Subjects -> MANUFACTURING AND TECHNOLOGY (Total: 363 journals)
    - CERAMICS, GLASS AND POTTERY (31 journals)
    - MACHINERY (34 journals)
    - MANUFACTURING AND TECHNOLOGY (223 journals)
    - METROLOGY AND STANDARDIZATION (6 journals)
    - PACKAGING (19 journals)
    - PAINTS AND PROTECTIVE COATINGS (4 journals)
    - PLASTICS (42 journals)
    - RUBBER (4 journals)

PLASTICS (42 journals)

Showing 1 - 40 of 40 Journals sorted alphabetically
ACS Applied Polymer Materials     Hybrid Journal   (Followers: 19)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Industrial and Engineering Polymer Research     Open Access   (Followers: 5)
Advances in Polymer Technology     Open Access   (Followers: 13)
Chinese Journal of Polymer Science     Hybrid Journal   (Followers: 9)
Cirugia Plastica Ibero-Latinoamericana     Open Access  
Current Applied Polymer Science     Hybrid Journal   (Followers: 2)
European Polymer Journal     Hybrid Journal   (Followers: 43)
High Performance Polymers     Hybrid Journal   (Followers: 1)
International Journal of Biobased Plastics     Open Access   (Followers: 1)
International Journal of Polymeric Materials     Hybrid Journal   (Followers: 7)
International Polymer Processing     Full-text available via subscription   (Followers: 1)
Iranian Journal of Polymer Science and Technology     Open Access   (Followers: 1)
Journal of Applied Polymer Science     Hybrid Journal   (Followers: 152)
Journal of Cellular Plastics     Hybrid Journal   (Followers: 1)
Journal of Elastomers and Plastics     Hybrid Journal  
Journal of Inorganic and Organometallic Polymers and Materials     Hybrid Journal   (Followers: 8)
Journal of Plastic Film and Sheeting     Hybrid Journal   (Followers: 1)
Journal of Polymer Research     Hybrid Journal   (Followers: 7)
Journal of Polymer Science Part C : Polymer Letters     Hybrid Journal   (Followers: 6)
Journal of Polymers and the Environment     Hybrid Journal   (Followers: 1)
Majalah Kulit, Karet, dan Plastik     Open Access  
Microplastics and Nanoplastics     Open Access   (Followers: 1)
Plastic and Polymer Technology     Open Access   (Followers: 41)
Plastic and Reconstructive Surgery     Hybrid Journal   (Followers: 31)
Plastics Engineering     Partially Free   (Followers: 3)
Polymer     Hybrid Journal   (Followers: 101)
Polymer Bulletin     Hybrid Journal   (Followers: 8)
Polymer Engineering & Science     Hybrid Journal   (Followers: 15)
Polymer Science Series B     Hybrid Journal   (Followers: 6)
Polymer Science Series C     Hybrid Journal   (Followers: 4)
Polymer Science Series D     Hybrid Journal   (Followers: 4)
Polymer Science, Series A     Hybrid Journal   (Followers: 4)
Polymer-Plastics Technology and Materials     Hybrid Journal   (Followers: 7)
Polymers and Polymer Composites     Hybrid Journal   (Followers: 4)
Polymers from Renewable Resources     Hybrid Journal   (Followers: 3)
Progress in Rubber, Plastics and Recycling Technology     Hybrid Journal   (Followers: 2)
Reinforced Plastics     Full-text available via subscription   (Followers: 15)
SPE Polymers     Open Access   (Followers: 1)
Similar Journals
Journal Cover
Plastic and Reconstructive Surgery
Journal Prestige (SJR): 1.731
Citation Impact (citeScore): 2
Number of Followers: 31  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0032-1052 - ISSN (Online) 1529-4242
Published by LWW Wolters Kluwer Homepage  [330 journals]
  • Strategies to Improve Public Speaking Skills

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      Authors: Aqeel; Zoha A.; Chung, Kevin C.
      Abstract: imageNo abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: A Decade of Nipple-Sparing Mastectomy: Lessons Learned in 3035
           Immediate Implant-Based Breast Reconstructions

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      Authors: Liston; Jared M.; Hollenbeck, Scott T.
      Abstract: No abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: The Volumetric Effect of Botulinum Toxin Type A Injection on
           the Parotid Gland: A Randomized Controlled Trial

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      Authors: Toyoda; Yoshiko; Percec, Ivona
      Abstract: No abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: The Ram Graft: Using One Complete Piece of Conchal Cartilage
           for Nasal Tip Reconstruction in East Asians

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      Authors: Toriumi; Dean M.
      Abstract: imageNo abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: Combined Use of Autologous Sustained-Release Scaffold of
           Adipokines and Acellular Adipose Matrix to Construct Vascularized Adipose
           Tissue

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      Authors: Panayi; Adriana C.; Orgill, Dennis P.
      Abstract: imageNo abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: Improved Facial and Skull-Base Symmetry following Osteotomy
           and Distraction of Unilateral Coronal Synostosis

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      Authors: Sanati-Mehrizy; Paymon; Hopper, Richard A.; Susarla, Srinivas M.
      Abstract: imageNo abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Evidence-Based Performance Measures for Reconstruction after Skin Cancer
           Resection: A Multidisciplinary Performance Measure Set

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      Authors: Chen; Andrew; Ray, Peter; Rogers, Howard; Bialowas, Christie; Butala, Parag; Chen, Michael; Daveluy, Steven D.; Davidson, Caryn; Faringer, Paul; Guarda, Helena; Kantor, Jonathan; Kaweski, Susan; Lawrence, Naomi; Lickstein, David; Lomax, John; Parra, Sylvia; Retson, Nicholas; Suryadevara, Amar; Smith, Ryan; Tollefson, Travis T.; Wisco, Oliver J.
      Abstract: imageBackground: The American Society of Plastic Surgeons commissioned the multidisciplinary Performance Measure Development Work Group on Reconstruction after Skin Cancer Resection to identify and draft quality measures for the care of patients undergoing skin cancer reconstruction. Included stakeholders were the American Academy of Otolaryngology–Head and Neck Surgery, the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American College of Mohs Surgery, the American Society for Mohs Surgery, and a patient representative.Methods: Two outcome measures and five process measures were identified. The outcome measures included the following: (1) patient satisfaction with information provided by their surgeon before their facial procedure, and (2) postprocedural urgent care or emergency room use. The process measures focus on antibiotic stewardship, anticoagulation continuation and/or coordination of care, opioid avoidance, and verification of clear margins.Results: All measures in this report were approved by the American Society of Plastic Surgeons Quality and Performance Measures Work Group and Executive Committee, and the stakeholder societies.Conclusion: The work group recommends the use of these measures for quality initiatives, Continuing Medical Education, Continuous Certification, Qualified Clinical Data Registry reporting, and national quality reporting programs.
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Discussion: Pain and Functional Outcomes following Targeted Muscle
           Reinnervation: A Systematic Review

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      Authors: Parikh; Rajiv P.; Kleiber, Grant
      Abstract: No abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Evidence-Based Practices in Cleft Palate Surgery

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      Authors: Applebaum; Sarah A.; Aronson, Sofia; Termanini, Kareem M.; Gosain, Arun K.
      Abstract: imageLearning Objectives: After studying this article, the participant should be able to: (1) Understand the embryologic origins, cause, and incidence of cleft palate. (2) Review the anatomy and common classifications of cleft palate and associated defects. (3) Describe surgical techniques for palatoplasty and understand their respective indications. (4) Gain an awareness of general perioperative care considerations, timing of repair, and risk factors for and operative mitigation of complications.Summary: Cleft palate affects 0.1 to 1.1 per 1000 births, with a higher incidence in certain ethnic groups but affecting both sexes equally. Cleft palate may occur in isolation or in combination with cleft lip or in association with other congenital anomalies including various syndromes. The goals of cleft palate repair are to anatomically separate the oral and nasal cavities for normal feeding and improved speech and minimize the risk of oronasal fistulas, velopharyngeal dysfunction, and disruption of facial growth. This review discusses the incidence, causes, and classification of cleft palate; surgical techniques for palatoplasty and perioperative patient management; and complications of palatoplasty.
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Reply: Lymphatic Microsurgical Preventative Healing Approach for the
           Primary Prevention of Lymphedema: A 4-Year Follow-Up

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      Authors: Murphy; Alexander I.; O’Connell, Gillian M.; Ishtihar, Sherene; Levy, Adam S.; Rohde, Christine H.
      Abstract: No abstract available
      PubDate: Wed, 24 Jan 2024 00:00:00 GMT-
       
  • Rewiring the Brain: The Next Frontier in Supermicrosurgery

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      Authors: Xie; Qingping; Louveau, Antoine; Pandey, Sonia; Zeng, Weifeng; Chen, Wei F.
      Abstract: No abstract available
      PubDate: Tue, 18 Jul 2023 00:00:00 GMT-
       
  • Modifiable Risk Factors for Prevention in Dupuytren Disease: A UK Biobank
           Case-Control Study

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      Authors: Kang; Youngjoo; Stewart, Max; Patel, Manal; Furniss, Dominic; Wiberg, Akira
      Abstract: imageBackground: Dupuytren disease is associated with significant comorbidity and mortality, and it has no existing prevention strategies. It is unclear which modifiable risk factors are most amenable for prevention. This study aimed to determine the strength of modifiable risk factors for Dupuytren disease, and to investigate associations with other diseases.Methods: Using UK Biobank data, this case-control study analyzed the association between phenotypic variables and Dupuytren disease through multivariable logistic regression. Exposures assessed were age, sex, body mass index, waist-to-hip ratio, Townsend deprivation index, smoking status, alcohol intake, diabetes mellitus, hypertension, cancer, liver disease, respiratory disease, rheumatoid arthritis, epilepsy, psoriasis, and gout.Results: There were 4148 cases and 397,425 controls. Male sex (OR, 3.23; 95% CI, 2.90 to 3.60; P = 1.07 × 10−100), increasing age (OR, 1.08; 95% CI, 1.07 to 1.08; P = 6.78 × 10−167), material deprivation (OR, 1.01; 95% CI, 1.00 to 1.02; P = 0.0305), high-density lipoprotein cholesterol (OR, 1.76; 95% CI, 1.58 to 1.96; P = 3.35 × 10−24), smoking exposure, and alcohol intake were all associated with increased odds of Dupuytren disease. With increasing obesity class, there was approximately 25% decreased odds (OR, 0.774; 95% CI, 0.734 to 0.816; P = 4.71 × 10−21). Diabetes with microvascular or end-organ complications was associated with more than 2.5 times increased odds of Dupuytren disease (OR, 2.59; 95% CI, 1.92 to 3.44; P = 1.92 × 10−10). Within this group, increasing hemoglobin A1c values by 10 mmol/mol, or 0.9%, increased the odds by 31% (OR, 1.31; 95% CI, 1.13 to 1.51; P = 2.19 × 10−4).Conclusion: Diabetes and poor glycemic control are major risk factors for Dupuytren disease, which present an opportunity for prevention.CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
      PubDate: Wed, 31 May 2023 00:00:00 GMT-
       
  • Subjective and Objective Differences in Patients with Unilateral and
           Bilateral Carpal Tunnel Syndrome and the Role of Obesity in Syndrome
           Severity

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      Authors: Vernick; Robert C.; Beckwitt, Colin H.; Fowler, John R.
      Abstract: imageBackground: It remains unclear whether physiologic differences exist in musculoskeletal ultrasound nerve measurements when comparing bilateral and unilateral carpal tunnel syndrome (CTS) patients. Similarly, the influence of body mass index on CTS severity is not well characterized.Methods: Unilateral and bilateral CTS patients were seen from October of 2014 to February of 2021. Obese and nonobese CTS patients were compared. Median nerve cross-sectional area (CSA), Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ), and six-item Carpal Tunnel Symptom Score (CTS-6) measures were obtained. Nerve conduction studies recorded distal motor latency (DML) and distal sensory latency (DSL). Statistical analysis used Wilcoxon signed rank testing for paired continuous variables, Mann-Whitney U testing for nonpaired continuous variables, and chi-square testing for continuous variables, with a significance level of P < 0.05.Results: A total of 109 (218 nerves) bilateral and 112 (112 nerves) unilateral CTS patients were reviewed. Bilateral patients had larger median nerve CSAs on their more symptomatic side, when defined by BCTSQ score (P < 0.0001), CTS-6 score (P < 0.0001), DML (P < 0.0001), and DSL (P < 0.01). Bilateral patients also had higher symptom severity scale (P < 0.01) and DSL (P < 0.001) outcomes compared with unilateral patients. Obese patients had higher median nerve CSA (P < 0.01), prolonged DML, and prolonged DSL (P < 0.0001) values despite similar CTS severity (BCTSQ and CTS-6).Conclusions: Ultrasound identifies the more symptomatic side in bilateral patients, which correlates with increasing severity (NCS and BCTSQ). Obesity increases median nerve CSA and prolongs nerve conduction studies without influencing CTS severity. This information can be used when considering which diagnostic test to order for CTS.
      PubDate: Wed, 31 May 2023 00:00:00 GMT-
       
  • Lambda Repair: A Novel Repair Technique for Chronic Boutonnière
           Deformity

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      Authors: Kim; Bong-Sung; Vasella, Mauro; Lee, Che-Hsiung; Hsu, Chung-Cheng; Chen, Shih-Heng; Lin, Cheng-Hung; Lien, Shwu-Huei; Lin, Yu-Te
      Abstract: imageSummary: Correction of a boutonnière deformity is one of the most demanding challenges in hand surgery. Surgical interventions are usually considered when functional use of the finger cannot be obtained after intense hand therapy. The authors introduce their newly described lambda (λ) repair, which is an easy-to-learn, straightforward surgical technique. The method involves an end-to-side tenorrhaphy of the lateral bands, resembling the Greek λ. Patients who underwent a lambda repair were retrospectively evaluated with preoperative and postoperative measurements of proximal interphalangeal (PIP) joint movement. Four patients (two male, two female; median age, 35.5 years) with a median follow-up period of 9.1 months were included. Three patients underwent lambda repairs for isolated boutonnière deformities, and one patient received a vascularized free toe transfer combined with a lambda repair. The preoperative average PIP joint extension lag or deficit was 28.75 degrees and could be reduced to 15 degrees. Preoperative average PIP joint active flexion was 60 degrees, which was improved to 88.75 degrees. No complications were observed. The lambda repair is a new tool in the reconstruction of boutonnière deformity, further expanding the armamentarium of hand surgeons.
      PubDate: Wed, 31 May 2023 00:00:00 GMT-
       
  • Lymphatic Microsurgical Preventive Healing Approach for the Primary
           Prevention of Lymphedema: A 4-Year Follow-Up

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      Authors: Campisi; Corrado C.; Scarabosio, Anna; Campisi, Corradino
      Abstract: No abstract available
      PubDate: Fri, 26 May 2023 00:00:00 GMT-
       
  • Lymphatic Microsurgical Preventative Healing Approach for the Primary
           Prevention of Lymphedema: A 4-Year Follow-Up

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      Authors: Friedman; Rosie; Johnson, Anna Rose; Brunelle, Cheryl L.; Chang, David W.; Coriddi, Michelle; Dayan, Joseph H.; Mehrara, Babak J.; Skoracki, Roman; Taghian, Alphonse G.; Singhal, Dhruv
      Abstract: No abstract available
      PubDate: Fri, 26 May 2023 00:00:00 GMT-
       
  • A Nasal Columellar Base Stabilizing Suture Technique

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      Authors: Baldini; Nicolas; Alomani, Mohammad; Fonseca, Eduardo; Saban, Yves
      Abstract: imageSummary: To achieve a more aesthetic and narrower columella, most of the required changes concern the middle and base of the columella. Narrowing and reshaping the columellar base require a sequential approach with good anatomical knowledge and aesthetics analysis. The columellar base is a three-dimensional structure that must be analyzed following three axes: transverse (thickness or width), frontal (height), and sagittal (nasolabial angle). Sutures that aim to close the distance between the medial crura footplates frequently result in modifying the nasolabial angle because of caudal protrusion of the columellar soft tissue. Methods to keep an adequate nasolabial angle are needed. A transverse columellar base stabilizing suture acting on these three axes, which enables maintenance of results after columellar base management, is described in this article.
      PubDate: Wed, 24 May 2023 00:00:00 GMT-
       
  • What Plastic Surgeons Should Know about Small-Joint Arthroplasty: Is This
           for Your Practice'

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      Authors: Rizzo; Marco; Chung, Kevin C.
      Abstract: imageSummary: This article reviews the state of the art for arthroplasty of the metacarpophalangeal and proximal interphalangeal joints. Arthritis that affects these joints can result in significant pain and compromised function. The authors review indications for arthroplasty for each joint, types of implants to consider, technical considerations, patient expectations, and outcomes and complications.
      PubDate: Tue, 16 May 2023 00:00:00 GMT-
       
  • Three-Dimensional Printable Open-Source Cleft Lip and Palate Impression
           Trays: A Single-Impression Workflow

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      Authors: Meyer; Simon; Benitez, Benito K.; Thieringer, Florian M.; Mueller, Andreas A.
      Abstract: imageSummary: Documenting complex three-dimensional (3D) cleft lip and palate malformation with plaster casts based on maxillary impressions is standard care. Presurgical orthopedic treatment also requires an impression. Digital impression-taking in patients with cleft lip and palate is feasible, but procurement costs hinder clinical implementation. Individualized impression trays allow for a precise impression, limiting airway risk. The authors present an open-source impression tray library with scalable impression trays not requiring 3D modeling knowledge. The cleft lip and palate impression tray library is accessible on Open Science Framework. Different shapes are available, and the tray size is selected based on the tuber distance. This allows 3D printing with biocompatible material at the point of care complying with local regulations. The open-source cleft tray library presented offers a hybrid solution for cleft centers, pending the implementation of digital impression.
      PubDate: Mon, 15 May 2023 00:00:00 GMT-
       
  • Technical Precision with Autologous Fat Grafting for Facial Rejuvenation:
           A Review of the Evolving Science

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      Authors: Strong; Amy L.; Rohrich, Rod J.; Tonnard, Patrick L.; Vargo, James D.; Cederna, Paul S.
      Abstract: imageSummary: The scientific study of facial aging has transformed modern facial rejuvenation. As people age, fat loss in specific fat compartments is a major contributor to structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft-tissue filler in the correction of facial atrophy. The addition of volume through fat grafting gives an aging face a more youthful, healthy, and aesthetic appearance. Harvesting and preparation with different cannula sizes and filter-cartridge techniques have allowed for fat grafts to be divided based on parcel size and cell type into three major subtypes: macrofat, microfat, and nanofat. Macrofat and microfat have the benefit of providing volume to restore areas of facial deflation and atrophy in addition to improving skin quality; nanofat has been shown to improve skin texture and pigmentation. In this article, the authors discuss the current opinions regarding fat grafting and how the evolving science of fat grafting has led to the clinical utility of each type of fat to optimize facial rejuvenation. The opportunity exists to individualize the use of autologous fat grafting with the various subtypes of fat for the targeted correction of aging in different anatomic areas of the face. Fat grafting has become a powerful tool that has revolutionized facial rejuvenation, and developing precise, individualized plans for autologous fat grafting for each patient is an important advancement in the evolution of facial rejuvenation.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • Comparable Effects on Healing between Autologous Diabetic Adipose-Derived
           Stem Cells and Allogeneic Normal Counterparts

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      Authors: Chen; Bin; Wei, Yating; Cai, Junrong; Zitkovsky, Helen S.; Guo, Lifei
      Abstract: imageBackground: Adipose-derived stem cell (ASC) therapy is considered a promising strategy for improving impaired wound healing, especially in diabetics. Although the therapeutic potential of allogeneic ASCs from healthy donors is naturally limited, that of autologous ASCs from diabetic patients is questionable. The aim of this study was to investigate the impact of diabetic ASCs in the treatment of diabetic wounds.Methods: Diabetic ASCs (DMA) and nondiabetic ASCs were isolated from db/db and C57BL/6J mice, and characterized by immunocytochemistry, proliferation, differentiation, and gene expression assays. The effects of both ASCs on healing were investigated using 36 male 10- to 12-week-old db/db mice. Wound size was measured semiweekly until day 28, and histologic and molecular analyses were performed at day 14.Results: Both ASCs had fibroblast-like morphology and were CD44+/CD90+/CD34−/CD45− at passage 4. Compared with nondiabetic ASCs in vitro, DMA proliferative capability was restored by passage 4 (P> 0.05). Although DMA osteogenesis was attenuated (P < 0.01), both ASCs had similar adipogenesis and expressions of PPARγ/LPL/OCN/RUNX2 (P> 0.05). In vivo experiments showed that, compared with phosphate-buffered saline control, both ASCs are comparable in improving wound healing (P < 0.0001), angiogenesis (P < 0.05), epithelial cell proliferation (P < 0.05), and granulation tissue formation (P < 0.0001).Conclusions: In both in vitro and in vivo murine models, DMAs have shown a comparable therapeutic capacity to normal ASCs in promoting diabetic wound healing by improving angiogenesis, reepithelialization, and granulation tissue formation. These results support clinical applications of autologous ASCs in diabetic wound treatments.Clinical Relevance Statement: This work has particular surgical relevance as it highlights a theoretical and clinical pathway to use diabetic patients’ own ASCs to treat their wounds, bypassing any concerns of cross-host sourcing issues in regenerative medicine.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • Electrochemical Lipolysis Induces Adipocyte Death and Fat Necrosis: In
           Vivo Pilot Study in Pigs

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      Authors: Pham; Tiffany T.; Heidari, Andrew E.; Hong, Ellen M.; Steward, Earl; Qu, Yueqiao; Chen, Lily Y.; Dunn, Brandyn S.; Seo, Soo Hong; Syed, Adeela; Dilley, Katelyn; Lee, Lauren; Hutchison, Dana M.; Hansen, Kyle D.; Patel, Urja; Kim, Sehwan; Hill, Michael G.; Wong, Brian J. F.
      Abstract: imageBackground: Current minimally invasive fat reduction modalities use equipment that can cost thousands of U.S. dollars. Electrochemical lipolysis (ECLL), using low-cost battery and electrodes (approximately $10), creates acid/base within fat (width, approximately 3 mm), damaging adipocytes. Longitudinal effects of ECLL have not been studied. In this pilot study, the authors hypothesize that in vivo ECLL induces fat necrosis, decreases adipocyte number/viability, and forms lipid droplets.Methods: Two female Yorkshire pigs (50 to 60 kg) received ECLL. In pig 1, 10 sites received ECLL, and 10 sites were untreated. In pig 2, 12 sites received ECLL and 12 sites were untreated. For ECLL, two electrodes were inserted into dorsal subcutaneous fat and direct current was applied for 5 minutes. Adverse effects of excessive pain, bleeding, infection, and agitation were monitored. Histology, live-dead (calcein, Hoechst, ethidium homodimer-1), and morphology (Bodipy and Hoechst) assays were performed on day 0 and postprocedure days 1, 2, 7, 14 (pig 1 and pig 2), and 28 (pig 2). Average particle area, fluorescence signal areas, and adipocytes and lipid droplet numbers were compared.Results: No adverse effects occurred. Live-dead assays showed adipocyte death on the anode on days 0 to 7 and the cathode on days 1 to 2 (not significant). Bodipy showed significant adipocyte loss at all sites (P < 0.001) and lipid droplet formation at the cathode site on day 2 (P = 0.0046). Histology revealed fat necrosis with significant increases in average particle area at the anode and cathode sites by day 14 (+277.3% change compared with untreated, P < 0.0001; +143.4%, P < 0.0001) and day 28 (+498.6%, P < 0.0001; +354.5%, P < 0.0001).Conclusions: In vivo ECLL induces fat necrosis in pigs. Further studies are needed to evaluate volumetric fat reduction.Clinical Relevance Statement: In vivo ECLL induces adipocyte death and fat necrosis. ECLL has the potential to be utilized in body fat contouring.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • Enhanced Effect of Secondary Administration of Adipose-Derived Stromal
           Cells Concurrent with Fat Grafting

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      Authors: Huang; Yan; Jin, Xian; Hong, Ki Yong; Chang, Hak
      Abstract: imageBackground: Cell-assisted lipotransfer, a fat graft mixed with adipose-derived stromal cells, is known to enhance fat graft retention. Previously, the authors showed that intravenous injection of adipose-derived stromal cells can improve the survival of grafted fat. In the present study, the authors investigated the effects of a secondary intravenous injection of adipose-derived stromal cells on fat grafting.Methods: Wild-type C57BL/6J (B6) mice were used as donors for grafted fat and as recipients. Adipose-derived stromal cells were harvested from green fluorescent protein and DsRed B6 mice. The recipient mice were divided into three groups: SI (n = 10), RI1 (n = 10), and RI2 (n = 11). All groups received intravenous injections of green fluorescent protein adipose-derived stromal cells immediately after fat grafting. The RI1 and RI2 groups received repeated intravenous injections of DsRed adipose-derived stromal cells at 1 and 2 weeks, respectively, after fat grafting. The grafted fat volume was measured using micro–computed tomography.Results: Secondarily injected DsRed adipose-derived stromal cells were recruited to the grafted fat and resulted in a higher retention of graft volume and vascular density (P < 0.05). The stromal-derived factor-1 and C-X-C chemokine receptor type 4 genes related to stem cell homing were highly expressed in the grafted fat and adipose-derived stromal cells (P < 0.05). The RI2 group showed a higher graft volume and vascular density than the SI and RI1 groups (P < 0.05).Conclusions: A secondary intravenous injection of adipose-derived stromal cells at a 2-week interval enhances the effect of adipose-derived stromal cell enrichment in fat grafting. These findings refine clinical protocols and enhance the therapeutic value of cell-assisted lipotransfer.Clinical Relevance Statement: In a modified animal model of cell-assisted lipotransfer, the authors demonstrated that secondary intravenous administration of adipose-derived stromal cells improved retention of grafted fat.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • Combined Use of Autologous Sustained-Release Scaffold of Adipokines and
           Acellular Adipose Matrix to Construct Vascularized Adipose Tissue

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      Authors: Xu; Mimi; He, Yunfan; Li, Yibao; Liu, Kaiyang; Zhang, Yuchen; Su, Ting; Yao, Yao; Jin, Xiaoxuan; Zhang, Xiangdong; Lu, Feng
      Abstract: imageBackground: Adipose tissue engineering plays a key role in the reconstruction of soft-tissue defects. The acellular adipose matrix (AAM) is a promising biomaterial for the construction of engineered adipose tissue. However, AAM lacks sufficient adipoinduction potency because of the abundant loss of matrix-bound adipokines during decellularization.Methods: An adipose-derived extracellular matrix collagen scaffold, “adipose collagen fragment” (ACF), was prepared using a novel mechanical method that provides sustained release of adipokines. Here, the authors used label-free proteomics methods to detect the protein components in AAM and ACF. In vivo, ACF was incorporated into AAM or acellular dermal matrix and implanted into nude mice to evaluate adipogenesis. Neoadipocytes, neovessels, and corresponding gene expression were evaluated. The effects of ACF on adipogenic differentiation of human adipose-derived stem cells and tube formation by human umbilical vein endothelial cells were tested in vitro.Results: Proteomics analysis showed that ACF contains diverse adipogenic and angiogenic proteins. ACF can release diverse adipokines and induce highly vascularized, mature adipose tissue in AAM, and even in nonadipogenic acellular dermal matrix. Higher expression of adipogenic markers peroxisome proliferator-activated receptor gamma and CCAAT/enhancer-binding protein alpha and greater numbers of tubule structures were observed in ACF-treated groups in vitro.Conclusion: The combination of ACF and AAM could serve as a novel and promising strategy to construct mature, vascularized adipose tissue for soft-tissue reconstruction.Clinical Relevance Statement: The combined use of AAM and ACF has been proven to induce a highly vascularized, mature, engineered adipose tissue in the nude mouse model, which may serve as a promising strategy for soft-tissue reconstruction.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • Effects of Catalpol from Rehmannia glutinosa Extract on Skin Flaps

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      Authors: Ma; Xinyi; Lin, Yi; Fang, Miaojie; Liu, Yingying; Li, Wenjie; He, Jibing; Lin, Dingsheng
      Abstract: imageBackground: Flaps are commonly used for repairing tissues and wounds in surgery. However, various factors can cause postoperative necrosis in these flaps. Catalpol is a bioactive component in extracts from Rehmannia glutinosa, which has pharmacologic characteristics that may improve flap survival.Methods: The experiments were performed in 36 male Sprague-Dawley rats divided into three groups: control, low-dose catalpol, and high-dose catalpol. The flap survival rate, neutrophil density, microvessel density, superoxide dismutase, and malondialdehyde levels were measured; histopathologic analysis was performed 7 days after surgery. Blood flow was measured by laser Doppler flowmetry and lead oxide–gelatin angiography. The levels of vascular endothelial growth factor, toll-like receptor 4, nuclear factor-kappa B, tumor necrosis factor-α, interleukin (IL)-6, nod-like receptor 3, cysteinyl aspartate specific proteinase-1 (caspase-1), IL-1β, and IL-18 were determined by immunohistochemistry.Results: Catalpol treatment increased flap survival, reduced neutrophil recruitment and release, decreased malondialdehyde levels, and increased superoxide dismutase levels; thus, it effectively reduced oxidative stress, up-regulated the expression of vascular endothelial growth factor, and increased microvessel density. Laser Doppler flowmetry and lead oxide–gelatin angiography showed that catalpol treatment improved angiogenesis. Immunohistochemical analyses showed that catalpol inhibited the production of inflammatory factors, such as tumor necrosis factor-α and IL-6, by down-regulating toll-like receptor 4 and nuclear factor-κB. Furthermore, catalpol reduced cell pyroptosis by inhibiting the production of nod-like receptor 3 inflammasomes, thereby down-regulating the release of IL-1β and IL-18.Conclusion: Catalpol can improve the rate of flap survival.Clinical Relevance Statement: The research verified that the Rehmannia extract catalpol, through angiogenesis, inflammatory response, ischemia-reperfusion injury, and pyroptosis-related pathways, effectively improved the flap survival rate, which will provide new ideas for clinical medication.
      PubDate: Tue, 09 May 2023 00:00:00 GMT-
       
  • A Decade of Nipple-Sparing Mastectomy: Lessons Learned in 3035 Immediate
           Implant-Based Breast Reconstructions

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      Authors: Lin; Alex M.; Lorenzi, Roberto; Van Der Hulst, Juliette E.; Liao, Eric C.; Austen, William G. Jr; Webster, Alexandra; Smith, Barbara L.; Colwell, Amy S.
      Abstract: imageBackground: Nipple-sparing mastectomy is commonly performed for breast cancer treatment or prevention. The authors present one of the largest breast reconstruction series in the literature.Methods: A single-institution retrospective review was conducted from 2007 to 2019.Results: The authors’ query identified 3035 implant-based breast reconstructions after nipple-sparing mastectomy, including 2043 direct-to-implant and 992 tissue expander–to-implant reconstructions. The overall major complication rate was 9.15%, and the nipple necrosis rate was 1.20%. Therapeutic mastectomy was associated with higher overall complications and explantations compared with prophylactic mastectomy (P < 0.01). In comparisons of unilateral and bilateral procedures, bilateral mastectomy had an increased risk for complications (OR, 1.46; 95% CI, 0.997 to 2.145; P = 0.05). Tissue-expander reconstructions had higher rates of nipple necrosis (1.9% versus 0.88%; P = 0.015), infection (4.2% versus 2.8%; P = 0.04), and explantation (5.1% versus 3.5%; P = 0.04) compared with direct-to-implant reconstruction. When assessing plane of reconstruction, the authors found similar rates of complications between subpectoral dual-plane and prepectoral reconstruction. There was no difference in complications between reconstruction with acellular dermal matrix or mesh compared with total or partial muscle coverage without acellular dermal matrix/mesh (OR, 0.749; 95% CI, 0.404 to 1.391; P = 0.361). Multivariable regression analysis revealed preoperative radiotherapy (OR, 2.465; 95% CI, 1.579 to 3.848; P < 0.001), smoking (OR, 2.53; 95% CI, 1.581 to 4.054; P < 0.001), and a periareolar incision (OR, 3.657; 95% CI, 2.276 to 5.875; P < 0.001) to be the strongest predictors of complications and nipple necrosis (P < 0.05).Conclusions: Nipple-sparing mastectomy and immediate breast reconstruction has a low rate of complications. In this series, radiation therapy, smoking, and incision choice predicted overall complications and nipple necrosis, whereas direct-to-implant reconstruction and acellular dermal matrix or mesh did not increase risk.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
      PubDate: Tue, 02 May 2023 00:00:00 GMT-
       
  • To Ablate or Not to Ablate: Does Umbilectomy Decrease Donor-Site
           Complications in DIEP Flap Breast Reconstruction'

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      Authors: Perez; Kevin; Teotia, Sumeet S.; Haddock, Nicholas T.
      Abstract: imageBackground: Improving outcomes for deep inferior epigastric perforator (DIEP) flap breast reconstruction is an evolving area of interest. The aim of this study was to evaluate the effect of umbilectomy in abdominally based breast reconstruction.Methods: This retrospective study evaluated postoperative outcomes of patients who underwent autologous DIEP flap breast reconstruction at an academic center between January of 2015 and December of 2021 performed by one of two reconstructive surgeons. The primary outcome variable was abdominal donor-site complications. A secondary outcome variable was treatment outcomes for complications. Covariates included demographic information, comorbidities, cancer treatment, and smoking.Results: A total of 408 patients underwent DIEP flap breast reconstruction, with 194 (47.5%) undergoing umbilectomy. Umbilectomy resulted in decreased number of total wounds per patient (0.35 ± 0.795) compared with umbilical preservation (0.75 ± 1.322; P < 0.001), as well as decreased associated risk of any reported wounds (OR, 0.530; P = 0.009). Associations that trended toward significance occurred between umbilectomy and minor wound separation and partial necrosis, with both showing decreased risk. A significant association was noted between umbilectomy and donor-site seroma [χ2(1) = 6.348; P = 0.016], showing an increased risk (OR, 5.761).Conclusions: Umbilectomy should be discussed with patients and considered as a part of DIEP flap breast reconstruction given the reduction in the risk of abdominal donor-site wounds. Although umbilectomy decreases the rate of wounds, it can increase the risk of seroma; therefore, other interventions, such as progressive tension sutures, may be explored to aid in reducing seroma and improving wound healing.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
      PubDate: Tue, 02 May 2023 00:00:00 GMT-
       
  • Prepectoral versus Submuscular Implant-Based Breast Reconstruction: A
           Matched-Pair Comparison of Outcomes

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      Authors: Talwar; Ankoor A.; Lanni, Michael A.; Ryan, Isabel A.; Kodali, Pranav; Bernstein, Elizabeth; McAuliffe, Phoebe B.; Broach, Robyn B.; Serletti, Joseph M.; Butler, Paris D.; Fosnot, Joshua
      Abstract: imageBackground: Implant-based breast reconstruction is the most common reconstructive approach after mastectomy. Prepectoral implants offer advantages over submuscular implants, such as less animation deformity, pain, weakness, and postradiation capsular contracture. However, clinical outcomes after prepectoral reconstruction are debated. The authors performed a matched-cohort analysis of outcomes after prepectoral and submuscular reconstruction at a large academic medical center.Methods: Patients treated with implant-based breast reconstruction after mastectomy from January of 2018 through October of 2021 were retrospectively reviewed. Patients were propensity score exact matched to control demographic, preoperative, intraoperative, and postoperative differences. Outcomes assessed included surgical-site occurrences, capsular contracture, and explantation of either expander or implant. Subanalysis was done on infections and secondary reconstructions.Results: A total of 634 breasts were included (prepectoral, 197; submuscular, 437). A total of 292 breasts were matched (146 prepectoral:146 submuscular) and analyzed for clinical outcomes. Prepectoral reconstructions were associated with greater rates of SSI (prepectoral, 15.8%; submuscular, 3.4%; P < 0.001), seroma (prepectoral, 26.0%; submuscular, 10.3%; P < 0.001), and explantation (prepectoral, 23.3%; submuscular, 4.8%; P < 0.001). Subanalysis of infections revealed that prepectoral implants have shorter time to infection, deeper infections, and more Gram-negative infections, and are more often treated surgically (all P < 0.05). There have been no failures of secondary reconstructions after explantation in the entire population at a mean follow-up of 20.1 months.Conclusions: Prepectoral implant-based breast reconstruction is associated with higher rates of infection, seroma, and explantation compared with submuscular reconstructions. Infections of prepectoral implants may need different antibiotic management to avoid explantation. Secondary reconstruction after explantation can result in long-term success.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
      PubDate: Tue, 02 May 2023 00:00:00 GMT-
       
  • Vanderbilt Mini-PROM–Breast for Breast Reconstruction: A Short-Form,
           Patient-Reported Outcomes Measure

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      Authors: Park; Benjamin C.; Drolet, Brian C.; Perdikis, Galen
      Abstract: imageBackground: Breast reconstruction procedures are among the most commonly performed plastic surgery operations. Although there are well-validated patient-reported outcomes measures (PROMs) for breast reconstruction, there are several patient-, provider-, and service-level barriers to their implementation in routine clinical settings. Therefore, we developed a short-form PROM to evaluate breast reconstruction outcomes.Methods: Using a mixed-methods approach, the Vanderbilt Mini-PROM–Breast (VMP-B) was constructed and validated to assess patient-reported outcomes from breast reconstruction. Classic test theory methods were used to evaluate acceptability, reliability, and validity. External validation was subsequently performed using the BREAST-Q as a reference standard.Results: The VMP-B is a 16-item instrument composed of three domains: quality of life, body image, and breast satisfaction. Psychometric properties including acceptability, reliability, and validity exceeded reference criteria. When tested with 104 patients, the authors found significant benefits of breast reconstruction on quality of life, body image, and breast satisfaction. These results were associated with sizeable effect sizes (g) (g = 0.421, g = 0.520, and g = 1.25) demonstrative of clinically meaningful results. When tested concurrently in 70 patients, the VMP-B and the BREAST-Q showed similar results, exhibiting excellent convergent validity.Conclusions: The VMP-B is a validated short-form PROM that reliably assesses breast reconstruction outcomes. As a short form, the VMP-B decreases both patient and provider burden, which allows for routine, point-of-care collection of breast reconstruction outcomes.
      PubDate: Tue, 02 May 2023 00:00:00 GMT-
       
  • Top 25 Medications the Plastic and Reconstructive Surgery Trainee Should
           Know for an Emergency Medicine Department Consult

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      Authors: Azoury; Saïd C.; Matros, Evan
      Abstract: imageSummary: Plastic surgery trainees are often called to render care in the emergency department (eg, for established patients, trauma, burns). Broad-based knowledge in pharmacotherapeutics during these encounters is critical. This includes an understanding of pain medications, anxiolytics, local anesthetics, antibiotics, anticoagulants, antidotes, and more to ensure optimal patient care. The purpose of this report is to describe 25 frequently used and other important medications that plastic surgery trainees should know for an adult emergency department encounter.
      PubDate: Tue, 02 May 2023 00:00:00 GMT-
       
  • Superior Sensibility after Full Breast Reconstruction with Autologous Fat
           Transfer

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      Authors: Wederfoort; Jamilla L. M.; Schop, Sander; van der Broeck, Lotte C. A.; Hommes, Juliette E.; van Kuijk, Sander M. J.; Timmermans, Floyd; Smit, Jan Maerten; Heuts, Esther M.; de Wit, Thijs; van der Hulst, René R. W. J.; Piatkowski, Andrzej A.
      Abstract: imageBackground: With developments in screening and treatment, survival rates of breast cancer patients are increasing, and so is the number of women opting for breast reconstruction to improve their quality of life. One factor that could play an important role in improving the quality of life is breast sensibility. Therefore, the aim of this study was to explore breast sensibility in participants of the Breast Reconstruction with External Preexpansion and Autologous Fat Transfer versus Standard Therapy trial: an ongoing randomized controlled trial comparing breast reconstruction with autologous fat transfer (AFT) versus implant-based reconstruction (IBR).Methods: This study was conducted on participants of the Breast Reconstruction with External Preexpansion and Autologous Fat Transfer versus Standard Therapy trial who were at least 12 months after final surgery. Semmes-Weinstein monofilaments were used to measure skin sensibility in breast cancer patients who underwent breast reconstruction with either AFT or IBR following their mastectomy.Results: A total of 46 patients were included in this study, resulting in 62 breast reconstructions (28 AFT breasts and 34 IBR breasts). Significantly higher mean monofilament values were found for skin sensibility after AFT (−0.7; P < 0.001), clinically correlating to “diminished protective function,” as opposed to the IBR group, with clinical values indicating “loss of protective function.”Conclusions: In this study, the authors found that breast cancer patients who underwent a mastectomy had a significantly better sensibility of the breast following AFT for total breast reconstruction as compared with IBR. Larger studies that include null measurements are required to further explore these noteworthy results of AFT.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
      PubDate: Fri, 28 Apr 2023 00:00:00 GMT-
       
  • Liposuction for Advanced Lymphedema in a Multidisciplinary Team Setting in
           Australia: 5-Year Follow-Up

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      Authors: Karlsson; Tobias; Mackie, Helen; Koelmeyer, Louise; Heydon-White, Asha; Ricketts, Robyn; Toyer, Kim; Boyages, John; Brorson, Håkan; Lam, Thomas
      Abstract: imageBackground: Liposuction for International Society of Lymphology late stage 2 or 3 limb lymphedema is an established surgical option to remove excessive adipose tissue deposition and has been performed in Australia since 2012 at the Australian Lymphoedema Education, Research, and Treatment (ALERT) Program of Macquarie University.Methods: Between May of 2012 and May of 2017, 72 patients with unilateral primary or secondary lymphedema of the arm or leg underwent suction-assisted lipectomy using the Brorson protocol. This prospective study presents 59 of these patients who had consented to research with a 5-year follow-up.Results: Of the 59 patients, 54 (92%) were women, 30 (51%) had leg lymphedema, and 29 (49%) had arm lymphedema. For patients with arm lymphedema, the median preoperative volume difference between the lymphedematous and the contralateral arm was 1061 mL, which was reduced to 79 mL 1 year after surgery and to 22 mL 5 years after surgery. For patients with leg lymphedema, the median preoperative volume difference was 3447 mL, which was reduced to 263 mL 1 year after surgery but increased to 669 mL 5 years after surgery.Conclusion: Suction-assisted lipectomy is a long-term option for the management of selected patients with International Society of Lymphology late stage 2 or 3 limb lymphedema when conservative management can offer no further improvement.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Fri, 28 Apr 2023 00:00:00 GMT-
       
  • Free Chimeric Superficial Circumflex Iliac Artery Perforator Flap in
           Reconstructing the Distal Complex Extensor Tendon Injury

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      Authors: Chu; Tinggang; Xiao, Jian; Zhou, Xijie; Lin, Kang; Tao, Zhenyu
      Abstract: imageSummary: The distal complex extensor tendon injury, presenting as traumatic skin, zones 1 and 2 of extensor pollicis longus and extensor hallucis longus, and bony insertion loss, represents a challenging issue and requires a well-vascularized skin paddle, tendinous graft, and insertional reconstruction. Guided by the all-in-one-step reconstruction rule, the chimeric superficial circumflex iliac artery perforator (SCIAP) flap, generally considered as a promising multiple-type tissue provider (eg, vascularized skin paddle, fascia, iliac flap), can fulfill the reconstructive demands and has an edge over the two-stage countermeasure. The authors adopted tripartite SCIAP flaps to reconstruct distal complex thumb or toe injuries in eight cases (six thumbs and two halluces), all of which were reattached with vascularized fascia lata–iliac crest conjunctions using a pull-out technique. All SCIAP flaps survived uneventfully without donor-site complications. The remodeled interphalangeal joints regained nearly normal radiologic manifestation. The chimeric SCIAP flap may be a promising technique for distal complex extensor tendon injury; providing vascularized skin paddle and fascia lata–iliac crest graft, it also qualifies for the all-in-one-stage reconstruction concept.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 27 Apr 2023 00:00:00 GMT-
       
  • Textured versus Smooth Tissue Expanders: A Comparison of Complications in
           3526 Breast Reconstructions

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      Authors: Nelson; Jonas A.; Rubenstein, Robyn N.; Vorstenbosch, Joshua; Haglich, Kathryn; Poulton, Richard T.; McGriff, De’von; Stern, Carrie S.; Coriddi, Michelle; Cordeiro, Peter G.; McCarthy, Colleen M.; Disa, Joseph J.; Mehrara, Babak J.; Matros, Evan
      Abstract: imageBackground: Increased understanding of breast implant–associated anaplastic large-cell lymphoma has led to a shift away from textured breast devices. A few small studies have compared the complication rates of textured and smooth tissue expanders (TEs). The aim of this study was to compare complication profiles in patients undergoing two-stage postmastectomy breast reconstruction with either textured or smooth TEs.Methods: The authors performed a retrospective review of female patients who underwent immediate breast reconstruction with textured or smooth TEs from 2018 to 2020 at their institution. Rates of seroma, infection/cellulitis, malposition/rotation, exposure, and TE loss were analyzed in the overall cohort and subgroups undergoing prepectoral and subpectoral TE placement. A propensity score–matched analysis was used to decrease the effects of confounders comparing textured and smooth TEs.Results: The authors analyzed 3526 TEs (1456 textured and 2070 smooth). More frequent use of acellular dermal matrix, SPY angiography, and prepectoral TE placement was noted in the smooth TE cohort (P < 0.001). Univariate analysis suggested higher rates of infection/cellulitis, malposition/rotation, and exposure in smooth TEs (all P < 0.01). Rates of TE loss did not differ. After propensity matching, no differences were noted in infection or TE loss. Prepectoral smooth expanders had increased rates of malposition/rotation.Conclusions: TE surface type did not affect rates of TE loss, although increased rates of expander malposition were noted in the smooth prepectoral cohort. Further research is needed to examine breast implant–associated anaplastic large-cell lymphoma risk with temporary textured TE exposure to improve decision-making.CLINICAL QUESTION/LEVEL OF EVIDENCW: Therapeutic, III.
      PubDate: Wed, 26 Apr 2023 00:00:00 GMT-
       
  • Two-Stage Implant-Based Breast Reconstruction Using Intraoperative
           Fluorescence Imaging: A Propensity Score–Matched Analysis

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      Authors: Escandón; Joseph M.; Christiano, Jose G.; Gooch, Jessica C.; Olzinski, Ann Therese; Prieto, Peter A.; Skinner, Kristin A.; Langstein, Howard N.; Manrique, Oscar J.
      Abstract: imageBackground: Limited comparability between study groups can generate significant selection and observer bias when evaluating the efficacy of the SPY system and fluorescence imaging for implant-based breast reconstruction. In this study, the authors compared the surgical outcomes and complications during the first stage of reconstruction between reconstructions evaluated intraoperatively with fluorescence imaging using the SPY system and clinical assessment using a matched analysis.Methods: The authors conducted a retrospective review of patients undergoing total mastectomy and immediate two-stage implant-based breast reconstruction with TEs from January of 2011 to December of 2020. The rate of complication, time for TE-to-implant exchange, and time to start radiotherapy were compared between groups (intraoperative fluorescence imaging versus clinical assessment) using a propensity score–matched analysis.Results: After propensity score matching, 198 reconstructions were evaluated. There were 99 reconstructions in each group. The median time for TE-to-implant exchange (140 days versus 185 days; P = 0.476) and time to initiate adjuvant radiotherapy (144 days versus 98 days; P = 0.199) were comparable between groups. The 30-day rate of wound-related complications (21% versus 9%; P = 0.017) and 30-day rate of wound-related unplanned interventions were significantly higher in reconstructions evaluated with clinical assessment when compared with the SPY system (16% versus 5%; P = 0.011). A higher 30-day rate of seroma (19% versus 14%; P = 0.041) and hematoma (8% versus 0%; P = 0.004) were found in reconstructions assessed intraoperatively with the SPY system.Conclusions: After matching, reconstructions evaluated with fluorescence imaging exhibited a lower incidence of early wound-related complications when compared with clinical evaluation alone. Nonetheless, the Wise pattern for mastectomy was found to be the only independent predictor associated with early wound-related complications.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
      PubDate: Wed, 26 Apr 2023 00:00:00 GMT-
       
  • Identification of Key Breast Features Using a Neural Network: Applications
           of Machine Learning in the Clinical Setting of Plastic Surgery

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      Authors: Kenig; Nitzan; Monton Echeverria, Javier; De la Ossa, Luis
      Abstract: imageBackground: In plastic surgery, evaluation of breast symmetry is an important aspect of clinical practice. Computer programs have been developed for this purpose, but most of them require operator input. Artificial intelligence has been introduced into many aspects of medicine. In plastic surgery, automated neural networks for breast evaluation could improve quality of care. In this work, the authors evaluate the identification of breast features with an ad hoc trained neural network.Methods: An ad hoc convolutional neural network was developed on the YOLOV3 platform to detect key features of the breast that are commonly used in plastic surgery for symmetry evaluation. The program was trained with 200 frontal photographs of patients who underwent breast surgery and was tested on 47 frontal images of patients who underwent breast reconstruction after breast cancer surgery.Results: The program was able to detect key features in 97.74% of cases (boundaries of the breast in 94 of 94 cases, the nipple-areola complex in 94 of 94 cases, and the suprasternal notch in 41 of 47 cases). Mean time of detection was 0.52 seconds.Conclusions: The ad hoc neural network was successful in localizing key breast features, with a total detection rate of 97.74%. Neural networks and machine learning have the potential to improve the evaluation of breast symmetry in plastic surgery by automated and quick detection of features used by surgeons in practice. More studies and development are needed to further knowledge in this area.
      PubDate: Wed, 26 Apr 2023 00:00:00 GMT-
       
  • Pain and Functional Outcomes following Targeted Muscle Reinnervation: A
           Systematic Review

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      Authors: ElAbd; Rawan; Dow, Todd; Jabori, Sinan; Alhalabi, Becher; Lin, Samuel J.; Dowlatshahi, Sammy
      Abstract: imageBackground: It is estimated that by 2050, a total of 3.6 million patients will be living with an amputation in the United States. The objective of this systematic review is to evaluate the effect of targeted muscle reinnervation (TMR) on pain and physical functioning in amputees.Methods: A literature search was performed on PubMed, Embase, and MEDLINE up to November 28, 2021. Clinical studies assessing the outcomes of TMR (pain, prosthesis control, life quality, limb function, and disability) were included.Results: Thirty-nine articles were included. The total number of patients who underwent TMR was 449, and 716 were controls. Mean follow-up was 25 months. A total of 309 (66%) lower-limb and 159 (34%) upper-limb amputations took place in the TMR group, the most common being below-knee amputations (39%). The control group included a total of 557 (84%) lower-limb and 108 (16%) upper-limb amputations; the greatest proportion being below-knee amputations in this group as well (54%). Trauma was the most common indication for amputation. Phantom limb pain scores were lower by 10.2 points for intensity (P = 0.01), 4.67 points for behavior (P = 0.01), and 8.9 points for interference (P = 0.09). Similarly, residual limb pain measures were lower for cases for intensity, behavior, and interference, but they failed to reach significance. Neuroma symptoms occurred less frequently, and functional and prosthesis control outcomes improved following TMR.Conclusion: The literature evidence suggests that TMR is a promising therapy for improving pain, prosthesis use, and functional outcomes after limb amputation.
      PubDate: Wed, 26 Apr 2023 00:00:00 GMT-
       
  • A Road Map to Creating a High-Quality Clinical Database in Plastic Surgery

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      Authors: Irgebay; Zhazira; Bruce, Madeleine K.; Fantuzzo, Jennifer A.; Beiriger, Justin W.; Anstadt, Erin E.; Dvoracek, Lucas A.; Smetona, John; Losee, Joseph E.; Goldstein, Jesse A.
      Abstract: imageBackground: Detailed in-house databases are a staple of surgical research and a crucial source of data for many studies from which clinical guidelines are built. Despite the importance of generating a clear and thorough developmental design, the literature on database creation and management is limited. In this article, the authors present their stepwise single-institution process of developing a clinical facial fracture database.Methods: The authors outline the process of development of a large single-institution clinical pediatric facial fracture database. The authors highlight critical steps from conception, regulatory approval, data safety/integrity, human resource allocation, data collection, quality assurance, and error remediation. The authors recorded patient characteristics, comorbidities, details of the sustained fracture, associated injuries, hospitalization information, treatments, outcomes, and follow-up information on Research Electronic Data Capture. Protocols were created to ensure data quality assurance and control. Error identification analysis was subsequently performed on the database to evaluate the completeness and accuracy of the data.Results: A total of 4451 records from 3334 patients between 2006 and 2021 were identified and evaluated to generate a clinical database. Overall, there were 259 incorrect entries of 120,177 total entries, yielding a 99.8% completion rate and a 0.216% error rate.Conclusions: The quality of clinical research is intrinsically linked to the quality and accuracy of the data collection. Close attention must be paid to quality control at every stage of a database setup. More studies outlining the process of database design are needed to promote transparent, accurate, and replicable research practices.
      PubDate: Tue, 25 Apr 2023 00:00:00 GMT-
       
  • Spatial Fidelity of Microvascular Perforating Vessels as Perceived by
           Augmented Reality Virtual Projections

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      Authors: Cholok; David J.; Fischer, Marc J.; Leuze, Christoph W.; Januszyk, Michael; Daniel, Bruce L.; Momeni, Arash
      Abstract: imageBackground: Autologous breast reconstruction yields improved long-term aesthetic results but requires increased resources of practitioners and hospital systems. Innovations in radiographic imaging have been increasingly used to improve the efficiency and success of free flap harvest. Augmented reality affords the opportunity to superimpose relevant imaging on a surgeon’s native field of view, potentially facilitating dissection of anatomically variable structures. To validate the spatial fidelity of augmented reality projections of deep inferior epigastric perforator flap–relevant anatomy, comparisons of three-dimensional (3D) models and their virtual renderings were performed by four independent observers. Measured discrepancies between the real and holographic models were evaluated.Methods: The 3D-printed models of deep inferior epigastric perforator flap–relevant anatomy were fabricated from computed tomographic angiography data from 19 de-identified patients. The corresponding computed tomographic angiography data were similarly formatted for the Microsoft HoloLens to generate corresponding projections. Anatomic points were initially measured on 3D models, after which the corresponding points were measured on the HoloLens projections from two separate vantage points (V1 and V2). Statistical analyses, including generalized linear modeling, were performed to characterize spatial fidelity regarding translation, rotation, and scale of holographic projections.Results: Among all participants, the median translational displacement at corresponding points was 9.0 mm between the real-3D model and V1, 12.1 mm between the 3D model and V2, and 13.5 mm between V1 and V2.Conclusion: Corresponding points, including topography of perforating vessels, for the purposes of breast reconstruction can be identified within millimeters, but there remain multiple independent contributors of error, most notably the participant and location at which the projection is perceived.
      PubDate: Tue, 25 Apr 2023 00:00:00 GMT-
       
  • United States Health Policies on Gender-Affirming Care in 2022

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      Authors: Chin; Madeline G.; LaGuardia, Jonnby S.; Morgan, Katarina B. J.; Ngo, Halena; Moghadam, Shahrzad; Huang, Kelly X.; Bedar, Meiwand; Cronin, Brendan J.; Kwan, Daniel; Lee, Justine C.
      Abstract: imageBackground: Within the United States, access to gender-affirming operations covered by health insurance has increased dramatically over the past decade. However, the perpetually changing landscape and inconsistencies of individual state health policies governing private and public insurance coverage present a lack of clarity for reconstructive surgeons and other physicians attempting to provide gender-affirming care. This work systematically reviewed the current U.S. health policies for both private insurance and Medicaid on a state-by-state basis.Methods: Individual state health policies in effect as of August of 2022 on gender-affirming care were reviewed using the LexisNexis legal database, state legislature publications, and Medicaid manuals. Primary outcomes were categorization of policies as protective, restrictive, or unclear for each state. Secondary outcomes included analyses of demographics covered by current health policies and geographic differences.Results: Protective state-level health policies related to gender-affirming care were present in approximately half of the nation for both private insurance (49.0%) and Medicaid (52.9%). Explicitly restrictive policies were found in 5.9% and 17.6% of states for private insurance and Medicaid, respectively. Regionally, the Northeast and West had the highest rates of protective policies, whereas the Midwest and South had the highest rates of restrictive policies on gender-affirming care.Conclusions: State-level health policies on gender-affirming care vary significantly across the United States with regional associations. Clarity in the current and evolving state-specific health policies governing gender-affirming care is essential for surgeons and physicians caring for transgender and gender-diverse individuals.
      PubDate: Tue, 25 Apr 2023 00:00:00 GMT-
       
  • Direct Transvestibular Feminization Thyroid Laryngochondroplasty

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      Authors: Carmel Neiderman; Narin N.; Arbel, Shimrit; Diamant, Noa; Wolfman, Karin; Yanko, Ravit; Lior, Yotam; Kidron, Anat; Ianculovici, Clariel; Kleinman, Shlomi; Oestreicher-Kedem, Yael
      Abstract: imageBackground: Feminization laryngochondroplasty (FLC) methods have evolved from using a midcervical incision to a submental, less visible incision. The scar may be unacceptable to the patient because it signals gender reassignment surgery. An endoscopic transoral approach to FLC inspired by transoral endoscopic thyroidectomy was recently suggested to avoid the neck scar; however, it requires special equipment and has a long learning curve. A vestibular incision is used to approach the chin in lower-third facial feminization surgery. The authors propose that this incision may be extended to the thyroid cartilage in performing direct FLCs. The authors describe their experience with a novel, minimally invasive, direct transvestibular use of the chin-reshaping incision.Methods: The medical records of all patients who underwent direct transvestibular FLC (DTV-FLC) from December of 2019 to September of 2021 were retrieved and reviewed for this retrospective cohort study. Data on the operative, postoperative, and follow-up courses, complications, and functional and cosmetic results were retrieved.Results: Nine transgender women were included. Seven DTV-FLCs were performed during lower-third facial feminization surgery, and two were isolated DTV-FLCs. One was a revision DTV-FLC. Transient minor complications were encountered and resolved by the postoperative visit at 1 to 2 months. Vocal fold function and voice quality remained intact. Eight available patients were satisfied with the surgical results. A blinded assessment by eight plastic surgeons determined that seven procedures were successful.Conclusion: The novel DTV-FTLC approach either in isolation or as part of lower-third facial feminization surgery facilitated scar-free FLC with satisfactory cosmetic and functional results.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 20 Apr 2023 00:00:00 GMT-
       
  • Neurofibromatosis Type II and Facial Paralysis: Clinical Evaluation and
           Management

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      Authors: Mohanty; Ahneesh J.; DeVahl, Julie; Kutz, Walter J.; Rozen, Shai M.
      Abstract: imageBackground: Facial paralysis secondary to neurofibromatosis type 2 (NF2) presents the reconstructive surgeon with unique challenges because of its pathognomonic feature of bilateral acoustic neuromas, involvement of multiple cranial nerves, use of antineoplastic agents, and management. Facial reanimation literature on managing this patient population is scant.Methods: A comprehensive literature review was performed. All patients with NF2-related facial paralysis who presented in the past 13 years were reviewed retrospectively for type and degree of paralysis, NF2 sequelae, number of cranial nerves involved, interventional modalities, and surgical notes.Results: Twelve patients with NF2-related facial paralysis were identified. All patients presented after resection of vestibular schwannoma. Mean duration of weakness before surgical intervention was 8 months. On presentation, one patient had bilateral facial weakness, 11 had multiple cranial nerve involvement, and seven were treated with antineoplastic agents. Two patients underwent gracilis free functional muscle transfer, five underwent masseteric-to-facial nerve transfer (of whom two were dually innervated with a crossfacial nerve graft), and one patient underwent depressor anguli oris myectomy. Trigeminal schwannomas did not affect reconstructive outcomes if trigeminal nerve motor function on clinical examination was normal. In addition, antineoplastic agents such as bevacizumab and temsirolimus did not affect outcomes if stopped in the perioperative period.Conclusions: Effectively managing patients with NF2-related facial paralysis necessitates understanding the progressive and systemic nature of the disease, bilateral facial nerve and multiple cranial nerve involvement, and common antineoplastic treatments. Neither antineoplastic agents nor trigeminal nerve schwannomas associated with normal examination affected outcomes.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
      PubDate: Thu, 20 Apr 2023 00:00:00 GMT-
       
  • Alar Crease Creation Suture in Nasal Reconstruction

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      Authors: Yen; Cheng-I; Huang, Chih-Jung; Chang, Chun-Shin; Chen, Hung-Chang; Yang, Shih-Yi; Chang, Shu-Yin; Yang, Jui-Yung; Chuang, Shiow-Shuh; Hsiao, Yen-Chang
      Abstract: imageSummary: The crescentic alar groove serves as a topographic landmark that frames the ala and separates this convex structure from the surrounding cosmetic subunits. This aesthetic landmark can be attenuated or even obliterated during wound repair in this area. Flaps spanning the alar crease are often noticeably bulky with a pin-cushioned appearance in nasal reconstruction, and it is challenging to reproduce a natural-appearing alar groove. The authors proposed a novel technique with a modified, interrupted inverted horizontal mattress suture to create an alar groove. From March of 2016 to May of 2021, 22 consecutive patients with alar defects who underwent nasal reconstruction with the paramedian forehead flap were identified. All patients underwent the authors’ novel technique for the creation of the alar groove. The mean follow-up time was 3 years 7 months (range, 14 months to 5 years). A total of 32 alar crease creation suture operations were performed. All uneven wounds healed uneventfully within 2 weeks. Two cases of postoperative fading alar grooves required alar crease creation sutures to be redone. The authors’ novel alar crease creation suture is a safe, straightforward, and reliable technique to create an aesthetic alar groove in forehead flap nasal reconstruction. It can create a medially shallow and laterally deep alar crease without apparent complications.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 20 Apr 2023 00:00:00 GMT-
       
  • Systematic Review of Nonsyndromic Craniosynostosis: Genomic Alterations
           and Impacted Signaling Pathways

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      Authors: Albaugh; Shaley L.; Diaz, Ashley; Wang, Esther; Shen, Timothy C.; Williams, Lydia; He, Tong-Chuan; Reid, Russell R.
      Abstract: imageBackground: Genetic research in nonsyndromic craniosynostosis remains limited compared with syndromic craniosynostosis. This systematic review aimed to comprehensively summarize the genetic literature of nonsyndromic craniosynostosis and highlight key signaling pathways.Methods: The authors performed a systematic literature search of PubMed, Ovid, and Google Scholar databases from inception until December of 2021 using search terms related to nonsyndromic craniosynostosis and genetics. Two reviewers screened titles and abstract for relevance, and three reviewers independently extracted study characteristics and genetic data. Gene networks were constructed using Search Tool for Retrieval of Interacting Genes/Proteins (version 11) analysis.Results: Thirty-three articles published between 2001 and 2020 met inclusion criteria. Studies were further classified into candidate gene screening and variant identification studies (n = 16), genetic expression studies (n = 13), and common and rare variant association studies (n = 4). Most studies were good quality. Using our curated list of 116 genes extracted from the studies, two main networks were constructed.Conclusions: This systematic review concerns the genetics of nonsyndromic craniosynostosis, with network construction revealing TGF-β/BMP, Wnt, and NF-κB/RANKL as important signaling pathways. Future studies should focus on rare rather than common variants to examine the missing heritability in this defect and, going forward, adopt a standard definition.
      PubDate: Tue, 18 Apr 2023 00:00:00 GMT-
       
  • Long-Term Outcomes after Pediatric Mandibular Reconstruction Using
           Vascularized Free Fibula Flap

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      Authors: Liu; Shuo; Zhang, Wen-Bo; Wang, Yang; Mao, Chi; Yu, Guang-Yan; Peng, Xin
      Abstract: imageBackground: The purpose of this study was to evaluate the long-term outcomes of mandibular reconstruction with vascularized free fibula flap in pediatric patients.Methods: Consecutive cases of mandibular reconstruction with vascularized free fibula flaps in pediatric patients at Peking University School and Hospital of Stomatology between 1999 and 2019 were reviewed. Postoperative computed tomography (CT) data of all patients were collected at each postoperative follow-up point, and after the age of 18 years. The length and height of the grafted fibula and the length of the remaining mandible were evaluated by measuring the three-dimensional CT data using ProPlan CMF 3.0 software. Lower limb function was evaluated using the Enneking evaluation scale. Facial symmetry was self-evaluated and scored. Statistical analysis was performed on the data obtained.Results: Fourteen patients were included in this study. All flaps were successful. The CT measurement results showed growth in the length of the grafted fibula that reconstructed the mandibular ramus and the residual mandible (P < 0.05). The height of the grafted fibula remained stable (P> 0.05). Eight patients were followed up until they were older than 18 years, and the CT measurement results after 18 years showed an essentially symmetric mandible profile (P> 0.05). All patients were satisfied with their postoperative facial symmetry. Enneking evaluation scores showed good recovery of lower limb functions.Conclusions: The vascularized free fibula flap for mandibular reconstruction in pediatric patients is safe and reliable. It also provides good cosmetic and functional outcomes, as it demonstrated positive growth.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 13 Apr 2023 00:00:00 GMT-
       
  • Improved Facial and Skull-Base Symmetry following Osteotomy and
           Distraction of Unilateral Coronal Synostosis

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      Authors: Mellgren; Jonas; Säljö, Karin; Tarnow, Peter; Maltese, Giovanni; Bhatti-Søfteland, Madiha; Olsson, Robert; Hallén, Tobias; Kölby, Lars
      Abstract: imageBackground: Unilateral coronal synostosis (UCS) results in a surgically demanding deformation, as the deformity is asymmetric in the calvaria but also presents with facial scoliosis and orbital dystopia. Traditional cranioplasties correct the forehead but have little effect on the face and orbits. In this article, the authors describe a consecutive series of patients operated on for UCS with osteotomy of the fused suture combined with distraction osteogenesis.Methods: Fourteen patients (mean age, 8.0 months; range, 4.3 to 16.6 months) were included in this study. The authors measured and compared the orbital dystopia angle, anterior cranial fossa deviation, and anterior cranial fossa cant between preoperative computed tomography results and those at distractor removal.Results: Blood loss was 6.1 mL/kg (range, 2.0 to 15.2 mL/kg), and length of stay was 4.4 days (range, 3.0 to 6.0 days). The authors observed significant improvements in the median orbital dystopia angle from 9.8 degrees (95% CI, 7.0 to 12.6 degrees) to 1.1 degrees (95% CI, −1.5 to 3.7 degrees) (P < 0.001), anterior cranial fossa deviation from 12.9 degrees (95% CI, 9.2 to 16.6 degrees) to 4.7 degrees (95% CI, 1.5 to 7.9 degrees) (P < 0.001), and anterior cranial fossa cant from 2.5 degrees (95% CI, 1.5 to 3.5 degrees) to 1.7 degrees (95% CI, 0.0 to 3.4 degrees) (P = 0.003).Conclusions: Osteotomy combined with a distractor for UCS straightened the face and relieved orbital dystopia by affecting the nose angle relative to the orbits, correcting the deviation of the cranial base in the anterior fossa, and lowering the orbit on the affected side. Furthermore, this technique demonstrated a favorable morbidity profile with low perioperative bleeding and a short inpatient period, suggesting its potential to improve the surgical treatment of UCS.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 13 Apr 2023 00:00:00 GMT-
       
  • Reconstruction of Concha-Type Microtia Using a Delayed Postauricular Skin
           Flap

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      Authors: Li; Gaofeng; Zhang, Bo; Ding, Wei; Ouyang, Huawei; Long, Xiren; Fu, Anqi; Liu, Xiaojia
      Abstract: imageSummary: Understanding how to remove and retain the relatively large residual auricle is important in concha-type microtia reconstruction. The authors present a method for concha-type microtia reconstruction using a delayed postauricular skin flap. A total of 40 patients with concha-type microtia who underwent ear reconstruction using a delayed postauricular skin flap were retrospectively examined. Reconstruction was performed in three stages. The first stage consisted of preparing a delayed postauricular skin flap and dealing with the residual auricle including removal of the upper residual auricular cartilage. In the second stage, an autogenous rib cartilage framework was placed and covered with a delayed postauricular skin flap, postauricular fascia flap, and autologous medium-thickness skin graft. The ear framework was carefully articulated and secured with the retained residual auricular cartilage to achieve a smooth junction between the two. The third stage involved modification of the reconstructed ear. Patients were followed up for 12 months after ear reconstruction. All reconstructed auricles had a good appearance, and there was a smooth connection between the reconstructed auricle and the residual ear, with similar color as well as a flat and thin scar. All patients were satisfied with the results.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Thu, 13 Apr 2023 00:00:00 GMT-
       
  • Treatment of Velopharyngeal Insufficiency Using Bilateral Myomucosal
           Buccinator Flaps

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      Authors: Raposo-Amaral; Cesar Augusto; Monte, Thais Miguel; Raposo-Amaral, Cassio Eduardo
      Abstract: imageSummary: The buccinator myomucosal flap, also referred to as a buccal myomucosal flap, is an effective technique to address velopharyngeal insufficiency after cleft palate repair. Challenges related to flap harvesting may deter plastic surgeons from incorporating this strategy as a first-line treatment. The primary objective of this study and accompanying video is to provide support regarding indications, planning, and surgical steps of the buccinator myomucosal flap technique, including important technical details for soft-palate dissection and flap harvesting.
      PubDate: Thu, 13 Apr 2023 00:00:00 GMT-
       
  • Mini-Shaped Kiss Flap Design for Palmar and Digital Soft-Tissue
           Resurfacing

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      Authors: Zheng; Youmao; Hallock, Geoffrey G.; Levin, L. Scott; Zhang, Yixin; Min, Peiru
      Abstract: imageBackground: Although palmar and digital soft-tissue resurfacing with intrinsic flaps may provide functional and aesthetic reconstruction, the donor site may result in a tight closure or need for a skin graft once the flap is raised. In this series, the “mini-shaped kiss flap” was used to increase the resurfacing efficiency and preserve hand function.Methods: The mini-shaped kiss flaps, based on common palmar digital arteries (eg, princeps pollicis artery and ulnar palmar digital artery), were developed for the resurfacing of distal or proximal finger areas. The tiny skin paddles were “kissed” together and transferred as pedicled in proposed dimensions and shape. The flap size, donor/recipient site, perforator source, whether free or pedicled, surgical outcome, and donor-site morbidity were evaluated.Results: Twenty mini-shaped kiss flaps were harvested for the purpose of palmar and digital resurfacing. The flap sizes varied from 3 × 1.2 cm to 5 × 2 cm. All 19 patients, aged 6 to 52 years (mean, 35 years), achieved successful reconstruction without major complications after 6- to 12-month follow-up.Conclusions: The mini-shaped kiss flap technique exhibited favorable surgical outcomes with excellent color and texture match to the recipient sites. The reverse midpalm, thenar, and hypothenar island flap can be raised at the cost of an unnoticeable linear scar with minimized functional compromise in the donor area.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Tue, 11 Apr 2023 00:00:00 GMT-
       
  • Hybrid Breast Augmentation: Double Benefit or Double Risk' A
           Comparative Study of 932 Cases

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      Authors: Li; Zhengyao; Zhang, Ziying; Zhang, Zixuan; Guan, Xiaoyu; Xin, Minqiang
      Abstract: imageBackground: The authors propose a hybrid breast augmentation (HBA) method combining implants and fat grafting and explore the outcome and safety through a retrospective, single-center, propensity score–matched, comparative study.Methods: Outcome, satisfaction, and complications were compared between the HBA group (302 cases) and the implant-based breast augmentation (IBA) group (353 cases), and between the HBA group and the autologous fat grafting (AFG) group (277 cases).Results: The mean follow-up period was 31.7 months. After propensity score matching (PSM), 270 cases were matched between the HBA and IBA groups, and 156 cases were matched between the HBA and AFG groups. Compared with the IBA group, HBA achieved higher scores of implant visibility/palpability and upper pole contour with the specialists’ evaluations (before and after PSM; P < 0.05). Regarding patient satisfaction, the scores of softness (before and after PSM), smoothness of the upper pole (before PSM), and overall satisfaction (after PSM) of the HBA group were better (P < 0.05). Implant-related complications occurred at a similar rate. Compared with the AFG group, HBA achieved higher scores of shape (before and after PSM) and symmetry (after PSM) with evaluations by specialists (P < 0.05). The scores of shape, symmetry, and overall satisfaction in the HBA group were better (before and after PSM; P < 0.05). The HBA group showed a lower incidence of palpable cysts, fat necrosis, oil cysts, and fat calcification (before PSM; P < 0.05).Conclusion: When the three techniques were compared objectively, HBA presented better indices of aesthetic outcomes, satisfaction, and acceptable complications rates when compared with IBA and AFG.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
      PubDate: Tue, 04 Apr 2023 00:00:00 GMT-
       
  • The Volumetric Effect of Botulinum Toxin Type A Injection on the Parotid
           Gland: A Randomized Controlled Trial

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      Authors: Jeong; Woo Shik; Hong, Dae Won; Ahn, Tae Joo; Han, Hyun Ho
      Abstract: imageBackground: Botulinum neurotoxin type A (BTX-A) to the masseter muscle is a useful tool for the aesthetic narrowing of the width of the lower face. The administration of BTX-A to visible parotid glands is also effective to reduce lower facial width. However, no studies have quantitatively analyzed the effect of BTX-A on the parotid glands.Methods: The purpose of this study was to confirm the impact of BTX-A injection on the parotid gland and to suggest the effective dosage of BTX-A in facial slimming. This study was conducted by selecting patients who desired facial slimming from among patients who required surgery for a facial bone fracture. Patients undergoing BTX-A injection were randomized to high-dose, low-dose, and placebo groups, and different doses of BTX-A for each group were injected into both parotid glands during facial bone surgery.Results: A total of 30 patients were enrolled in this study. Ten patients in the high-dose group, eight in the low-dose group, and nine in the control group completed the clinical trial. There were significant changes in both the high- and low-dose groups compared with the control group (P < 0.001, P < 0.001), and in interaction of time and group (P < 0.001). Volume recovery after 3 months was found in 7.6% in the high-dose group and in 4.8% in the low-dose group.Conclusion: BTX-A injection into parotid glands can be an effective treatment option in managing salivary gland enlargement for lower face contouring.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
      PubDate: Tue, 04 Apr 2023 00:00:00 GMT-
       
  • Needle Microcores: Can They Pose an Occlusive Threat with Nonparticulate
           Injections'

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      Authors: Soares; Danny J.; Bowhay, Alexis; von Haven, Haley N.; Ugarte, Angela J.; Blevins, Larry W.; Birusingh, Rhea J.; Kechriotis, Chris; Yi, Christina H.
      Abstract: imageSummary: The incidence of vascular occlusion injuries has risen substantially along with the increasing popularity of cosmetic injectables. Among these occurrences, instances of soft-tissue ischemic events following the injection of nonparticulate solutions, such as botulinum, represent an enigmatic etiology that has yet to be fully understood. One hypothesized mechanism of injury underlying these events relates to the accidental capture and intravascular ejection of needle microcores, defined as submillimeter tissue fragments trapped by the beveled lumen of a needle during conventional injections. To test this hypothesis, the authors conducted a cytologic evaluation of dermal remnants incidentally captured by 31-G tuberculin needles following repeated injections into postrhytidectomy skin fragments. Their findings revealed the presence of dermal tissue microcores ranging from 100 to 275 μm in diameter with an overall microcoring incidence of 0.7%. These findings confirm the ability of ultrafine needles, commonly used in botulinum injections, to produce tissue microcores that may serve as causative agents of vascular occlusion with nonparticulate solutions. Awareness of this mechanism of injury may be of benefit in the early recognition and management of these rare occurrences.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
      PubDate: Tue, 04 Apr 2023 00:00:00 GMT-
       
  • The Resting Angle Suture

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      Authors: Finocchi; Valerio; Todaro, Mattia; Çakir, Bariş; Cervelli, Daniele
      Abstract: imageSummary: The goal of every rhinoplasty surgeon is to create a functional and aesthetically pleasing nose. The lateral crura resting angle, a recently described key concept, should be taken into consideration to achieve a satisfactory result. In this article, the authors describe the resting-angle suture, a novel technique derived from the inversion suture used to correct ectropion deformity in lower eyelid surgery.
      PubDate: Thu, 30 Mar 2023 00:00:00 GMT-
       
  • The Ram Graft: Using One Complete Piece of Conchal Cartilage for Nasal Tip
           Reconstruction in East Asians

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      Authors: Qiao; Congzhen; Gao, Wei; Chang, Lei; Qiu, Yajing; Lin, Xiaoxi
      Abstract: imageSummary: Adequate nasal tip projection remains a challenge in aesthetic rhinoplasty for East Asians. Various surgical techniques have been developed to reshape the nasal tip using auricular cartilage. In this article, we introduce the new ram graft to increase nasal tip projection by using one complete piece of conchal cartilage. Between 2019 and 2021, 19 patients who underwent nasal tip reconstruction using ram grafts were reviewed in a single hospital. The complication rate, satisfaction rate, and changes in nasolabial angle and nasal proportion were recorded. Nineteen patients with a mean age (± SD) of 28.9 ± 6.1 years underwent nasal tip reconstruction. The mean follow-up time was 15.4 ± 6.6 months. Nasolabial angle increased from 87.4 ± 10.0 degrees to 91.2 ± 10.2 degrees (P> 0.05). Sixteen of 19 patients (84.2%) were satisfied with their results. The nasal length–to–nasal tip projection–to–dorsal height–to–radix height ratio is 2:0.8:0.62:0.19 preoperatively and 2:0.92:0.77:0.35 postoperatively. Complications including alloplast-related infection (two of 19) and septal extension graft–related decrease of nasal tip projection (one of 19) were recorded. By using one complete piece of conchal cartilage, the ram graft is a simple and effective approach to increase nasal tip projection for East Asians.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
      PubDate: Mon, 27 Mar 2023 00:00:00 GMT-
       
  • Anatomical Proposal for Botulinum Neurotoxin Injection for Horizontal
           Forehead Lines

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      Authors: Yi; Kyu-Ho; Lee, Ji-Hyun; Seo, Kyle K.; Kim, Hee-Jin
      Abstract: imageSummary: The frontalis muscle is situated across the forehead and is a representative target muscle for botulinum neurotoxin (BoNT) injections aimed at treating horizontal wrinkles in this region. However, a lack of anatomical information regarding the shape and thickness of the frontalis may lead to unexpected adverse effects, such as ptosis and samurai eyebrows, caused by the lack of detail on anatomical variation. Achieving the maximum effect using the minimal amount of BoNT requires a precise injection into the frontalis muscle. The anatomical factors associated with BoNT injection into the frontalis muscle have been reviewed in the current study. Up-to-date understanding of the localization of the BoNT injection point according to an updated understanding of the anatomy leads to more accurate localization of the injection point into the frontalis muscle. Optimal injection sites have been provided for the frontalis muscle, and the injection method has been recommended. The authors suggest optimal injection sites according to the external anatomical landmarks of the forehead. Furthermore, these proposals could aid in a more precise procedure that avoids the deleterious effects of BoNT.
      PubDate: Mon, 27 Mar 2023 00:00:00 GMT-
       
  • Average Three-Dimensional Skeletofacial Model as a Template for Bone
           Repositioning during Virtual Orthognathic Surgery

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      Authors: Ho; Cheng Ting; Denadai, Rafael; Lo, Lun-Jou; Lin, Hsiu-Hsia
      Abstract: imageBackground: Virtual planning has revolutionized orthognathic surgery. This study presents a computer-assisted method for constructing average three-dimensional skeletofacial models that can be applied as templates for surgical planning for maxillomandibular repositioning.Methods: The authors used the images of 60 individuals (30 women and 30 men) who had never undergone orthognathic surgery to construct an average three-dimensional skeletofacial model for male participants and one for female participants. The authors validated the accuracy of the newly developed skeletofacial models by comparing their images with 30 surgical simulation images (ie, skulls) that had been created using three-dimensional cephalometric normative data. The comparison was conducted by superimposing surgical simulation images created using the authors’ models with the previously created images to analyze their differences, particularly differences in the jawbone position.Results: For all participants, the authors compared the jaw position in the surgical simulation images created using the authors’ average three-dimensional skeletofacial models with that in the images created using three-dimensional cephalometric normative data. The results revealed that the planned maxillary and mandibular positions were similar in both images and that the differences between all facial landmarks were less than 1 mm, except for one dental position. Most studies have reported less than 2 mm to be the success criterion for the distance difference between planned and outcome images; thus, the authors’ data indicate high consistency between the images in terms of jawbone position.Conclusion: The authors’ average three-dimensional skeletofacial models provide an innovative template-assisted orthognathic surgery planning modality that can enhance the fully digital workflow for virtual orthognathic surgical planning.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
      PubDate: Tue, 21 Mar 2023 00:00:00 GMT-
       
  • Systematic Review of Capsular Contracture Management following Breast
           Augmentation: An Update

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      Authors: Boyd; Carter J.; Chiodo, Michael V.; Lisiecki, Jeffrey L.; Wagner, Ryan D.; Rohrich, Rod J.
      Abstract: imageBackground: Capsular contracture is one of the most frequent indications for revision following breast augmentation. Management goals focus on restoring breast aesthetics and minimizing subsequent recurrence of capsular contracture. As new data emerge, close review of the data are merited to build evidence-based clinical guidelines to inform surgical practice and management of capsular contracture.Methods: A systematic review of the MEDLINE, Embase, and Cochrane Database of Systematic Reviews databases was conducted to characterize the surgical management of capsular contracture in revision breast augmentations. The primary endpoint was capsular contracture recurrence rate.Results: The review was conducted in November of 2021. Primary search revealed 14,163 results. Initial screening by title left 1223 articles. Abstract review left 90 articles for full-text review, of which 34 were ultimately included and were all observational in nature.Conclusions: Capsular contracture management remains an important topic, with limited high-level evidence for establishing clear evidence-based treatment guidelines. Although more evidence is required to assess the effects of capsulectomy, implant exchange, and plane change, these appear to be useful mechanisms for reducing recurrent capsular contracture. There is more evidence regarding the use of acellular dermal matrix, although this still requires long-term follow-up studies. New developments regarding textured implants limit the revision breast augmentation surgeon to smooth devices.
      PubDate: Tue, 07 Mar 2023 00:00:00 GMT-
       
 
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  Subjects -> MANUFACTURING AND TECHNOLOGY (Total: 363 journals)
    - CERAMICS, GLASS AND POTTERY (31 journals)
    - MACHINERY (34 journals)
    - MANUFACTURING AND TECHNOLOGY (223 journals)
    - METROLOGY AND STANDARDIZATION (6 journals)
    - PACKAGING (19 journals)
    - PAINTS AND PROTECTIVE COATINGS (4 journals)
    - PLASTICS (42 journals)
    - RUBBER (4 journals)

PLASTICS (42 journals)

Showing 1 - 40 of 40 Journals sorted alphabetically
ACS Applied Polymer Materials     Hybrid Journal   (Followers: 19)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Industrial and Engineering Polymer Research     Open Access   (Followers: 5)
Advances in Polymer Technology     Open Access   (Followers: 13)
Chinese Journal of Polymer Science     Hybrid Journal   (Followers: 9)
Cirugia Plastica Ibero-Latinoamericana     Open Access  
Current Applied Polymer Science     Hybrid Journal   (Followers: 2)
European Polymer Journal     Hybrid Journal   (Followers: 43)
High Performance Polymers     Hybrid Journal   (Followers: 1)
International Journal of Biobased Plastics     Open Access   (Followers: 1)
International Journal of Polymeric Materials     Hybrid Journal   (Followers: 7)
International Polymer Processing     Full-text available via subscription   (Followers: 1)
Iranian Journal of Polymer Science and Technology     Open Access   (Followers: 1)
Journal of Applied Polymer Science     Hybrid Journal   (Followers: 152)
Journal of Cellular Plastics     Hybrid Journal   (Followers: 1)
Journal of Elastomers and Plastics     Hybrid Journal  
Journal of Inorganic and Organometallic Polymers and Materials     Hybrid Journal   (Followers: 8)
Journal of Plastic Film and Sheeting     Hybrid Journal   (Followers: 1)
Journal of Polymer Research     Hybrid Journal   (Followers: 7)
Journal of Polymer Science Part C : Polymer Letters     Hybrid Journal   (Followers: 6)
Journal of Polymers and the Environment     Hybrid Journal   (Followers: 1)
Majalah Kulit, Karet, dan Plastik     Open Access  
Microplastics and Nanoplastics     Open Access   (Followers: 1)
Plastic and Polymer Technology     Open Access   (Followers: 41)
Plastic and Reconstructive Surgery     Hybrid Journal   (Followers: 31)
Plastics Engineering     Partially Free   (Followers: 3)
Polymer     Hybrid Journal   (Followers: 101)
Polymer Bulletin     Hybrid Journal   (Followers: 8)
Polymer Engineering & Science     Hybrid Journal   (Followers: 15)
Polymer Science Series B     Hybrid Journal   (Followers: 6)
Polymer Science Series C     Hybrid Journal   (Followers: 4)
Polymer Science Series D     Hybrid Journal   (Followers: 4)
Polymer Science, Series A     Hybrid Journal   (Followers: 4)
Polymer-Plastics Technology and Materials     Hybrid Journal   (Followers: 7)
Polymers and Polymer Composites     Hybrid Journal   (Followers: 4)
Polymers from Renewable Resources     Hybrid Journal   (Followers: 3)
Progress in Rubber, Plastics and Recycling Technology     Hybrid Journal   (Followers: 2)
Reinforced Plastics     Full-text available via subscription   (Followers: 15)
SPE Polymers     Open Access   (Followers: 1)
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