Investigating the Impact of Flap Overdesign on Viability.

 Partial or complete flap necrosis is a detrimental outcome complicating reconstructive surgery. The purpose of this study was to evaluate the impact of flap overdesign on viability in the rat model.  Forty Sprague-Dawley rats were equally divided into four groups receiving flaps of varying length-to-width ratios: 2:1, 3:1, 4:1, and 5:1.

Evaluation of abdominal cutaneous sensibility following abdominoplasty.

Background: Cutaneous hypesthesia is an undesirable postoperative outcome following abdominoplasty. The purpose of this study was to evaluate postabdominoplasty cutaneous sensibility using clinical, quantitative, and reproducible methods.

Methods: Thirty patients who underwent abdominoplasty were divided into three groups: 0 to 12 months (short-term follow-up), 12 to 24 months (intermediate-term follow-up), and greater than 24 months (long-term follow-up) following abdominoplasty.

Duration of smoking cessation and its impact on skin flap survival.

Background: Empirical and experimental evidence abounds as to the negative effects of smoking on skin flaps. The ideal duration of preoperative smoking cessation is unclear. The present study evaluates the effect of various durations of smoking cessation on skin flap survival in a rat model.

Evaluation of a new 4-strand flexor tendon repair in a cadaveric porcine model.

Purpose: Numerous flexor tendon repairs have been described. The ideal core flexor tendon repair optimizes strength characteristics while minimizing factors felt to contribute to adhesion formation. The present study compares ultimate tensile strength, gap strength, and surgical time in the Lahey repair, a new 4-strand flexor tendon repair, to 2 previously described techniques.

Fingertip injuries.

The fingertip is a complex anatomic unit highly specialized in function and particularly prone to injury. Its complex design and the difficulty of secondary repairs demand great care in initial evaluation, diagnosis, and treatment for optimal long-term outcome. The goals of treatment should be to preserve length, maintain sensation, mobilize early, return function expediently, and be mindful of cosmesis.

Distal anterior interosseous nerve in the recurrent motor branch graft for reconstruction of a median nerve neuroma-in-continuity.

Median nerves with neuromas-in-continuity are preferably managed by the identification and preservation of the functioning motor fascicles proximal and distal to the neuroma. The non-functioning, painful sensory fibers are divided proximally and distally and are reconstructed with nerve grafts. In cases where the proximal motor fascicle may not be safely and effectively isolated because of scarring or previous surgical intervention, the distal anterior interosseous nerve (dAIN) may be grafted to the recurrent motor branch of the median (RMB) nerve distal to the neuroma.

Management of neuromas.

After nerve injury and regeneration, significant pain may be associated with the scar and altered sensation observed within the distribution of the injured nerve. A bulbous swelling may form at the severed nerve end, constituting a traumatic neuroma. The development of a painful neuroma may be more disabling to the patient than an area of anesthesia or even loss of motor function.