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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 2, SJR: 0.267, h-index: 14)
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.699, h-index: 8)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.676, h-index: 39)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 0.98, h-index: 63)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 4, SJR: 0.981, h-index: 50)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.284, h-index: 16)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.457, h-index: 17)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.419, h-index: 54)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.252, h-index: 11)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.342, h-index: 26)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 7)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.951, h-index: 70)
J. of Computers in Education     Hybrid Journal   (Followers: 5)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.725, h-index: 16)
J. of Consumer Policy     Hybrid Journal   (Followers: 3, SJR: 0.44, h-index: 23)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.115, h-index: 4)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 4)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 4, SJR: 0.441, h-index: 16)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.406, h-index: 13)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 7, SJR: 0.168, h-index: 8)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.412, h-index: 23)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.757, h-index: 6)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.598, h-index: 49)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.445, h-index: 24)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.183, h-index: 5)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 8, SJR: 0.207, h-index: 3)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.615, h-index: 23)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.535, h-index: 29)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 7, SJR: 0.296, h-index: 3)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.556, h-index: 22)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.33, h-index: 29)
J. of Earth Science     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 11)
J. of Earth System Science     Open Access   (Followers: 39, 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: 7, SJR: 0.694, h-index: 14)
J. of Elasticity     Hybrid Journal   (Followers: 5, SJR: 0.821, h-index: 38)
J. of Electroceramics     Hybrid Journal   (SJR: 0.566, h-index: 49)
J. of Electronic Materials     Hybrid Journal   (Followers: 3, 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: 4, SJR: 0.127, h-index: 7)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, 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: 4, SJR: 0.565, h-index: 34)
J. of Experimental Criminology     Hybrid Journal   (Followers: 30, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, 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: 16, SJR: 0.552, h-index: 45)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.241, h-index: 6)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, 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: 3, 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: 3, 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: 13, 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: 4, 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: 3, 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: 4, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
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: 5, 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: 12, SJR: 1.064, h-index: 68)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 6, SJR: 0.411, h-index: 11)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.65, h-index: 39)
J. of Information Technology     Hybrid Journal   (Followers: 48, SJR: 1.659, h-index: 43)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 6)
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: 9, SJR: 0.537, h-index: 36)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, 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. Business Studies     Hybrid Journal   (Followers: 27, SJR: 4.835, h-index: 108)
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 Intl. Relations and Development     Hybrid Journal   (Followers: 18, SJR: 0.35, h-index: 15)
J. of Labor Research     Hybrid Journal   (Followers: 15, SJR: 0.228, h-index: 21)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 6, SJR: 0.63, h-index: 20)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 2, SJR: 0.773, h-index: 48)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, 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 Marketing Analytics     Hybrid Journal   (Followers: 3)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, 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: 12, 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: 13, SJR: 1.042, h-index: 14)
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: 20)
J. of Medical and Biological Engineering     Hybrid Journal   (SJR: 0.434, h-index: 13)
J. of Medical Humanities     Hybrid Journal   (Followers: 18, SJR: 0.251, h-index: 13)
J. of Medical Systems     Hybrid Journal   (Followers: 1, SJR: 0.604, h-index: 32)
J. of Medical Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.765, h-index: 21)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 1, 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: 9, SJR: 1.07, h-index: 99)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, 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: 9, 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   (Followers: 1, SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, 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: 13, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 1.367, h-index: 63)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 8, 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: 18, 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: 12, 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: 3, SJR: 0.831, h-index: 2)
J. of Optics     Hybrid Journal   (Followers: 4)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 3, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 21)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     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: 8, 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: 21, SJR: 0.567, h-index: 41)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.367, h-index: 31)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.171]   [H-I: 14]   [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]
  • Bilateral autologous microtia reconstruction: a simultaneous two-stage
           approach
    • Authors: Sabrina Cugno; Neil W. Bulstrode
      Pages: 257 - 264
      Abstract: Background Traditionally, for cases of bilateral autologous ear reconstruction, each side is addressed independently in discrete operative sessions. Herein, we describe our approach to bilateral microtia reconstruction, where each stage is performed simultaneously on both sides. Methods All patients who underwent autologous ear reconstruction by a single surgeon (NWB) from April 2006 to January 2012 were retrospectively reviewed. Reconstruction was realized as a two-stage procedure, with each stage performed simultaneously on both sides in bilateral cases. Patient demographics, operative details and incidences of peri- and post-operative complications were collected. A cost comparison of two-stage versus four-stage bilateral auricular reconstruction was completed. Results Among a total of 182 patients who underwent autologous ear reconstruction, 18 patients (male, 10, median age, 11.4 years) had simultaneous bilateral auricular correction. Based on estimates derived from unilateral reconstruction theatre times, simultaneous bilateral reconstruction resulted in a savings of 56 min for the first stage and 97 min for the second stage of reconstruction. Moreover, surgical times decreased as operative experience with auricular reconstruction was accrued. There was no increased incidence of peri- or post-operative complications noted. Based on cost estimates at our institution, bilateral reconstruction as a two-stage procedure resulted in a health care cost savings of £10448.16 ($16790.72 USD) per patient with bilateral microtia. Conclusions Simultaneous bilateral autologous ear reconstruction is a practicable cost-effective treatment strategy with notable aesthetic and personal benefit to the patient with no increased morbidity. Level of Evidence Level III, therapeutic study.
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-016-1194-6
      Issue No: Vol. 39, No. 4 (2016)
       
  • Computer-assisted analysis contour lines of aesthetic unit for the
           assessment of lip augmentation
    • Authors: Hassan Bagheri; Suzan Sirinturk; Figen Govsa; Yelda Pinar; Mehmet Asim Ozer
      Pages: 265 - 272
      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: 2016-08-01
      DOI: 10.1007/s00238-016-1190-x
      Issue No: Vol. 39, No. 4 (2016)
       
  • The use of a single local analgesics infusion in operation cavity
           following mastectomy and its effect on postoperative pain—a
           retrospective cohort study
    • Authors: Martin Sollie; Camilla Bille
      Pages: 273 - 278
      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: 2016-08-01
      DOI: 10.1007/s00238-016-1195-5
      Issue No: Vol. 39, No. 4 (2016)
       
  • Ten years of acute hand trauma: is day case surgery still working' A
           review of 726 patients
    • Authors: Arvind Mohan; Richard M. Thomson; Garth Titley; Darren L. Chester
      Pages: 287 - 292
      Abstract: Background Day surgery units (DSUs) have streamlined the treatment of hand trauma. This study describes how the establishment of the Birmingham Hand DSU has improved the service over a 10-year period. Methods Data was collected on patients requiring surgery for acute hand trauma for a period of 1 month at four separate time points: (1) prior to establishment of DSU, (2) 1 month following DSU opening, (3) 1 year following DSU opening and (4) 8 years following DSU opening. The number and types of operation performed, day case rates, and bed occupancy rates were analysed. Statistical analysis was performed using Fisher’s exact test. Results The volume of hand trauma has increased over time (77 cases/month-2002; 109-2003; 90-2004; av. 150-2011). Sharp lacerations and crush injuries remain the most common. The percentage of patients admitted has fallen (84.4% 2002; 64.2% 2003; 46.7% 2004; 33.6% 2011 p = 0.0003) whilst the day case rate has increased (13.0% 2002; 33.9% 2003; 51.1% 2004; 67.5% 2011 p = 0.004). Bed occupancy rate per patient has fallen (2.64 days-2002; 2.08-2003; 1.34-2004; 1.21-2011). Conclusions Despite an increased caseload, increased utilisation of the DSU has led to reduced patient waiting times and bed occupancy rates whilst increasing patient satisfaction and reducing costs. Level of Evidence: Level III, risk/prognostic study.
      PubDate: 2016-06-01
      DOI: 10.1007/s00238-016-1203-9
      Issue No: Vol. 39, No. 4 (2016)
       
  • Local muscle flaps via video-assisted thoracoscopic surgery (VATS) without
           thoracotomy for dead space obliteration
    • Authors: James E. McCarthy; Steven J. Kempton; Michael L. Bentz; Tracy L. Weigel
      Pages: 293 - 296
      Abstract: The obliteration of intra-thoracic dead space following tumor or empyema extirpation is imperative to successful long-term outcomes. We sought to describe the technique of using a pedicled latissmus dorsi muscle flap for obliteration of a large 14 × 6cm intrathoracic dead space following pleural decortication of chronic empyema, without thoracotomy or rib spreading via video-assisted thoracoscopic surgery (VATS). Specific attention is directed to the technical details of the flap harvest and inset in relation to the modifications required to inset the flap without a thoracotomy or rib spreading. The patient’s history, presenting symptoms, pre-operative imaging, intraoperative details, and post-operative course are delineated with a focus on the length of stay, post-operative pain, and morbidity. The length of stay was 2 days with minimal pain on post-operative day one managed with oral nacrotic; long term post-operative X-ray revealed obliterated dead space and the patient experienced no complications. Inset of pedicled latissmus muscle flaps via VATS technique without thoracotomy or rib spreading seems a safe and effective technique that can offer short hospitalization with minimal pain morbidity. Level of Evidence: Level V, therapeutic study
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-016-1180-z
      Issue No: Vol. 39, No. 4 (2016)
       
  • Management of pyoderma gangrenosum with combination of systemic treatment,
           vacuum-assisted closure and synthetic dermal substitute
    • Authors: Ashley Novo-Torres; Francisco Javier Céspedes-Guirao; Nozay Guzmán Restituyo; Elena Lorda-Barraguer
      Pages: 297 - 302
      Abstract: Pyoderma gangrenosum (PG) is a destructive, necrotizing cutaneous process where surgical debridement can produce 'pathergy' phenomenon. Actually, an accepted strategy is to control the disease medically and follow-up with delayed surgical intervention with a split-thickness skin grafting after prolonged courses of immunosuppressive therapy. We report two cases of pretibial PG, one of them a complicated case of a 23 year-old woman with ulcerative colitis and a huge PG which was successfully treated with a synergistic approach utilizing a sequential protocol with systemic treatment, surgical debridement, antimicrobial silver dressing (Acticoat®), vacuum-assisted closure (VAC) therapy and a double layer of synthetic dermal substitute (Integra®) with a skin graft. A systematic review of the literature displays no previous cases utilizing this combined approach. Rare case reports have described VAC therapy use in the management of PG, and only one has described Integra® use. In both cases, rebuilding of the scaffolding were achieved, there was no evidence of recurrence of PG, the cosmetic results were overall satisfactory without limitation of movement for extension and flexion of the foot. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-015-1147-5
      Issue No: Vol. 39, No. 4 (2016)
       
  • Intralesional cryosurgery for the treatment of keloid scars following
           cochlear implant surgery and removal of cholesteatoma
    • Authors: Ariel Roitman; Michal Luntz; Yaron Har-Shai
      Pages: 307 - 312
      Abstract: The development of hypertrophic scars and keloids is a relatively common complication of different otologic procedures involving incision of the skin behind the ear. This case report aims to describe the successful treatment of keloids that developed following ear surgeries that have been performed via a retro-auricular approach (cochlear implantation and the removal of cholesteatoma) by an intralesional cryosurgery method. Two patients who were previously operated for an extensive pediatric cholesteatoma and one patient who underwent a cochlear implant surgery have developed large keloids at the radix helix. The keloids were treated under local anesthesia by the intralesional cryosurgery method. Over a 6-month period, the scars gradually flattened and became paler and the clinical symptoms of itchiness, pain, and tenderness have significantly been reduced. No complications were documented, and there were no recurrences in a follow-up period of 30 months. This case report demonstrates that intralesional cryosurgery provides the surgeon with an effective method to treat keloid scars following the removal of cholesteatoma or cochlear implantation, thus improving the quality of life and body image and enabling the patients to use the implanted device in an adequate and satisfactory way. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-016-1183-9
      Issue No: Vol. 39, No. 4 (2016)
       
  • Flap within a first dorsal metacarpal artery flap for recurrent thumb
           injury
    • Authors: Chandan N. Jadhav; Ramesh K. Sharma
      Pages: 313 - 314
      Abstract: Thumb pulp defects are commonly due to avulsion injuries. It is important to reconstruct these defects using sensate. A very good option for these defects is the islanded first dorsal metacarpal artery flap (FDMA). We present a patient, a carpenter by occupation, who had initial thumb pulp injury which was reconstructed with islanded first dorsal metacarpal artery flap. At 6-month follow-up, he had near normal sensation and two-point discrimination of 2 mm. The same patient represented after 1 year with similar injury to the same reconstructed thumb. This time, VY advancement flap was designed within the remnant of the previous FDMA flap. Flap within a flap is not a new concept. In the present scenario, it worked as a great indigenous solution as it was a simple alternative. It preserved the sensation and avoided the need of other complex reconstructions. The procedure was performed under local anaesthesia, and patient could return to his normal activities within 2 weeks post-op. This is a rare case report of making use of the concept of flap within a flap for recurrent thumb injury which was reconstructed previously with FDMA flap. VY advancement design aided the necessary movement required to cover the defect yet preserving the regained sensation making it a useful tool before embarking upon complex reconstructions. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-015-1150-x
      Issue No: Vol. 39, No. 4 (2016)
       
  • An unusual case of life-threatening airway compromise complicating a neck
           dissection
    • Authors: Poonam Valand; Christopher John Lewis; Stuart Marsden; Philip Rubin
      Pages: 315 - 316
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-015-1134-x
      Issue No: Vol. 39, No. 4 (2016)
       
  • Encysted haematoma formation following a latissimus dorsi flap-based
           breast reconstruction
    • Authors: Fayyaz A. K. Mazari; Akin Rae; Ashleigh Genever; Iman A. Azmy
      Pages: 317 - 318
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-015-1138-6
      Issue No: Vol. 39, No. 4 (2016)
       
  • Porcine acellular dermis-based breast reconstruction: complications and
           outcomes following adjuvant radiotherapy
    • Authors: Hannah Headon; Hiba El Hage Chehade; Abdul Kasem; Amtul R. Carmichael; Kefah Mokbel
      Pages: 319 - 320
      PubDate: 2016-08-01
      DOI: 10.1007/s00238-016-1187-5
      Issue No: Vol. 39, No. 4 (2016)
       
  • Pseudoaneurysm of superficial and deep arch of the hand after penetrating
           wound
    • Authors: Asra Hashmi; Adam Schumaier; Faraz Ali Khan; Tolga Gursel; Guillermina Nava
      Abstract: Pseudoaneurysm of the hand is often the result of focal penetrating trauma. The goal of this report is to describe a rare case of a patient with a pseudoaneurysm of the superficial palmar arch, and deep arch, and her subsequent surgical treatment. A 67-year-old patient sustained an accidental laceration to her palm, with a kitchen knife. The patient was initially treated in the Emergency Department, with a simple repair of a 1 cm laceration. No imaging was obtained at that time. The patient subsequently developed a large, pulsatile, painful mass in her palm near the site of injury, and presented to Emergency Department again for evaluation. Using a color flow Doppler US, the patient was initially diagnosed with a pseudoaneurysm of the superficial palmar arch. Superficial aneurysm was treated with two thrombin injections, after which a CT angiogram was obtained that showed a pseudoaneurysm in the deep arch. The patient was subsequently taken to the operating room, and both pseudoaneurysms were successfully resected and repaired. The patient did well after surgery, with no lasting sensory or motor deficits to the hand, and patency of superficial and deep arch, as well as, well flow to the digital arteries. To our knowledge, this is the only case reporting post-traumatic pseudoaneurysm of superficial and deep arch. Although, a rare phenomenon, pseudoaneurysm of the superficial palmar arch and deep arch can coexist. Level of Evidence: Level V, diagnostic/therapeutic study.
      PubDate: 2016-08-19
      DOI: 10.1007/s00238-016-1235-1
       
  • Role of FDG-PET/CT in stage 1–4 malignant melanoma patients
    • Authors: Mai Eldon; Ulrik Knap Kjerkegaard; Mette Heisz Ørndrup; Pia Sjøgren; Lars Bjørn Stolle
      Abstract: Background The number of patients diagnosed with malignant melanoma (MM) has increased over several years. Despite early diagnosis of MM and therefore better prognosis, the number of FDG-PET/CT scans (PET/CT) seems to be increasing. This study aimed to describe all MM patients who were PET/CT scanned in 2012 at a department of plastic surgery and to analyze the pattern of referral and outcome of PET/CT scans of these patients all back from early diagnosis of the patient in the period 2008–2012. Methods All patients with MM stages 1–4 (AJCC stages) and melanoma of unknown primary (MUP) who were PET/CT scanned in 2012 were included. This resulted in a study group of 58 patients with 109 PET/CT scans during the study period 2008–2012. Results Indications for referring stages 1 and 2 patients to PET/CT were usually based on subjective symptoms of disease, whilst patients in stages 3 and 4 were usually appointed to a PET/CT based on objective, radiological or histological signs of relapse. Approximately, two thirds of the PET/CT scans of stages 1 and 2 patients, respectively, were negative, which is twice as many compared to stages 3–4. Five patients were upgraded in stage because of a biopsy taken after PET/CT. The number of additional examinations triggered per PET/CT increased with the stages. Conclusions Some PET/CT scans of stages 1 and 2, MM patients might have been unnecessary considering the vague indications for referral and the relatively large number of negative scans. Earlier, there was no national guideline for the use of PET/CT scans of MM patients. Hopefully, the recently published guideline from The Danish Health Board will help optimize the cost-benefit of each PET/CT scan. Level of Evidence: Level IV, diagnostic study.
      PubDate: 2016-08-18
      DOI: 10.1007/s00238-016-1228-0
       
  • Metastatic melanoma (stage III) and lymph node dissection at a university
           hospital facility
    • Authors: Ulrik K Kjerkegaard; Pia Sjøgren; Lars B Stolle
      Abstract: Background Malign melanoma continues to present a severe health problem, and the incidence is still raising. Nodal status and ulceration of the primary melanoma are strong prognostic factors. The main treatment of node-positive melanomas (stage III) is complete lymph node dissection. The aim of this study was to describe the outcome in patients with stage III melanoma who underwent completion lymphadenectomy at a department of plastic surgery. Methods Retrospectively, we included all patients who underwent complete lymph node dissection in the period from 2008 to 2012 subsequent to a positive sentinel node biopsy or palpable metastasis from a cutaneous malign melanoma. Primary outcomes were disease-free survival and melanoma-specific survival. Results We included 150 patients with an average age of 57 (16–82) years. Melanoma thickness was 3.1 (0.53–15) mm. Ulceration of primary tumor was present in 35 %. Complete lymph node dissection was performed in the neck, axilla, inguinal region, and aberrant region. There was no difference in occurrence of nodal metastases comparing the regions. Seroma was most frequent in the axilla (23.5 %) and inguinal region (18.9 %). Lymphedema occurred in the inguinal region (15.1 %) and the axilla (4.7 %), and wound infection occurred in the inguinal region (30.2 %), the axilla (15.3 %), and the neck (11.1 %). The 5-year nodal recurrence rate was 16.9 % [95 % CI 8.2–33.1 %] and the 5-year rate of distant metastases was 48.3 % [95 % CI 36.5–61.8 %]. Overall survival was 51.8 % [95 % CI 35.6–65.8 %]. More than two nodal metastases worsened the prognosis (reference: <2 lymph nodes). Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2016-08-16
      DOI: 10.1007/s00238-016-1234-2
       
  • Hypospadias reconstruction: 11-year follow-up study of outcomes and
           patient satisfaction
    • Authors: Ayad Harb; Felicity Page; Mohammad Nassimizadeh; Alan Park
      Abstract: Background Hypospadias is the most common congenital penile malformation, with ventral and proximal displacement of the urethral meatus. Relevant data on long-term outcomes and satisfaction following hypospadias reconstruction are scarce. The purpose of this study was to evaluate the 11-year surgical results and patient satisfaction ratings in a group of patients with hypospadias who underwent repair over a 6-year period. Methods Retrospective analysis was performed on 122 hypospadias patients operated on by a single surgeon at a single centre between August 2000 and December 2006. Information was collected through a review of patient notes, postal questionnaires and telephone contact with patients. Data collection included the patients’ functional results, cosmetic outcomes and satisfaction ratings. Satisfaction was rated on a 1–10 scale and responses were collected over a 2-month period. Results A total of 122 patients underwent hypospadias repair. The average age was 38 months (range 1–360 months). Two stage procedures were done in 56 patients, with 66 patients undergoing single stage repair. There was a total of 22 complications reported in separate patients (18 %). Functional and cosmetic outcomes were generally good. Overall patient satisfaction was high (8.7/10). Conclusions This is one of the largest outcome and patient satisfaction studies following hypospadias repair. The results provide a reliable indicator of complication rates and long-term outcomes and satisfaction rates. Hypospadias repair is associated with high patient satisfaction. The chief complaint among hypospadias patients is of penile shape and inadequate size. Longer prospective follow-up would be beneficial. Level of Evidence: Level IV, therapeutic study
      PubDate: 2016-08-15
      DOI: 10.1007/s00238-016-1231-5
       
  • The influence of plastic surgeon age and gender on decision-making in
           breast reconstruction: a national survey of American plastic surgeons
    • Authors: Shruti C. Tannan; Shawna R. Kleban; Wendy M. Novicoff; Chris A. Campbell
      Abstract: There are numerous options for breast reconstruction after mastectomy, and the final reconstructive option is often influenced by patient preference. This study surveyed plastic surgeons regarding their personal preferences for breast reconstruction after mastectomy to identify the impact of gender and age on reconstructive preference. An anonymous online survey was distributed to plastic surgeons in the American Society of Plastic Surgeons member directory and current plastic surgery residents. Female surgeons were asked to select reconstructive options for themselves as patients, while male surgeons were asked to answer the same questions as if advising a loved one. After unilateral mastectomy, 60.2 % of respondents preferred implant-based reconstruction, increasing to 67.8 % after bilateral mastectomy. Top reasons for selecting implant-based reconstruction were recovery time (78.0 %) and hospital length of stay (54.5 %). In contrast, respondents who preferred abdominal flap-based autologous reconstruction cited the longevity (83.3 %) and the aesthetic appearance of the final result (82.7 %) as top reasons. Female surgeons were significantly more likely to choose implant-based reconstruction than male surgeons (68.7 vs. 56.6 %, p = 0.001). Younger male surgeons preferred autologous reconstruction (58.8 %). Plastic surgeons’ reconstructive choices parallel current patient-based surveys favoring breast reconstruction with implants. Respondents’ reasons for selecting one reconstructive method over another are consistent with prior patient-based surveys. Female plastic surgeons prefer implant-based reconstruction to a greater extent than male plastic surgeons. This survey identifies the need for further prospective study of physician perspectives of patient experiences. Level of Evidence: Not ratable.
      PubDate: 2016-08-12
      DOI: 10.1007/s00238-016-1229-z
       
  • Pneumomediastinum, pneumothorax and subcutaneous emphysema following
           cryoinsufflation for the treatment of hidradenitis suppurativa
    • Authors: A. Kramer; I. Metanes; N. Eyal; L. Brizgalin; S. Halabi; L. Har-Shai; Y. Har-Shai
      Abstract: The treatment of hidradenitis suppurativa is challenging. Recently, cryoinsufflation was described for treating this perplexing condition. We hereby report the occurrence of pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema following the treatment of sternal hidradenitis suppurativa by cryoinsufflation. These complications were gradually resolved spontaneously under careful observation. Notwithstanding that the trapped gas in the subcutaneous and lung tissues in our patient gradually reabsorbed spontaneously, we are now in the opinion that cryoinsufflation in the thorax area should be performed under deep sedation or general anesthesia, with close observation of the patient including overnight hospitalization and monitoring by oximetry. Alternatively, the use of different cryosurgery techniques such as contact or intralesional methods could be considered. Level of evidence: Level V, risk study
      PubDate: 2016-08-11
      DOI: 10.1007/s00238-016-1230-6
       
  • De novo experience of resorbable woven mesh in immediate breast
           reconstruction post-mastectomy
    • Authors: Shiva Sharma; Susie Van Barsel; Mitchell Barry; Malcolm R. Kell
      Abstract: Background Implant based reconstruction (IBR) is the most common form of breastreconstruction. IBR has advantages; uncomplicated surgery, no donor site and goodaesthetic outcome. However, disadvantages include infection with implant loss andphysical limitation to the size of breast which can be used. The use of surgical matricesto increase the size of implants used has gained in popularity, however concernsregarding increased complication rates exists. Here we describe our initial experienceusing a resorbable mesh in post mastectomy patients. Methods Post mastectomy patients after cancer surgery or for risk reducing surgerywere examined. We examined our initial experience over an 18 month period ofpatients undergoing reconstruction with the use of resorbable mesh and implant basedreconstruction. Patients were followed for major or minor complications including flap necrosis, implant loss, haematoma, seroma and infection rates. Results Few major complications were encountered. There were no instances of flap necrosis or haematoma formation. However, 5 reconstructed breasts (n=74, 6.7%)resulted in loss of the implant due to infection. These losses were associated withpatients who were either current or ex-smokers, or in patients who had or wereundergoing either radiation or chemotherapy. Minor complications such as superficialwound infections were seen in 8 of 74 (10.8%) reconstructed breasts. The overallcomplication rate was 17.5%, or 13 of 74 reconstructed breasts. Conclusions The use of resorbable mesh provides excellent cosmetic outcomes withminimal complications. To avoid major complications discretion should be used inpatients with risk factors such as smoking and radiation therapy. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-08-11
      DOI: 10.1007/s00238-016-1227-1
       
  • Influence of postoperative vasoactive agent administration on free flap
           outcomes
    • Authors: Dimitra Kotsougiani; Cornelia M. Banz; Caroline A. Hundepool; Thomas Kremer; Ulrich Kneser; Marcus Lehnhardt; Leila Harhaus
      Abstract: Background The use of vasoactive agents (VAs) in free flap reconstruction remains controversial due to the potential risk of free flap failure. Most of the existing literature has focussed on intraoperatively administered VAs in free flap procedures. However, hypotension frequently requires VA support, both intraoperatively and in the first postoperative days. The objective of this study was to analyse the influence of postoperatively administered VAs on thromboembolic complications. Methods A retrospective study was performed including all patients undergoing free flap reconstruction between February 2010 and June 2012. Logistic regression analysis identified predictors for postoperative VA administration and whether its use was a prognostic risk factor for the outcome parameters of revision surgery or free flap loss due to vascular compromise of the venous or arterial anastomosis. Results A total of 209 free flap procedures were performed, with an overall survival rate of 94.3 %. In 19.7 % of the free flap procedures performed, postoperative VA administration was noted. Predictors for postoperative VA administration were intraoperative VAs, age ≥50, ASA ≥3, hypertension and peripheral vascular disease. Postoperative VA administration was found to be a significant risk factor for the outcome parameter of revision surgery, particularly in the perforator free flaps used for lower extremity reconstruction. However, there was no significant correlation between the postoperative use of VAs and free flap loss. Conclusions We have demonstrated an association between postoperative VA administration and an increased revision rate in free flaps. Appropriate flap selection, close free flap monitoring and optimally adjusted anticoagulation therapy are recommended in patients receiving VA support during the early postoperative free flap period. Level of Evidence: Level III, risk/prognostic study.
      PubDate: 2016-08-10
      DOI: 10.1007/s00238-016-1223-5
       
  • Forehead lipoma excision: a comparative study of open versus endoscopic
           technique
    • Authors: Hui Wen Ng; Yew Ming Samuel Ho; Siyun Michelle Ho; Sze-Wei Matthew Yeo; Thien Chong Marcus Wong
      Abstract: Background Endoscopic excision of forehead lipoma is increasingly utilized for its inconspicuous scarring, good intraoperative visualization and low complication rates. Currently, studies comparing outcomes from endoscopic and open excision of forehead lipomas are lacking. This retrospective study compares the surgical outcomes of the two techniques. Methods The authors retrospectively reviewed medical records of all patients who had undergone forehead lipoma excision at a single institution between 2010 and 2015. Data collected included patient demographics, lesion size, mean operative time and postoperative complications. A comparison was made between the two groups of patients. Results Sixty-two patients underwent excision of their forehead lipoma (38 endoscopic and 24 open excisions). Patient groups were similar in terms of sex ratios, size of lesion, choice of anaesthesia, mean operative time and duration of follow-up. Swelling beyond 1 week in the endoscopic group was 1/38 (2.6 %) compared to 4/24 (16.7 %) in the open excision group (p = 0.07). Postoperative scalp numbness in the endoscopic group was 2/38 (5.2 %) versus 2/24 (8.3 %) in the open excision group (p = 0.64). Incidence of haematoma in the endoscopic group was 1/38 (2.6 %) compared to 2/24 (4.2 %) in the open excision group (p = 1). All 38 patients in the endoscopic group were satisfied with their scars compared with 4/24 (16.7 %) in the open excision group who reported dissatisfaction (p = 0.02). Conclusions Complication rates of both surgical techniques are similar. Given that the endoscopic technique results in cosmetically superior outcomes, with no increase in morbidity, the authors recommend the use of endoscopic technique for forehead lipoma excision. Level of Evidence: Level III, therapeutic study.
      PubDate: 2016-08-05
      DOI: 10.1007/s00238-016-1225-3
       
 
 
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