K-wire Fixation of Closed Hand Fractures Outside the Main Operating Room Does Not Increase Infections.

Unlabelled: Closed reduction and internal fixation (CRIF) of closed hand fractures in the main operating room (OR) is much more expensive than outside of the OR. However, there is a reluctance to fix fractures out of the OR due to the perceived increase in infections. Our goal was to prospectively analyze the infection rates of performing CRIF of closed metacarpal and phalangeal fractures in these two settings.

Axilla versus Wrist as the Recipient Site in Vascularized Lymph Node Transfer for Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis.

Background:  Vascularized lymph node transfers (VLNT) are being used with increasing frequency for the treatment of breast cancer-related lymphedema (BCRL). However, there is a lack of consensus in the surgical field as to which recipient site should be utilized. We, therefore, aim to assess the evidence comparing the wrist and axilla as recipient sites for VLNT in BCRL.

Pyrocarbon Arthroplasty Implants in the Upper Extremity: A Systematic Review of Outcomes and Pooled Analysis of Complications.

Background: Growing use of pyrocarbon implants in upper extremity arthroplasty has culminated in a breadth of literature ascertaining outcomes and complications at long-term follow-up. However, at present, the literature remains devoid of studies synthesizing the available evidence for upper extremity surgeons to adequately assess the safety and utility of these implants relative to other available options.

Methods: A systematic search of the National Library of Medicine, MEDLINE, and Embase databases was performed to determine clinical outcomes and complication and reoperation rates following pyrocarbon arthroplasties in the upper extremity.

The ideal flap for reconstruction of circumferential pharyngeal defects: A systematic review and meta-analysis of surgical outcomes.

Background: There is a lack of consensus regarding the superiority of the common free flaps for the reconstruction of circumferential pharyngeal defects.

Methods: A systematic literature search was conducted to identify studies reporting the complications of circumferential pharyngeal reconstruction between 2005 and 2020. Anterolateral thigh free flaps (ALTFF), jejunal free flaps (JFF), and radial forearm free flaps (RFFF) were compared.

Spontaneous necrosis of a single digit: watershed necrosis.

Anatomical variations in the superficial and deep palmar arches are common, but rarely lead to digital necrosis. We report the case of necrosis of the third digit caused by a 'watershed' effect in the context of atherosclerotic disease and rare congenital variations of the superficial and deep palmar arches.

A National Survey to Assess the Population's Perception of Breast Implant-Associated Anaplastic Large Cell Lymphoma and Breast Implant Illness.

Background: The goal of this study was to gauge the public's general perception of breast implants, levels of concern, spontaneous word associations, and misperceptions that might need to be addressed by plastic surgeons regarding breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant illness (BII).

Methods: An anonymous survey was completed by a total of 979 female participants in the United States by means of Amazon Mechanical Turk.

Results: Over 91 percent of participants indicated that they had never heard the term BIA-ALCL.

Perception of Implants among Breast Reconstruction Patients in Montreal.

Background: In light of the recent surge of media coverage and social media influence regarding breast implants, it is essential to understand patients' concerns and misconceptions so that we can better serve them.

Methods: The authors designed a survey study for assessing the awareness and perception of patients toward breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant illness (BII). In total, 130 patients presenting to the senior author's breast reconstruction clinic completed the survey.

Breast Implant-associated Anaplastic Large Cell Lymphoma: A Canadian Surgical Oncology Survey.

Background: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) awareness has increased, resulting in concerns regarding the safety of implant-based reconstruction. Breast cancer patients are first seen by surgical oncologists, who are therefore potentially the first health-care professionals to encounter concerns regarding BIA-ALCL. We therefore surveyed surgical oncologists on their understanding of BIA-ALCL to better assess potential effects on plastic surgery practice.

COVID-19 pandemic and medical education: A medical student's perspective.

The specific impact of the COVID-19 pandemic on medical education remains elusive and evolving. Clinical teaching opportunities have become limited with the shift in focus of supervising physicians away from trainees and towards the care of the sick and vulnerable. The presence of medical students in hospitals has come to represent an added strain on vital resources, and the added risk of viral dissemination into communities has left medical students eager to help observing from only the sidelines.

Trapezoidal fractures: Overview and introduction of a novel diagnostic classification system.

Introduction: Trapezoidal fractures account for only 0.4% of all carpal bone fractures. Owing to their rarity, there is paucity in the literature regarding the clinical findings and treatment.

Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair.

Unlabelled: Despite recent advances in surgical, anesthetic, and safety protocols in the management of nonsyndromic craniosynostosis (NSC), significant rates of intraoperative blood loss continue to be reported by multiple centers. The purpose of the current study was to examine our center's experience with the surgical correction of NSC in an effort to determine independent risk factors of transfusion requirements.

Methods: A retrospective cohort study of patients with NSC undergoing surgical correction at the Montreal Children's Hospital was carried out.

A comparison of delayed versus immediate reconstruction following lower-extremity sarcoma resection.

Background: Identifying patients who may be at high risk for wound complications postsarcoma resection and reconstruction is essential for improving functional outcomes and quality of life. Currently, the effect of timing on sarcoma reconstruction has been poorly investigated. The purpose of this study was to compare outcomes of delayed and immediate reconstruction in the setting of sarcoma resection requiring flap reconstruction in the lower extremity.

Complications of tissue expansion in the head and neck.

Background: The authors aim to present a comprehensive review detailing the present state of evidence with regard to complications following tissue expansion in the head and neck.

Methods: A systematic literature search was conducted to identify all studies reporting complications of tissue expansion in the head and neck between 2000 and 2019. Subgroup comparisons based on expander locations and planes were conducted.

Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis.

Unlabelled: Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysis is to shed light on overall outcomes for resorbable implants and to compare these results to those for metallic counterparts.

Management of Pediatric Mandibular Fractures Using Resorbable Plates.

Introduction: Despite there being several clinical studies reporting promising outcomes of resorbable plates for fixation of pediatric mandible fractures, the literature is devoid of large studies or comprehensive reviews assessing safety rates, complications and long-term outcomes. The purpose of the current review is to obtain a global consensus, shed light on efficacy and complications, and provide the reader with evidence-based data to help guide clinical management.

Methods: A systematic review of clinical studies assessing outcomes for resorbable plates in pediatric mandibular fractures was carried out.

Spontaneous Osteogenesis of a Traumatic Mandibular Defect in the Pediatric Population.

Spontaneous osteogenesis of traumatic mandibular defects in the pediatric population remains a relatively rare phenomenon with only 2 patients reported in the literature. In the adult population, a low threshold exists for bone graft placement in the presence of small mandibular gaps, with no role for spontaneous osteogenesis in significant mandibular defects. The approach to traumatic mandibular defects in the pediatric population is not clearly described in the literature and the risks and benefits associated with donor site morbidity of bone graft harvest must be tempered by the possibility for potential spontaneous osteogenesis.

A Review of Wound Infusion With Local Anesthetics in Plastic Surgery.

Background: Suboptimal pain management is a common, yet largely unrecognized, problem in the postsurgical patient population. Current treatment protocols heavily rely on opioid use and, though generally effective in providing pain relief, are associated with multiple side effects. The present systematic review aims to offer plastic surgeons insight into the current state of literature on prolonged local anesthetic wound infusion regimens, evaluating both their efficacy in lowering pain scores and the potential opioid-sparing effect.

Routine Postoperative Admission to the Intensive Care Unit Following Repair of Nonsyndromic Craniosynostosis: Is it Necessary?

Background: Cranial vault surgery for craniosynostosis is generally managed postoperatively in the intensive care unit (ICU). The purpose of the present study was to examine our center's experience with the postoperative management of otherwise healthy patients with nonsyndromic craniosynostosis (NSC) without routine ICU admission.

Methods: A retrospective cohort study of patients with NSC operated using a variety of vault reshaping techniques in our pediatric center between 2009 and 2017 was carried out.

Transcranial Blade Injuries and Principles of Their Safe Extraction.

Retained cranial blade injuries are uncommon events lacking standardized recommendations for appropriate surgical extraction. The authors present a case of a 30-year-old male who sustained a penetrating blade injury of the left orbit with intracranial extension through the skull base into the temporal lobe. The patient walked to the emergency room and remained alert.

Preservation of lower extremity spare parts using the University of Wisconsin solution.

The management of a mangled limb is a challenging endeavor. With the advancement in microsurgery, spare parts surgery (fillet flaps) has gained recent interest. In the context of lower extremity amputation secondary to trauma, viable spare parts can provide stump soft tissue coverage, potentially preserving critical length and obviating above-knee amputations.