A decision-making algorithm for recipient vein selection in bipedicle deep inferior epigastric artery perforator flap autologous breast reconstruction.

The bipedicle deep inferior epigastric artery perforator (DIEP) flap allows reliable transfer of the entire lower abdominal flap in patients who have a small pannus or require a large volume breast reconstruction. Selection of recipient vessels for the second pedicle can however, be challenging. We describe our experience with a consecutive series of twenty three bipedicle DIEP flaps with particular focus on selection of the recipient veins.

Associations between patient expectations of joint arthroplasty surgery and pre- and post-operative clinical status.

Improvements in implant materials and designs have broadened surgical indications and improved the technical successes of joint arthroplasty surgery. Nevertheless, a small but notable proportion of patients remain dissatisfied despite technically successful surgery. Given reported associations between unfulfilled patient expectations and dissatisfaction, we performed a systematic review to investigate the current state of knowledge concerning potential associations between clinical status and patient expectations of joint arthroplasty procedures.

Measuring expectations in orthopaedic surgery: a systematic review.

Background: Advances in the surgical treatment of musculoskeletal conditions have resulted in an interest in better defining and understanding patients' expectations of these procedures, but the best ways to do this remain a topic of considerable debate.

Questions/purposes: (1) What validated instruments for the assessment of patient expectations of orthopaedic surgery have been used in published studies to date? (2) How were these expectation measures developed and validated? (3) What unvalidated instruments for the assessment of patient expectations have been used in published studies to date?

Methods: A systematic literature search was performed using the OVID Medline and EMBASE databases, in duplicate, to identify all studies that assessed patient expectations in orthopaedic surgery. Sixty-six studies were ultimately included in the present review.