zejn A Buja; Shkelqim H Derguti
      Pages: 397 - 398
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-015-1179-x
      Issue No: Vol. 39, No. 5 (2016)
       
  • Unsuccessful vascularized fibular periosteal graft for treatment of
           femoral head osteonecrosis
    • Authors: Mariano E. Menendez; Cesar G. Fontecha; Vasco V. Mascarenhas; Jorge Knorr; Francisco Soldado
      Pages: 399 - 400
      PubDate: 2016-10-01
      DOI: 10.1007/s00238-015-1168-0
      Issue No: Vol. 39, No. 5 (2016)
       
  • Microsurgical flaps in the treatment of thoracic radionecrosis: a case
           series
    • Abstract: Background Radionecrosis of the thoracic wall is a late complication of radiotherapy mainly found in breast cancer patients. During the treatment of severe thoracic radionecrosis, the aggressive ablation of a large amount of damaged tissue is fundamental, making the use of healthy remote tissue provided by a free flap essential. However, most of the papers focusing in the reconstruction of this entity are dated or case reports. This article is intended to present the utility and results of reconstructive microsurgical techniques in these patients. Methods We carried out a retrospective review of the patients who underwent microsurgical reconstruction of extensive thoracic defects associated with radionecrosis in the period 2007 to 2012 in our centre. The variables studied were sex, age, size of the lesion, type of reconstructive procedure used, the postoperative evolution of the flap and the donor area, and the length of the hospital stay. Results Four patients with extensive thoracic defects associated with radionecrosis were included. After debridement, bone reconstruction was performed using a polytetrafluorethylene mesh, while soft tissue reconstruction was achieved using a free flap. One of the patients was reconstructed with a deep inferior epigastric perforator free (DIEP) flap and the rest with transverse myocutaneous gracilis (TMG) free flap. No flap-related complications were observed during the postoperative period. Conclusions The effects of radiation on soft tissues and bones are the cause of the increasing complexity of thoracic reconstruction. We believe that the use of free flaps to provide large amounts of tissue or cover particularly problematic areas can be an extremely useful tool for these patients. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-09-27
       
  • Freestyle local perforator flaps for facial reconstruction: clinical
           experience and complications
    • Abstract: Background Reconstruction of facial defects always represents a surgical challenge as functional and cosmetic outcomes must be taken into account more than any region of the body. The concept of freestyle perforator flaps has been developed to obtain a complete range of freedom in their movement to reach the defect. We present our clinical experience with facial perforator flaps, focusing on indications, surgical technique, and complications. Methods Thirty-one facial defects were reconstructed with freestyle local perforator flaps between January 2007 and November 2014. Doppler identification of perforator vessels preceded preoperative planning and the flap harvesting followed the dissection of perforator vessels. Results Twenty-two clinical cases had no complications. Four had venous congestion that resolved spontaneously, three had a distal 1/3 superficial necrosis, one suffered hematoma, and one had a 1/5 distal area of full thickness necrosis. Conclusions Freestyle perforator approach was applied to gain more freedom for facial reconstruction, allowing one-stage procedures and low donor site morbidity. Good anatomical understanding, precise planning, and meticulous technique can affect clinical results of perforator flaps in the face. A critical approach is essential to get better results. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-09-27
       
  • Electroneuromyographic study of orbicularis oculi muscle for evaluation of
           denervation after a transcutaneous inferior blepharoplasty with
           musculocutaneous flap
    • Authors: Fernando Vicente de Araujo; Leão Faiwichow; Cidia Vasconcellos; An Wang Ching; Marcel Vinicius Aguiar Menezes; Gustavo Henrique Araujo Pereira
      Abstract: Background Despite of the advances in plastic surgery, the approach to inferior eyelid is still considered a potential area for complications. Inferior transcutaneous blepharoplasty, without a canthal support, can lead to malposition of the inferior eyelid in 15 to 20 % of the individuals. The purpose of the study was to evaluate orbicularis oculi muscle function through electroneuromyographic studies of the face and inferior eyelid after inferior transcutaneous blepharoplasty with musculocutaneous flap. Methods Fifteen individuals, 30 eyelids, were submitted to inferior blepharoplasty with musculocutaneous flap and lateral canthopexy. Electroneuromyography with standard needles and facial nerve conductive studies were performed before and after surgery on both sides of the face. Statistical analysis was used. Results All the operated eyelids showed electroneuromyographic activity during voluntary contraction of orbicularis oculi muscle. Blink reflexes and facial nerve studies revealed no signs of denervation in both sides (p > 0.01). Functional and aesthetical results were considered satisfactory. Conclusions Electroneuromyographic studies after inferior transcutaneous blepharoplasty showed a viable muscle, functional and electrically active to inferior eyelid. Denervation was not evidenced. Level of Evidence: Level IV, prognostic study.
      PubDate: 2016-09-20
      DOI: 10.1007/s00238-016-1233-3
       
  • Finger proximal interphalangeal joint gap arthroplasty
    • Authors: Mohamed Elsaid Abdelshaheed; Ahmed Abdel-Galil Khalil; Reda Abdallah Younis; Ahmed Mohamed Bahaa El-Din Moustafa; Samy Ahmed Mahmoud Shehabeldin
      Abstract: Background The proximal interphalangeal (PIP) joint plays an important role in both grasp and pinch. In terms of mobility and stability, an intact PIP joint plays an important role in isolated finger function as well as the function of the entire hand. Currently, there are only a few surgical management protocols: arthrodesis, arthroplasty without joint replacement and arthroplasty with prosthetic replacement. This study aims to evaluate the gap arthroplasty technique as an alternative method for PIP joint reconstruction and to identify its advantages and disadvantages. Methods This interventional prospective study was conducted in a university hospital setting. We performed PIP joint gap arthroplasty using a dynamic traction device system after resection of the ankylotic area. The assessed outcome parameters were pain relief and range of motion (ROM) at 6 months, post-operatively. Results The results showed a complete pain relief, excellent passive ROM (in mean 65°) and a good active ROM (in mean 41°). This allows the patient to move the four ulnar fingers together without interruption from the injured finger. Overall patient satisfaction was very good. Conclusions Gap arthroplasty is an easy and effective technique for the PIP joint, and it does not require expensive materials as do artificial joint procedures. However, further studies are needed to conduct a long-term functional evaluation. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-09-15
      DOI: 10.1007/s00238-016-1243-1
       
  • Antibiotic prophylaxis with cefazolin in reducing the infection rate of
           non-melanocytic skin tumors: a randomized clinical trial
    • Authors: Rodrigo Dreher; Juliana L. C. Tenório; Ygor A. Ferrão; Pedro B. Ely
      Abstract: Background Surgical wound infections are a significant problem and may interfere with healing. There is no uniform data in the literature regarding the rate of infection among the resection of skin tumors and the benefit of antibiotic prophylaxis. This study evaluated the effectiveness of antibiotic prophylaxis with cefazolin in resections of nonmelanocytic skin tumors and whether the histological type and ulceration is related to the rate of wound infection. Methods Two hundred and twenty-seven patients undergoing non-melanocytic skin tumor resection were randomly divided into two groups: group I without antibiotic prophylaxis of surgical site infection, and group II with intravenous cefazolin prophylaxis.
      Authors looked for surgical wound infection during a month of follow-up. Comparison intra and extra groups were made considering the tumor histology, and if it was ulcerated or not to surgical site infection. Results The infection rate in the sample was 25 lesions (12.01 %). Antibiotic prophylaxis proved to be effective in ulcerative lesions, and the infection rate was reduced from 12 cases (30 %) to 3 cases (9.85 %) (p Fisher = 0.04; RRR = 0.61; NNT = 4.80) but was not associated with reduced infection rates in any histological type. Conclusions Antibiotic prophylaxis was effective in preventing wound infection in ulcerated non-melanocytic skin tumor. Level of Evidence: Level I, therapeutic study.
      PubDate: 2016-09-14
      DOI: 10.1007/s00238-016-1240-4
       
 
 
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